The Role of the Therapeutic Alliance in the Regulation of Emotion in Psychosis: An Attachment Perspective
Article first published online: 9 MAY 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Clinical Psychology & Psychotherapy
Volume 20, Issue 6, pages 523–530, November-December 2013
How to Cite
Owens, K. A., Haddock, G. and Berry, K. (2013), The Role of the Therapeutic Alliance in the Regulation of Emotion in Psychosis: An Attachment Perspective. Clin. Psychol. Psychother., 20: 523–530. doi: 10.1002/cpp.1793
- Issue published online: 3 DEC 2013
- Article first published online: 9 MAY 2012
- Manuscript Accepted: 9 APR 2012
- Manuscript Revised: 7 APR 2012
- Manuscript Received: 27 MAY 2011
- Emotion Regulation;
- Therapeutic Alliance
Objectives: This article aims to explore the value of attachment theory as a framework for understanding the ways in which the staff–patient relationship is associated with different methods of regulating emotion in individuals with a diagnosis of psychosis. Method: Patient participants with a diagnosis of schizophrenia, schizoaffective disorder or psychosis not otherwise specified and mental health workers were recruited from 24-hour rehabilitation teams. Patient participants completed questionnaires assessing emotion regulation, attachment, therapeutic alliance and symptomatology. The therapeutic alliance was also assessed from mental workers' perspective. Results: Insecure attachment was significantly associated with greater difficulties in regulating emotions. A strong therapeutic alliance was associated with fewer difficulties in regulating emotions. Conclusions: Attachment is a useful theoretical construct for understanding psychosis, with evidence for a link between a positive staff–patient relationship and enhanced emotion regulation. Clinical implications of these findings are discussed. Copyright © 2012 John Wiley & Sons, Ltd.
Key Practitioner Message
- The study supports a link between attachment organisation and psychosis, characterised by difficulties in emotion regulation.
- A positive patient-key worker relationship may facilitate the development of emotion regulation in this client group.
- A key implication of these findings is the training of MDT staff in the implementation of attachment-informed interventions.