Insecure Attachment Styles and Their Impact on Group Therapy: A Systematic Review

Background: Attachment theory has taken steam as an effective theory in explaining and predicting outcomes of therapy for individuals. Many authors have evaluated attachment styles to predict therapy outcomes. Of these, seventeen studies tested effectiveness of group therapy for adults who fall into anxious or avoidant attachment styles. Comparison across treatment types was difficult because each author evaluated effectiveness with differing outcomes. Treatment types also differed in their effectiveness to improve mental health. Yet, there is no consensus about best way to evaluate group therapy outcomes using attachment styles. In this study, we systematically reviewed existing literature on the effectiveness of group therapy with anxious and avoidant attachment styles for group performance. Method: We searched databases (Academic Search Complete, APA PsycArticles, APA PsycInfo, Health Source: Nursing/Academic Edition, MEDLINE, CINAHL Complete, Psychology and Behavioral Sciences Collection, GreenFILE, Global Health. ERIC) for trials examining effectiveness of group therapy for participants with anxious and/or avoidant attachment styles. Results: This search yielded seventeen studies testing effectiveness of various group therapies. For both anxious and avoidant attachment styles, group therapy proved effective for most studies, but two studies did not. Conclusion: A thorough comparison between studies was difficult because control-groups and measured outcomes differed greatly. Therefore, the field needs more rigorous large-scale trials, with long-term follow-up and more uniformity in outcome measures, investigating the effectiveness of group therapy for certain attachment styles, to be able to draw evidence-based conclusions about best practices for group therapy with various attachment styles.