The Real Relationship in Psychotherapy: Relationships to Adult Attachments, Working Alliance, Transference, and Therapy Outcome

Journal of Counseling Psychology

Volumn 56, Issue 3, 2009, Pages 337-350

  Marmarosh, Cheri L ^a   Gelso, Charles J ^b   Markin, Rayna D ^c   Majors, Rebekah ^d   Mallery, Coretta ^a   Choi, Jaehwa ^a  

^a GEORGE WASHINGTON UNIVERSITY   (United States)

^b UNIVERSITY OF MARYLAND   (United States)

^c VILLANOVA UNIVERSITY   (United States)

^d CATHOLIC UNIVERSITY OF AMERICA   (United States)

Author keywords

attachment; therapy alliance; therapy outcome; transference

Indexed keywords

EID: 67650168152     PISSN: 00220167     EISSN: None     Source Type: Journal    
DOI: 10.1037/a0015169     Document Type: Article

References (74)

1. Allen M. Understanding regression analysis (1998), Plenum, New York
2. Baekelund F., and Lundwall L. Dropping out of treatment: A critical review. Psychological Bulletin 82 (1975) 738-783
3. Baldwin S., Wampold B., and Imel Z. Untangling the alliance-outcome correlation: Exploring the relative importance of therapist and patient variability in the alliance. Journal of Consulting and Clinical Psychology 75 (2007) 842-852
4. Barber J.P., Foltz C., and Weinryb R.M. The Central Relationship Questionnaire: Initial report. Journal of Counseling Psychology 45 (1998) 131-142
5. Barrett M.S., Thompson D., Chua W., Crits-Christoph P., and Gibbons M.B. Early withdrawal from mental health treatment: Implications for psychotherapy practice. Psychotherapy: Theory, Research, Practice, Training 45 (2008) 247-267
6. Blatt S.J., and Behrends R.S. Internalization, separation-individuation, and the nature of the therapeutic action. International Journal of Psychoanalysis 68 (1987) 279-297
7. Blatt S.J., and Shahar G. Psychoanalysis: With whom, for what, and how: An empirical investigation of differences between psychoanalysis and psychotherapy. Journal of the American Psychoanalytic Association 52 (2004) 393-447
8. Bordin E.S. The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research, and Practice 16 (1979) 252-260
9. Bouchard M., Target M., Lecours S., Fonagy P., Tremblay L., Schachter A., and Stein H. Mentalization in adult attachment narratives: Reflective functioning, mental states, and affect elaboration compared. Psychoanalytic Psychology 25 (2008) 47-66
10. Bowlby J. Attachment and loss: Vol. 2. Separation: Anxiety and anger (1973), Basic Books, New York
11. Bowlby J. Attachment and loss: Vol. 3. Loss: Sadness and depression (1980), Basic Books, New York
12. Bowlby J. A secure base: Parent-child attachments and healthy human development (1988), Basic Books, New York
13. Brennan K.A., Clark C.L., and Shaver P.R. Self-report measurement of adult attachment: An integrative overview. In: Simpson J.A., and Rholes W.F. (Eds). Attachment theory and close relationships (1998), Guilford Press, New York 46-76
14. Busseri M.A., and Tyler J.D. Interchange ability of the Working Alliance Inventory and Working Alliance Inventory, Short Form. Psychological Assessment 15 (2003) 193-197
15. Cohen J., Cohen P., West S.G., and Aiken L.S. Applied multiple regression/correlation analysis for the behavioral sciences. 3rd ed. (2003), Erlbaum, Mahwah, NJ
16. Constantino M.J., Castonguay L.G., and Schut A.J. The working alliance: A flagship for the scientist-practitioner model in psychotherapy. In: Tryon G.S. (Ed). Counseling based on process research: Applying what we know (2002), Allyn & Bacon, Boston 81-131
17. Couch A.S. Therapeutic functions of the real relationship in psychoanalysis. Psychoanalytic Study of the Child 54 (1999) 131-168
18. Crits-Christoph P., and Connolly Gibbons M.B. Research developments on the alliance in psychodynamic psychotherapy. Psychoanalytic Inquiry 23 (2003) 332-349
19. Derogatis L.R., Lipman R.S., Rickels K., Uhlenhuth E.H., and Covi L. The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Behavioral Science 19 (1974) 1-15
20. Dozier M., and Tyrrell C. The role of attachment in therapeutic relationships. In: Simpson J.A., and Rholes W.S. (Eds). Attachment theory and close relationships (1998), Guilford Press, New York 221-228
21. Eames V., and Roth A. Patient attachment orientation and the early working alliance: A study of patient and therapist reports of alliance quality and ruptures. Psychotherapy Research 10 (2000) 421-434
22. Fonagy P., Gergely G., Jurist E., and Target M. Affect regulation, mentalization, and the development of self (2002), Other Press, New York 368-371
