Psychotherapy © 2014 American Psychological Association

2014, Vol. 51, No. 4, 514 –518 0033-3204/14/$12.00 http://dx.doi.org/10.1037/a0037092

COMMENTARY

Common Factors Are Not So Common and Specific Factors Are Not So
Specified: Toward an Inclusive Integration of Psychotherapy Research
Joel Weinberger
Adelphi University

The dichotomy between what has been termed empirically supported treatments (EST) and common
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

factors (CF) is false and counterproductive. Neither has a monopoly on empirical truth. The term
This document is copyrighted by the American Psychological Association or one of its allied publishers.

nonspecific is unproductive and misleading. Specified versus nonspecified is more empirically correct.
Assumptions of the EST and CF approaches are questionable. Common factors (both currently specified
and not so specified) are reviewed. These include the therapeutic relationship, expectancies, attributions
for therapeutic success, exposure, and mastery. Far from maximizing therapeutic success, the CF EST
dichotomy and its resulting theoretical squabbles result in weaker outcomes than would be the case if
empirical results were taken seriously, and factors shown to be effective (both specified and nonspeci-
fied) were systematically investigated and integrated so as to create maximally effective treatments.

Keywords: EBP, EST, common factors, RCT, nonspecific

The vast majority of psychotherapists would agree that the
treatments offered our patients should be backed by solid empirical
evidence. Some have been more provocative, arguing that only
certain treatments should be offered and that not to do so is
unethical (Baker, McFall, & Shoham, 2009; Chambless & Crits-
Cristoph, 2006). Those championing this point of view adhere to
what has been termed empirically supported treatments (EST;
Chambless & Hollon, 1998). Their empirical gold standard is
randomly controlled trials (RCTs). This has led to some acrimony,
as others point out weaknesses in RCTs (Westen, Novotny, &
Thompson-Brenner, 2004). Some argue for a multiplicity of ap-
proaches and believe that non-RCT data can also demonstrate
therapeutic effectiveness (Laska, Gurman, & Wampold, 2014, pp.
467– 481; Weinberger, 1995; Weinberger & Eig, 1998; Wein-
berger & Rasco, 2007). In agreement with Laska, Gurman, &
Wampold, (2014), my position is that science thrives best in an
open market place of ideas that allows different theories and
research approaches to be contrasted and tested. Censorship, a
priori exclusion, of different ways of understanding phenomena, is
anathema to science. This view of science also underlies American
Psychological Association (APA) support of what is termed
evidence-based practice (APA Presidential Task Force on
Evidence-Based Practice, 2006).
Laska et al. (2014) compare the EST approach and its preferred
RCT methodology with their common factors (CF) approach. They
This article was published Online First August 11, 2014.
Joel Weinberger, Derner Institute of Advanced Psychological Studies,
Adelphi University.
Correspondence concerning this article should be addressed to Joel
Weinberger, Derner Institute of Advanced Psychological Studies, Adelphi
University, Box 701, Garden City, NY 11530. E-mail: weinberger@
adelphi.edu
then argue for moving forward with both. I have taken a similar
view (Weinberger, 1995; Weinberger & Rasco, 2007) with some
differences. I would like to first highlight and then question the
veracity of some of the assumptions of both the EST and the Laska
et al. CF approach. Further, I will recommend including what EST
advocates term nonspecific factors in EST research. I will also
recommend that some specific techniques supported by EST ad-
vocates be considered common factors and included in the CF
approach. It is not the case that one side needs to leave the field
and make way for the other, more scientifically pure (EST) or
more clinically valid (CF), approach. Both are scientifically re-
spectable; both have clinical merit, and both have weaknesses.
The Specific Versus Nonspecific Fallacy
I do not believe that the blanket term “nonspecific” advances the
scientific study of psychotherapy. I would prefer to say that some
important factors may have not been operationalized well enough to
be studied empirically; they have not yet been specified. Thus, they
are nonspecified, not nonspecific. Contrary to the views of those
questioning their scientific bona fides (e.g., Baker et al., 2009), so-
called nonspecific effects are not ontologically nonspecific. They are
capable of being empirically specified. They are therefore amenable
to scientific scrutiny. Similarly, I would include some of what Laska
et al. (2014) and EST advocates would term specific techniques in the
CF approach. That is, some techniques are ameliorative in all forms of
treatment and should therefore be considered common factors. That
these techniques have traditionally been termed “specific” does not
mean that they are not common factors.
