Changes in attachment representations during psychological therapy
Abstract
OBJECTIVES: This review systematically examines research that investigates changes in adult attachment representations during psychological therapy. METHOD: Studies from two adult attachment approaches are reviewed (interview and self-report) with the aim of concluding whether psychotherapy can improve attachment representations. To guide the interpretation of findings, the methodological quality of studies is assessed. RESULTS: The results suggest that attachment security increases following therapy, whereas attachment anxiety decreases following therapy. Findings are unclear with regard to attachment avoidance. Improvements are observed across different methodologies, patient groups, therapeutic approaches, and therapy settings. Findings also appear to be consistent across different levels of study quality. CONCLUSIONS: Overall, research supports the suggestion that attachment styles may alter during the course of psychotherapy, but further controlled trials are required to confirm this conclusion.
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Therapy has the potential for enhancing attachment security.
“Therapy has the potential for enhancing attachment security (Taylor et al. 2015).”
From Reciprocal Dynamics of Therapeutic Alliance and Depressive Symptoms in Inpatient Cognitive Behavioural Analysis System of Psychotherapy: The Role of Attachment Insecurity. (2025) · cites this paper as Taylor et al. 2015
Results on AR avoidance after psychological treatment are less clear.
“However, the results on AR avoidance were less clear.”
From Get secure soon: attachment in abused adolescents and young adults before and after trauma-focused cognitive processing therapy. (2021) · cites this paper as [28]
Taylor et al.'s review of 14 studies found that the majority showed improvement in attachment following psychological treatment, especially an increase in secure attachment patterns and a decrease in AR anxiety.
“In a recent review, Taylor et al. [28] included 14 studies on changes in adult attachment representations after psychological treatment. The majority showed an improvement in attachment following treatment, especially an increase in secure attachment patterns and a decrease in AR anxiety.”
From Get secure soon: attachment in abused adolescents and young adults before and after trauma-focused cognitive processing therapy. (2021) · cites this paper as [28]
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- Authors
- Taylor, P., Rietzschel, J., Danquah, A., & Berry, K.
- Affiliations
- University of Liverpool (GB)
- Wrightington, Wigan and Leigh NHS Foundation Trust (GB)
- Pennine Care NHS Foundation Trust (GB)
- University of Manchester (GB)
- Corresponding author
- Taylor, Peter
- Venue
- Psychotherapy Research
- Publisher
- Informa UK Limited
- Published
- 2014-02-21
- Volume
- 25
- Issue
- 2
- Pages
- 222-238
- ISSN
- 1050-3307 (ISSN-L)
- 1468-4381
- OpenAlex
- W2019674006
- Cited by
- 150
- References
- 90
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 9 · 2023: 20 · 2022: 14 · 2021: 17 · 2020: 13 · 2019: 14 · 2018: 14 · 2017: 9 · 2016: 9 · 2015: 6 · 2014: 4
- FWCI
- 13.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy Research (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- attachment representations, adult attachment, psychotherapy outcome, attachment security, attachment anxiety, attachment avoidance, attachment styles, therapeutic change
- MeSH terms
- Anxiety, Humans, Interpersonal Relations, Object Attachment, Psychotherapy, Treatment Outcome
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