Transference and Client Attachment to Therapist: Changes across the Course of Psychodynamic Psychotherapy

Abstract

Although there are important clinical connections between transference and client attachment (Bowlby, 1983), limited empirical research exists examining their relationship across psychotherapy. This study examined the association between positive and negative transference and Client Attachment to Therapist (CAT; Mallinckrodt et al., 1995) across the course of 51 cases of open-ended psychodynamic psychotherapy. Using multilevel growth modeling, results indicated that Client Secure CAT increased and Avoidant-Fearful CAT decreased across the course of psychotherapy. In addition, higher initial Avoidant CAT was associated with higher initial negative transference, and a decrease in negative transference across psychotherapy. Finally, psychological distress moderated the relationship between CAT and transference, such that only clients reporting high psychological distress showed significant associations between insecure attachment and transference at the beginning of psychotherapy. Implications for research, practice, and therapist training are offered.