Therapeutic distance in client-therapist narratives: client attachment, therapist attachment, and dyadic effects

Sharon Egozi*, Orya Tishby, Hadas Wiseman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Based on the attachment framework, therapeutic distance conceptualization focuses on closeness–distance dynamics in the therapeutic relationship. We aimed to evaluate the psychometric properties of the Therapeutic-Distance-Scale, Observer-version (TDS-O) and apply a dyadic approach to examine associations between attachment characteristics and therapeutic distance experiences of clients, therapists, and mutual effects. Sixty-six clients and their 29 therapists completed the ECR and relational narratives collected in RAP interviews at early, mid, and late psychodynamic-therapy were rated on TDS-O scales: too close, too distant, autonomy, and engagement. The TDS-O showed good IRR, internal reliability and content validity. Client anxiety was not associated with therapeutic distance but associated with autonomy. Client avoidance associated with clients’ experiencing therapist as too close, and lower engagement only at early therapy, but was not associated with therapists’ experience. Therapist anxiety was not related to closeness–distance at early therapy but related to gaps between client and therapist experiences at mid and late therapy. Therapist avoidance related to clients experiencing therapists as too close and granting less autonomy at early and mid-therapy, and to therapist experience of distance at late therapy. The findings underscore the importance of therapists’ regulating therapeutic distance through attunement to client’s interpersonal needs and therapy phase.

Original languageAmerican English
Pages (from-to)963-976
Number of pages14
JournalPsychotherapy Research
Issue number8
StatePublished - Nov 2021

Bibliographical note

Publisher Copyright:
© 2021 Society for Psychotherapy Research.


  • Relationship Anecdotes Paradigm
  • attachment style
  • dyadic analytical framework
  • therapeutic distance
  • therapeutic relationship


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