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The Psychological Record

, Volume 55, Issue 3, pp 377–399 | Cite as

The Common Factors, Empirically Validated Treatments, and Recovery Models of Therapeutic Change

  • Andrew D. ReisnerEmail author
Article

Abstract

I review the Common Factors Model, the Empirically Validated Therapy Model, and the Recovery Model of therapeutic change and effectiveness. In general, psychotherapy appears to be effective and common factors account for more of the variance than do specific techniques. However, in some areas, particularly in the treatment of anxiety disorders, behavioral and cognitive behavioral therapies may be more effective than other treatments. The Recovery Model is an overarching model of change which can incorporate empirically validated therapies and which makes use of common factors. This model is consistent with empirically supported concepts concerning improvement of mental health but needs further research.

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References

  1. ACKERMAN, S. J., & HILSENROTH, M. J. (2001). A review of therapist characteristics and techniques negatively impacting the therapeutic alliance. Psychotherapy, 38(2), 171–185.CrossRefGoogle Scholar
  2. ACKERMAN, S. J., & HILSENROTH, M. J. (2003). A review of therapist characteristics and techniques positively impacting the therapeutic alliance. Clinical Psychology Review, 23(1), 1–33.CrossRefPubMedGoogle Scholar
  3. ANTHONY, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990’s. Psychosocial Rehabilitation Journal, 16(4), 11–24.CrossRefGoogle Scholar
  4. ARONSON, D. (2002, October). Therapies for schizophrenia. Conference on evidence supported behavioral practices. Ohio Department of Mental Health Behavior Therapy Committee. Columbus, Oh.Google Scholar
  5. ASAY, T. P., & LAMBERT, M. J. (1999). The empirical case for the common factors in therapy. In M. A. Hubble, B. L. Duncan, & S. D. MILLER (Eds.), The heart and soul of change: What works in therapy (pp. 23–55). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  6. BANDURA, A. (1989). Human agency in social cognitive theory. American Psychologist, 44(9), 1175–1184.CrossRefGoogle Scholar
  7. BARLOW, D. (1996). Health care policy, psychotherapy research, and the future of psychotherapy. American Psychologist, 51(10), 1050–1058.CrossRefPubMedGoogle Scholar
  8. BARLOW, D. H., CRASKE, M. G., CERNY, J. A., & KLOSKO, J. S. (1989). Behavioral treatment of panic disorder. Behavior Therapy, 20, 261–282.CrossRefGoogle Scholar
  9. BEUTLER, L. E. (2000). David and Goliath: When empirical and clinical standards of practice meet. American Psychologist, 55(9), 997–1007.CrossRefPubMedGoogle Scholar
  10. BOISVERT, C. M., & FAUST, D. (2003). Leading researchers’ consensus on psychotherapy findings: Implications for the teaching and conduct of psychotherapy. Professional Psychology: Research and Practice, 34(5), 508–513.CrossRefGoogle Scholar
  11. BROM, D., KLEBER, R. J., & DEFARES, P. B. (1989). Brief psychotherapy for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 57(5), 607–612.CrossRefPubMedGoogle Scholar
  12. CARROLL, L. (1865/1993). Alice’s Adventures in Wonderland. Mineola, NY: Dover.Google Scholar
  13. CASTONGUAY, L., GOLDFRIED, M. R., WISER, S., RAUE, P. J., & HAYES, A. M. (1996). Predicting the effect of cognitive therapy for depression: A study of unique and common factors. Journal of Consulting and Clinical Psychology, 64(3), 497–504.CrossRefGoogle Scholar
  14. CHAMBLESS, D. L. (1996). Identification of empirically supported psychological interventions. Clinical Research Digest-Supplemental Bulletin, 14(6), 1–2.Google Scholar
  15. CHAMBLESS, D. L. (2002). Beware the dodo bird: The dangers of overgeneralization. Clinical Psychology: Science and Practice, 9(1), 13–16.Google Scholar
  16. CHAMBLESS, D. L., BAKER, M. J., BAUCOM, D. H., BEUTLER, L. E., CALHOUN, K. S., CRITS-CHRISTOPH, R., et al. (1998). Update on empirically validated therapies, II. The Clinical Psychologist, 51, 3–16.Google Scholar
