common factors in couple and family therapy pdf

Common Factors In Couple And Family Therapy Pdf

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Common factors theory , a theory guiding some research in clinical psychology and counseling psychology , proposes that different approaches and evidence-based practices in psychotherapy and counseling share common factors that account for much of the effectiveness of a psychological treatment. Saul Rosenzweig started the conversation on common factors in an article published in that discussed some psychotherapies of his time.

View larger. Sprenkle , Sean D. Davis , and Jay L. Hardcover August 10, Paperback November 25,

Common factors theory

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Download PDF. A short summary of this paper. Sprenkle Sean D. Davis Jay L. Two Paradigms What is responsible for therapeutic change? Science offers many examples of misguided assumptions about causality. Until the early s, the majority of physicians as well as lay people believed peptic ulcers were caused by worry, stress, and personality variables or by excessive coffee drinking or spicy foods. When I D. I was encouraged to eat a lot of spinach since it was high in vitamins A and C. I was discouraged from eating blueberries since they had few vitamins and therefore did not contain the essential ingredients that caused good health.

Now we know that phytochemicals make a much greater contribution to wellness and that some foods like blueberries, with relatively few vitamins, are loaded with phytochemicals that powerfully promote health. In this instance, while vitamins contribute to good health, they turned out to be not as central as science had previously assumed. This book challenges the commonly held assumption that what causes change in psychotherapy is primarily the unique ingredients in therapy models and techniques.

While, like vitamins, these ingre- dients are typically beneficial and we hold them in high regard, we nonetheless challenge their centrality in the process of change. For the answer surely guides what we do in the consulting room, determines how we view or explain what we do, and should be the focus of what we investigate. Our answer to this question differs from how we the three authors of this book were trained and goes against the grain of most of the most powerful forces in the psychotherapy establishment.

This book sets forth an emerging paradigm common-factors-driven change of why therapy works, with a special emphasis on how this paradigm plays out in couple and family therapy. In brief, this para- digm suggests that psychotherapy works predominantly not because of the unique contributions of any particular model of therapy or unique set of interventions what we call the model-driven change paradigm but rather because of a set of common factors or mecha- nisms of change that cuts across all effective therapies.

We further believe that this emerging view has powerful implications for thera- pists, supervisors, and trainers, and that mastering this approach will improve your results. These groups largely remain committed to the model- driven paradigm. The three authors of this book are all practicing therapists with a special emphasis in couple and family therapy.

Although we also teach and do research at universities, we see individuals, couples, and families on a daily basis and have the hearts of clinicians. Because we work in the trenches, we will endeavor to speak to practitioners as the primary audience for this book. We came to believe in this emerging paradigm because we thought the evidence for it is more compelling than for the earlier paradigm.

Wherever possible, then, we do not expect you simply to take our word for these ideas but instead offer data that we think support the emerging paradigm.

In sum, this book is written for practitioners and students who are open to being theoretically and research-informed. Two Paradigms of Therapeutic Change If you ask most psychotherapists why change occurs, they would explain the process primarily in terms of their preferred model of change.

A narrative therapist might say that change occurs when therapists encourage clients to reauthor their lives from disempow- ering, subjugated life stories to self-narratives that are empowering and self-efficacious.

Common factors that cut across all successful therapies might be mentioned and might even be valued considered necessary , but they would not likely be considered the major reasons that change occurs. Instead, the emphasis would be on the unique contribution of the model.

If you had asked all three of us the same question 10—15 years ago, we probably would have probably answered it in terms of the earlier paradigm.

For me D. Remember that a paradigm is a large interpre- tive framework that shapes how we see things, and until and unless we undergo a paradigm shift, it is almost impossible for us to view things differently.

Couple and family therapy, of course, is not unique in its fascina- tion with models. At least different models of psychotherapy have been documented as model developers have continued the unending quest to answer the question that opened this chapter. Some of the major factors that distinguish the two paradigms— old and new—are depicted in Figure 1. In the explanations that follow the figure, we make clear that the two paradigms are not polar opposites but rather represent matters of emphasis that probably exist along a continuum.

We also believe that there is some merit to the model-driven change paradigm. More details of the two paradigms will be supplied in later chapters. In keeping with our thesis that the two paradigms are not Model-driven change Common-factors-driven change Primary Explanation for Change Emphasizes the unique elements Emphasizes the common mechanisms and mechanisms of change within of change that cut across all effective each model. Guiding Metaphor Medical: considers treatment as Contextual: believes such qualities analogous to medical procedures as credibility, alliance, and allegiance and drugs.