Assumptions of the EST/RCT Approach
To conduct an EST study (inevitably an RCT), the treatment to
be tested must be described in detail and set down in a treatment

514
 COMMON FACTORS ARE NOT SO COMMON
manual that clearly conveys how to conduct it. Practitioners are to
follow the manual when delivering the treatment. This is assessed
to ensure that the treatment is delivered correctly. This manualized
treatment is compared with an alternative or alternatives. This can
be an alternative treatment (also manualized), something often
dubbed treatment as usual, or an ersatz treatment (placebo, wait-
list control, etc.). Assignment of patients to the EST candidate
treatment or the alternative(s) must be random. In order for the
EST candidate to be considered efficacious, it must outperform the
alternative treatment(s). And then it must do so again. If the EST
candidate turns out to be superior in two or more RCT studies, it
is considered empirically supported and is designated an EST
(Chambless & Hollon, 1998).
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
Random Assignment and Prepotence of Technique
Over Personality
The RCT approach seems to rest on a bedrock of good scientific
research principles. But there are many assumptions inherent in
this intuitively appealing EST model that do not necessarily enjoy
empirical support. One is that random assignment of patients to
treatments is neutral as to outcome and therefore provides the least
biased results. This is not necessarily the case. Psychotherapy is
not akin to a social psychology experiment conducted on an
undergraduate population or even a medical experiment conducted
on patients suffering from the same physical disorder. Psychother-
apy patients usually choose the type of treatment they enter and the
therapist they work with. For this and other reasons, patient vari-
ables can be of great importance. Which patient is assigned to
which treatment can matter greatly and affect results (Blatt &
Zuroff, 2005). Laska et al. (2014) correctly make much of patient
variables. However, patient variables are virtually never assessed
in ESTs, where all we typically know is primary diagnosis. It
should not be assumed that patient variables are randomly distrib-
uted across conditions and are therefore irrelevant. This assumes
(and this is a big one) that the method is a stronger determinant of
outcome than is the person being treated. This is an empirical
question and should be treated as such. In all probability, both are
important, as are their interactions. That is, we should not ignore
the person in favor of the method. (The same holds true for
therapist variables, cf. Baldwin & Imel, 2013.)
Positive Outcomes Prove That the Factors Emphasized
in the Manual Are Responsible
Another assumption is that if an EST is effective, this is attrib-
utable to the specific interventions detailed in the treatment man-
ual. This is an empirical question that is not and cannot be
addressed by RCTs. The effectiveness of the specific factors
requires independent verification before one can say with confi-
dence that the outcome was attributable to them. One could easily
argue that the success of an EST is due to factors other than those
specified and adhered to in the manual. And this is just what
advocates of the CF approach do argue. Meta-analyses showing no
differences in outcome across radically different kinds of treat-
ments support this understanding. So do well conducted outcome
studies (see APA, 2013; Lambert, 2013; and Laska et al., 2014 for
listings and reviews). Although individual meta-analyses have
been disputed and general flaws have been asserted (DeRubeis,
515
Brotman, & Gibbons, 2005), the consistency of these empirical
reviews should at least be troubling to and require more than ad
hoc explanations by advocates of the primacy of specific tech-
niques (cf. Laska et al., 2014; Weinberger, 1995; Weinberger &
Rasco, 2007).
Placebos Are Good Controls for
Psychotherapy Research
Another assumption is that a placebo treatment constitutes a
valid control for psychotherapy. The concept of placebo comes
from medical research where it is used to control for psychological
effects so that one can be certain that the effects obtained are due
to physical causes. When transplanted to psychotherapy research,
what we have is a condition that controls for psychological effects
in comparison with a treatment that relies on psychological effects.
At best, we are testing some psychological effects, which we can
specify (the identified factors in the RCT), against others, which
we have not specified (factors operating in the placebo—Wein-
berger, 1995; Weinberger & Rasco, 2007). Sweeping these psy-
chological phenomena under the rug by grouping them under the
term placebo or nonspecific deprives us of the opportunity to
understand what they do and how they do it (cf. Kirsch, 1999).
