The capacity of potential attachment is central to the formation of working alliance in Psychotherapy: A Grounded Theory
DOI:
https://doi.org/10.61841/f8542k96Keywords:
Working Alliance, Psychotherapeutic Process, Reflective Function, Attachment,, AvoidanceAbstract
The main objective of this study was to explore the dynamics of working alliance during the prerecorded psychotherapy sessions using a grounded theory paradigm. To collect the data, fifteen psychotherapeutic pre-recorded videos were selected based on theoretical sampling procedures. Three coders were trained to extract initial open codes related to the working alliance phenomenon after they watched psychotherapeutic videos. We encoded the data in three stages of open, axial and selective coding through deductive and inductive methods. In the final stage, we used a paradigm coding strategy to develop our grounded theory of working alliance. The ground theory indicates that “reflective functioning” (causal condition), in interaction with “rapport and goal setting” (context) and “resistance” (intervening condition) “engages the client and psychotherapist in “learning process” (action/interaction strategies) which in turn activates the appropriate or non-appropriate patterns of attachment of both client and psychotherapist. These interactions, in turn, exert its direct influence on the formation or disruption of working alliance (consequences). These five elements are involved in the formation of working alliance during any type of psychotherapy regardless of the psychotherapy approach and the capacity of potential attachment is central to the model.
Downloads
References
[1] Bateman, A., & Fonagy, P. (2016). Mentalization-based treatment for personality disorders: a practical guide.
Oxford University Press, 10-11.
[2] Benz, C. R., Ridenour, C. S., & Newman, I. (2008). Mixed methods research: Exploring the interactive
continuum. SIU Press.
[3] Bohart, A. C., & Wade, A. G. (2013). The client in psychotherapy. Bergin and Garfield’s Handbook of
Psychotherapy and Behavior Change, 6, 219-257.
[4] Boritz, T. Z., Bryntwick, E., Angus, L., Greenberg, L. S., & Constantino, M. J. (2014). Narrative and emotion
process in psychotherapy: An empirical test of the Narrative-Emotion Process Coding System
(NEPCS). Psychotherapy Research, 24(5), 594-607.
[5] CASTONGUAY, L. G., & BEUTLER, L. E. (Eds.). (2006). Principles of therapeutic change that work. New
York: Oxford University Press.
[6] Charmaz, K. (2008). Grounded theory as an emergent method. Handbook of emergent methods, 155, 172.
[7] Creswell, J. W., Hanson, W. E., Clark Plano, V. L., & Morales, A. (2007). Qualitative research designs:
Selection and implementation. The counseling psychologist, 35(2), 236-264.
[8] Dimaggio, G., & Lysaker, P. H. (2015). Metacognition and mentalizing in the psychotherapy of patients with
psychosis and personality disorders. Journal of Clinical Psychology, 71(2), 117-124.
[9]
[10] Ekamparam, G. (2008). Insecure attachment and the therapeutic relationship: relational dynamics between
therapist and addicts in psychotherapy (Doctoral dissertation, Auckland University of Technology).
[11] Farber, B. A., & Metzger, J. A. (2009). The therapist as secure base. Attachment Theory and Research in
Clinical Work with Adults, 46-70.
[12] Fertuck, E. A., Mergenthaler, E., Target, M., Levy, K. N., & Clarkin, J. F. (2012). Development and criterion
validity of a computerized text analysis measure of reflective functioning. Psychotherapy Research, 22(3), 298-
305.
[13] Fonagy, P., Steele, M., Steele, H., Moran, G. S., & Higgitt, A. C. (1991). The capacity for understanding mental
states: The reflective self in parent and child and its significance for security of attachment. Infant mental health
journal, 12(3), 201-218.
[14] Glaser, B., & Strauss, A. (1967). The discovery of grounded theory. 1967. Weidenfield & Nicolson, London, 1-
19.
[15] GOLDFRIED, M. R. (1980). Toward the delineation of therapeutic change principles. American Psychologist,
35, 991–999.
[16] Horvath, A. O., & Greenberg, L. S. (Eds.). (1994). The working alliance: Theory, research, and practice (Vol.
173). John Wiley & Sons, 13-15.
[17] Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual
psychotherapy. Psychotherapy, 48(1), 9.
[18] HILL, C. E. (2004). Helping skills: Facilitating exploration, insight, and action (2nd ed.). Washington, DC:
American Psychological Association.
[19] Obegi, J. H. (2008). The development of the client-therapist bond through the lens of attachment
theory. Psychotherapy: Theory, Research, Practice, Training, 45(4), 431.
[20] Ogrodniczuk, J. S., Piper, W. E., & Joyce, A. S. (2011). Effect of alexithymia on the process and outcome of
psychotherapy: A programmatic review. Psychiatry Research, 190(1), 43-48.
[21] Prochaska, J., & Norcross, J. (2013). Systems of psychotherapy: A transtheoretical analysis. Nelson Education,
11.
[22] Rameshni, M. (2017). The Relevance of Attachment Theory Principles to Psychotherapy and How It Can
Contribute to Fostering Therapeutic Alliance and The Change Process for Clients: A Literature
Review (Doctoral dissertation, City University of Seattle).
[23] Rowley, J. (2012). Conducting research interviews. Management ResearchReview, 35(3/4), 260-271..
[24] Slade, A. (2007). Parental reflective functioning: An introduction. Attachment and Human Development, 7,
269-281.
[25]
[26] Stapleton D., Pati S., Beach E. & Julmanichoti P. (2004). Activity-based costing for logistics and marketing.
Business Process Management Journal, 10(5), pp. 584-597.
[27] Strauss, A., & Corbin, J. M. (1997). Grounded theory in practice. Sage Publications.
[28] Strauss, A., & Corbin, J. (1998). Basics of qualitative research techniques. Thousand Oaks, CA: Sage
Publications.
[29] Talia, A., Miller-Bottome, M., Katznelson, H., Pedersen, S. H., Steele, H., Schröder, P. & Lingiardi, V. (2018).
Mentalizing in the presence of another: Measuring reflective functioning and attachment in the therapy
process. Psychotherapy Research, 1-14.
[30] Yeryomenko, N. (2012). Does the depth of client experiencing predict good psychotherapy outcomes? A metaanalysis of treatment outcomes, Electronic Theses and Dissertations, University of Windsor, 3-5.
Downloads
Published
Issue
Section
License
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.