Common Factors of Psychotherapy

COMMON FACTORS OF PSYCHOTHERAPY

Is the Dodo Bird alive or extinct?

Come talk with me!

Joel Thomas: [email protected] Office hours: 2-3pm Tu/Th, Espresso Royale

Café Travel, soccer, tennis, bass guitar Master’s in Counseling from UW-Madison,

Counseling-Psychology Department Interpersonal/Common Factors Training Research Interests:

how and why psychotherapy works how psychotherapy compares with other cultural healing

practices PhD student in Clinical/Community Psychology,

UIUC Letting the path unfold!

Reflection Exercise

Peter is a single, 35-year-old Native American man who resides in an urban environment. Since graduating college with a degree in computer science, Peter has worked as an entry-level programmer, but he feels he is denied career opportunities because of racism and discrimination. Peter's job performance begins to deteriorate, and he experiences increasing feelings of depression. He begins to drink to numb feelings of worthlessness and extreme loneliness.

 Who would you recommend Peter see and why?A. PsychiatristB. Traditional healer from the Native communityC. Primary care doctorD. A good friend you know who has gone through a similar

experienceE. A counselor with whom you are familiar and who you trust

Objectives for Today

Explain findings of Consumer Reports Study (Seligman)

Describe the Dodo Bird Effect

Link the Dodo Bird Effect to the importance of common factors in psychotherapy (Wampold)

Define and describe the 4 commonalities of healing practices in different cultures

Seligman…

M. E. P. Seligman, Consumer Reports Study (1995)

Methodology 180,000 readers

received issue, 7000 filled out survey, 3000 saw mental health professionals

Educated, middle-class, 50% female, median age = 46

Outcome measures: Specific improvement Satisfaction Global Improvement

Consumer Reports Study (Findings) Psychotherapy led to

improvement for 90%

Psychiatrists, psychologists, social workers equally effective

Longer treatment led to better outcomes

Limitations on insurance led to worse outcomes

Consumer Reports Study (Findings) People who felt worst before treatment

reported the most improvement No difference between different types of

therapies No difference between psychotherapy alone

and psychotherapy with meds Active shoppers and active clients did

better Conclusion: Psychotherapy Works! Critique: non-random, self-report, no

control groups, cognitive dissonance

Dodo Bird effect

"Everybody has won, and all must have prizes."

Chapter 3 of Lewis Carroll's Alice's Adventures in Wonderland

Dodo bird effect (graphical form)(Wampold, 2001)

(NO significant differences among psychotherapies)

(significant differences among psychotherapies)

If the Dodo lives: why does psychotherapy work? (Wampold, 2001)

Common Factors of Psychotherapy(Examples) (Tracey, 2003)

Relationship Factors Client forms an alliance with therapist Client receives warmth and positive regard Client is a partner in therapeutic interaction

Learning Factors Client is provided with information and education Client’s emotional and interpersonal learning is

enhanced Client receives feedback in order to gain a more

realistic perspective Action Factors

Client is persuaded to change Client experiences tension reduction Client experiences therapeutic techniques and

rituals

Common Factors (Continued) Therapist factors that DON’T matter

Demographics unrelated to outcomes (but important to clients)

Therapist’s modality (theoretical orientation) Therapist’s specific degree (PhD vs PsyD vs MSW)

Therapist factors that DO matter Expertise in specific presenting problem Acknowledgement of limitations Commitment to self improvement and staying

current Experience

Client factors that DO matter Motivation, degree of distress, > IQ, willingness to

see problems as psychological, optimism about therapy

Commonalities of Healing Practices Across Cultures (Frank & Frank, 1991)

Healer: An individual who is culturally sanctioned as a healer and possesses expertise Ex: psychologist, acupuncturist, shaman

Healing Setting: A context in which the healing art is practiced Ex: office, home, religious location

Ritual: A set of procedures that is necessary for the healing process Ex: talk, physical manipulation of the body,

performance Myth: A rationale for the treatment that is

consistent with the ritual Ex: psychodynamic, physiologic, spiritual

explanation