Cheri L. Marmarosh

Therapists' group attachments and their expectations of patients' attitudes about group therapy.

Abstract A large body of literature has supported the application of attachment theory to the understanding of psychotherapy. In addition, a more recent social psychological literature is exploring the application of attachment theory to the area of group dynamics and group process. The current study is designed to integrate these two distinct bodies of literature. In a preliminary fashion, we examined the relationship between group therapists’ group attachment styles and their assumptions and expectations of their patients’ attitudes about group psychotherapy. Seventy–six therapists completed the Smith, Murphy & Coats (1999) measure of group attachment style. They also completed the Revised Group Therapy Survey (Carter, Mitchell, & Krautheim, 2001) from the viewpoint of a typical patient they treat. As hypothesized, therapists with more group attachment anxiety assumed that patients would hold more negative myths and misconceptions about group treatment than therapists with less group attachment anxiety. The utility of a group attachment construct in future research and practice is discussed.

The Insecure Psychotherapy Base: Using Client and Therapist Attachment Styles to Understand the Early Alliance

The purpose of this study was to test the notion that complementary attachments are best for achieving a secure base in psychotherapy. Specifically, we predicted third to fifth session alliance from client- and therapist-rated attachment style interactions. Using a combined sample of 46 therapy dyads from a community mental health clinic and university counseling center, the client- and therapist-perceived therapy alliance, attachment anxiety, and attachment avoidance were examined at the beginning of therapy. The results of an Actor-Partner Interdependence Model (APIM; Kenny & Cook, 1999, Partner effects in relationship research: Conceptual issues, analytic difficulties, and illustrations. Personal Relationships, 6, 433-448.) indicated that there was no direct effect of either client or therapist attachment style on therapist or client early ratings of the alliance. One significant interaction emerged and indicated that client-perceived alliance was influenced by therapist and client attachment anxiety. The client-perceived early alliance was higher when more anxious therapists worked with clients with decreasing anxiety. The client early alliance was higher when less anxious therapists worked with clients with increasing anxiety. The findings partially support the notion that different attachment configurations between the therapist and client facilitate greater alliance, but this was the case only when assessing client-perceived early alliance and only with regards to the dimension of attachment anxiety. There were no significant main effects or interactions when exploring therapist-perceived alliance. Implications of the findings are discussed along with recommendations for future study and clinical training.

Empirical Research on Attachment in Group Psychotherapy: Moving the Field Forward

Despite a large literature applying attachment to individual, family, and couple psychotherapy, it has taken much longer for clinicians to apply attachment theory to group psychotherapy. The lack of research attention in this area makes these three studies in this special section even more important to the field. They contribute significant findings that have the potential to help group leaders facilitate more cohesive and effective treatments for patients as well as move the field forward. Not only do we see the long-term impact of group treatment for those with insecure attachments, but we also learn how attachment anxiety impacts the group process, and how the attachment to the therapy group itself relates to changes in group members personal attachment styles. The greatest contribution is the drawing of our attention to the many future studies that are needed to fully understand how group therapy facilitates change and how attachment theory plays a critical role in this process. Clinical implications are presented.

Multiple attachments and group psychotherapy: implications for college counseling centers.

Abstract A large body of literature has supported the application of attachment theory to the understanding of college student development and the process of individual psychotherapy. Despite group treatment being one of the major methods of intervention in college counseling centers, there has been very little research guided by attachment theory that has been applied to the area of group psychotherapy. Many current assessment instruments used in college counseling centers can be supported with attachment theory, and many group therapy interventions are aimed at facilitating secure working models of self, other, and groups. This paper explores the importance of personal and group attachments in group psychotherapy and specifically addresses implications for clinical training and research in university counseling centers.

Client and therapist therapeutic alliance, session evaluation, and client reliable change: a moderated actor-partner interdependence model.