Place in the Culture Most funded research e. Two paradigms of therapeutic change. However, pro- ponents of our favored paradigm see models less as unique sources of change than the vehicles through which common factors operate. Therapists need models to give their work coherence and direction, but this paradigm values them more for their capacity to activate com- mon mechanisms of change found in all successful psychotherapies.

The older model uses a medical lens through which to view psy- chotherapy—hardly surprising, given that the earliest psychothera- pists were physicians. We will never understate the importance of this hard-fought knowledge gained through clinical trials research. However, it is one thing to say that we know that psychotherapy is effective but quite another to say that we know why psychother- apy is effective.

Another major difference between the two paradigms is the role of the therapist. As Lebow has put it: Psychotherapy researchers typically focus exclusively on differ- ent clinical interventions while ignoring the psychotherapists who make use of them.

Too often research- ers regard the skills, personality, and experiences of the therapist as side issues, features to control or to ensure that different treatment groups receive comparable interventions.

New- paradigm advocates suggest that the role of the therapist is underem- phasized in traditional psychotherapy research, given its emphasis on pitting treatments against one another. This focus also flies in the face of common sense since it is obvious that therapists differ in their effec- tiveness. As Wampold has noted, just as some lawyers achieve better outcomes than others, some artists produce more memorable sculptures, and some teachers engender greater student achievement, it only makes sense that some therapists will achieve better results.

We present the empirical case for differences in therapist effectiveness in Chapter 4. Because of its emphasis on the unique treatment being offered, the older paradigm often ends up being more therapist-centric. Many model-driven therapists, especially those with a social constructionist bent, work in ways that are very collaborative. When change does occur, we believe this therapist is also more likely to believe the cli- ent will think the change is due to these unique operations.

In other words, this therapist will believe that the clients use the therapy in the way that the therapist thinks he or she uses it. For example, the structural family therapist will believe that the family in treatment was successful because its members used the therapy to develop more clear boundaries.

Similarly, the narrative therapist will believe that therapy was successful because his or her clients learned to create new and more empowering stories about themselves. In the newly emerging paradigm, there is more of a tendency to see clients as actively utilizing whatever is offered for their own purposes.

For example, in the largest and arguably the best psychotherapy outcome study ever com- pleted, cognitive-behavioral therapy for depression achieved no better results than interpersonal therapy, a psychodynamic treatment Elkin et al.

Shadish and Baldwin have demonstrated that the results of 20 meta-analyses show no differences or only modest ones between the various seemingly disparate relational therapies. That is, clients use whatever is offered, in their own idiosyncratic ways, to achieve their goals. If anything, I thought I encouraged hope for the relationship throughout couple and individual sessions with this client. She used—as clients often do—whatever the therapist offered for her own purposes in getting better.

In fairness, however, the NIH does fund process research, and so it is not the case that its entire emphasis is on com- parative treatment research. So, to repeat, the contrasts between the two paradigms should not be overdrawn. What Is Responsible for Therapeutic Change? They believe that this movement too readily embraces the most commonly researched models typically cognitive behavior and its variations when other approaches often better suited to particular therapists are likely to be just as effective.

Given the varied and changing needs of clients, proponents of common factors also want to make a larger place for therapist improvisation. In summary, advocates of the two paradigms typically use the same ingredients, but they view them very differently. Just as the Ptolemaic and Copernican paradigms both included the earth, the sun, and the planets but saw their interrelationships differently, simi- larly advocates of both the old and the emerging paradigms of change use the same phenomena—models, therapists, clients, and the process of change—but see their interrelations differently.

For example, if your competence as a therapist—independent of the model you adopt—is more important than the model itself, you are likely to search for common ingredients in therapist expertise and push for researchers to learn more about these variables.

The broad conceptual- ization Hubble et al. Generally speaking, the broader approach is favored throughout this book. But whether broadly or narrowly defined, common factors can be contrasted with specific factors—those variables that contribute to outcome that are unique to a particular approach or model. Resistance to Common Factors among Relational Therapists We believe that there appears to be more resistance to the common factors paradigm among relational therapists than among individual therapists.

