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Patient attachment to therapist rating scale: development and psychometric properties
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
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2014 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, Vol. 24, no 2, 184-201 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To report on the development and initial psychometric properties of a new rating scale for patent-therapist attachment. Method: Seventy interviews from the Young Adult Psychotherapy Project (YAPP) were rated. Results: Excellent internal consistency (Cronbach's > .90) was observed for all four subscales (Security, Deactivation, Hyperactivation, and Disorganization). Three subscales showed good inter-rater reliability (ICC > .60), while one (Hyperactivation) had poor (ICC < .40). Correlations with measures of alliance, mental representations, and symptom distress support the construct validity of the reliable subscales. Exploratory factor analysis indicated three underlying factors explaining 82% of the variance. Conclusions: The Patient Attachment to Therapist Rating Scale is a promising approach for assessing the quality of attachment to therapist from patient narratives. Future development should focus on improving the discrimination of the insecure subscales.

Place, publisher, year, edition, pages
2014. Vol. 24, no 2, 184-201 p.
Keyword [en]
attachment to therapist, rating scale, reliability, construct validity
National Category
Psychology
Identifiers
URN: urn:nbn:se:su:diva-101475DOI: 10.1080/10503307.2013.867462ISI: 000330690800006OAI: oai:DiVA.org:su-101475DiVA: diva2:704833
Note

AuthorCount:6;

Available from: 2014-03-13 Created: 2014-03-10 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Exploring therapeutic action in psychoanalytic psychotherapy: Attachment to therapist and change
Open this publication in new window or tab >>Exploring therapeutic action in psychoanalytic psychotherapy: Attachment to therapist and change
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to explore therapeutic action in psychoanalytic psychotherapy from different perspectives (patient, therapist, observer), using different methodological approaches (qualitative and quantitative). Study I explores patients’ views of therapeutic action with grounded theory methodology. The results indicated that talking openly in a safe therapeutic relationship led to new relational experiences and expanding self-awareness. Hindering factors included difficulties “opening up” and experiencing something missing in treatment. Study II investigates experienced therapists’ views of therapeutic action. The development of a close and trusting relationship was perceived as the core curative factor. Patients’ fear of closeness hindered treatment from the therapists’ perspective. Study III involves the development and psychometric examination of a new rating scale for patient-therapist attachment (Patient Attachment to Therapist Rating Scale; PAT-RS). Inter-rater reliability was good for three of the subscales (Security, Deactivation, Disorganization), but poor for one (Hyperactivation). Patterns of correlations with other measures suggest construct validity for the reliable subscales. Study IV examines the relationships between secure attachment to therapist, alliance, and outcome. Linear mixed-effects models, controlling for therapist effects, treatment length and patient-rated alliance, indicated that secure attachment to therapist relates to outcome. Further, the unique variance associated with secure attachment to therapist predicted continued gains in functioning during follow-up. The results of this thesis suggest that the development of a secure attachment to the therapist is a central mechanism of therapeutic change. The results are discussed in relation to established notions of therapeutic action in psychoanalytic psychotherapy. Two tentative process models that may be useful for clinical practice and future research are proposed. 

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University, 2014. 73 p.
Keyword
Therapeutic action, mechanisms of change, psychoanalytic, psychodynamic, psychotherapy, young adults, attachment to therapist, therapeutic alliance, process, outcome, grounded theory, linear mixed models
National Category
Applied Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-106501 (URN)978-91-7447-988-1 (ISBN)
Public defence
2014-11-21, David Magnussonsalen (U31), Frescati hagväg 8, Stocksholm, 13:00 (English)
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Note

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 4: Epub ahead of print.

Available from: 2014-10-30 Created: 2014-08-08 Last updated: 2014-11-21Bibliographically approved

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