https://doi.org/10.4081/ripppo.2022.653
An exploratory study on how attachment classifications manifest in group psychotherapy
Submitted: July 25, 2022
Accepted: August 29, 2022
Published: November 4, 2022
Accepted: August 29, 2022
Abstract Views: 2033
PDF: 371
HTML: 16
HTML: 16
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Recently, attachment-informed researchers and clinicians have begun to show that attachment theory offers a useful framework for exploring group psychotherapy. However, it remains unclear whether patients with differing attachment classifications would behave and speak in distinct ways in group therapy sessions. In this study, we conducted an exploratory analysis of the discourse of patients in group therapy who had independently received different classifications with gold standard interview measures of attachment in adults. Each patient participant attended one of three mentalization-based parenting groups. Before treatment, the Adult Attachment Interview (AAI) or the Parent Development Interview (PDI) were administered to each patient, and interviews were transcribed and coded to obtain the patient’s attachment classification. Groups included 2, 5, and 5 patients, respectively, and any session was led by at least two co-therapists. A total of 14 group sessions were transcribed verbatim. Sessions were analysed through a semi-inductive method, in order to identify markers that would typify patients of different attachment classifications in session. Through transcript excerpts and narrative descriptions, we report on the differing ways in which patients of different attachment classifications communicate in group psychotherapy, with the therapist and with each other. Our work provides useful information for group therapists and researchers regarding how differences in attachment status may play out in group sessions.
Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2009). The first 10,000 Adult Attachment Interviews: Distributions of adult attachment representations in clinical and non-clinical groups. Attachment & Human Development, 11(3), 223–263. https://doi.org/10.1080/14616730902814762
DOI: https://doi.org/10.1080/14616730902814762
Békés, V., Aafjes-van Doorn, K., Spina, D., Talia, A., Starrs, C., & Perry, J. (2021). The Relationship Between Defense Mechanisms and Attachment as Measured by Observer-Rated Methods in a Sample of Depressed Patients: A Pilot Study. Frontiers in Psychology, 12.
DOI: https://doi.org/10.3389/fpsyg.2021.648503
Bowlby, J. (1949). The study and reduction of group tensions in the family. Human Relations, 2, 123–128. https://doi.org/10.1177/001872674900200203
DOI: https://doi.org/10.1177/001872674900200203
Bowlby, J. (1969/1982). Attachment and loss: Vol 1. Attachment. New York, NY: Basic Books.
Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. Basic Books.
Bowlby, J. (1991). Ethological light on psychoanalytical problems. In P. Bateson (Ed.), The development and integration of behaviour: Essays in honour of Robert Hinde (pp. 301–313). Cambridge, UK: Cambridge University Press.
Byrne, G., Sleed, M., Midgley, N., Fearon, P., Mein, C., Bateman, A., & Fonagy, P. (2019). Lighthouse Parenting Programme: Description and pilot evaluation of mentalization- based treatment to address child maltreatment. Clinical Child Psychology and Psychiatry, 24(4), 680–693. https://doi.org/10.1177/1359104518807741
DOI: https://doi.org/10.1177/1359104518807741
Cassidy & P. R. Shaver (Ed.), Handbook of attachment (3rd ed., pp. 759–779). New York, NY: Guilford Press.
Duschinsky, R. (2020) Cornerstones of Attachment Research. Oxford University Press.
DOI: https://doi.org/10.1093/med-psych/9780198842064.001.0001
Fonagy, P., & Allison, E. (2014). The role of mentalizing and epistemic trust in the therapeutic relationship. Psychotherapy, 51(3), 372–380. https://doi.org/10.1037/a0036505
DOI: https://doi.org/10.1037/a0036505
George, C., Kaplan, N., & Main, M. (1985). Adult Attachment Interview [Unpublished Manuscript].
DOI: https://doi.org/10.1037/t02879-000
Granqvist, P. (2021). Attachment, culture, and gene-culture co-evolution: expanding the evolutionary toolbox of attachment theory. Attachment & Human Development, 23(1), 90-113.
