Influence of Therapist Attachment Style on the Working Alliance in Individual Psychotherapy: A Systematic Review and Meta-Analysis

IF 3.2 3区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical psychology & psychotherapy Pub Date : 2025-02-10 DOI:10.1002/cpp.70025

María Marín-Cavestany, María Ángeles De la Cruz, Juan I. Durán, Bryan J. Stiles, Guillermo Lahera, Nelson Andrade-González

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引用次数: 0

Abstract

Introduction

Attachment style and working alliance are two fundamental variables in psychotherapy. This systematic review aims to provide data on the relationship between therapist attachment and alliance in psychotherapy, updating a previous review and providing a quantitative synthesis (meta-analysis).

Method

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement recommendations were followed. The databases PsycINFO, PubMed and Web of Science were searched from June 1, 2016, to May 30, 2024, supplemented by a manual search. A regulated study selection process was performed, followed by data extraction and risk of bias assessment. A qualitative and quantitative analysis of the included studies was performed.

Results

Nine studies were selected for the systematic review that included 354 patients and 741 mental health professionals. In five studies, different types of attachment (secure, anxious and avoidant) were related to the alliance. In addition, this relationship was partially mediated by therapeutic optimism, role security, therapeutic commitment or emotional regulation strategy. Of the 23 articles selected from both systematic reviews, 12 studies were included in the meta-analysis. A systematic correlation between anxious attachment style and the alliance was found only when the assessment of the alliance was performed by therapists (r = −0.31).

Conclusions

There is evidence that therapist attachment may influence the formation and maintenance of a higher-quality working alliance. However, further studies with more precise measures of both constructs are needed to better understand this relationship and its clinical implications.

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治疗师依恋类型对个体心理治疗工作联盟的影响：系统回顾与元分析

依恋类型和工作联盟是心理治疗的两个基本变量。本系统综述旨在提供心理治疗中治疗师依恋与联盟关系的数据，更新先前的综述并提供定量综合（荟萃分析）。方法采用系统评价和荟萃分析的首选报告项目（PRISMA）。检索了2016年6月1日至2024年5月30日期间的PsycINFO、PubMed和Web of Science数据库，并辅以人工检索。进行规范的研究选择过程，然后进行数据提取和偏倚风险评估。对纳入的研究进行定性和定量分析。结果本系统评价共纳入9项研究，包括354名患者和741名心理健康专业人员。在五项研究中，不同类型的依恋（安全型、焦虑型和回避型）与联盟有关。此外，治疗乐观主义、角色安全、治疗承诺和情绪调节策略对上述关系有部分中介作用。从两个系统综述中选择的23篇文章中，有12篇研究被纳入meta分析。只有当治疗师对联盟进行评估时，才发现焦虑依恋类型与联盟之间存在系统相关性（r = - 0.31）。结论治疗师依恋可能影响高质量工作联盟的形成和维持。然而，需要进一步的研究对这两种结构进行更精确的测量，以更好地理解这种关系及其临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical psychology & psychotherapy PSYCHOLOGY, CLINICAL-

CiteScore

6.30

自引率

5.60%

发文量

106

期刊介绍： Clinical Psychology & Psychotherapy aims to keep clinical psychologists and psychotherapists up to date with new developments in their fields. The Journal will provide an integrative impetus both between theory and practice and between different orientations within clinical psychology and psychotherapy. Clinical Psychology & Psychotherapy will be a forum in which practitioners can present their wealth of expertise and innovations in order to make these available to a wider audience. Equally, the Journal will contain reports from researchers who want to address a larger clinical audience with clinically relevant issues and clinically valid research.