Changes in clients and therapists experiences of therapeutic distance during psychodynamic therapy

Attachment theory provides a framework for examining closeness–distance experiences in the development of the therapeutic relationship. Objective: To examine changes in clients' and therapists' experiences of therapeutic distance along with psychodynamic therapy. Hypotheses: Clients' and therapists' comfort with closeness and distance will increase, and the client's autonomy and engagement will increase with time. Method: A total of 67 clients and their 27 therapists underwent Relationship Paradigm interviews in which they told narratives about their experience with each other, three times during therapy. The narratives were rated on the Therapeutic Distance Scale-Observer (TDS-O) version. Results: Growth curve analysis of the TDS-O ratings showed that clients decrease in perceiving therapists as too distant and increase in engagement. Therapists showed a decrease in perceiving clients as too close and an increase in granting autonomy and engagement. A clinical illustration depicts these experiences in a client–therapist dyad. Conclusions: Therapists' awareness of clients' changing needs of closeness and autonomy may enhance attunement.