DOI: https://doi.org/10.1080/14616734.2019.1709086
Gullo, S., Lo Coco, G. L., Di Fratello, C., Giannone, F., Mannino, G., & Burlingame, G. (2015). Group climate, cohesion and curative climate: A study on the common factors in group process and their relation with members attachment dimensions. Research in Psychotherapy: Psychopathology, Process and Outcome, 18(1), 10–20. https://doi.org/10.4081/ripppo.2015.160
DOI: https://doi.org/10.4081/ripppo.2015.160
Harel, Y., Shechtman, Z., & Cutrona, C. (2011). Individual and group process variables that affect social support in counseling groups. Group Dynamics: Theory, Research, and Practice, 15(4), 297.
DOI: https://doi.org/10.1037/a0025058
Holtz, A. (2004). Measuring the therapy group attachment in group psychotherapy: A validation of the Social Group Attachment Scale [Dissertation, Psychology]. The Catholic University of America.
Howes, C., & Spieker, S. (2008). Attachment relationships in the context of multiple caregivers. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 317–332). The Guilford Press.
Illing, V., Tasca, G. A., Balfour, L., & Bissada, H. (2011). Attachment dimensions and group climate growth in a sample of women seeking treatment for eating disorders. Psychiatry: Interpersonal and Biological Processes, 74(3), 255–269. https://doi.org/10.1521/psyc.2011.74.3.255
DOI: https://doi.org/10.1521/psyc.2011.74.3.255
Keating, L., Tasca, G. A., Gick, M., Ritchie, K., Balfour, L., & Bissada, H. (2014). Change in attachment to the therapy group generalizes to change in individual attachment among women with binge eating disorder. Psychotherapy, 51(1), 78–87. https://doi.org/10.1037/a0031099
DOI: https://doi.org/10.1037/a0031099
Lo Coco G, Gullo S, Oieni V, Giannone F, Di Blasi M, Kivlighan DM. The relationship between attachment dimensions and perceptions of group relationships over time: An actor–partner interdependence analysis. Group Dyn Theory Res Pract. 2016, 20(4), 276–293. https://doi.org/10.1037/gdn0000056.
DOI: https://doi.org/10.1037/gdn0000056
Kivlighan DM, Lo Coco G, Gullo S, et al.: Attachment anxiety and attachment avoidance: members’ attachment fit with their group and group relationships. In J Group Psychother 2017; 67:223–239
DOI: https://doi.org/10.1080/00207284.2016.1260464
Kleinbub, J. R., Talia, A., & Palmieri, A. (2020). Physiological synchronization in the clinical process: A research primer. Journal of Counseling Psychology, 67(4), 420.
DOI: https://doi.org/10.1037/cou0000383
Korfmacher, J., Adam, E., Ogawa, J., & Egeland, B. (1997). Adult Attachment: Implications for the therapeutic process in a home visitation intervention. Applied Developmental Science, 1(1), 43–52. https://doi.org/10.1207/s1532480xads0101_5
DOI: https://doi.org/10.1207/s1532480xads0101_5
Main, M., & Cassidy, J. (1988). Categories of response to reunion with the parent at age 6: Predictable from infant attachment classifications and stable over a 1-month period. Developmental Psychology, 24(3), 415–426. https://doi.org/10.1037/0012- 1649.24.3.415
DOI: https://doi.org/10.1037/0012-1649.24.3.415
Main, M., Kaplan, N., & Cassidy, J. (1985). Security in infancy, childhood, and adulthood: A move to the level of representation. Monographs of the Society for Research in Child Development, 50(1/2), 66–104. https://doi.org/10.2307/3333827
DOI: https://doi.org/10.2307/3333827
Markin, R. D., & Marmarosh, C. (2010). Application of adult attachment theory to group member transference and the group therapy process. Psychotherapy: Theory, Research, Practice, Training, 47(1), 111–121. https://doi.org/10.1037/a0018840
DOI: https://doi.org/10.1037/a0018840
Marmarosh., C. L. (2007). Attachment in group psychotherapy: bridging theories, research, and clinical techniques. Int J Group Psychother 2017; 67:157–160
DOI: https://doi.org/10.1080/00207284.2016.1267573
Marmarosh, C. L. (2014). Empirical research on attachment in group psychotherapy: Moving the field forward. Psychotherapy, 51(1), 88–92. https://doi.org/10.1037/a0032523
DOI: https://doi.org/10.1037/a0032523
Marmarosh, C. L. (Ed., 2019). Attachment in Group Psychotherapy. London: Routledge.
