Therapeutic Alliance and Common Factors in Treatment

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). A unified perspective on the role and significance of common factors is made more difficult by the degree to which similar nonspecific factors have been discussed as distinct concepts, with little guidance on the degree of overlap between these concepts. For example, therapeutic alliance, empathy, goal consensus, and therapist-patient collaboration have each been cited as important contributors to therapeutic change (Norcross, 2002), despite the obvious overlap between these concepts. For the organization of this chapter, we will use therapeutic alliance as a central organizing concept for discussing a range of common factors. As such, the focus of this chapter is on those factors distinct from the specific treatment interventions that are most commonly the focus of randomized controlled treatment trials. (PsycINFO Database Record (c) 2019 APA, all rights reserved)