Towards a Taxonomy of Common Factors in Psychotherapy—Results of an Expert Survey

Authors

  • Wolfgang Tschacher,

    Corresponding author
    1. Department of Psychotherapy, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
    • Correspondence to: Prof. Dr. Wolfgang Tschacher, Department of Psychotherapy, University Hospital of Psychiatry, University of Bern, Laupenstrasse 49, 3010 Bern, Switzerland.

      E-mail: tschacher@spk.unibe.ch

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  • Ulrich Martin Junghan,

    1. Department of Psychotherapy, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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  • Mario Pfammatter

    1. Department of Psychotherapy, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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Abstract

Background

How change comes about is hotly debated in psychotherapy research. One camp considers 'non-specific' or 'common factors', shared by different therapy approaches, as essential, whereas researchers of the other camp consider specific techniques as the essential ingredients of change. This controversy, however, suffers from unclear terminology and logical inconsistencies. The Taxonomy Project therefore aims at contributing to the definition and conceptualization of common factors of psychotherapy by analyzing their differential associations to standard techniques.

Methods

A review identified 22 common factors discussed in psychotherapy research literature. We conducted a survey, in which 68 psychotherapy experts assessed how common factors are implemented by specific techniques. Using hierarchical linear models, we predicted each common factor by techniques and by experts' age, gender and allegiance to a therapy orientation.

Results

Common factors differed largely in their relevance for technique implementation. Patient engagement, Affective experiencing and Therapeutic alliance were judged most relevant. Common factors also differed with respect to how well they could be explained by the set of techniques. We present detailed profiles of all common factors by the (positively or negatively) associated techniques. There were indications of a biased taxonomy not covering the embodiment of psychotherapy (expressed by body-centred techniques such as progressive muscle relaxation, biofeedback training and hypnosis). Likewise, common factors did not adequately represent effective psychodynamic and systemic techniques.

Conclusion

This taxonomic endeavour is a step towards a clarification of important core constructs of psychotherapy. Copyright © 2012 John Wiley & Sons, Ltd.

Key Practitioner Message

  • This article relates standard techniques of psychotherapy (well known to practising therapists) to the change factors/change mechanisms discussed in psychotherapy theory.
  • It gives a short review of the current debate on the mechanisms by which psychotherapy works.
  • We provide detailed profiles of change mechanisms and how they may be generated by practice techniques.

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