Abstract

Based on the attachment framework, therapeutic distance conceptualization focuses on closeness–distance dynamics in the therapeutic relationship. We aimed to evaluate the psychometric properties of the Therapeutic-Distance-Scale, Observer-version (TDS-O) and apply a dyadic approach to examine associations between attachment characteristics and therapeutic distance experiences of clients, therapists, and mutual effects. Sixty-six clients and their 29 therapists completed the ECR and relational narratives collected in RAP interviews at early, mid, and late psychodynamic-therapy were rated on TDS-O scales: too close, too distant, autonomy, and engagement. The TDS-O showed good IRR, internal reliability and content validity. Client anxiety was not associated with therapeutic distance but associated with autonomy. Client avoidance associated with clients’ experiencing therapist as too close, and lower engagement only at early therapy, but was not associated with therapists’ experience. Therapist anxiety was not related to closeness–distance at early therapy but related to gaps between client and therapist experiences at mid and late therapy. Therapist avoidance related to clients experiencing therapists as too close and granting less autonomy at early and mid-therapy, and to therapist experience of distance at late therapy. The findings underscore the importance of therapists’ regulating therapeutic distance through attunement to client’s interpersonal needs and therapy phase.

摘要

基于依恋框架，治疗距离概念化侧重于治疗关系中的亲密-距离动态。我们旨在评估治疗距离量表、观察者版 (TDS-O) 的心理测量特性，并应用二元方法来检查依恋特征与客户、治疗师的治疗距离体验之间的关联以及相互影响。66 位来访者和他们的 29 位治疗师完成了 ECR，并且在早期、中期和晚期心理动力学治疗的 RAP 访谈中收集的关系叙述在 TDS-O 量表上进行了评级：太近、太远、自主和参与. TDS-O 表现出良好的 IRR、内部信度和内容效度。来访者焦虑与治疗距离无关，但与自主有关。客户回避与客户体验治疗师太接近有关，并且仅在早期治疗中降低参与度，但与治疗师的经验无关。治疗师的焦虑与早期治疗时的亲密距离无关，而是与来访者和治疗师在治疗中后期的经验差距有关。治疗师回避与来访者体验治疗师太近和在治疗早期和中期给予较少的自主性有关，以及治疗师在治疗后期的距离感。研究结果强调了治疗师通过适应客户的人际关系需求和治疗阶段来调节治疗距离的重要性。