Attachment patterns and working alliance in trauma therapy for victims of political violence

We examined the development of alliance in therapy in different attachment groups in a naturalistic setting. The participants were 36 self-referred Palestinian political ex-prisoners, who were victims of torture and ill treatment and had sought psychotherapy. Their therapy lasted for 10-12 months. The analyses showed that the development of alliance during therapy followed different patterns across the attachment groups. Yet early alliance did not differ between the groups. For the autonomous individuals, alliance dropped in the middle of therapy, and increased back to its initial level by the end. Similarly, for the preoccupied individuals alliance decreased steeply in the middle of the therapy, and then increased even more steeply by the end. In contrast, for the dismissing individuals, alliance was approximately the same at the beginning and in the middle of the therapy, and then it decreased at the end.