Specificity of Matching Treatments With Disorders
Another assumption of ESTs is that treatments need to be
specifically tailored to the disorder under investigation. This leads
to a myriad of ESTs. There are currently more ESTs than any
clinician could possibly learn. As of 2006, there were ⬎150
(Beutler & Johannsen, 2006), and they have grown since. Laska et
al. (2014) make this point as well. EST advocates now acknowl-
edge that there are general principles that cut across at least some
disorders (Barlow Allen & Choate, 2004). Yet the assumption of
specificity still seems to be modal to the EST approach. It is used,
for example, to argue against the notion of common factors (Baker
et al., 2009).
Assumptions of the CF Approach
The CF approach essentially states that different kinds of psy-
chotherapy do not achieve their effects through the techniques and
principles they espouse. Rather, their effectiveness is due to, often
unacknowledged, factors that they share (Laska et al., 2014).
Hence the term common factors.
There are two untested assumptions in this way of understand-
ing psychotherapy. First, the specific techniques described as
central by EST advocates are assumed to be of secondary impor-
tance. This is an empirical question and needs to be tested. Second,
the CF approach assumes that as all psychotherapies perform
similarly, they partake of common factors in a roughly equivalent
fashion. Much of this thinking is based on the pioneering and
brilliant work of Jerome Frank (Frank & Frank, 1993). Laska et al.
(2014) summarize this point of view: “Any effective psychother-
apy is characterized by (a) an emotionally charged bond between
the therapist and patient, (b) a confiding healing setting in which
therapy takes place, (c) a therapist who provides a psychologically
derived and culturally embedded explanation for emotional dis-
tress, (d) an explanation that is adaptive (i.e., provides viable and
 516 WEINBERGER
believable options for overcoming specific difficulties) and is
accepted by the patient, and (e) a set of procedures or rituals
engaged by the patient and therapist that leads the patient to enact
something that is positive, helpful, or adaptive” (p. 469).
I agree with this view except for two areas. First, the Laska et al.
(2014) CF approach does not give real importance to specified
mechanisms of change. They are part of items (c), (d), and (e)
above and not ameliorative in their own right. They simply rep-
resent something for the patient to believe in and do. Similarly, I
would include item (a) above, the therapeutic relationship, as a
specifiable, rather than a generalized common factor. I would also
argue that the equivalence in outcome correctly predicted by the
CF approach is more due to the various treatments being similarly
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
incomplete and inadequate, with some providing more or better
This document is copyrighted by the American Psychological Association or one of its allied publishers.
versions of some common factors and others providing more or
better versions of other common factors (cf. Weinberger, 1995;
Weinberger & Rasco, 2007). Thus, all are inadequate and incom-
plete. If this is true and we could construct a treatment that
maximized the use and instantiation of all (or most) common
factors, we could substantially increase the effectiveness of psy-
chotherapy, which would then rest on a more secure and less
contrarian empirical base.
Unspecified Factors That Contribute to All
Treatments (So-Called Nonspecific Factors)
The most empirically supported so-called nonspecific factor is the
therapeutic relationship. It is far more specified than some seem to
believe (cf. Weinberger & Rasco, 2007). The Division 29 task force
(Norcross, 2002) concluded that the therapeutic alliance, empathy,
goal consensus, and collaboration between therapist and patient, as
well as a sense of cohesion between therapist and patient all contribute
to therapy outcome. Also see Norcross and Lambert (2006) and
Wampold and Budge (2012). These findings have led some EST
theorists to include the therapeutic relationship as an efficacious factor
in psychotherapy (Chambless & Crits-Cristoph, 2006). Thus, the
relationship is a both a common and a specified factor. It is central to
psychodynamic and humanistic/experiential approaches but relatively
neglected in the behavioral and cognitive schools (Emmelkamp,
1994; Hollon & Beck, 1994; Weinberger, 1995; Weinberger & Rasco,
2007; Whisman, 1993).
Expectancies of Treatment Effectiveness
Expectancy is an unspecified factor central to placebo effects.
