Influence of Therapist Attachment Style on the Working Alliance in Individual Psychotherapy: A Systematic Review and Meta‐Analysis
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2025
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| author | María Marín‐Cavestany María Ángeles De la Cruz Juan I. Durán Bryan J. Stiles Guillermo Lahera Nelson Andrade‐González |
| author_facet | María Marín‐Cavestany María Ángeles De la Cruz Juan I. Durán Bryan J. Stiles Guillermo Lahera Nelson Andrade‐González María Marín‐Cavestany María Ángeles De la Cruz Juan I. Durán Bryan J. Stiles Guillermo Lahera Nelson Andrade‐González |
| collection | Wiley Open Access |
| contents | Influence of Therapist Attachment Style on the Working Alliance in Individual Psychotherapy: A Systematic Review and Meta‐Analysis María Marín‐Cavestany María Ángeles De la Cruz Juan I. Durán Bryan J. Stiles Guillermo Lahera Nelson Andrade‐González Clinical Psychology & Psychotherapy ABSTRACTIntroductionAttachment style and working alliance are two fundamental variables in psychotherapy. This systematic review aims to provide data on the relationship between therapist attachment and alliance in psychotherapy, updating a previous review and providing a quantitative synthesis (meta‐analysis).MethodThe Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) Statement recommendations were followed. The databases PsycINFO, PubMed and Web of Science were searched from June 1, 2016, to May 30, 2024, supplemented by a manual search. A regulated study selection process was performed, followed by data extraction and risk of bias assessment. A qualitative and quantitative analysis of the included studies was performed.ResultsNine studies were selected for the systematic review that included 354 patients and 741 mental health professionals. In five studies, different types of attachment (secure, anxious and avoidant) were related to the alliance. In addition, this relationship was partially mediated by therapeutic optimism, role security, therapeutic commitment or emotional regulation strategy. Of the 23 articles selected from both systematic reviews, 12 studies were included in the meta‐analysis. A systematic correlation between anxious attachment style and the alliance was found only when the assessment of the alliance was performed by therapists (r = −0.31).ConclusionsThere is evidence that therapist attachment may influence the formation and maintenance of a higher‐quality working alliance. However, further studies with more precise measures of both constructs are needed to better understand this relationship and its clinical implications. 10.1002/cpp.70025 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1002/cpp.70025 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_cpp_70025 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Influence of Therapist Attachment Style on the Working Alliance in Individual Psychotherapy: A Systematic Review and Meta‐Analysis María Marín‐Cavestany María Ángeles De la Cruz Juan I. Durán Bryan J. Stiles Guillermo Lahera Nelson Andrade‐González Clinical Psychology & Psychotherapy Influence of Therapist Attachment Style on the Working Alliance in Individual Psychotherapy: A Systematic Review and Meta‐Analysis María Marín‐Cavestany María Ángeles De la Cruz Juan I. Durán Bryan J. Stiles Guillermo Lahera Nelson Andrade‐González Clinical Psychology & Psychotherapy ABSTRACTIntroductionAttachment style and working alliance are two fundamental variables in psychotherapy. This systematic review aims to provide data on the relationship between therapist attachment and alliance in psychotherapy, updating a previous review and providing a quantitative synthesis (meta‐analysis).MethodThe Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) Statement recommendations were followed. The databases PsycINFO, PubMed and Web of Science were searched from June 1, 2016, to May 30, 2024, supplemented by a manual search. A regulated study selection process was performed, followed by data extraction and risk of bias assessment. A qualitative and quantitative analysis of the included studies was performed.ResultsNine studies were selected for the systematic review that included 354 patients and 741 mental health professionals. In five studies, different types of attachment (secure, anxious and avoidant) were related to the alliance. In addition, this relationship was partially mediated by therapeutic optimism, role security, therapeutic commitment or emotional regulation strategy. Of the 23 articles selected from both systematic reviews, 12 studies were included in the meta‐analysis. A systematic correlation between anxious attachment style and the alliance was found only when the assessment of the alliance was performed by therapists (r = −0.31).ConclusionsThere is evidence that therapist attachment may influence the formation and maintenance of a higher‐quality working alliance. However, further studies with more precise measures of both constructs are needed to better understand this relationship and its clinical implications. 10.1002/cpp.70025 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Influence of Therapist Attachment Style on the Working Alliance in Individual Psychotherapy: A Systematic Review and Meta‐Analysis |
| topic | Clinical Psychology & Psychotherapy |
| url | https://onlinelibrary.wiley.com/doi/10.1002/cpp.70025 |