How important are the common factors in psychotherapy? An update

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Abstract

The common factors have a long history in the field of psychotherapy theory, research and practice. To understand the evidence supporting them as important therapeutic elements, the contextual model of psychotherapy is outlined. Then the evidence, primarily from meta-analyses, is presented for particular common factors, including alliance, empathy, expectations, cultural adaptation, and therapist differences. Then the evidence for four factors related to specificity, including treatment differences, specific ingredients, adherence, and competence, is presented. The evidence supports the conclusion that the common factors are important for producing the benefits of psychotherapy.

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A comprehensive review of the placebo effect: recent advances and current thought.

Donald D Price, Damien Finniss, Fabrizio Benedetti (2008)

Our understanding and conceptualization of the placebo effect has shifted in emphasis from a focus on the inert content of a physical placebo agent to the overall simulation of a therapeutic intervention. Research has identified many types of placebo responses driven by different mechanisms depending on the particular context wherein the placebo is given. Some placebo responses, such as analgesia, are initiated and maintained by expectations of symptom change and changes in motivation/emotions. Placebo factors have neurobiological underpinnings and actual effects on the brain and body. They are not just response biases. Other placebo responses result from less conscious processes, such as classical conditioning in the case of immune, hormonal, and respiratory functions. The demonstration of the involvement of placebo mechanisms in clinical trials and routine clinical practice has highlighted interesting considerations for clinical trial design and opened up opportunities for ethical enhancement of these mechanisms in clinical practice.

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Marketing actions can modulate neural representations of experienced pleasantness.

Hilke Plassmann, John O'Doherty, Baba Shiv … (2008)

Despite the importance and pervasiveness of marketing, almost nothing is known about the neural mechanisms through which it affects decisions made by individuals. We propose that marketing actions, such as changes in the price of a product, can affect neural representations of experienced pleasantness. We tested this hypothesis by scanning human subjects using functional MRI while they tasted wines that, contrary to reality, they believed to be different and sold at different prices. Our results show that increasing the price of a wine increases subjective reports of flavor pleasantness as well as blood-oxygen-level-dependent activity in medial orbitofrontal cortex, an area that is widely thought to encode for experienced pleasantness during experiential tasks. The paper provides evidence for the ability of marketing actions to modulate neural correlates of experienced pleasantness and for the mechanisms through which the effect operates.

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Finding "meaning" in psychology: a lay theories approach to self-regulation, social perception, and social development.

Daniel Molden, Carol Dweck (2006)

Much of psychology focuses on universal principles of thought and action. Although an extremely productive pursuit, this approach, by describing only the "average person," risks describing no one in particular. This article discusses an alternate approach that complements interests in universal principles with analyses of the unique psychological meaning that individuals find in their experiences and interactions. Rooted in research on social cognition, this approach examines how people's lay theories about the stability or malleability of human attributes alter the meaning they give to basic psychological processes such as self-regulation and social perception. Following a review of research on this lay theories perspective in the field of social psychology, the implications of analyzing psychological meaning for other fields such as developmental, cultural, and personality psychology are discussed. 2006 APA, all rights reserved