Development of affiliation during psychotherapy training Towards a benevolent attitude

Objective The study investigated the development of affiliation in psychotherapy trainees with respect to their therapeutic conduct, their self-perception and their perception of clients. In addition, the influence of attachment representations and personal therapy on affiliation was examined. Material and methods In a naturalistic pre-post design, trainees of different therapeutic orientations (n = 126) rated different dimensions of affiliation in difficult therapy situations (Intrex questionnaire short form) over an interval of 3 years. Attachment anxiety and attachment avoidance were assessed at baseline (experiences in close relationships, ECR-RD) as well as length of and satisfaction with self-experience at the end of training. Hierarchical linear modeling was implemented for data analyses. Results Affiliation of the trainees' behavior towards clients and their perception of client behavior showed increases of a small effect size, whereby attachment avoidance predicted a lower affiliation in own behavior. Self-related affiliation showed a decrease with a medium effect size and attachment anxiety was associated with a lower affiliation. The duration of self-experience showed a negative association with the perception of client behavior, although this effect was reversed with high levels of attachment avoidance. The satisfaction with self-experience had no influence on the development of affiliation. Conclusion The interpersonal and intrapsychic affiliation of trainee psychotherapists is partly influenced by attachment representations but is subject to developmental processes. The decrease in self-related affiliation shows the necessity of compensatory and resource strengthening measures in psychotherapy training.