This heightened resistance may be attributable to the fact that the application of common factors to couple and family therapy did not appear in the literature to any great extent prior to the s. Nonetheless, we also believe that the history of relationship therapy has tended to emphasize differences—first, in order to differentiate it from mainstream psychotherapy and, second, from other relational approaches.

In addition, the field has historically focused on difficult cases, and this tendency may have contributed to the belief that unique models and methods are neces- sary for successful outcomes. Moreover, the field has always welcomed innovation and may therefore attract people with an above-average need to believe what they are doing is uniquely relevant.

Finally, since couple and family therapies are frequently promoted by charismatic figures on the workshop circuit, such an undramatic approach as common factors may seem dull by comparison.

Of course, not all model developers are charismatic, and some value evidence more than dogma; but we maintain that the field has had more than its share of religion masquerading as science. Chapter 2 traces the history of common factors. While the contemporary his- tory stretches back to , you may be fascinated to learn—or be reminded—that as early as the late s healers were making causal claims for specific methods that undoubtedly worked through com- mon factors.

Indeed, the history of psychotherapy in general and rela- tionship therapy in particular is a history of growing awareness and appreciation albeit only relatively recently for relationship therapies of commonalities among change models.

Although much more has been written about common factors in the individual therapy literature, Chapter 3 focuses on four common factors that are unique to couple and family therapy: 1 conceptual- izing difficulties in relational terms, 2 disrupting dysfunctional rela- tional patterns disruption, 3 expanding the direct treatment system, and 4 expanding the therapeutic alliance.

While few in number, these common factors are extremely important and rooted in the ways in which relationship therapy is itself distinctive. Six categories of common factors are offered, along with an overview of the research evidence supporting them. This chapter sets the stage for Chapters 6—9, which present most of these categories in greater detail.

Common factors across theories of marriage and family therapy: a modified Delphi study.

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: X Corpus ID: Common factors across theories of marriage and family therapy: a modified Delphi study. Blow and D. Blow , D.

Most DVDs check out for one week. Additional materials books, ebooks, journal articles, videos, etc. Subject Search: Marital Therapy. Keyword Search: " Family Therapy " published last 10 years. Subject Search: Depression published last 5 years.

Enter your mobile number or email address below and we'll send you a link to download the free Kindle App. Then you can start reading Kindle books on your smartphone, tablet, or computer - no Kindle device required. To get the free app, enter your mobile phone number. Grounded in theory, research, and extensive clinical experience, this pragmatic book addresses critical questions of how change occurs in couple and family therapy and how to help clients achieve better results. The authors show that regardless of a clinician's orientation or favored techniques, there are particular therapist attributes, relationship variables, and other factors that make therapy--specifically, therapy with couples and families--effective.


Common Factors in Couple and Family Therapy The Overlooked Foundation for Effective Practice Douglas H. Sprenkle Sean D. Davis Jay L. Lebow THE.


Common Factors in Couple and Family Therapy The Overlooked Foundation for Effective Practice

Meta-analysis research supports the notion that common factors are at work across theoretically different therapies. However, some advocates of empirically supported treatments ESTs criticize that there is no common factor chronological map to guide clinicians across different stages of therapy initial, intermediate, termination. In this chapter, supported by recent research, we propose a preliminary chronological map which has the potential to guide clinicians as they use common factors across all three stages of couple and family therapy.

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The study of common factors focuses on identifying core elements of effective couple and family therapy CFT. Proponents of common factors claim that once model-specific language is removed, most CFT theories orient the therapist to similar patterns of dysfunction and help them guide the family towards similar patterns of health. Much of what makes therapy effective is also inherent in the structure of therapy itself.

У меня нет на это времени, - сказала себе Сьюзан. На поиски вируса может уйти несколько дней. Придется проверить тысячи строк программы, чтобы обнаружить крохотную ошибку, - это все равно что найти единственную опечатку в толстенной энциклопедии. Сьюзан понимала, что ей ничего не остается, как запустить Следопыта повторно. На поиски вируса нужно время, которого нет ни у нее, ни у коммандера. Но, вглядываясь в строки программы и думая, какую ошибку она могла допустить, Сьюзан чувствовала, что тут что-то не. Она запускала Следопыта месяц назад, и никаких проблем не возникло.


Generic Common Factors. In addition to the principles described above, many common factors of effective CFT are shared with psychotherapy.


Common Factors in Couple and Family Therapy The Overlooked Foundation for Effective Practice

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