  17. CRITELLI, J. W., & NEUMANN, K. F. (1984). The placebo: Conceptual analysis of a construct in transition. American Psychologist, 39(1), 32–39.CrossRefPubMedGoogle Scholar
  18. CRITS-CHRISTOPH, P. (1992). The efficacy of brief dynamic psychotherapy: A meta-analysis. The American Journal of Psychiatry, 149(2), 151–158.CrossRefPubMedGoogle Scholar
  19. DERUBEIS, R. J., & CRITS-CHRISTOPH, P. (1998). Empirically supported individual and group psychological treatments for adult mental disorders. Journal of Clinical Psychology, 66(1), 37–52.Google Scholar
  20. ELKIN, I., SHEA, M. T., WATKINS, J. T., IMBER, S. D., STOTSKY, S. M., COLLINS, J. F., et al. (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program: General effectiveness of treatments. Archives of General Psychiatry, 46, 971–982.CrossRefPubMedGoogle Scholar
  21. EYSENCK, H. J. (1952). The effects of psychotherapy: An evaluation. Journal of Consulting Psychology, 16, 319–324.CrossRefPubMedGoogle Scholar
  22. FOA, E. B., & MEADOWS, E. A. (1997). Psychosocial treatments for posttraumatic stress disorder: A critical review. Annual Review of Psychology, 48, 449–80.CrossRefPubMedGoogle Scholar
  23. FOA, E. B., ZOELLNER, L. A., FEENY, N. C., HEMBREE, E. A., & ALVAREZ-CONRAD, J. (2002). Does imaginai exposure exacerbate Ptsd symptoms? Journal of Consulting and Clinical Psychology, 70(4), 1022–1028.CrossRefGoogle Scholar
  24. FRANK, J. D. (1974). Persuasion and healing (Rev. ed.). New York: Shocken.Google Scholar
  25. FRANK, J. D. (1995). Psychotherapy as rhetoric: Some implications. Clinical Psychology: Science and Practice, 2(1), 90–93.Google Scholar
  26. FRESE, F. J., III, & DAVIS, W. W. (1997). The consumer-survivor movement, recovery, and consumer professionals. Professional Psychology: Research and Practice, 28(3), 243–245.CrossRefGoogle Scholar
  27. FRESE, F. J., III, STANLEY, J., KRESS, K., & VOGEL-SCIBILIA, S. (2001). Integrating evidence based practices and the Recovery Model. Psychiatric Services, 52(11), 1462–1468.CrossRefPubMedGoogle Scholar
  28. GASTON, L. (2003, December). Integrating Treatments for Ptsd. Workshop conducted in Akron, Oh.Google Scholar
  29. GINGERICH, S. L., & BELLACK, A. S. (1995). Research based family interventions for the treatment of schizophrenia. The Clinical Psychologist, 48(1), 24–27.Google Scholar
  30. HAGESFELD, T. (2002, October). Cognitive-behavior therapy for schizophrenia. Conference on evidence supported behavioral practices. Ohio Department of Mental Health Behavior Therapy Committee. Columbus, Oh.Google Scholar
  31. HENRY, W. P., STRUPP, H. H., BUTLER, S. F., SCHACHT, T. E., & BINDER, J. L. (1993). Effects of training in time-limited dynamic psychotherapy: Changes in therapist behavior. Journal of Consulting and Clinical Psychology, 61(3), 434–440.CrossRefPubMedGoogle Scholar
  32. HOGARTY, G. E. (2002). Personal therapy for schizophrenia and related disorders: A guide to individualized treatment. New York: Guilford.Google Scholar
  33. HUBBLE, M. A., DUNCAN, B. L., & MILLER, S. D. (1999). Introduction. In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 1–19). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  34. Institute Of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Institute of Medicine: Washington, DC.Google Scholar
  35. IRONSON, G., FREUND, B., STRAUSS, J. L., & WILLIAMS, J. (2002). Comparison of two treatments for traumatic stress: A community-based study of Emdr and prolonged exposure. Journal of Clinical Psychology, 58(1), 113–128.CrossRefPubMedGoogle Scholar
  36. JACOBSON, N., & GREENLEY, D. (2001). What is recovery? A conceptual model and explication. Psychiatric Services, 52(4), 482–485.CrossRefPubMedGoogle Scholar
  37. JONES, E. E., CUMMING, J. D., & HOROWITZ, M. J. (1988). Another look at the nonspecific hypothesis of therapeutic effectiveness. Journal of Consulting and Clinical Psychology, 56(1), 48–55.CrossRefPubMedGoogle Scholar
