Attachment Theory and Research as a Guide to Psychotherapy Practice

Abstract

This article evaluates relevant links between theory and research on attachment relationships; cognitive structures including schemas and internal working models; aspects of the client-therapist relationship; and psychotherapeutic intervention models, arguing that attachment theory can be employed to more fully understand psychotherapeutic processes and change. First we review relevant background literature on attachment theory, delineating distinctions between attachment and other relevant theoretical formulations. Then we discuss aspects of the client-therapist relationship which may be affected by attachment, providing a brief overview of extant research on attachment and psychotherapy. Finally, we discuss the ways in which attachment theory has been employed in the design of psychotherapy models, specifically focusing on two treatment models which illustrate diversity in attachment-based treatment. Throughout we argue that the recent addition of reflective function, which is the capacity to understand the ways in which mental states underlie behavior in self and others, both enhances attachment theory and elucidates the connections between psychotherapeutic process and the development of self-regulatory insight during childhood through sensitive parental caregiving.