Attachment and the therapeutic bond in a community mental health clinic: A pilot study

Abstract This study explored attachment theory and related concepts as related to mental health treatment. While attachment has traditionally been conceived as a robust element of one's personality, its relationship to therapeutic relations has not been fully explored. In this study, we attempted to assess the relations between general attachment style, the specific attachment one creates with one's therapist and the therapeutic bond. The study took place in a public mental health clinic, in which several mental health workers provide treatment for patients with a wide array of diagnoses. Attachment to the therapists was generally higher (more secure) than personal habitual attachment style. No significant relations were found with therapeutic bonding. Avoidantly attached patients seem to weaken their habitual (avoidant) attachment in the therapeutic relationship more than anxiously attached patients do. Avoidant patients seem to be less avoidant when working with psychodynamic psychotherapists, while Cognitive Behavioural Therapy (CBT) therapists seem to be more suitable for anxious patients. These findings may bear far‐reaching implications concerning the nature of the therapeutic process, which may alter the patient's habitual attachment style. In other words, mental health treatment may affect the patients' modes of attachment. However, generalisability of the study is limited, mainly due to a small number of subjects and therapists, location of a single clinic, a single language of the questionnaires and limitations of the measurement tools.