Common factors aren't so common: The common factors dilemma.

Abstract

There is apparently little difference in the effectiveness of different kinds of psychotherapy. One explanation is that common factors cut across them. The major schools do not much attend to common factors, however, and it may be that outcome equivalence is due as much t o common neglect of common factors as t o their use. Five common factors are discussed: the therapeutic relationship, expectations, confronting problems, mastery, and attribution of outcome. Linear conceptions of causality seem to contribute t o the problem of selective neglect of common factors, and it is suggested that reciprocal interaction may constitute a more viable way of understanding therapeutic processes. Although technical eclecticism and therapy integration have been proposed as potentially integrating the common factors, eclecticism lacks theoretical coherence, and viable integrations have yet t o be offered, although statistical methods for testing them (causal modeling) may exist. To suggest what a productive integration could look like, a clinical example is connected metaphorically t o a developmental model of attachment.Strategies for further research are also suggested.

Complexity and Nonlinear Dynamics in Psychotherapy

“…the therapeutic relationship and working alliance, patient's expectations and attitudes concerning therapy, the fitting of patient's subjective disease theories and therapist's treatment theory, therapist's authenticity and genuineness, conditions in the social environment of the patient (partnership, family, occupation), setting variables, and so on. 28,29 8. Patient variables seem to have the most important impact on the therapy outcome.…”

Case Studies in Clinical Psychology: Are We Giving up a Publication Type and Methodology in Research on and Teaching of Psychopathology and Psychotherapy?

“…Therefore, clinical psychology should not-based on stereotypes and methodological biases-simply add case studies/reports to the garbage heap of merely historically relevant publication types and research methodologies. In the last three decades, recently, and in the near future clinical case studies were, are, and will be especially relevant for the development of a general, differential, i.e., an integrative psychotherapy (see, e.g., Frank et al, 1980;Grawe, 2004;Karasu, 1986;Weinberger, 1995), because it is important and cost-saving to explore and test novel and/or combined treatment methods and techniques in straightforward contexts. Case studies/reports should be viewed as an essential part of science.…”

On Tone, Play, and Healing: Commentary on Riordan's Case Studies

“…Reflecting on this question, I started to reflect on the importance to treatment of phenomena such as prosody, facial affect, body language, humor, and the therapist's overall genuineness. These qualities, so hard to capture even in transcribed materials (and so inadequately denoted in phrases such as "common factors"), are central to the therapist's art (Anstadt, Merten, Ullrich & Krause, 1997;Weinberger, 1995).…”