23. Fuertes J., Mislowack A., Brown S., Gur-Arie S., Wilkinson S., and Gelso C. Correlates of the real relationship in psychotherapy: A study of dyads. Psychotherapy: Theory, Research, Practice, Training 17 (2007) 423-430
24. Gelso C.J. The real relationship: The "something more" of psychotherapy. Journal of Contemporary Psychotherapy 32 1 (2002) 35-40
25. Gelso, C. J. (in press). The real relationship in a post-modern world: Theoretical and empirical explorations. Psychotherapy Research
26. Gelso C.J., and Carter J.A. The relationship in counseling and psychotherapy: Components, consequences, and theoretical antecedents. Counseling Psychologist 13 (1985) 155-243
27. Gelso C.J., and Carter J.A. Components of the psychotherapy relationship: Their interaction and unfolding during treatment. Journal of Counseling Psychology 41 (1994) 296-306
28. Gelso C.J., and Hayes J.A. The psychotherapy relationship (1998), Wiley, New York
29. Gelso C.J., and Hayes J.A. The management of countertransference. In: Norcross J. (Ed). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (2002), Oxford University Press, New York 267-284
30. Gelso C.J., and Hayes J.A. Countertransference and the therapist's inner experience: Perils and possibilities (2007), Erlbaum, Mahwah, NJ
31. Gelso C.J., Kelley F.A., Fuertes J.N., Marmarosh C., Holmes S.E., and Costas C. Measuring the real relationship in psychotherapy: Initial validation of the Therapist Form. Journal of Counseling Psychology 52 (2005) 640-649
32. Gelso C.J., Kivlighan D.M., Wine B., Jones A., and Friedman S.C. Transference, insight, and the course of time-limited therapy. Journal of Counseling Psychology 44 (1997) 209-217
33. Gelso C.J., and Samstag L. A tripartite model of the therapeutic relationship in psychotherapy. In: Brown S., and Lent R. (Eds). Handbook of counseling psychology. 4th ed. (2008), Wiley, New York 267-283
34. Graff H., and Luborsky L.L. Long-term trends in transference and resistance: A report on a quantitative-analytic method applied to four psychoanalyses. Journal of the American Psychoanalytic Association 25 (1977) 471-490
35. Greenson R.R. The technique and practice of psychoanalysis 1 (1967), International Universities Press, New York
36. Greenson R.R. The origin and fate of new ideas in psychoanalysis. International Journal of Psychoanalysis 50 (1969) 503-515
37. Greenson R.R. Explorations in psychoanalysis (1978), International Universities Press, New York
38. Greenson R.R., and Wexler M. The non-transference relationship in the psychoanalytic situation. International Journal of Psychoanalysis 50 (1969) 27-39
39. Hill C., Nutt-Williams E., Heaton K.J., Thompson B.J., and Rhodes R.H. Therapist retrospective recall of impasses in long-term psychotherapy: A qualitative analysis. Journal of Counseling Psychology 43 (1996) 207-217
40. Horvath A.O., and Greenberg L.S. The development of the Working Alliance Inventory. In: Greenberg L., and Pinsoff W.M. (Eds). The psychotherapeutic process (1986), Guilford Press, New York 529-556
41. Horvath A.O., and Greenberg L. Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology 36 (1989) 223-232
42. Horvath A.O., and Greenberg L. The working alliance: Theory, research, and practice (1994), Wiley, New York
43. Kelley, F. A., Gelso, C. J., Fuertes, J., Marmarosh, C., & Lanier, S. (2009). The development and psychometric investigation of the client version of the Real Relationship Inventory. Manuscript submitted for publication.
44. Kivlighan D., Patton M.J., and Foote D. Moderating effects of client attachment on the counselor experience-working alliance relationship. Journal of Counseling Psychology 45 (1998) 274-278
45. Kivlighan D., and Shaughnessy P. Patterns of working alliance development: A typology of client's working alliance ratings. Journal of Counseling Psychology 47 (2000) 362-371
46. Kramer U., Roten Y., Beretta V., Michel L., and Despland J. Patients' and therapists' view of early alliance building in dynamic psychotherapy: Patterns and relation to outcome. Journal of Counseling Psychology 55 (2008) 89-95
47. Krull J.L., and MacKinnon D.P. Multilevel modeling of individual and group level mediated effects. Multivariate Behavioral Research 36 (2001) 249-277
48. Lambert M.J., and Hill C.E. Assessing psychotherapy outcomes and processes. In: Bergin A.E., and Garfield S.L. (Eds). Handbook of psychotherapy and behavior change. 4th ed. (1994), Wiley, New York 72-113
49. Ligiero D.P., and Gelso C. Countertransference, attachment, and the working alliance: The therapists' contribution. Psychotherapy: Theory, Research, Practice, Training 39 (2002) 3-11
