Factors Affecting Transition from Child to Adult Mental Health Services. Considering the role of Client and Therapist Attachment Styles on the Therapeutic Relationship

Abstract

Chapter one of this thesis is a systematic review consisting of 13 studies, aiming to explore the evidence regarding association between attachment styles and the therapeutic relationship. Findings demonstrated that complementary attachment styles (e.g anxious client x avoidant therapist, therapist secure x client insecure or highly anxious therapist x less anxious client) do help the therapeutic relationship, in terms of working alliance, greater session depth and smoothness. Clinical and theoretical implications are discussed and recommendations for future research outlined.

Chapter two is a research paper exploring factors which predict transition satisfaction when moving from child to adult mental health services (AMHS). The role of attachment to one’s therapist is also explored. A series of regression analyses found that young people who had an individualised care plan, involvement of transition services and ensuring that treatment in AMHS constitutes a continuation of treatment in CAMHS, were more likely to successfully transition. Involving young people during the transition, supportive relationships young people had with their CAMHS clinician, alongside positive parent involvement in AMHS predicted transition satisfaction. The results suggest clients’ transition process might be significantly improved by focusing on transition structure and the young person’s involvement during their transition, as well as young people having a choice with regards to the level of parent involvement post transition. Working on a secure attachment may be a way to improve transition satisfaction on the AMHS side. Implications for theory and clinical practice are identified and discussed.

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ORCID for Alison Bennetts: orcid.org/0000-0003-2461-7868

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