Research: Therapeutic Common Factors in Different Modalities of Psychotherapy

There are as many styles of psychotherapy as there are therapists. Within modalities of psychotherapy, one would learn that the art snd style of the therapist’s work are unique to the person of the therapist in relation to the personality of the client.

In this article, I would like to highlight the concept of common factors among all psychotherapeutic work. The significance of the common factors are well established in psychotherapy research (Budge & Wampold 2015).

Verhaeghe, a critic of the mental health profession in general, mentions this:

“It has recently become increasingly clear that the effective factors in therapeutic practice are very much the same, beyond and above the various different paradigms. Every theoretically based clinical practice (psychoanalytic, cognitive behavioral, systemic, experiential . . . ) has its good and bad therapists, and this evidently has less to do with the particular theory than with the way these therapists are (un-)able to handle these common factors (Verhaeghe, 2008. p.72)”

What are the common factors? A meta-study

The meta-study by Grencavage & Norcross (1990) on the common factors that are attributed to psychotherapeutic change process are as follows:

Client Characteristics

  • Positive expectation/hope or faith
  • Distressed or incongruent client
  • Patient actively seeks help

Therapists Qualities

  • General positive descriptors
  • Cultivates hope/enhances expectancies
  • Warmth/positive regard
  • Empathic understanding
  • Socially sanctioned healer
  • Acceptance

Change Processes

  • Opportunity for catharsis/ventilation
  • Acquisition and practice of new behaviors
  • Provision of rationale
  • Foster insight/awareness
  • Emotional and interpersonal learning
  • Feedback/reality testing
  • Suggestion
  • Success and mastery experiences
  • Persuasion
  • Placebo effect
  • Identification with the therapist
  • Contingency management
  • Tension reduction
  • Therapist modeling
  • Desensitization
  • Education/information provision

Treatment Structure

  • Use of techniques/rituals
  • Focus on “inner world7exploration of
  • emotional issues
  • Adherence to theory
  • A healing setting
  • There are participants/an interaction
  • Communication (verbal and nonverbal)
  • Explanation of therapy and participants’ roles

Therapeutic Relationship

  • Development of alliance/relationship (general)
  • Engagement
  • Transference

The therapeutic alliance, described as “the quintessential integrative variable” (Wolfe & Goldfried, 1988) and probably the most often cited “common factor” in psychotherapy (Wampold, 2001).

What does this tell us?

The process of change in psychotherapy is a client-therapist dynamic. It is however, the job of the therapist to be effective. In return the client can be trusted to want to go through with the work for his/her own benefit.

That the psychotherapeutic theory alone is not listed explicitly as a common factor, tells us that it is the relationship and the contract to work is important. Education and continued self-awareness of the therapist determines how well the therapist can work with the client, and provide the necessary qualities that the client needs in the therapeutic sessions.

Bibliography

Budge, S. L., & Wampold, B. E. (2015). The relationship: How it works. In Psychotherapy research (pp. 213-228). Springer Vienna.

Grencavage, L. M., & Norcross, J. C. (1990). Where are the commonalities among the therapeutic common factors?. Professional Psychology: Research and Practice21(5), 372.

Verhaeghe, P. (2008). On being normal and other disorders: A manual for clinical psychodiagnostics. Karnac Books.

Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Erlbaum.

Wolfe, B. E., & Goldfried, M. R. (1988). Research on psychotherapy integration: Recommendations and conclusions from an NIMH workshop. Journal of Consulting and Clinical Psychology, 56, 448–451.

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