CCMH 506 Week 5 Interpersonal and Attachment-Based Approaches Example

The Breakup as a Role Transition: Interpersonal Psychotherapy and an Attachment Lens for Alana

[Student Name]

University of Phoenix

CCMH/506: Personality Theories and Counseling Models

Week 5 Assignment

[Instructor Name]

[Date]

The clinic, the client and all details are composites written for a model paper; theories and research findings come from the sources listed.

Earlier weeks examined Alana's history, her experience, her behavior and her thoughts. Interpersonal and attachment-based approaches look at her relationships: the one that ended, the ones she has withdrawn from and the one forming with me.

An Interpersonal Frame

Interpersonal psychotherapy treats depression as occurring in an interpersonal context and focuses on one of four problem areas: grief after a death, disputes with important others, transitions between life roles and long-standing difficulty forming or keeping relationships. The counselor and client choose a focus, link mood to events in that area and work on it over a set number of sessions, often twelve to sixteen.

Alana's depression began when her partner ended their relationship, and she has since withdrawn from friends. The best fit is a role transition: she has lost her role as a partner, with its routines, future plans and sense of being chosen, and has not yet built a new role as a single woman in her late twenties.

Attachment Across the Life Span

Bowlby (1977) argued that the tendency to form strong bonds with particular people and to seek closeness to them under threat is a basic part of human nature that continues throughout life rather than a childish dependency to be outgrown. Threats to these bonds stir anxiety and anger, and their loss brings sorrow and mourning. Experiences with attachment figures in childhood shape expectations about whether others will be available and responsive, and those expectations influence later relationships and vulnerability to distress. He suggested that therapists could offer a secure base from which clients explore these patterns.

Alana's Pattern

Alana's father walked out in her sixth year, and her mother, though devoted, was often working double shifts. Alana learned that closeness could disappear and that being good might keep people near. In her relationship, she described texting her partner repeatedly when he was late, asking whether he was upset with her and redoubling efforts to please when she sensed distance. When her partner called her "too intense," he may have been describing this anxious pursuit. Since the breakup, she has swung toward withdrawal, avoiding friends to avoid the pain of possible rejection.

Alana's intensity with her partner and her silence with friends may be two ways of managing the same fear of being left.

Interpersonal Work on the Transition

Interpersonal psychotherapy for a role transition involves mourning the old role, acknowledging both its good and bad sides, examining what the new role offers and building skills and support for it. With Alana, early sessions will review the relationship honestly: what she loved, what she gave up and what was hard, including her constant worry. Middle sessions will explore what being single at twenty-nine could mean, from reconnecting with friends to time for her own interests. We will link her mood each week to interpersonal events, such as feeling better after dinner with a friend and worse after seeing her former partner's photos online.

Evidence for Interpersonal Psychotherapy

Cuijpers et al. (2011) meta-analyzed thirty-eight studies of interpersonal psychotherapy for depression with more than four thousand participants. Interpersonal psychotherapy clearly outperformed control conditions, performed similarly to other psychotherapies and, when combined with medication, helped prevent relapse more than medication alone. The authors concluded that it is one of the best-supported treatments for depression.

Attachment and Outcome

Levy et al. (2011) meta-analyzed studies of clients' attachment styles and psychotherapy outcomes. Higher attachment anxiety was associated with somewhat poorer outcomes, greater attachment security with somewhat better outcomes and attachment avoidance was not reliably related to outcome. The authors suggested that therapists adapt their approach to clients' attachment patterns.

For Alana, this suggests patience. Her anxious pattern may make progress uneven, especially if she senses distance or judgment from me, so I will plan for setbacks around breaks and endings, including the end of our sixteen sessions.

The Counseling Relationship

Attachment patterns often appear with the counselor. Alana apologizes when she is a minute late and asks whether she is "doing therapy right." When I took a week off, she skipped the next session, later saying she assumed I was tired of her. These moments are opportunities. I can respond consistently and reliably, name the pattern gently and invite her to notice how it echoes her other relationships. Being a steady presence through her worry is itself a corrective experience. After the missed session, I called to say I had noticed her absence and looked forward to seeing her the next week. She told me later that the call surprised her; she had expected me to be annoyed, and instead she heard that her absence mattered. We talked about how rarely she lets herself test whether people will stay.

Culture and Family

Alana's mother's vigilance reflected love and fear for a Black daughter's future, and her father's absence has its own history Alana is only beginning to explore. I will avoid framing her mother as the cause of her problems. Her extended family and church community are attachment resources too, and strengthening those ties belongs in the new role.

Building the New Role

The new role needs content, not just the absence of the old one. Alana listed what she had set aside during the relationship: a book club, Sunday dinners at her grandmother's and a plan to take the paralegal certification exam. Each became a small goal. She rejoined the book club in week eight and found that two members had also recently ended relationships, which made the evenings feel less like a performance. Interpersonal therapy treats such steps as more than distraction; they rebuild the network of relationships through which mood recovers.

Comparing Approaches

Interpersonal work shares cognitive therapy's structure and time limits but focuses on relationships rather than thoughts. It shares psychodynamic interest in history and the therapy relationship but stays anchored in present relationships and a defined problem area.

Measures and Timeline

We will plan sixteen sessions, tracking her depression score, the number of social contacts each week and her ratings of how secure she feels in relationships.

When the Former Partner Called

Midway through our work, Alana's former partner texted asking to meet for coffee. She arrived at session flooded with hope and dread. Interpersonal work helped her slow down: we reviewed what the relationship had given her and cost her, and what she now wanted from a partner. She decided to meet him briefly and to listen without trying to win him back. Afterward she said the meeting felt like a goodbye she had never gotten, a sign that the mourning part of the role transition was moving forward.

Conclusion

Framing Alana's depression as a role transition and her intensity and withdrawal as expressions of an anxious attachment pattern gives counseling a clear focus. Interpersonal psychotherapy, well supported for depression, and a steady counseling relationship offer her both a structured path through the transition and an experience of security.

References

Bowlby, J. (1977). The making and breaking of affectional bonds: I. Aetiology and psychopathology in the light of attachment theory. British Journal of Psychiatry, 130(3), 201-210. https://doi.org/10.1192/bjp.130.3.201

Cuijpers, P., Geraedts, A. S., van Oppen, P., Andersson, G., Markowitz, J. C., & van Straten, A. (2011). Interpersonal psychotherapy for depression: A meta-analysis. American Journal of Psychiatry, 168(6), 581-592. https://doi.org/10.1176/appi.ajp.2010.10101411

Levy, K. N., Ellison, W. D., Scott, L. N., & Bernecker, S. L. (2011). Attachment style. Journal of Clinical Psychology, 67(2), 193-203. https://doi.org/10.1002/jclp.20756