In this article, we examine the science and policy implications of the common factors perspective (CF; Frank & Frank, 1993; Wampold, 2007). As the empirically supported treatment (EST) approach, grounded in randomized controlled trials (RCTs), is the received view (see Baker, McFall, & Shoham, 2008; McHugh & Barlow, 2012), we make the case for the CF perspective as an additional evidence-based approach for understanding how therapy works, but also as a basis for improving the quality of mental health services. Finally, we argue that it is time to integrate the 2 perspectives, and we challenge the field to do so.

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Interest in so-called briefer approaches to psychotherapy is growing in the United States and abroad. In this article we examine therapist, patient, and system attitudinal factors in brief therapy practice. Attitudinal factors in brief and long-term therapy are contrasted, and technical treatment issues, patient selection, dangers, and future issues in brief therapy are discussed. Rather than presenting brief therapy as a specific school or model of treatment, we seek to integrate various approaches that can make therapy beneficial within a wellplanned, limited amount of time.Although interest in brief psychotherapy has recently been renewed (Marmor, 1979), clinical theoreticians differ in their views about time boundaries and essential characteristics of short-term therapy. Brief therapies, for example, can range from 1 session (Bloom, 1981) to 40 or 50 sessions (Malan, 1976;Sifneos, 1972); behavioral clinicians-often considered brief therapists-see some patients for 100 sessions or more (cf. Klein, Dittman, Parloff, & Gill, 1969; Wilson, 1981).Beyond societal pressures for more efficient psychotherapy (Goleman, 1981), current enthusiasm for short-term psychotherapy can be attributed to the clinical and conceptual challenges of carefully and judiciously allotting a limited amount of time. Time, however, can be allocated in numerous ways: For example, although weekly 1 -hour sessions over 15 weeks would probably be considered brief therapy, these 15 hours could be distributed in other ways that are logical and appropriate to each patient's therapeutic needs. Thus, a crisis intervention model, aimed at rapid restoration of patients to precrisis levels of functioning (Beebe, 1975), might involve 1 hour each weekday for 3 weeks (the equivalent of 15 treatment hours). Certain family therapy models, most notably that of Selvini-Palazzoli, Boscolo, Cecchin, and Prata (1978) who work with schizophrenics and their families, suggest that one meeting per month is preferable to the more commonplace weekly meetings.Thus, merely tabulating hours spent in clinical contact does not offer, an adequate index of whether a therapy is brief: The temporal density of brief therapies allows for varied allocation of therapeutic time for different, although equally compelling, clinical and conceptual reasors. Although Butcher and Koss (1978), in their excellent review of brief therapy, define 25 sessions as the upper limit of brief treatment, they do not address the issue of what constitutes a session or how the 25 sessions can be distributed and still be regarded as short term.In our experience as pracitioners of brief therapy, we have concluded that (to paraphrase James Thurber) "there is no length in number." What is, in fact, being examined in any discussion of brief treatment is therapy in which the time allotted to treatment is rationed. The therapist hopes to help the patient achieve maximum benefit with the lowest investment of therapist time and patient cost, both financial and psychological. Brief, or short-term, therapy might ...

Guidelines for Evidence-Based Treatments in Family Therapy are intended to help guide clinicians, researchers, and policy makers in identifying specific clinical interventions and treatment programs for couples and families that have scientifically based evidence to support their efficacy. In contrast to criteria, which simply identify treatments that "work" and have been employed in the evaluation of other psychotherapies, these guidelines propose a three-tiered levels-of-evidence-based model that moves from "evidence-informed," to "evidence-based," to "evidence-based and ready for dissemination and transportation within diverse community settings." Each level reflects an interaction between the specificity of the intervention, the strength and readth of the outcomes, and the quality of the studies that form the evidence. These guidelines uniquely promote a clinically based "matrix" approach in which the empirical support is evaluated according to various dimensions including strength of the outcomes, the applicability across cultural contexts, and demonstration of specific change mechanisms. The guidelines are offered not only as a basis for understanding the evidence for diverse clinical approaches in couple and family therapy within the systemic tradition of the field, but also as an alternative aspirational model for evaluating all psychotherapies.