Degree Name

Doctor of Philosophy (Clinical Psychology)


School of Psychology


The aim of this study was to use an empirically validated process tool to discover the impact of attachment styles and introjective and anaclitic personality configurations on the therapy process. Introjective and anaclitic personalities have their origins in attachment history. Attachment patterns exert considerable influence on personality development; however, the specific impact of attachment patterns on the therapy process requires further research. This is an important area of study, as the literature consistently demonstrates that clients with insecure attachment styles and clients with introjective personality styles are vulnerable to depression and are more likely to have a poor response to treatment (Blatt & Shahar, 2005; Cyranowski et al., 2002; Santor & Zuroff, 1997). In order to enhance the treatment of depression, there is a need to discover the personality-driven processes that impede or enhance engagement with therapy. Study 1 (N = 62) examined the relationship between depressed clients’ scores on two personality measures. The impact of personality differences on the working alliance was also examined. Study 2 extended the findings of study 1 by examining the therapy process in a subgroup of clients, where ten clients had a rapid response to therapy and ten made modest gains. The therapy process was examined using the Psychotherapy Process Q-Set (PQS) (Jones, 2000). The PQS is a pan-theoretical measure that assesses client behaviour, therapist behaviour and the interaction between the client and the therapist. Personality characteristics were assessed with the Relationship Questionnaire (RQ) and the Depressive Experience Questionnaire (DEQ). Study 3 examined the impact of personality on response to treatment. Study 1 demonstrated that introjective clients in this sample demonstrated either a fearful or a dismissing attachment style. Study 2 showed that the therapy process could be differentiated by personality characteristics, which did not affect the therapist’s use of generic skills, but did appear to interfere with the use of specific techniques that characterise psychotherapy. Introjective clients who had a fearful attachment style appeared to engage more with the therapy process than introjective clients who had a dismissing attachment style. Study 3 indicated that fearfully attached clients had a slower response to therapy, and that they may need a longer course of therapy. In conclusion, this study provides further evidence for the interactional patterns between patients and therapists in psychotherapy, and highlights the profound influence of attachment models of personality on the speed and depth of psychotherapeutic work.