Attachment, Working Alliance and therapeutic relationship: What makes a psychotherapy work?
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The results of the evidence-based research have confirmed that various models of psychotherapy produce very positive results, but no psychotherapeutic technique has shown a significant superiority compared to the others. A factor significantly related to patient satisfaction and to the final result of psychotherapy seems to be the quality of the therapeutic alliance or Working Alliance, and the attachment paradigm has been used as a key for interpretation and assessment of this dimension. Despite methodological limitations, and the variability of the investigated dimensions, research has shown that attachment security of the patient and the therapist positively influence the quality of the relationship, the therapeutic process and the outcome of the treatment, while insecurity in attachment, particularly preoccupied type, is associated with a lower quality and instability of the alliance and a decreased therapeutic efficacy.