Clinicians as caregivers: role of attachment organization in treatment

Abstract

The relationship between case managers' attachment organization and interventions used with clients who have serious psychopathological disorders was examined. Adult Attachment Interviews were administered to 27 clients and their 18 case managers. Interviews were coded by means of Kobak's Q-set, which yields scores for secure-insecure and preoccupied-dismissing attachment strategies. Case managers were interviewed during each of 5 months regarding their most recent interventions; interventions were coded for depth of intervention and attention to dependency needs. Compared with secure case managers, insecure case managers attended more to dependency needs and intervened in greater depth with preoccupied clients than they did with dismissing clients. Case managers who were more preoccupied intervened with their clients in greater depth than did case managers who were more dismissing.