A Systematic Review of the Effect of Therapists' Internalized Models of Relationships on the Quality of the Therapeutic Relationship

Journal of Clinical Psychology
Catherine SteelThomas Schroder

Abstract

Previous reviews have found equivocal evidence of an association between therapists' internalized relational models and the therapeutic relationship and have neglected empirical literature based on Sullivan's notion of introject. This review expanded upon previous reviews to examine the effect of therapist internalized relational models on a broader conceptualization of the therapeutic relationship. Systematic search processes identified 22 papers measuring therapist attachment and/or introject and therapeutic relationship: 19 on therapist attachment, 5 on introject with 2 overlapping. Overall, despite heterogeneity in design and variable methodological quality, evidence suggests that therapist attachment affects therapeutic relationship quality, observed in client-rated evaluation, therapist negative countertransference, empathy, and problems in therapy. Interaction effects between client and therapist attachment style were also found. Evidence suggesting that therapist introject also affects therapeutic relationship quality, including therapists' manner and feelings toward their clients, was stronger. Evidence clearly shows that therapists' internalized relational models affect the therapeutic relationship. More research is n...Continue Reading

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Citations

Nov 6, 2018·Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine·Rebecca MurrayAlison K Beck
Nov 13, 2019·Journal of Clinical Psychology·David E OrlinskyUlrike Willutzki
Oct 20, 2018·Attachment & Human Development·Alessandro TaliaSvenja Taubner
May 21, 2020·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Agostino BrugneraGianluca Lo Coco
Aug 7, 2019·Journal of Clinical Psychology·Thomas MunderAntje Gumz
Oct 22, 2020·International Journal of Environmental Research and Public Health·Dorthe Varning PoulsenSigurd Wiingaard Uldall
Aug 18, 2020·Child Abuse & Neglect·Jutta LindertMaria Cabello

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