  38. JUDGE, T. A., EREZ, A., BONO, J. E., THORESEN, C. J. (2002). Are measures of self-esteem, neuroticism, locus of control, and generalized self-efficacy indicators of a common core construct? Journal of Personality and Social Psychology, 83(3), 693–710.CrossRefPubMedGoogle Scholar
  39. KARON, B. P., & VANDENBOS, G. R. (1970). Experience, medication, and the effectiveness of psychotherapy with schizophrenics. British Journal of Psychiatry, 116, 427–428.CrossRefPubMedGoogle Scholar
  40. KARON, B. P., & VANDENBOS, G. R. (1972). The consequences of psychotherapy for schizophrenic patients. Psychotherapy: Theory, Research and Practice, 9(2), 111–119.CrossRefGoogle Scholar
  41. KARON, B. P., & VANDENBOS, G. R. (1981). Psychotherapy of schizophrenia: The treatment of choice. Northvale, NJ: Jason Aronson.Google Scholar
  42. KENNEDY, J. (2002, October). Therapies for anxiety disorders. Conference on evidence supported behavioral practices. Ohio Department of Mental Health Behavior Therapy Committee. Columbus, Oh.Google Scholar
  43. KOERNER, K., & LINEHAN, M. M. (2000). Research on dialectical behavior therapy for patients with borderline personality disorder. The Psychiatric Clinics of North America, 23(1), 151–167.CrossRefPubMedGoogle Scholar
  44. LAMBERT, M. J. (1998). Manual-based treatment and clinical practice: Hangman of life or promising development. Clinical Psychology: Science and Practice, 5(3), 391–395.Google Scholar
  45. LAMBERT, M. J., & BARLEY, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38(4), 357–361.CrossRefGoogle Scholar
  46. LAMBERT, M. J., & BERGIN, A. E. (1994). The effectiveness of psychotherapy. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 143–198). New York: Wiley.Google Scholar
  47. LEICHSENRING, R., & LEIBING, E. (2003). The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: A meta-analysis. American Journal of Psychiatry, 160(7), 1223–1232.CrossRefPubMedGoogle Scholar
  48. LEVANT, R. F. (2003, October). The empirically-validated treatments movement: A practical perspective. The Ohio Psychologist-Update, Issue 2, 2–4.Google Scholar
  49. LINEHAN, M. M. (1993). Cognitive-behavioral treatment of borderline personality Disorder. New York: Guilford.Google Scholar
  50. LINEHAN, M. M., ARMSTRONG, H. E., SUAREZ, A., ALLMON, D., & HEARD, H. L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064.CrossRefPubMedGoogle Scholar
  51. LOHR, J. M., FOWLER, K. A., & LILIENFELD, S. O. (2002). Dissemination and promotion of pseudoscience in clinical psychology: The challenge to legitimate clinical science. The Clinical Psychologist, 55(3), 4–10.Google Scholar
  52. LUBORSKY, L. (1995). Are common factors across different psychotherapies the main explanation for the dodo bird verdict that “Everyone has won and all must have prizes”? Clinical Psychology: Science and Practice, 2(1), 106–109.Google Scholar
  53. LUBORSKY, L., CRITS-CHRISTOPH, P., MCLELLAN, A. T., WOODY, G., PIPER, W., LIBERMAN, B., et al. (1986). Do therapists vary much in their success? Findings from four outcome studies. American Journal of Orthopsychiatry, 56(4), 501–512.CrossRefPubMedGoogle Scholar
  54. LUBORSKY, L., DIGUER, L., SELIGMAN, D. A., ROSENTHAL, R., KRAUSE, E.D., JOHNSON, S., et al. (1999). The researcher’s own therapy allegiances: A “wild card” in comparisons of treatment efficacy. Clinical Psychology: Science and Practice, 6(1), 95–106.Google Scholar
  55. LUBORSKY, L., MCLELLAN, A. T., DIGUER, L., WOODY, G., & SELIGMAN, D. A. (1997). The psychotherapist matters: Comparison of outcome across twenty-two therapists and seven patient samples. Clinical Psychology: Science and Practice, 4(1), 53–65.Google Scholar
  56. LUBORSKY, L., MCLELLAN, A. T., WOODY, G. E., O’BRIEN, C. P., & AURBACH, A. (1985). Therapist success and its determinants. Archives of General Psychiatry, 42, 602–611.CrossRefPubMedGoogle Scholar
  57. LUBORSKY, L., SINGER, B., & LUBORSKY, L. (1975). Comparative studies of psychotherapies: Is it true that “Everyone has won and all must have prizes”? Archives of General Psychiatry, 32(8), 995–1008.CrossRefPubMedGoogle Scholar
