Working models of attachment: The impact of emotionally focused marital therapy.

Couples in which at least one partner was rated as insecurely attached were randomly assigned to an Emotionally Focused Therapy (EFT) treatment group or a waitlist control group to determine whether EFT could improve attachment working models of self and other. Fifteen couples received a minimum of 15 sessions of EFT. Eleven couples served as the control group. Assessment of the EFT group took place at recruitment, at the end of therapy, and four months later. The control group was assessed at recruitment, and 4 and 8 months later. Measures included two self-report measures of Bartholomew's four category model of attachment and a measure of marital satisfaction. Results indicated that at the end of therapy the EFT group showed significantly greater improvement in model of self, and in 3 of the 4 attachment prototypes for one attachment measure and in 2 of the 4 for the second measure of attachment. Gains were not maintained at 4-month follow-up. Changes in marital satisfaction did not differ significantly between groups from either pre- to posttreatment or from pretreatment to follow-up. For the EFT group as a whole, gains in marital satisfaction from pre- to posttreatment were predicted by increases in models of self and other scores, and improvement in secure and avoidant-fearful ratings of attachment. Gender differences were found for the treatment group. Increases in DAS scores for females in the treatment group were predicted by increases in model of self scores and in secure ratings. For males in the treatment group, improvement in DAS scores was predicted by an increase in model of other scores, and by improvement in secure and avoidant-fearful ratings