title: Changes in attachment representations during psychological therapy.
abstract: OBJECTIVE
  This review systematically examines research that investigates changes in adult attachment representations during psychological therapy.
  
  
  METHODS
  Studies from two adult attachment approaches are reviewed (interview and self-report) with the aim of concluding whether psychotherapy can improve attachment representations. To guide the interpretation of findings, the methodological quality of studies is assessed.
  
  
  RESULTS
  The results suggest that attachment security increases following therapy, whereas attachment anxiety decreases following therapy. Findings are unclear with regard to attachment avoidance. Improvements are observed across different methodologies, patient groups, therapeutic approaches, and therapy settings. Findings also appear to be consistent across different levels of study quality.
  
  
  CONCLUSIONS
  Overall, research supports the suggestion that attachment styles may alter during the course of psychotherapy, but further controlled trials are required to confirm this conclusion.
authors.affiliation: a University of Liverpool , Liverpool , UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Taylor
authors.forename: Julia
authors.initials: J
authors.lastname: Rietzschel
authors.forename: Adam
authors.initials: A
authors.lastname: Danquah
authors.forename: Katherine
authors.initials: K
authors.lastname: Berry
mesh_terms: D001007:Anxiety / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D009769:Object Attachment; D011613:Psychotherapy / Q000592:standards*; D016896:Treatment Outcome
keywords: attachment; psychological therapy; psychotherapy; recovery; systematic review