The Effect of Therapist Attachment on Working Alliance with Multi-Problem Families

  • Liesbeth Gudde (Speaker)
  • Overbeek, M. (Speaker)
  • Corine Rijnberk (Speaker)
  • Daniëla Beijer (Speaker)
  • Sylvana Robbers (Speaker)
  • Athanasios Maras (Speaker)

Activity: Lecture / PresentationAcademic


Aim: Multi-problem families experience problems in several areas of functioning, including psychopathology of parents and children, domestic violence, financial problems, and limited social support. Previous treatments have had insufficient effect for these families, causing feelings of hopelessness and distrust toward health care providers. Yet, a good working alliance is required for positive treatment results (McLeod, 2011). The aim of this study was to assess the effect of therapist attachment on the quality of the working alliance with multi-problem families.

Methods: From April 2015 to December 2016, 114 multi-problem families were followed during their specialized intensive multidisciplinary treatment at the Family Psychiatry department of a Dutch mental health organization. Therapist attachment was assessed by a questionnaire at the start of the study and working alliance was assessed by observations at start and end of treatment.

Results: From start to end of treatment, parents’ self-reported working alliance significantly improved (t=4.10, p<.001), whereas ‘involvement’ observed in therapists (t=-2.58, p=.013) and clients (t=-3.00, p=.004) decreased. Attachment in therapists was positively related with improvement in parental self-reported working alliance from start to end of treatment (r = .317, p = .014).

Conclusion: During treatment, parents gained more confidence in the treatment. At the end of treatment, parents were better able to continue on their own than at the start of treatment. Attachment of therapists is related to the quality of the working alliance as parents experience it. Parents treated by therapists with a more secure attachment report a better working alliance with their therapist.
Period27 Jun 201830 Jun 2018
Event title49th Society for Psychotherapy Research (SPR) International Annual Meeting
Event typeConference
LocationAmsterdam, NetherlandsShow on map
Degree of RecognitionInternational