And placebos, far from being inert sugar pills, can be quite
powerful (Kirsch, 1999; Wampold, Minami, Tierney, & Baskin,
2005). Weinberger has proposed expectancy as a common factor
(Weinberger, 1995; Weinberger & Eig, 1998; Weinberger &
Rasco, 2007). So have Wampold et al. (2005). Most recently,
Constantino, Ametrano, and Greenberg (2012) have weighed in on
this issue.
Despite the obvious therapeutic importance of expectancy, no
EST approach incorporates it into its manual. Instead, RCTs ex-
plicitly try to control for expectancies through placebo control
groups or treatments as usual. They seem to treat it as though it
was somehow therapeutically illegitimate. Although the CF ap-
proach recognizes the importance of expectancies, until recently
(Constantino et al., 2012), they did no systematic investigation of
what underlies it or how to take advantage of it. No school of
therapy makes explicit use of this factor. This is unfortunate. We
should be investigating and exploiting expectancies in our treat-
ments.
Attributions of Therapeutic Outcome
Although patients typically improve in therapy, they also often
relapse. Freud (1937) recognized this long ago for psychodynamic
therapy. It has also been acknowledged in behavioral (Bandura,
1989) and cognitive therapy (Elkin, 1994). Although the different
schools of therapy recognize the problem, they have done little to
address it (Weinberger, 1995; Weinberger & Eig, 1998; Wein-
berger & Rasco, 2007). Research suggests that how patients un-
derstand treatment outcome affects the likelihood of relapse. Pa-
tients may attribute successful outcome to internal causes like their
hard work in therapy, improvements in their coping skills, and/or
altered personality. Or, they can attribute positive change to ex-
ternal causes like the therapist and/or powerful treatment tech-
niques.
Treatment success is more likely to last when the patient be-
lieves that positive changes can be attributed to internal changes.
These internal attributions result in what Bandura (1989) has
termed self-efficacy. Conversely, relapse is more likely when
external attributions are made because the patient believes that the
therapy worked because of the skills of the therapist and/or the
power of the treatment techniques. Once these are removed (e.g.,
because treatment ended), the perceived reasons for success are no
longer operating.
I have not seen attributions of success or self-efficacy measured
in any RCT study. CF advocates refer to it in vague terms like
expectancies without discussing or measuring it. Self-efficacy
provides operationalization of this factor and methods for enhanc-
ing it. This common factor seems to be potentially specifiable and
could be investigated in both the EST and CF traditions.
So-Called Specific Factors That Can Be Construed as
Common Factors
Confronting or Facing Problems (Exposure)
Weinberger (1995) and Weinberger and Rasco (2007) argued
that facing, as opposed to avoiding, anxiety is a goal in all schools
of psychotherapy. The nature of this confrontation and the types of
fears faced differ greatly across the various schools. Psychody-
namic therapists have argued that discussing anxiety-laden mate-
rial is therapeutic (Weiss, Sampson, et al., 1986). Data support
this. Undergraduate participants writing or talking about upsetting
and/or traumatic events often felt worse immediately afterward but
showed better emotional health later. Even more remarkable, they
evidenced healthier immune functioning and fewer health prob-
lems months later (see Smyth, Pennebaker, & Arigo, 2012 for a
review of this work). Humanistic/experiential theorists (Green-
berg, Elliott, & Lietaer, 1994) have also discussed confrontation or
facing problems, and some data indicate that it is beneficial (Di-
erick & Lietaer, 1990).
In cognitive therapy (Beck, Rush, Shaw, & Emery, 1979),
negative cognitions, of which patients are relatively unaware (au-
tomatic thoughts), are recorded, examined, and thereby con-
 COMMON FACTORS ARE NOT SO COMMON
fronted. In Ellis’ (1962) rational emotive therapy, the therapist
forcefully confronts the patient with examples of his or her
illogical thinking and/or self-defeating behaviors. Additionally,
patients are encouraged to expose themselves to problematic
situations outside of therapy and report back on the outcome.
Role-playing is also encouraged, often as a prelude to “real
world” trials (Hollon & Garber, 1990).
Exposure may be the most important therapeutic method used
by behaviorists (Emmelkamp, 1994), and a great deal of data
support it (Weinberger, 1995; Weinberger & Rasco, 2007). Both
EST and CF proponents often identify exposure with this school.