50. Lopez F.G., and Brennan K.A. Dynamic processes underlying adult attachment organization: Toward an attachment theoretical perspective on the healthy and effective self. Journal of Counseling Psychology 47 (2000) 283-300
51. Mallinckrodt B. Attachment, social competencies, and interpersonal process in psychotherapy. Psychotherapy Research 10 (2000) 239-266
52. Mallinckrodt B., Coble H.M., and Gantt D.L. Working alliance, attachment memories, and social competencies of women in brief therapy. Journal of Counseling Psychology 42 (1995) 79-84
53. Mallinckrodt B., Gantt D., and Coble H. Attachment patterns in the psychotherapy relationship: Development of the Client Attachment to Therapist Scale. Journal of Counseling Psychology 42 (1995) 307-317
54. Mallinckrodt B., Porter M., and Kivlighan D. Client attachment to therapist, depth of in-session exploration, and object relations in brief psychotherapy. Psychotherapy: Theory, Research, Practice, Training 42 (2005) 85-100
55. Markin R., and Kivlighan D. Bias in psychotherapist ratings of client transference and insight. Psychotherapy: Theory, Research, Practice, Training 44 (2007) 300-315
56. Martin D.J., Garske J.P., and Davis K.D. Relation of therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology 68 (2000) 428-450
57. Mikulincer M., and Shaver P.R. The attachment behavioral system in adulthood: Activation, psychodynamics, and interpersonal processes. In: Zanna M.P. (Ed). Advances in experimental social psychology 35 (2003), Academic Press, New York 53-152
58. Mohr J.J., Gelso C.J., and Hill C.E. Client and counselor trainee attachment as predictors of session evaluation and countertransference behavior in first counseling sessions. Journal of Counseling Psychology 52 (2005) 298-309
59. Multon K.D., Patton M.J., and Kivlighan D.M. Development of the Missouri Identifying Transference Scale. Journal of Counseling Psychology 43 (1996) 243-252
60. Norcross J. Psychotherapy relationships that work: Therapist relational contributions to effective psychotherapy (2002), Oxford University Press, London
61. Okiishi J.C., Lambert M.J., Eggett D., Nielsen L., Dayton D.D., and Vermeersch D.A. An analysis of therapist treatment effects: Toward providing feedback to individual therapists on their clients' psychotherapy outcome. Journal of Clinical Psychology 62 (2006) 1157-1172
62. Pariente P., and Guelfi J.D. Inventaires d'auto-évaluation de la psychopathologie chez l'adulte [Self-report inventories of adult psychopathology]. Psychiatrie Psychobiologique 5 (1990) 49-63
63. Pedhazur E.J. Multiple regression in behavioral research: Explanation and prediction. 2nd ed. (1982), Holt, Rinehart, & Winston, Fort Worth, TX
64. Raudenbush S.W., and Bryk A.S. Hierarchical linear models: Applications and data analysis methods. 2nd ed. (2002), Sage, Thousand Oaks, CA
65. Raudenbush S.W., Bryk A.S., Cheong Y.F., and Congdon R.T. HLM: Hierarchical linear and nonlinear modeling (2004), Scientific Software International, Chicago
66. Rogers C.R. The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology 21 (1957) 95-103
67. Safran J.D., and Muran J.C. Negotiating the therapeutic alliance: A relational treatment guide (2000), Guilford Press, New York
68. Satterfield W.A., and Lyddon W.J. Client attachment and perceptions of the working alliance in counselor trainees. Journal of Counseling Psychology 42 (1995) 187-189
69. Sauer E.M., Lopez F.G., and Gormley B. Respective contributions of therapist and client adult attachment orientations to the development of the early working alliance: A preliminary growth modeling study. Psychotherapy Research 13 (2003) 371-382
70. Stiles W.B., Agnew-Davies R., Hardy G.E., Barkham M., and Shapiro D. Relationship of the alliance with psychotherapy outcome: Findings in the Second Sheffield Psychotherapy Study. Journal of Consulting and Clinical Psychology 66 (1998) 791-802
71. Tabachnick B.G., and Fidell L.S. Using multivariate statistics. 4th ed. (1996), Allyn & Bacon, Boston
72. Tracey T.J., and Kokotovic A.M. Factor structure of the Working Alliance Inventory. Psychological Assessment 1 (1989) 207-210
73. Wampold B.E. The great psychotherapy debate: Models, methods, and findings (2001), Erlbaum, Mahwah, NJ
74. Woodhouse S., Schlosser R., Crook R.E., Ligiero D., and Gelso C.J. Patient attachment to therapist: Relations to transference and patient recollections of parental caregiving. Journal of Counseling Psychology 50 (2003) 395-408