Rubino, Gabriella; (1999) The influence of therapist's attachment style on the resolution of ruptures in the therapeutic alliance. Doctoral thesis (D.Clin.Psy.), UCL (University College London).

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Abstract

This study was an exploratory investigation of the impact of therapists' self- reported attachment styles and parental bonds on the way in which they resolve ruptures within the therapeutic alliance. The study used an analogue of the therapy situation. Seventy-seven Clinical Psychologists in Training from University College London, taken from three consecutive years, participated in the study. Their attachment style was measured by means of the Relationship Scales Questionnaire and their parental bonds by means of the Parental Bonding Instrument. Participants also watched four video clips of hypothetical patients interacting with their therapist. Patients were meant to display one of four attachment styles (one secure and three insecure). The role-played therapy sessions exemplified a strain or 'rupture' in the therapeutic alliance and ended with the patient making a statement, which participants were asked to respond to. Participants' responses were tape-recorded and followed by a brief exploratory interview adapted from Interpersonal Process Recall. It was predicted that securely attached participants would respond overall more deeply and more empathically than insecure participants. It was also predicted that insecure participants would respond less deeply and less empathically to patients whose attachment style was similar to their own. The responses produced by first year trainees were also compared to those produced by second and third year trainees, with a view to exploring whether training moderated the impact of attachment styles and parental bonds on their responses. Participants clustered into two groups: 1) the 'secure group', characterised by optimal parenting (i.e. high parental care and low paternal protection), high security, low fearfulness and low preoccupation and 2) the 'insecure group', characterised by less positive parenting (i.e. lower parental care and higher protection), lower security, higher fearfulness and higher preoccupation. The results provided some evidence for the first prediction, in that there was a trend for the secure group to respond more empathically than the insecure group, although the null hypothesis could not be rejected with confidence. There was also some evidence for the second prediction, in that the insecure group responded less empathically than the secure one to the fearful patient. As the insecure group was high on fearfulness, there seemed to be some patient-therapist match effects in the predicted direction. As insecure third years responded overall more deeply than insecure second and first years, training seemed to moderate the effects of insecure participants' attachment styles on their responses. These results have implications for the training of Clinical Psychologists and also highlight the importance for therapists to be aware of and reflect on their own conflicts, as these may affect the quality of their clinical work.

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