This limits the scope of this factor to concrete physical objects that
patients explicitly fear (i.e., phobias and a small subset of anxiety
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
disorders). However, it need not be limited this way. Facing
This document is copyrighted by the American Psychological Association or one of its allied publishers.
problems, whether termed exposure or something else, can be (and
is) an effective specifiable factor, common to various forms or
therapy.
Mastery
A great deal of evidence supports the positive effects of a sense
of control or mastery. Most schools of therapy find it valuable, but
some deem it more important than others. Humanistic/experiential
approaches have surprisingly little to say about mastery. In the
Rogerian (Rogers, 1951) view, potential unfolds naturally and
organically. There is no need for the therapist to encourage the
process explicitly or otherwise. Experiential writers do not think it
is quite this automatic. They have some sense that the therapist
must try to foster mastery, and there is some evidence that mastery
experiences occurring within sessions generalize to the real world
(Greenberg & Webster, 1982). Although psychodynamic schools
believe that insight into desires, fears, and inhibitions can lead to
the beginnings of mastery experiences, true mastery requires suc-
cessfully applying these insights. The process is long and pains-
taking. Less writing is devoted to this than to any other aspect of
psychodynamic thinking, and there is virtually no empirical work
on it.
In the behavioral tradition, mastery and control are typically
discussed in terms of skills training, or as an emergent quality of
exposure. For example, Lewinsohn and Hoberman (1982) see
depression as attributable to difficulties in obtaining gratification.
Treatment involves teaching need-gratifying skills. Exposure leads
to greater control and mastery because the patient is less troubled
by anxiety in important life situations.
A sense of mastery and cognitive control is most central to
cognitive conceptions. In rational emotive therapy (Ellis, 1962),
the patient is taught to challenge assumptions and develop more
adaptive problem-solving techniques. Homework is assigned to aid
in this endeavor. Beck’s cognitive therapy explicitly fosters mas-
tery experiences. Cognitive therapy provides patients with struc-
tured tasks having well-defined goals. Beck et al. (1979) recom-
mended dividing these tasks into small, progressively more
difficult steps. The first few steps are conducted in the treatment
room. When they prove successful, the remainder are assigned as
homework. This is termed “graded task assignment.” To track the
patient’s subjective sense of mastery and make it salient, Beck et
al. designed what they termed the “mastery and pleasure tech-
nique.” Other mastery increasing techniques include logical anal-
ysis and hypothesis testing (Jarrett & Nelson, 1987), role-playing
517
(Hollon & Garber, 1990), and reframing (Kleinke, 1994). All of
these methods enjoy empirical support (Hollon & Beck, 1994;
Whisman, 1993). Thus, cognitive therapy seems to apply this
factor most strongly.
The Point of All of This
I have described five empirically supported factors. Three are
usually considered “nonspecific” and therefore tend to be empha-
sized by the CF approach (relationship, expectancy, and attribu-
tions of outcome); two are usually considered “specific” (exposure
and mastery) and fall under the EST approach. I showed that all
are active in many different forms of psychotherapy and can be
fruitfully subsumed under both the EST and CF approaches. I
have also tried to show that different schools of psychotherapy
make differential use of these factors. As a result, the different
forms of psychotherapy may not be as effective as they other-
wise might be. Investigating these common factors and deter-
mining how they can be best instantiated could improve psy-
chotherapy outcome. It is my hope that this can serve as the sort
of bridge between CF and EST advocated by Laska et al. (2014)
I also think leveraging these factors can result in constructing
better treatments for our patients and enable us to escape the
straightjacket of our current antagonistic therapeutic models.
References
American Psychological Association (APA). (2013). Recognition of psy-
chotherapy effectiveness. Psychotherapy, 50, 102–109. doi:
10.1037/a0030276
American Psychological Association (APA) Presidential Task Force on
Evidence-Based Practice. (2006). Evidence-based practice in psychol-
ogy. American Psychologist, 61, 271–285. doi:10.1037/0003-066X.61.4
.271
Baker, T. B., McFall, R. M., & Shoham, V. (2009). Current status and
future prospects of clinical psychology: Toward a scientifically princi-
pled approach to mental and behavioral health care. Psychological
Science in the Public Interest, 9, 67–103.
