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A panel of 9 therapists generated items for an instrument designed to measure the psychotherapy relationship from the perspective of attachment theory. The initial version of the Client Attachment to Therapist Scale (CATS) contained 100 items that were administered at 4 counseling agencies in survey packets to 138 clients who had completed at least 5 sessions with their therapists. Factor analysis suggested that 36 items loaded on 3 subscales, which we labeled Secure, kvoidant-Fearful, and Preoccupied-Merger. CATS factors correlated in expected directions with survey measures of object relations, client-rated working alliance, social self-efficacy, and adult attachment. Cluster analysis identified 4 types of client attachment. Significant differences in social competencies (object relations, etc.) were evident across types of attachment. Implications of attachment patterns for the understanding of client transference are discussed. Attachment theory was originally developed to explain the behavioral and emotional responses that keep young children and their caregivers in close physical proximity (Bowlby, 1969). From this foundation, attachment theory offers an explanation for responses to separation and loss (Bowlby, 1973) and the development of emotional attachments after infancy (Ainsworth, 1989; Bowlby, 1977). In an optimal attachment bond, the caregiver provides a comforting presence for the child that reduces anxiety and promotes feelings of security. From this secure base, the child is able to explore the physical and social environment (Bowlby, 1969, 1988). In Ainsworth's pioneering studies of attachment (Ainsworth, Blehar, Waters, & Wall, 1978), in sequential phases of a laboratory observation, children explored a novel play environment in the presence of their mother and were then observed during a brief separation from their mother, exposure to a stranger, and reunion with their mother. Three patterns of attachment were identified. Infants who displayed the secure pattern freely explored in their mother's
Mallinckrodt et al. (Sat,) studied this question.