DOI: https://doi.org/10.4324/9781351010818
Marmarosh, C. L., & Markin, R. D. (2007). Group and personal attachments: Two is better than one when predicting college adjustment. Group Dynamics: Theory, Research, and Practice, 11(3), 153–164. https://doi.org/10.1037/1089-2699.11.3.153
DOI: https://doi.org/10.1037/1089-2699.11.3.153
Marrone, M. (2014). Attachment and interaction: From Bowlby to current clinical theory and practice (2nd ed.). Jessica Kingsley Publishers.
Maxwell, H., Tasca, G. A., Ritchie, K., Balfour, L., & Bissada, H. (2014). Change in attachment insecurity is related to improved outcomes 1-year post group therapy in women with binge eating disorder. Psychotherapy, 51(1), 57–65. https://doi.org/10.1037/a0031100
DOI: https://doi.org/10.1037/a0031100
Mikulincer, M., Shaver, P.R. (2007). Attachment in adulthood. Structure, dynamics and changes. New York, London: The Guilford Press.
Miller-Bottome, M., Talia, A., Eubanks, C. F., Safran, J. D., & Muran, J. C. (2019). Secure in-session attachment predicts rupture resolution: Negotiating a secure base. Psychoanalytic Psychology, 36(2), 132–138. https://doi.org/10.1037/pap0000232
DOI: https://doi.org/10.1037/pap0000232
Neukel, C., Bermpohl, F., Kaess, M., Taubner, S., Boedeker, K., Williams, K., ... & Herpertz, S. C. (2021). Understanding and breaking the intergenerational cycle of abuse in families enrolled in routine mental health services: study protocol for a randomized controlled trial and two non-interventional trials investigating mechanisms of change within the UBICA II consortium. Trials, 22(1), 1-15.
DOI: https://doi.org/10.1186/s13063-021-05653-3
Parks, C. D., & Tasca, G. A. (Eds.). (2021). The psychology of groups: The intersection of social psychology and psychotherapy research. American Psychological Association. https://doi.org/10.1037/0000201-000
DOI: https://doi.org/10.1037/0000201-000
Rosendahl, J., Alldredge, C. T., Burlingame, G. M., & Strauss, B. (2021). Recent developments in group psychotherapy research. American Journal of Psychotherapy, 74(2), 52-59.
DOI: https://doi.org/10.1176/appi.psychotherapy.20200031
Schroder-Pfeifer, P., Talia, A., Volkert, J., & Taubner, S. (2018). Developing an assessment of epistemic trust: a research protocol. Research in Psychotherapy: Psychopathology, Process, and Outcome, 21(3).
DOI: https://doi.org/10.4081/ripppo.2018.330
Slade, A. (2005). Parental reflective functioning: An introduction. Attachment & Human Development, 7(3), 269–281. https://doi.org/10.1080/14616730500245906
DOI: https://doi.org/10.1080/14616730500245906
Slade, A. (2016). The implications of attachment theory and research for adult psychotherapy research and practice. In J. Cassidy & P. R. Shaver (Ed.), Handbook of attachment (3rd ed., pp. 759–779). New York, NY: Guilford Press.
Slade, A., Aber, J. L., Bresgi, I., Berger, B., & Kaplan, M. (2004). The Parent Development Interview—Revised [Unpublished protocol].
