The Couples' Closeness-Distance Scale- Observation through joint-drawing: A pilot dyadic validation study.

The study aimed to evaluate the Couples' Closeness-Distance Scale (CCDS), an observational assessment reflecting couples' relational dynamics; based on joint-drawing, it offers measurable dimensions. Forty cohabiting Israeli couples participated in the joint-drawing task and answered self-report questionnaires for attachment, differentiation of self, and relationship satisfaction. The paintings were assessed by trained observers on the CCDS scales (too distant, too close, autonomy, engagement) for both the women's and men's experiences. A two-level-dyadic model showed that differentiation and relationship satisfaction predicted the CCDS and revealed a "pursue-withdraw cycle": Women sensed the men as too distant, while men sensed the women as too close. Participants' sense of discomfort from their partners' distance related to less autonomy and engagement during the painting, with a greater effect on the women. The pilot implies that the CCDS enables observing dyadic-systemic aspects of couple dynamics and may enrich clinical evaluation.

Self-Differentiation, Psychological Flexibility, and Difficulties in Practice in Social Workers and Social Work Students.

Practicing social work involves unique difficulties, which may vary with seniority. This study aimed to identify these difficulties among social workers and social work students and to examine the associations between psychological flexibility (PF), self-differentiation (SF), and difficulties in practice in both groups. Ninety-one social work students and seventy-five social workers completed the following questionnaires: Difficulties in Practice, the Acceptance and Action Questionnaire-II, and Differentiation of Self Inventory. Results showed higher difficulties among social work students regarding their professional competence. Social workers demonstrated higher levels of PF, while no significant difference was found in SF. SF and PF were positively correlated, and both were negatively correlated with difficulties in practice in both groups. Among social work students, a moderating effect of PF was found for the association between SF and difficulties in practice. The current study emphasizes the importance of developing SF and cultivating PF during social work education to enhance professional competence and reduce difficulties in practice.

The experience of closeness and distance in the therapeutic relationship of patients with different attachment classifications: an exploration of prototypical cases.

Background: Individuals with different attachment classifications (Secure, Avoidant and Preoccupied) may experience emotional closeness differently, in their intimate relationships but also as clients in psychotherapy. However, evidence for this assumption almost exclusively comes from research with self-report questionnaires. Aims: In this paper, we use observer-rated measures to explore in depth how patients with different attachment classifications experience closeness and distance from the therapist in different phases of therapy. Method: Three patients' and their therapists' narratives about the therapeutic relationship at three time points during therapy were extracted and analyzed with two transcript-based observational measures: The Patient Attachment Coding System (PACS), which classifies patients' attachment according to their discourse behavior, and the therapeutic-Distance Scale-Observer version (TDS-O), which assesses the therapeutic relationship in terms of closeness, distance, autonomy and engagement. Cases were chosen from a larger research project due to their different prototypical attachment classification on the PACS. The narratives were obtained from Relationship Anecdote Paradigm (RAP) interviews in which the patients and their therapists narrated separately about meaningful interactions with each other, at early, middle and late phases of therapy. In addition, we followed patients self-report of the alliance and symptoms (OQ-45). Results: Although all patients reported experiencing discomfort with feeling distant from the therapist the therapeutic distance, the secure patient was able to reflect on his feelings and, in the therapist's recollection, was able to share them with the therapist. This allowed the therapist to harness these feelings for the benefit of the therapy. The avoidant and the preoccupied patients both experienced the therapist as distant, but the avoidant patient prevented closeness by a minimal expression of feelings, and the preoccupied described strong frustration with the therapist in a one-sided manner that prevented collaborative processing and left the therapist confused. Discussion: It appears that patient discourse is a stable (trait-like) component of attachment, while the therapeutic-distance is a process (state-like) component that may change along therapy. The discourse of insecure patients may hinder therapists' ability to adjust the therapeutic-distance to patients' needs. Therapists' knowledge about the ways patients with different attachment classifications communicate their proximity wishes may improve their attunement.

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

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.

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.