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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ACKERMAN, S. J., & HILSENROTH, M. J. (2001). A review of therapist characteristics and techniques negatively impacting the therapeutic alliance. Psychotherapy, 38(2), 171–185.
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.
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.
ARONSON, D. (2002, October). Therapies for schizophrenia. Conference on evidence supported behavioral practices. Ohio Department of Mental Health Behavior Therapy Committee. Columbus, Oh.
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.
BANDURA, A. (1989). Human agency in social cognitive theory. American Psychologist, 44(9), 1175–1184.
BARLOW, D. (1996). Health care policy, psychotherapy research, and the future of psychotherapy. American Psychologist, 51(10), 1050–1058.
BARLOW, D. H., CRASKE, M. G., CERNY, J. A., & KLOSKO, J. S. (1989). Behavioral treatment of panic disorder. Behavior Therapy, 20, 261–282.
BEUTLER, L. E. (2000). David and Goliath: When empirical and clinical standards of practice meet. American Psychologist, 55(9), 997–1007.
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.
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.
CARROLL, L. (1865/1993). Alice’s Adventures in Wonderland. Mineola, NY: Dover.
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.
CHAMBLESS, D. L. (1996). Identification of empirically supported psychological interventions. Clinical Research Digest-Supplemental Bulletin, 14(6), 1–2.
CHAMBLESS, D. L. (2002). Beware the dodo bird: The dangers of overgeneralization. Clinical Psychology: Science and Practice, 9(1), 13–16.
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.
CRITELLI, J. W., & NEUMANN, K. F. (1984). The placebo: Conceptual analysis of a construct in transition. American Psychologist, 39(1), 32–39.
CRITS-CHRISTOPH, P. (1992). The efficacy of brief dynamic psychotherapy: A meta-analysis. The American Journal of Psychiatry, 149(2), 151–158.
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.
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.
EYSENCK, H. J. (1952). The effects of psychotherapy: An evaluation. Journal of Consulting Psychology, 16, 319–324.
FOA, E. B., & MEADOWS, E. A. (1997). Psychosocial treatments for posttraumatic stress disorder: A critical review. Annual Review of Psychology, 48, 449–80.
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.
FRANK, J. D. (1974). Persuasion and healing (Rev. ed.). New York: Shocken.
FRANK, J. D. (1995). Psychotherapy as rhetoric: Some implications. Clinical Psychology: Science and Practice, 2(1), 90–93.
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.
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.
GASTON, L. (2003, December). Integrating Treatments for Ptsd. Workshop conducted in Akron, Oh.
GINGERICH, S. L., & BELLACK, A. S. (1995). Research based family interventions for the treatment of schizophrenia. The Clinical Psychologist, 48(1), 24–27.
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.
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.
HOGARTY, G. E. (2002). Personal therapy for schizophrenia and related disorders: A guide to individualized treatment. New York: Guilford.
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.
Institute Of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Institute of Medicine: Washington, DC.
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.
JACOBSON, N., & GREENLEY, D. (2001). What is recovery? A conceptual model and explication. Psychiatric Services, 52(4), 482–485.
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.
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.
KARON, B. P., & VANDENBOS, G. R. (1970). Experience, medication, and the effectiveness of psychotherapy with schizophrenics. British Journal of Psychiatry, 116, 427–428.
KARON, B. P., & VANDENBOS, G. R. (1972). The consequences of psychotherapy for schizophrenic patients. Psychotherapy: Theory, Research and Practice, 9(2), 111–119.
KARON, B. P., & VANDENBOS, G. R. (1981). Psychotherapy of schizophrenia: The treatment of choice. Northvale, NJ: Jason Aronson.
KENNEDY, J. (2002, October). Therapies for anxiety disorders. Conference on evidence supported behavioral practices. Ohio Department of Mental Health Behavior Therapy Committee. Columbus, Oh.
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.
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.
LAMBERT, M. J., & BARLEY, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38(4), 357–361.
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.
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.
LEVANT, R. F. (2003, October). The empirically-validated treatments movement: A practical perspective. The Ohio Psychologist-Update, Issue 2, 2–4.
LINEHAN, M. M. (1993). Cognitive-behavioral treatment of borderline personality Disorder. New York: Guilford.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
MOHR, D. O. (1995). Negative outcome in psychotherapy: A critical review. Clinical Psychology: Science and Practice, 2(1), 1–27.
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.
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.
NAJAVITS, L. M., & STRUPP, H. H. (1994). Differences in the effectiveness of psychodynamic therapies: A process-outcome study. Psychotherapy, 31(1), 114–123.
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.
NORCROSS, J. C. (2001). Purposes, processes, and products of the task force on empirically supported therapy relationships. Psychotherapy, 38(4), 345–356.
ODMH (2002). Recovery process model. Retrieved July 21, 2003, from http://www.mh.state.oh.us/offices/oper/recovmodel.html.
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.
ORWELL, G. (1946). Animal farm. New York: Signet Classic, Penguin Putnam.
ÖST, L. G. (1989). One-session treatment for simple phobias. Behaviour Research and Therapy, 27(1), 1–7.
PARLOFF, M. B. (1986). Frank’s “common elements” in psychotherapy: Nonspecific factors and placebos. American Journal of Orthopsychiatry, 56(4), 521–530.
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.
PEYSER, H. (2001). What is recovery? A commentary. Psychiatric Services, 52(4), 486–487.
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.
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.
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.
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.
ROSENZWEIG, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry, 6, 412–415.
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.
SCHEEL, K. R. (2000). The empirical basis of dialectical behavior therapy: Summary, critique, and implications. Clinical Psychology: Science and Practice, 7(1), 68–83.
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.
SELIGMAN, M. E. P. (1995). The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist, 50(12), 965–974.
SELIGMAN, M. E. P., & LEVANT, R. F. (1998). Managed care policies rely on inadequate science. Professional Psychology: Research and Practice, 29(3), 211–212.
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.
SILVERMAN, W. (1996). Cookbooks, manuals, and paint-by-numbers: Psychotherapy in the 90’s. Psychotherapy, 33(2), 207–215.
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.
SMITH, M. L., GLASS, G. V., & MILLER, T. I. (1980). The benefits of psychotherapy. Baltimore: Johns Hopkins Press.
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.
STRUPP, H. H., & ANDERSON, T. (1997). On the limitations of therapy manuals. Clinical Psychology: Science and Practice, 4(1), 76–82.
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.
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)
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.
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.
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.
WEINBERGER, J. (1995). Common factors aren’t so common: The common factors dilemma. Clinical Psychology: Science and Practice, 2(1), 45–69.
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.
WILSON, T. G. (1998). Manual-based treatment and clinical practice. Clinical Psychology: Science and Practice, 5(3), 363–375.
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Reisner, A.D. The Common Factors, Empirically Validated Treatments, and Recovery Models of Therapeutic Change. Psychol Rec 55, 377–399 (2005). https://doi.org/10.1007/BF03395517
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DOI: https://doi.org/10.1007/BF03395517
