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

Author: Kanninen, K., Salo, J., Punamaeki, R.L.

Source:
Psychotherapy Research, 10(4), 435-449.
Examined the development of alliance in therapy in different attachment groups in a naturalistic setting. Ss were 36 self-referred Palestinian political ex-prisoners, who were victims of torture and ill treatment and had sought psychotherapy. Ss filled out attachment, posttraumatic stress, and somatic-symptom questionnaires before the therapy and the Working Alliance Inventory (WAI; Horvath and L. Greenberg, 1989) after the 3rd session, in the middle, and after the second to last session the therapy. Their therapy lasted for 10 to 12 mo. The analyses show 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.