Actor-partner interdependence modeling (APIM; Kashy & Kenny, 2000) was used to study the early therapeutic alliance in 74 clients being treated by 29 therapists to explore the relationship between the alliance and treatment progress, while prioritizing the dyadic nature of the alliance. The APIM examines collaboration/influence by modeling the impact of one dyad members alliance ratings on the other members session impact rating (partner effects). In terms of the alliance, the results revealed significant client-actor effects for client ratings of session depth and positivity as well as significant therapist-actor effects for therapist ratings of session smoothness and positivity. For client-rated alliance, there were also significant client-partner effects for therapist ratings of session depth. For clients who made a reliable change in treatment, an increase in client-reported alliance was related to therapist reporting more arousal in the 3rd session. For clients who did not make a reliable change in treatment, client-reported alliance was not related to therapist arousal. Limitations of the study and implications of the findings are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Novice therapist attachment and perceived ruptures and repairs: a pilot study.

Although extensively discussed in theoretical articles, empirical studies of therapist attachment and perceptions of ruptures and repairs are lacking. The present study examined the relationship between therapist attachment anxiety and avoidance and their perceptions of rupture tension, effort, and repair. Twenty-two novice therapists completed a measure of adult romantic attachment and a measure to assess perceptions of ruptures and repairs following the eighth session with their first clients. Results revealed that there was a strong positive correlation between therapist attachment anxiety and effort spent focused on perceived ruptures and a moderate positive correlation between attachment anxiety and rupture tension. There was no significant relationship between attachment anxiety and perceived repairs of ruptures. Attachment avoidance was not significantly correlated with either perceptions of the ruptures or repairs. Therapists who were higher on anxiety and avoidance, more fearful therapists, reported the most ruptures. Limitations and implications of the findings are presented.

Empirically supported perspectives on transference.

There is much debate about the definition of transference and the use of transference in psychotherapy treatment. The current section brings together three papers presented at the American Psychological Associations Annual conference that bridge diverse areas of psychology and the study of transference. Each of these papers contributes to our understanding of what transference is, where it exists, and how it can influence people. The papers also shed light on what we still do not know about transference and our continued need to struggle with what transference is and is not, how it can best be used to help people, and how future empirical research, across psychology disciplines, is critical to move our field forward.

The Influence of Individual Attachment Styles on Group Members' Experience of Therapist Transitions

Abstract Attachment theory has recently been applied to clinical practice in an effort to improve understanding and treatment of the maladaptive relational patterns clients bring to therapy. While most of this research has focused on individual therapy, interest in the application of attachment theory to group psychotherapy is growing. This paper will explore the impact of clients’ attachment styles on their experiences of co-therapist transition in an ongoing psychodynamic therapy group. This discussion will elucidate how knowledge of attachment theory and an understanding of clients’ individual attachment styles can be useful in predicting responses to therapist-initiated terminations and transitions.

Love and Sexuality in the Therapeutic Relationship

We examine sexual and loving feelings, on the part of both the therapist and patient, as they relate to their real relationship, patient transference, and therapist countertransference. Loving feelings (agape) often are part of a strong real relationship and they tend to have a positive effect. Sexual feelings, too, may be part of the real relationship, but they are also often more conflict-based, residing in the transference and countertransference experience. It is deeply important for the therapist to seek understanding of his or her own and the patients loving and sexual feelings, and to tease apart, as much as possible, the extent to which they are real relationship versus transference-countertransference-based. The patients loving and sexual feelings toward the therapist need to be explored and understood just as other feelings. Although it is crucial that the therapist seek understanding of his or her own loving and sexual feelings toward the patient, we express serious reservations about the therapeutic value of sharing these with the patient.

Neurosciences and Adult Health Behaviors: Recent Findings and Implications for Counseling Psychology

The current review comprehensively examines recent advances in 2 innovative areas of neuroscience research on healthy adults regarding neuropsychosocial interactions on human cognition and behavior, as well as implications for counseling psychologists conducting research and in practice. Advances in how oxytocin influences prosocial behavior and the mitigation of social stress, and the influence of environmentally mediated gene expressions on the development of attachment disorders are surveyed and discussed in terms of how counseling psychologists might best integrate recent neuroscience research into a framework for therapeutic intervention.