Baldwin, S. A., & Imel, Z. E. (2013). Therapist effects: Findings and
methods. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of
psychotherapy and behavior change (6th ed., pp. 258 –297). New York,
NY: Wiley.
Bandura, A. (1989). Human agency in social cognitive theory. American
Psychologist, 44, 1175–1184. doi:10.1037/0003-066X.44.9.1175
Barlow, D. H., Allen, D. H., & Choate, M. L. (2004). Toward a unified
treatment for emotional disorders. Behavior Therapy, 35, 205–230.
doi:10.1016/S0005-7894(04)80036-4
Beck, A. T., Rush, A. J., Shaw, F. B., & Emery, G. (1979). The cognitive
therapy of depression. New York, NY: Guilford Press.
Beutler, L. E., & Johannsen, B. E. (2006). Principles of change. In J. C.
Norcross, L. E. Beutler, & R. F. Levant (Eds.), Evidence-based practices
in mental health (pp. 226 –234). Washington, DC: American Psycho-
logical Association.
Blatt, S. J., & Zuroff, D. C. (2005). Empirical evaluation of the assump-
tions in identifying evidence based treatments in mental health. Clinical
Psychology Review, 25, 459 – 486. doi:10.1016/j.cpr.2005.03.001
Chambless, D. L., & Crits-Christoph, P. (2006). The treatment method. In
J. C. Norcross, L. E. Beutler, & R. F. Levant (Eds.), Evidence-based
practices in mental health (pp. 191–200). Washington, DC: American
Psychological Association.
Chambless, D. L., & Hollon, S. D. (1998). Defining empirically supported
therapies. Journal of Consulting and Clinical Psychology, 66, 7–18.
doi:10.1037/0022-006X.66.1.7
 518 WEINBERGER
Constantino, M. J., Ametrano, R. M. & Greenberg, R. P. (2012). Clinician
interventions and participant characteristics that foster adaptive patient
expectations for psychotherapy and psychotherapeutic change. Psycho-
therapy, 49, 557–569. doi:10.1037/a0029440
DeRubeis, R. J., Brotman, M. A., & Gibbons, C. J. (2005). A conceptual
and methodological analysis of the nonspecifics argument. Clinical
Psychology: Science and Practice, 12, 174 –183. doi:10.1093/clipsy
.bpi022
Dierick, P., & Litaer, G. (1990). Member and therapist perceptions of
therapeutic factors in therapy and growth groups: Comments on a
category system. In G. Litaer, J. Rombauts, & R. Van Balen (Eds.),
Client-centered and experiential psychotherapy in the nineties (pp. 741–
770). Leuven, Belgium: Leuven University Press.
Elkin, I. (1994). The NIMH treatment of Depression collaborative Re-
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
search Program: Where we began and where we are. In A. E. Bergin &
This document is copyrighted by the American Psychological Association or one of its allied publishers.
S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change
(4th ed., pp, 114 –142). New York, NY: Wiley.
Ellis, A. (1962). Reason and emotion in psychotherapy. New York, NY:
Stuart.
Emmelkamp, P. M. G. (1994). Behavior therapy with adults. In A. E.
Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behav-
ior change (4th ed., pp. 379 – 427). New York, NY: Wiley.
Frank, J. D., & Frank, J. B. (1993). Persuasion and healing: A comparative
study of psychotherapy (3rd ed.). Baltimore, MD: Johns Hopkins Uni-
versity Press.
Freud, S. (1937). Analysis terminable and interminable. In J. Strachey (Ed.
and trans.), The standard edition of the complete psychological work of
Sigmund Freud (Vol. 23, pp. 216 –254). London: Hogarth Press.
Greenberg, L. S., Elliott, R., & Lietaer, G. (1994). Research on experiential
psychotherapies. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of
psychotherapy and behavior change (4th ed., pp. 509 –542). New York,
NY: Wiley.
Greenberg, L. S., & Webster, M. (1982). Resolving decisional conflict by
means of two-chair dialogue and empathic reflection at a split in coun-
seling. Journal of Counseling Psychology, 29, 468 – 477. doi:10.1037/
0022-0167.29.5.468
Hollon, S. D., & Beck, A. T. (1994). Cognitive and cognitive-behavioral
therapies. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psy-
chotherapy and behavior change (4th ed., pp. 428 – 466). New York,
NY: Wiley.
