Attachment patterns and the early working alliance: A study of patient and therapist reports of alliance quality and raptures

The current study was an exploratory investigation of the relationships between self- reported attachment patterns in adults and the early therapeutic alliance. Attachment style was measured by self-report following the first session of therapy. The alliance was studied in terms ratings of its quality and tensions or 'ruptures' reported following sessions 2, 3, 4 and 5, among a sample of 30 patients and 12 therapists. The results were analysed using correlation and multiple regression statistics and the findings suggest that different attachment styles are associated with different patterns of alliance difficulties. In line with predictions, fearfulness in attachment style was a significant predictor of lower patient rated alliance at session 5, especially on the subscales measuring goal an task agreement. Against expectations, a dismissing style was associated with higher alliance ratings at session 5. In addition, the rate at which ruptures were reported varied with attachment style. High preoccupied scores were associated with increased rupture reporting and high dismissing scores were associated with decreased rupture reporting. Implications for clinical understanding and future research are discussed