Attachment as a moderator of psychotherapy outcome across treatment type: A meta-analysis

Open Access
Gooch, Caroline Victoria
Area of Honors:
Bachelor of Science
Document Type:
Thesis Supervisors:
  • Kenneth N. Levy , Thesis Supervisor
  • Kenneth N. Levy, Honors Advisor
  • Frank G. Hillary, Faculty Reader
  • Psychotherapy
  • Attachment
  • Meta-analysis
To ensure we are providing psychotherapy patients the best treatment possible, it is important to understand how different patient characteristics impact treatment response. Attachment style, the characteristic way in which a person bonds to and relates with significant others, has been hypothesized to play an important role in psychotherapy because of the interpersonal context and importance of the patient-therapist relationship in psychotherapy. The aim of the current study is to examine the relationship between patients’ attachment anxiety or avoidance to treatment outcome and how type of psychotherapy moderates that relationship. Specifically, using meta-analysis, the relation between patients’ attachment security, anxiety, or avoidance to treatment outcome are examined as a function of type of psychotherapy. It was hypothesized that both attachment anxiety and avoidance would be negatively correlated with outcome and that different types of treatment would moderate the attachment style-outcome association. Following an extensive literature search, relevant studies were coded for effect sizes and study characteristics. To date, a total of 13 studies were included in the meta-analytic review. Findings indicate that Attachment security, anxiety, and avoidance were found to be small to moderate predictors of outcome. Moderator analyses of treatment type on this association were nonsignificant, though informative of potential moderator effects. These findings are discussed in terms of implications for both research and clinical practice.