What is the Role of Attachment in Contemporary Psychotherapy? A Grounded Theory Exploration of the Perspective of Experienced Psychologists

摘要

Since Bowlby devised his theory of attachment, originally for clinical purposes,udrefinements and extensions have developed its clinical utility. The researchudquestion asked how experienced contemporary clinicians now perceive the role ofudattachment in the formulation and treatment of distress by reference to their clinicaludwork.udUsing grounded theory methodology, underpinned by a relativist, moderate socialudconstructionist epistemology, initial sampling consisted of 16 in-depth interviewsudwith experienced clinicians. The tentative theoretical categories that emerged wereudthen developed in theoretical sampling in further interviews with 5 of the initialudinterviewees. The final theoretical categories to emerge concerned the prevalenceudof caregiver-related problems, the provision of safety together with the prioritisationudof the relationship with self as attachment-related treatment strategies, andudattachment theory’s provision of understanding in problem formulation. Whilst thisudsuggests that attachment-related ideas are integrated in contemporary practice, itudalso suggests that the clinical utility now offered by attachment theory, asudestablished in the literature, has not found broad appeal amongst clinicians despiteudthe commonness of attachment-related presenting problems.udThe implications of this are manifold. To begin with, attachment theorists haveudlargely failed to bring the potential now offered by attachment-related therapeuticudinterventions to the market. This situation makes it incumbent on the nextudgeneration of attachment researchers to more clearly articulate techniques withudwhich clinicians, of whatever theoretical orientation, can better leverageudattachment-related knowledge in their clinical work. In this enterprise, perhaps theudknowledge and experience of expert clinicians could be harvested, as this researchudhas done. Moreover, researchers must expand the evidence base that suchudinterventions actually work. Beyond the implications for clinical utility andudefficacy, the findings strengthen counselling psychology’s influence on society’sudperception and treatment of attachment-related problems.