Slade, A., Grienenberger, J. F., Bernbach, E., Levy, D., & Locker, A. (2005). Maternal reflective functioning, attachment, and the transmission gap: A preliminary study. Attachment & Human Development. https://doi.org/10.1080/14616730500245880
DOI: https://doi.org/10.1080/14616730500245880
Smith, E.R., Murphy, J., Coats S. (1999). Attachment to groups: theory and measurement. J. Person. Soc. Psychol. 77(1): 94–110.
DOI: https://doi.org/10.1037/0022-3514.77.1.94
Talia, A., Daniel, S. I., Miller-Bottome, M., Brambilla, D., Miccoli, D., Safran, J. D., & Lingiardi, V. (2014). AAI predicts patients’ in-session interpersonal behavior and discourse: A “move to the level of the relation” for attachment-informed psychotherapy research. Attachment & Human Development, 16(2), 192–209. https://doi.org/10.1080/14616734.2013.859161
DOI: https://doi.org/10.1080/14616734.2013.859161
Talia, A., Duschinsky, R., Mazzarella, D., Hauschild, S. & Taubner, S. (2021) Epistemic Trust and the Emergence of Conduct Problems: Aggression in the Service of Communication. Frontiers in Psychiatry, 12.
DOI: https://doi.org/10.3389/fpsyt.2021.710011
Talia, A., Duschinsky, R., Mazzarella, D., Begus, K., Miller-Bottome, M., Taubner, S., Holmes, J., & Fonagy, P. (in review). Rethinking attachment: From Proximity seeking to Epistemic trust.
Talia, A., Miller-Bottome, M., & Daniel, S. I. (2017). Assessing attachment in psychotherapy: Validation of the patient attachment coding system (PACS). Clinical Psychology & Psychotherapy, 24(1), 149–161. https://doi.org/10.1002/cpp.1990
DOI: https://doi.org/10.1002/cpp.1990
Talia, A., Miller-Bottome, M., Katznelson, H., Pedersen, S. H., Steele, H., Schröder, P., Origlieri, A., Scharff, F. B., Giovanardi, G., Andersson, M., Lingiardi, V., Safran, J. D., Lunn, S., Poulsen, S., & Taubner, S. (2019a). Mentalizing in the presence of another: Measuring reflective functioning and attachment in the therapy process. Psychotherapy Research, 29(5), 652–665. https://doi.org/10.1080/10503307.2017.1417651
DOI: https://doi.org/10.1080/10503307.2017.1417651
Talia, A., Muzi, L., Lingiardi, V., & Taubner, S. (2020). How to be a secure base: Therapists’ attachment representations and their link to attunement in psychotherapy. Attachment & human development, 22(2), 189-206.
DOI: https://doi.org/10.1080/14616734.2018.1534247
Talia, A., Miller-Bottome, M., Wyner, R., Lilliengren, P., & Bate, J. (2019a). Patients’ Adult Attachment Interview classification and their experience of the therapeutic relationship: Are they associated? Research in Psychotherapy: Psychopathology, Process and Outcome, 22(2), Article 2. https://doi.org/10.4081/ripppo.2019.361
DOI: https://doi.org/10.4081/ripppo.2019.361
Talia, A., Taubner, S., Miller-Bottome, M. (2019b). Advances in attachment-informed psychotherapy practice. Research in Psychotherapy: Psychopathology, Process and Outcome, 22(2), Article 2. https://doi.org/10.4081/ripppo.2019.361
DOI: https://doi.org/10.4081/ripppo.2019.405
Talia, A., Taubner, S., Miller-Bottome, M., Murholm, S. D., Winter, A., Frandsen, F., Harpøth, T., Tongerslev, M., Simonsen, S., Poulsen, S., Duschinsky, R. (in review). The Discourse of Unresolved/disorganized Psychotherapy Patients: A Qualitative Study of an Attachment Classification In-session. Frontiers: Psychology.
