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

Sharon Egozi, Orya Tishby, Hadas Wiseman

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)910-926
Number of pages17
JournalJournal of Clinical Psychology
Issue number4
StatePublished - Apr 2021

Bibliographical note

Publisher Copyright:
© 2020 Wiley Periodicals LLC

© 2020 Wiley Periodicals LLC.


  • psychodynamic therapy
  • relationship narratives
  • secure base in therapy
  • therapeutic distance
  • therapeutic relationship
  • Professional-Patient Relations
  • Humans
  • Psychotherapy

ASJC Scopus subject areas

  • Clinical Psychology
  • Arts and Humanities (miscellaneous)


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