Abstract
Changes in therapy can result from variables unique to a particular treatment package (i.e., specific factors), as a function of variables common to a variety of treatments (i.e., nonspecific/common factors), or a combination of both specific and nonspecific ingredients (Kazdin,1979). Nonspecific (or common) treatment factors include variables that are common across different treatment modalities, which are thought to influence outcomes in therapy but are often not well linked to a mechanism of change. Due to differences in what is posited to be important to the change process by any one treatment theory, specific factors that are deemed crucial for one theoretical approach might be considered a common factor for another approach (Kazdin,1979; Wilkins,1979).
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Arnkoff, D. B., Glass, C. R., & Shapiro, S. J. (2002). Expectations and preferences. In J. C. Norcross (Ed.), Psychotherapy relationships that work (pp. 335–356). New York: Oxford University Press.
Basoglu, M., Lax, T., Kasvikis, Y., & Marks, I. M. (1988). Predictors of improvement in obsessive-compulsive disorder. Journal of Anxiety Disorders, 2(4), 299–317.
Basoglu, M., Marks, I. M., Kilic, C., Brewin, C. R., & Swinson, R. P. (1994). Alprazolam and exposure for panic disorder with agoraphobia: Attribution of improvement to medication predicts subsequent relapse. British Journal of Psychiatry, 164, 652–659.
Biondi, M., & Picardi, A. (2003). Increased probability of remaining in remission from panic disorder with agoraphobia after drug treatment in patients who received concurrent cognitive-behavioural therapy: A follow-up study. Psychotherapy and Psychosomatics, 72(1), 34–42.
Bonner, B. L., & Everett, F. L. (1982). Influence of client preparation and therapist prognostic expectations on children’s attitudes and expectations of psychotherapy. Journal of Clinical Child Psychology, 11(3), 202–208.
Bonner, B. L., & Everett, F. L. (1986). Influence of client preparation and problem severity on attitudes and expectations in child psychotherapy. Professional Psychology: Research and Practice, 17(3), 223–229.
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research and Practice, 16, 252–260.
Borkovec, T. D., & Costello, E. (1993). Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 61(4), 611–619.
Borkovec, T. D., & Roemer, L. (1995). Perceived functions of worry among generalized anxiety disorder subjects: Distraction from more emotionally distressing topics? Journal of Behavior Therapy and Experimental Psychiatry, 26(1), 25–30.
Brewin, C., & Antaki, C. (1982). The role of attributions in psychological treatment. In C. Antaki & C. Brewin (Eds.), Attributions and psychological change: Applications of attributional theories to clinical and educational practice (pp. 23–31). London: Academic Press.
Briere, J. (1988). The long-term clinical correlates of childhood sexual victimization. Annals of the New York Academy of Sciences, 528, 327–334.
Burke, B. L., Arkowitz, H., & Menchola, M. (2003). The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials. Journal of Consulting and Clinical Psychology, 71(5), 843–861.
Chambless, D. L., & Gracely, E. J. (1989). Fear of fear and the anxiety disorders. Cognitive Therapy and Research, 13(1), 9–20.
Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66(1), 7–18.
Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.
Chambless, D. L., Tran, G. Q., & Glass, C. R. (1997). Predictors of response to cognitive-behavioral group therapy for social phobia. Journal of Anxiety Disorders, 11(3), 221–240.
Chemtob, C. M., Novaco, R. W., Hamada, R. S., & Gross, D. M. (1997). Cognitive-behavioral treatment for severe anger in posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 65(1), 184–189.
Cloitre, M., Koenen, K. C., Cohen, L. R., & Han, H. (2002). Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse. Journal of Consulting and Clinical Psychology, 70(5), 1067–1074.
Cloitre, M., Stovall-McClough, K. C., Miranda, R., & Chemtob, C. M. (2004). Therapeutic alliance, negative mood regulation, and treatment outcome in child abuse-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 72(3), 411–416.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.
