The present study examines relationships between patient attachment and therapist countertransference in a large, naturalistic, longitudinal study of psychodynamic psychotherapy in a safety-net hospital. This study explored patterns in the relationship between therapist countertransference and patient attachment in two ways: (a) by studying cross sectional associations between patient-reported attachment and therapist-reported countertransference at 3 months into treatment, and (b) by studying if changes in patient-reported attachment over the course of psychotherapy are associated with changes in therapist-reported countertransference. In a sample of 101 therapy dyads, patients completed self-report attachment domains and therapists completed self-report countertransference measures 3 months following initiation of psychotherapy. Results showed initial significant positive associations between patient-rated attachment anxiety and therapist-rated “parental/protective,” “special/overinvolved,” and “overwhelmed/disorganized” countertransference. A sample of 119 therapy dyads (these included dyads in which therapists and patients completed measures at any point in time) was analyzed using multilevel modeling. Results showed that initial patient-rated attachment anxiety was associated with decreases in therapist-rated parental/protective and special/overinvolved countertransference over time. Decreases in patient-rated attachment anxiety were associated with subsequent increases in therapist reports of feeling overwhelmed/disorganized. These findings provide a greater understanding of how attending to patient attachment and therapist countertransference together may cofacilitate treatment and improve patient outcomes.

中文翻译：

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心理动力学心理治疗中的患者依恋和治疗师反移情。

本研究在安全网医院的心理动力学心理治疗的大型自然主义纵向研究中检查了患者依恋与治疗师反移情之间的关系。本研究以两种方式探索了治疗师反移情与患者依恋之间关系的模式：（a）通过研究患者报告的依恋与治疗师报告的治疗师报告的反移情之间的横断面关联，以及（b）通过研究患者报告的心理治疗过程中的依恋与治疗师报告的反移情变化有关。在 101 个治疗组合的样本中，患者完成了自我报告依恋领域，治疗师在开始心理治疗 3 个月后完成了自我报告反移情措施。结果显示，患者评价的依恋焦虑与治疗师评价的“父母/保护性”、“特殊/过度投入”和“不知所措/无组织”反移情之间存在显着的正相关。使用多级建模分析了 119 个治疗对组样本（其中包括治疗师和患者在任何时间点完成测量的对组）。结果表明，初始患者评定的依恋焦虑与治疗师评定的父母/保护性和特殊/过度参与的反移情随时间的减少有关。患者评定的依恋焦虑的减少与随后治疗师报告感到不知所措/杂乱无章有关。