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Therapeutic alliance and attachment in play therapy Heller, Deborah C.

Abstract

This study examined how the evolution of therapeutic alliance during child-centered play therapy varied between two children with differing patterns of attachment. The two children recruited, both 5 years-old, were a female, classified as insecure-defended (subclassification A3 - caretaking) and a male, classified as insecure-coercive (subclassification C2 - disarming). The children's attachment patterns were determined by two independent raters, using Crittenden's (1992a) classification of quality of attachment of preschool-aged children. Each child received 10 weekly non-directive play therapy sessions, which were videotaped, with the investigator as therapist. Participant-observation was used for data collection, and open coding and pattern-matching was used for data analysis. Pattern differences that emerged in the children's categories of play and categories of the therapeutic relationship were related to changes in therapeutic alliance and in attachment strategies for managing distress. Over time, the A3 child responded more to the therapist's responsive behaviours to her expressed needs and feelings; and engaged in relatively more self expression in her play. Over time, the C2 child responded more to the therapist's mere availability to the child; and tended to engage in relatively more self agency (self direction) in his play. Further play therapy research is needed to confirm the relationship between attachment and therapeutic alliance with children.

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