Cole, P. M., & Putnam, F. W. (1992). Effect of incest on self and social functioning: A developmental psychopathology perspective. Journal of Consulting and Clinical Psychology, 60(2), 174–184.
Conoley, C. W., Padula, M. A., Payton, D. S., & Daniels, J. A. (1994). Predictors of client implementation of counselor recommendations: Match with problem, difficulty level, and building on client strengths. Journal of Counseling Psychology, 41(1), 3–7.
Constantino, M. J., Castonguay, L. G., & Schut, A. J. (2002). The working alliance: A flagship for the “scientist–practitioner” model in psychotherapy. In G. S. Tryon (Ed.), Counseling based on process research: Applying what we know (pp. 81–131). Boston, MA: Allyn & Bacon.
Davison, G. C., Tsujimoto, R. N., & Glaros, A. G. (1973). Attribution and the maintenance of behavior change in falling asleep. Journal of Abnormal Psychology, 82(1), 124–133.
Day, L., & Reznikoff, M. (1980). Preparation of children and parents for treatment at a children’s psychiatric clinic through videotaped modeling. Journal of Consulting and Clinical Psychology, 48(2), 303–304.
Delsignore, A., & Schnyder, U. (2007). Control expectancies as predictors of psychotherapy outcome: A systematic review. British Journal of Clinical Psychology, 46(4), 467–483.
Devilly, G. J., & Borkovec, T. D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavior Therapy and Experimental Psychiatry, 31(2), 73–86.
Dew, S. E., & Bickman, L. (2005). Client expectancies about therapy. Mental Health Services Research, 7(1), 21–33.
Dozois, D. J. A., & Westra, H. A. (2005). Development of the anxiety change expectancy scale (ACES) and validation in college, community, and clinical samples. Behaviour Research and Therapy, 43(12), 1655–1672.
Ehlers, A., Mayou, R. A., & Bryant, B. (1998). Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. Journal of Abnormal Psychology, 107(3), 508–519.
Frank, J. D., & Frank, J. B. (1991). Persuasion and healing: A comparative study of psychotherapy (3rd ed.). Baltimore: Johns Hopkins University Press.
Franklin, M. E., & Foa, E. B. (1998). Cognitive-behavioral treatments for obsessive-compulsive disorder. In P. E. Nathan & J. M. Gorman (Eds.), A guide to treatments that work (pp. 339–357). New York: Oxford University Press.
Freud, S. (1958). On beginning the treatment: Further recommendations on the technique of psychoanalysis. In J. Strachey (Ed. & Trans.), The standard edition of the complete psychological works of Sigmund Freud (pp. 122–144). London: Hogarth Press. (Original work published 1913)
Garfield, S. L. (1994). Research on client variables in psychotherapy. In A. E. Bergin & S. L. Garfield (Eds.) , Handbook of psychotherapy and behavior change (4th ed., pp. 190–228). Oxford: John Wiley & Sons.
Goossens, M. E. J. B., Vlaeyen, J. W. S., Hidding, A., MKole-Snijders, A. M., & Evers, S. M. A. A. (2005). Treatment expectancy affects the outcome of cognitive-behavioral interventions in chronic pain. Clinical Journal of Pain, 21(1), 18–26.
Greenberg, R. P., Constantino, M. J., & Bruce, N. (2006). Are patient expectations still relevant for psychotherapy process and outcome? Clinical Psychology Review, 26(6), 657–678.
Hofmann, S. G., & Smits, J. A. J. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry, 69, 621–632.
Hogue, A., Henderson, C. E., Dauber, S., Barajas, P. C., Fried, A., & Liddle, H. A. (2008). Treatment adherence, competence, and outcome in individual and family therapy for adolescent behavior problems. Journal of Consulting and Clinical Psychology, 76(4), 544–555.
Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36(2), 223–233.
Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology, 38(2), 139–149.