Tasca, G. A., Balfour, L., Ritchie, K., Bissada, H. (2007). The relationship between attachment scales and group therapy alliance growth differs by treatment type for women with binge eating disorder. Group Dyn Theory Res Pract, 11(1), 1-14. https://doi.org/10.1037/1089-2699.11.1.1.
DOI: https://doi.org/10.1037/1089-2699.11.1.1
Tasca, G. A. (2014). Attachment and group psychotherapy: Introduction to a special section. Psychotherapy, 51(1), 53–56. https://doi.org/10.1037/a0033015
DOI: https://doi.org/10.1037/a0033015
Tasca, G. A., & Maxwell, H. (2021). Attachment and group psychotherapy: Applications to work groups and teams. In C. D. Parks & G. A. Tasca (Eds.), The psychology of groups: The intersection of social psychology and psychotherapy research (pp. 149–167). American Psychological Association. https://doi.org/10.1037/0000201-009
DOI: https://doi.org/10.1037/0000201-009
Taubner, S., Georg, A., Volkert, J., Hauschild, S., & Byrne, G. (2019) Leuchtturm Psychiatrie. Mentalisierungsbasiertes Programm für Eltern mit psychischen Störungen. [Lighthouse psychiatry. Mentalization-based program for parents with a mental illness]. Unpublished manual.
Teti, D. M., Killeen, L. A., Candelaria, M., Miller, W., Hess, C. R., & O’Connell, M. (2008). Adult attachment, parental commitment to early intervention, and developmental outcomes in an African American sample. In H. Steele & M. Steele (Eds.), Clinical applications of the adult attachment interview (pp. 126–153). New York, NY: Guilford Press.
Volkert, J., Georg, A., Hauschild, S., Herpertz, S. C., Neukel, C., Byrne, G., & Taubner, S. (2019). Bindungskompetenzen psychisch kranker Eltern stärken: Adaptation und Pilottestung des mentalisierungsbasierten Leuchtturm-Elternprogramms [Strengthen attachment competencies of mentally ill parents: Adaptation and pilot-testing of the mentalization-based Lighthouse parent program]. Praxis der Kinderpsychologie und Kinderpsychiatrie, 68(1), 27–42.
DOI: https://doi.org/10.13109/prkk.2019.68.1.27
Tomasello, M. (2014). The ultra-social animal. European journal of social psychology, 44(3), 187-194.
DOI: https://doi.org/10.1002/ejsp.2015
Treboux, D., Crowell, J. A., & Waters, E. (2004). When" new" meets" old": configurations of adult attachment representations and their implications for marital functioning. Developmental psychology, 40(2), 295.
DOI: https://doi.org/10.1037/0012-1649.40.2.295
Tucker, J.R., Wade, N.G., Abraham, W.T., Bittman-Heinrichs, R.L., Cornish, M.A., Post, P.C. (2020). Modeling cohesion change in group counseling: the role of client characteristics, group variables, and leader behaviors. J Couns Psychol. 67(3):371-385. https://doi.org/10.1037/cou0000403.
DOI: https://doi.org/10.1037/cou0000403
Yalom, I. D., & Leszcz, M. (2020). The theory and practice of group psychotherapy. Basic Books
Zegers, M. A. M., Schuengel, C., van IJzendoorn, M. H., & Janssens, J. M. A. M. (2006). Attachment representations of institutionalized adolescents and their professional caregivers: Predicting the development of therapeutic relationships. American Journal of Orthopsychiatry, 76(3), 325–334. doi:10.1037/0002-9432.76.3.325
DOI: https://doi.org/10.1037/0002-9432.76.3.325
How to Cite
Talia, A., Georg, A., Siepe, B., Gullo, S. ., Miller-Bottome, M. ., Volkert, J., Neukel, C., Kaess, M., Bempohl, F., Herpertz, S. C., & Taubner, S. (2022). An exploratory study on how attachment classifications manifest in group psychotherapy. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(3). https://doi.org/10.4081/ripppo.2022.653
Copyright (c) 2022 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
List of Cited By :
