Effective Treatment Relationships for Persons With Serious Psychiatric Disorders: The Importance of Attachment States of Mind

Participants were 54 clients with serious psychiatric disorders and 21 clinical case managers. Clients' serious psychiatric disorders included Axis I diagnoses, such as schizophrenia and bipolar disorder. This study examined how attachment states of mind of both clients and case managers influe...

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Bibliographic Details
Published in:Journal of consulting and clinical psychology 1999-10, Vol.67 (5), p.725-733
Main Authors: Tyrrell, Christine L, Dozier, Mary, Teague, Gregory B, Fallot, Roger D
Format: Article
Language:English
Subjects:
Adult
Attachment Behavior
Attachment style
Biological and medical sciences
Case Management
Case Management - standards
Case managers
Cross-Sectional Studies
Factors
Female
Human
Humans
Individual psychotherapy
Influence
Male
Medical sciences
Mental Disorders
Mental Disorders - therapy
Middle Aged
Object Attachment
Patients
Personal relationships
Professional-Patient Relations
Psychiatric disorders
Psychiatric Patients
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychotherapeutic Processes
Psychotherapies. Psychological and clinical counseling
Psychotherapy - standards
Regression Analysis
Therapeutic Alliance
Therapist-Client relationships
Therapy
Treatment Outcome
Treatments
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Summary:Participants were 54 clients with serious psychiatric disorders and 21 clinical case managers. Clients' serious psychiatric disorders included Axis I diagnoses, such as schizophrenia and bipolar disorder. This study examined how attachment states of mind of both clients and case managers influenced the effectiveness of therapeutic relationships and client functioning. Client and case manager attachment states of mind interacted in predicting the working alliance and client functioning. Specifically, clients who were more deactivating with respect to attachment had better alliances and functioned better with less deactivating case managers, whereas clients who were less deactivating worked better with more deactivating case managers. These findings highlight the importance of clinicians and clients being matched in ways that balance their interpersonal and emotional strategies.
ISSN:0022-006X
1939-2117
DOI:10.1037/0022-006X.67.5.725