Huppert, J. D., Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2006). The interaction of motivation and therapist adherence predicts outcome in cognitive behavioral therapy for panic disorder: Preliminary findings. Cognitive and Behavioral Practice, 13(3), 198–204.
Jeffrey, D. B. (1974). A comparison of the effects of external control and self-control on the modification and maintenance of weight. Journal of Abnormal Psychology, 83(4), 404–410.
Kazdin, A. E. (1979). Nonspecific treatment factors in psychology outcome research. Journal of Consulting and Clinical Psychology, 47(5), 846–851.
Klein, D. N., Schwartz, J. E., Santiago, N. J., Vivian, D., Vocisano, C., Castonguay, L. G., et al. (2003). Therapeutic alliance in depression treatment: Controlling for prior change and patient characteristics. Journal of Consulting and Clinical Psychology, 71(6), 997–1006.
Lazarus, A. A. (2003). Some reactions to Robert Kohlenberg’s article. The Behavior Therapist, 26(7), 380–381.
Linehan, M. M., Cochran, B. N., Mar, C. M., Levensky, E. R., & Comtios, K. A. (2000). Therapeutic burnout among borderline personality disordered clients and their therapists: Development and evaluation of two adaptations of the Maslach Burnout Inventory. Cognitive and Behavioral Practice, 7(3), 329–337.
Livanou, M., Basoglu, M., Marks, I. M., De Sliva, P., Noshirvani, H., Lovell, K., et al. (2002). Beliefs, sense of control and treatment outcome in post-traumatic stress disorder. Psychological Medicine, 32(1), 157–165.
Loeb, K. L., Wilson, G. T., Labouvie, E., Pratt, E. M., Hayaki, J., Walsh, B. T., et al. (2005). Therapeutic alliance and treatment adherence in two interventions for bulimia nervosa: A study of process and outcome. Journal of Consulting and Clinical Psychology, 73(6), 1097–1107.
Maltby, N., & Tolin, D. F. (2005). A brief motivational intervention for treatment-refusing OCD patients. Cognitive Behaviour Therapy, 34(3), 176–184.
Marmar, C. R., Weiss, D. S., & Gaston, L. (1989). Toward the validation of the California therapeutic alliance rating system. Journal of Consulting and Clinical Psychology, 1(1), 46–52.
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68(3), 438–450.
Miller, W. R. (1983). Motivational interviewing with problem drinkers. Behavioural Psychotherapy, 11, 147–172.
Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people to change addictive behavior. New York: The Guilford Press.
Nock, M. K., & Kazdin, A. E. (2001). Parent expectancies for child therapy: Assessment and relation to participation in treatment. Journal of Child and Family Studies, 10(2), 155–180.
Norcross, J. C. (Ed.). (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. New York: Oxford University Press.
Otto, M. W., & Hofmann, S. G. (Eds.). (2009). Avoiding treatment failures in the anxiety disorders. New York: Springer.
Powers, M. B., Smits, J. A. J., Whitley, D., Bystritsky, A., & Telch, M. J. (2008). The effect of attributional processes concerning medication taking on return of fear. Journal of Consulting and Clinical Psychology, 76(3), 478–490.
Raue, P. J., Goldfried, M. R., & Barkham, M. (1997). The therapeutic alliance in psychodynamic-interpersonal and cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 65(4), 582–587.
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95–103.
Rubak, S., Sandboek, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: A systematic review and meta-analysis. The British Journal of General Practice, 55, 305–311.
Safran, J. D. (1990). Towards a refinement of cognitive therapy in light of interpersonal theory: I. Theory. Clinical Psychology Review, 10(1), 87–105.
Shirk, S. R., & Karver, M. (2003). Prediction of treatment outcome from relationship variables in child and adolescent therapy: A meta-analytic review. Journal of Consulting and Clinical Psychology, 71(3), 452–464.