Hollon, S. D., & Garber, J. (1990). Cognitive therapy for depression: A
social cognitive perspective. Personality and Social Psychology Bulle-
tin, 16, 58 –73. doi:10.1177/0146167290161005
Jarrett, R. B., & Nelson, R. O. (1987). Mechanisms of change in cognitive
therapy of depression. Behavior Therapy, 18, 227–241. doi:10.1016/
S0005-7894(87)80017-5
Kirsch, I. (Ed.). (1999). How expectancies shape experience. Washington
DC: American Psychological Association. doi:10.1037/10332-000
Kleinke, C. L. (1994). Common principles of psychotherapy. Pacific
Grove, CA: Brooks/Cole.
Lambert, M. J. (2013). The efficacy and effectiveness of psychotherapy. In
M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy
and behavior change (6th ed., pp. 169 –218). New York, NY: Wiley.
Laska, K. M., Gurman, A. S., & Wampold, B. E. (2014). Expanding the
lens of evidence-based practice in psychotherapy: A common factors
perspective. Psychotherapy, 51, 467– 481. doi:10.1037/a0034332
Lewinsohn, P. M., & Hoberman, H. M. (1982). Depression. In A. S.
Bellack, M. Hersen, & A. E. Kazdin (Eds.), International handbook of
behavior modification and therapy (pp. 397– 431). New York, NY:
Plenum Press. doi:10.1007/978-1-4615-7275-6_14
Norcross, J. C. (Ed.). (2002). Psychotherapy relationships that work. New
York, NY: Oxford University Press.
Norcross, J. C., & Lambert, M. J. (2006). The therapy relationship. In J. C.
Norcross, L. E. Beutler, & R. F. Levant (Eds.), Evidence-based practices
in mental health (pp. 208 –218). Washington, DC: American Psycho-
logical Association.
Rogers, C. (1951). Client-centered therapy. Boston, MA: Houghton Mif-
flin.
Smyth, J. M., Pennebaker, J. W., & Arigo, D. (2012). What are the health
effects of disclosure. In A. Baum, T. A. Revenson, & J. Singer (Eds.),
Handbook of health psychology (2nd ed., pp. 175–191). New York, NY:
Psychology Press.
Wampold, B. E., & Budge, S. L. (2012). The 2011 Leona Tyler Award
Address: The relationship and its relationship to the common and spe-
cific factors of psychotherapy. The Counseling Psychologist, 40, 601–
623. doi:10.1177/0011000011432709
Wampold, B. E., Minami, T., Tierney, S. C., & Baskin, T. W. (2005). The
placebo is powerful: Estimating placebo effects in medicine and psy-
chotherapy from randomized clinical trials. Journal of Clinical Psychol-
ogy, 61, 835– 854. doi:10.1002/jclp.20129
Weinberger, J. (1995). Common factors aren’t so common: The common
factors dilemma. Clinical Psychology: Science and Practice, 2, 45– 69.
doi:10.1111/j.1468-2850.1995.tb00024.x
Weinberger, J., & Eig, A. (1998). Expectancies: The ignored common
factor in psychotherapy. In I. Kirsch (Ed.), How expectancies shape
experience. Washington, DC: American Psychological Association.
Weinberger, J., & Rasco, C. (2007). Empirically supported common fac-
tors. In S. Hoffmann & J. Weinberger (Eds.), Art and science in
psychotherapy (pp. 103–131). New York, NY: Rutledge.
Weiss, J. Sampson, H., & the Mount Zion Psychotherapy Research Group.
(1986). The psychoanalytic process: Theory, clinical observation and
empirical research. New York, NY: Guilford Press.
Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004). The em-
pirical status of empirically-supported psychotherapies: Assumptions,
findings, and reporting in controlled clinical trials. Psychological Bul-
letin, 130, 631– 663. doi:10.1037/0033-2909.130.4.631
Whisman, M. A. (1993). Mediators and moderators of change in cognitive
therapy of depression. Psychological Bulletin, 114, 248 –265. doi:
10.1037/0033-2909.114.2.248
Received April 6, 2014
Accepted April 7, 2014 䡲