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Changes in client attachment in relation to client distress: A response surface analysis.

Mira An1, Justin W Hillman1, Dennis M Kivlighan1

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Client attachment anxiety levels significantly impact psychological distress. Consistent high anxiety correlates with increased distress, while decreasing anxiety is linked to lower distress in psychodynamic psychotherapy.

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Area of Science:

  • Psychology
  • Clinical Psychology
  • Psychotherapy Research

Background:

  • Attachment theory is crucial for understanding adult relationships and psychological well-being.
  • Psychological distress in clients can be influenced by various interpersonal and intrapersonal factors during therapy.

Purpose of the Study:

  • To investigate the relationship between changes in client attachment anxiety and avoidance and subsequent psychological distress.
  • To examine how consistency and change in attachment dimensions affect distress within psychodynamic psychotherapy sessions.

Main Methods:

  • Utilized multilevel polynomial regression and response surface analysis.
  • Analyzed 253 nine-session periods from 65 adult clients in open-ended psychodynamic psychotherapy.
  • Measured client attachment anxiety and avoidance at Time 1 and Time 2, and psychological distress at Time 2.

Main Results:

  • Consistent high client attachment anxiety predicted higher psychological distress.
  • Decreasing client attachment anxiety was associated with lower psychological distress.
  • Attachment avoidance consistency or change did not significantly predict client distress.

Conclusions:

  • Client attachment anxiety is a significant predictor of psychological distress in psychodynamic psychotherapy.
  • Therapeutic interventions may benefit from addressing fluctuations in client attachment anxiety.
  • Attachment avoidance appears less critical than anxiety in predicting short-term distress outcomes.