  58. MAY, P. R. A., & TUMA, A. H. (1970). Methodological problems in psychotherapy research: Observations on the Karon-VandenBos study of psychotherapy and drugs in schizophrenia. British Journal of Psychiatry, 117, 569–570.CrossRefPubMedGoogle Scholar
  59. MESSER, S. B., & WAMPOLD, B. E. (2002). Let’s face the facts: Common factors are more potent than specific therapy ingredients. Clinical Psychology: Science and Practice, 9(1), 21–25.Google Scholar
  60. MOHR, D. O. (1995). Negative outcome in psychotherapy: A critical review. Clinical Psychology: Science and Practice, 2(1), 1–27.Google Scholar
  61. MUNETZ, M. R., & FRESE, F. J. (2001). Getting ready for recovery: Reconciling mandatory treatment with the recovery vision. Psychiatric Rehabilitation Journal, 25(1), 35–42.CrossRefPubMedGoogle Scholar
  62. MUNETZ, M. R., GALON, P. A., & FRESE, F. J., III. (2003). The ethics of mandatory community treatment. Journal of the American Academy of Psychiatry and Law, 31, 173–183.Google Scholar
  63. NAJAVITS, L. M., & STRUPP, H. H. (1994). Differences in the effectiveness of psychodynamic therapies: A process-outcome study. Psychotherapy, 31(1), 114–123.CrossRefGoogle Scholar
  64. New Freedom Commission On Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final Report. Dhhs Pub. No. Sma-03-3832. Rockville, Md.Google Scholar
  65. NORCROSS, J. C. (2001). Purposes, processes, and products of the task force on empirically supported therapy relationships. Psychotherapy, 38(4), 345–356.CrossRefGoogle Scholar
  66. ODMH (2002). Recovery process model. Retrieved July 21, 2003, from http://www.mh.state.oh.us/offices/oper/recovmodel.html.Google Scholar
  67. OGLES, B. M., ANDERSON, T., & LUNNEN, K. M. (1999). The contribution of models and techniques to therapeutic efficacy. In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 201–225). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  68. ORWELL, G. (1946). Animal farm. New York: Signet Classic, Penguin Putnam.Google Scholar
  69. ÖST, L. G. (1989). One-session treatment for simple phobias. Behaviour Research and Therapy, 27(1), 1–7.CrossRefPubMedGoogle Scholar
  70. PARLOFF, M. B. (1986). Frank’s “common elements” in psychotherapy: Nonspecific factors and placebos. American Journal of Orthopsychiatry, 56(4), 521–530.CrossRefPubMedGoogle Scholar
  71. PERKINS, B. R., & ROUANZOIN, C. C. (2002). A critical evaluation of current views regarding eye movement desensitization and reprocessing (Edmr): Clarifying points of confusion. Journal of Clinical Psychology, 58(1), 77–97.CrossRefPubMedGoogle Scholar
  72. PEYSER, H. (2001). What is recovery? A commentary. Psychiatric Services, 52(4), 486–487.CrossRefPubMedGoogle Scholar
  73. PITMAN, R. K., ALXMAN, B., GREENWALD, E., LONGPRE, R., MACKLIN, M. L., POIRÉ, R. E., et al. (1991). Psychiatrie complications during flooding therapy for post traumatic stress disorder. Journal of Clinical Psychology, 52(1), 17–20.Google Scholar
  74. PITMAN, R. K., ORR, S. P., ALTMAN, B., LONGPRE, R. E., POIRÉ, R. E., & MACKLIN, M. L. (1996). Emotional processing during eye-movement desensitization and reprocessing therapy of Vietnam veterans with chronic post-traumatic stress disorder. Comprehensive Psychiatry, 37, 419–429.CrossRefPubMedGoogle Scholar
  75. PROCHASKA, J. O., DICLEMENTE, C. O., & NORCROSS, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47(9), 1102–1114.CrossRefPubMedGoogle Scholar
  76. RECTOR, N. A., & BECK, A. T. (2001). Cognitive behavioral therapy for schizophrenia: An empirical review. Journal of Nervous and Mental Disease, 189(5), 278–287.CrossRefPubMedGoogle Scholar
  77. ROSENZWEIG, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry, 6, 412–415.CrossRefGoogle Scholar
  78. ROUNSAVILLE, B. J., O’MALLEY, S., FOLEY, S., & WEISSMAN, M. M. (1988). Role of manual-guided training: The conduct and efficacy of interpersonal psychotherapy for depression. Journal of Consulting and Clinical Psychology, 56(5), 681–688.CrossRefPubMedGoogle Scholar
