Vinculação, aliança terapêutica e mudança em psicoterapia

Abstract

Change is the main objective of psychotherapeutic intervention and, despite the diversity of conceptualizations thereon and of methods used to assess it, the study of the process of change and the contribution towards that change of some common factors in psychotherapy has been eliciting a growing interest. Attachment theory, developed by Bowlby (1973), and its contribution on internal working models appears to provide an appropriate framework for the exploration of the client/therapist relationship, knowing that research about change in psychotherapy under this theory's matrix is ongoing. The general objective of this exploratory case study is understanding the relationship established between the individual's attachment organization, the therapeutic alliance and the therapeutic change, within an individual psychotherapeutic process. The subject of this study was a 39-year-old woman who began a psychotherapeutic process, with the entire content of the therapy sessions having been audio-recorded and transcribed apart from the first. After the initial session, the AAI (Adult Attachment Interview) was conducted and the BSI (Brief Symptom Inventory) administered; at the end of sessions 4 and 8, the WAI (Working Alliance Inventory) was administered; and, at the end of session 8, an Exploration and Change interview was conducted, and the BSI administered. The results show that the subject's attachment organization, classified as preoccupied, influences the way in which she perceives herself, in which she interacts with others and, consequently, in which she perceives and effects change, but does not hinder her compliance to therapy and its process of self exploration. She gained, throughout the process, insight into the way she perceives herself, a therapeutic result that she values, in addition to some improvement with regard to mood. The subject established a therapeutic alliance early in the psychotherapeutic process, with average scores, which decreased slightly over time. The representation she establishes of the therapeutic relationship throughout the process values the confidence in the therapist's competency and highlights the incisive nature of the therapist's interventions, the use of irony and confrontation as the characteristics of the therapeutic relationship that promote change. The results corroborate the conclusion that the internal working models are difficult to change and tend to operate automatically, as a consequence of each individual's attachment history. Knowing their clients' attachment organization can help therapists create a relational context that helps securing the relationship, adjusting their behaviour from one moment to the next, in order to be perceived as a secure base, or redefining alternative courses of action.

Date of Award	24 Jul 2014
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Vânia Sousa Lima (Supervisor)