Shuman, A. L., & Shapiro, J. P. (2002). The effects of preparing parents for child psychotherapy on accuracy of expectations and treatment attendance. Community Mental Health Journal, 38(1), 3–16.
Slagle, D. M., & Gray, M. J. (2007). The utility of motivational interviewing as an adjunct to exposure therapy in the treatment of anxiety disorders. Professional Psychology: Research and Practice, 38(4), 329–337.
Smits, J. A. J., Reese, H. E., Powers, M. B., & Otto, M. W. (2009). Combined treatment strategies: Current efficacy and future directions. In M. W. Otto & S. G. Hofmann (Eds.), Avoiding treatment failures in the anxiety disorders (pp. 67–81). New York: Springer.
Snyder, C. R., Ilardi, S., Michael, S. T., & Cheavens, J. (2000). Hope theory: Updating a common process for psychological change. In C. R. Snyder, & R. E. Ingram (Eds.), Handbook of psychological change: Psychotherapy processes and practices for the 21st century (pp. 128–153). New York: Wiley.
Snyder, C. R., Michael, S., & Cheavens, J. (1999). Hope as a psychotherapeutic foundation of common factors, placebos, and expectancies. In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 179–200). Washington, DC: American Psychological Association.
Sonne, J., & Janoff, D. (1979). The effect of treatment attributions on the maintenance of weight reduction: A replication and extension. Cognitive Therapy and Research, 3(4), 389–397.
Spinhoven, P., Giesen-Bloo, J., van Dyck, R., & Arntz, A. (2007). The therapeutic alliance in schema-focused therapy and transference-focused psychotherapy for borderline personality disorder. Journal of Consulting and Clinical Psychology, 75(1), 104–115.
Spitzer, R. L., Williams, J. B., Gibbon, M., & First, M. B. (1990). User’s guide for the structured clinical interview for DSM-III-R – Personality Disorders (SCID-II). Washington, DC: American Psychiatric Association.
Strauss, J. L., Hayes, A. M., Johnson, S. L., Newman, C. F., Brown, G. K., Barber, J. P., et al. (2006). Early alliance, alliance ruptures, and symptom change in a nonrandomized trial of cognitive therapy for avoidant and obsessive-compulsive personality disorders. Journal of Consulting and Clinical Psychology, 74(2), 337–345.
Tang, T. Z., & DeRubeis, R. J. (1999). Sudden gains and critical sessions in cognitive-behavioral therapy for depression. Journal of Consulting and Clinical Psychology, 67(6), 894–904.
Waltz, J., Addis, M. E., Koerner, K., & Jacobson, N. S. (1993). Testing the integrity of a psychotherapy protocol: Assessment of adherence and competence. Journal of Consulting and Clinical Psychology, 61(4), 620–630.
Westra, H. A., & Dozois, D. J. A. (2006). Preparing clients for cognitive behavioral therapy: A randomized pilot study of motivational interviewing for anxiety. Cognitive Therapy and Research, 30(4), 481–498.
Westra, H. A., Dozois, D. J. A., & Marcus, M. (2007). Expectancy, homework compliance, and initial change in cognitive-behavioral therapy for anxiety. Journal of Consulting and Clinical Psychology, 75(3), 363–373.
Wilkins, W. (1979). Expectancies in therapy research: Discriminating among heterogeneous nonspecifics. Journal of Consulting and Clinical Psychology, 47(5), 837–845.
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(3), 448–451
Woods, C. M., Chambless, D. L., & Steketee, G. (2002). Homework compliance and behavior therapy outcome for panic with agoraphobia and obsessive compulsive disorder. Cognitive Behaviour Therapy, 31(2), 88–95.
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Halperin, D.M., Weitzman, M.L., Otto, M.W. (2010). Therapeutic Alliance and Common Factors in Treatment. In: Otto, M., Hofmann, S. (eds) Avoiding Treatment Failures in the Anxiety Disorders. Series in Anxiety and Related Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0612-0_4
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