  79. SCHEEL, K. R. (2000). The empirical basis of dialectical behavior therapy: Summary, critique, and implications. Clinical Psychology: Science and Practice, 7(1), 68–83.Google Scholar
  80. SCOVERN, A. (1999). From placebo to alliance: The role of common factors in medicine. In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 259–295). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  81. SELIGMAN, M. E. P. (1995). The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist, 50(12), 965–974.CrossRefPubMedGoogle Scholar
  82. SELIGMAN, M. E. P., & LEVANT, R. F. (1998). Managed care policies rely on inadequate science. Professional Psychology: Research and Practice, 29(3), 211–212.CrossRefGoogle Scholar
  83. SENSKY, T., TURKINGTON, D., KINGDON, D., SCOTT, J. L., SCOTT, J., SIDDLE, R., et al. (2000). A randomized controlled trial of cognitive-behavioral therapy for persistent symptoms in schizophrenia resistant to medication. Archives of General Psychiatry, 57, 165–172.CrossRefPubMedGoogle Scholar
  84. SILVERMAN, W. (1996). Cookbooks, manuals, and paint-by-numbers: Psychotherapy in the 90’s. Psychotherapy, 33(2), 207–215.CrossRefGoogle Scholar
  85. SLOANE, R. B., STAPLES, F. R., CRISTOL, A. H., YORKSTON, N. J., & WHIPPLE, K. (1975). Short-term analytically oriented psychotherapy versus behavior therapy. American Journal of Psychiatry, 132(4), 373–377.CrossRefPubMedGoogle Scholar
  86. SMITH, M. L., GLASS, G. V., & MILLER, T. I. (1980). The benefits of psychotherapy. Baltimore: Johns Hopkins Press.Google Scholar
  87. SOLOMON, S. D., GERRITY, E. T., & MUFF, A. M. (1992). Efficacy of treatments for post traumatic stress disorder: An empirical review. Journal of the American Medical Association, 268(5), 633–638.CrossRefPubMedGoogle Scholar
  88. STRUPP, H. H., & ANDERSON, T. (1997). On the limitations of therapy manuals. Clinical Psychology: Science and Practice, 4(1), 76–82.Google Scholar
  89. Task Force On Promotion And Dissemination Of Psychological Procedures. Division of Clinical Psychology, American Psychological Association. (1995). Training in and dissemination of empirically validated psychological treatments: Report and recommendations. The Clinical Psychologist, 48(1), 3–23.Google Scholar
  90. TOWNSEND, W., BOYD, S., GRIFFIN, G., HICKS, P. L., HOGAN, M. F., & MARTIN, S. L. (2000). Emerging best practices in mental health recovery. (Available from the Ohio Department of Mental Health, 30 East Broad Street, Columbus, Oh 43215-3430)Google Scholar
  91. TUMA, A. H., & MAY, P. R. A. (1975). Psychotherapy, drugs and therapist experience in the treatment of schizophrenia: A critique of the Michigan State project. Psychotherapy: Theory, Research and Practice, 12(2), 138–142.CrossRefGoogle Scholar
  92. VAN ETTEN, M. L., & TAYLOR, S. (1998). Comparative efficacy of treatments for post traumatic stress disorder: A meta-analysis. Clinical Psychology and Psychotherapy, 5, 126–144.CrossRefGoogle Scholar
  93. WAMPOLD, B. E., MONDIN, G. W., MOODY, M., STICH, F., BENSON, K., & AHN, H. (1997). A meta-analysis of outcome studies comparing bona fide psychotherapies: Empirically, “All must have prizes.” Psychological Bulletin, 122(3), 203–215.CrossRefGoogle Scholar
  94. WEINBERGER, J. (1995). Common factors aren’t so common: The common factors dilemma. Clinical Psychology: Science and Practice, 2(1), 45–69.Google Scholar
  95. WESTEN, D., & MORRISON, K. (2001). A multidimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: An empirical examination of the status of empirically supported therapies. Journal of Consulting and Clinical Psychology, 69(6), 875–899.CrossRefPubMedGoogle Scholar
  96. WILSON, T. G. (1998). Manual-based treatment and clinical practice. Clinical Psychology: Science and Practice, 5(3), 363–375.Google Scholar

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© Association of Behavior Analysis International 2005

Authors and Affiliations

  1. 1.Appalachian Behavioral Healthcare: Cambridge CampusCambridge Psychiatric HospitalCambridgeUSA

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