Expanding the lens of evidence-based practice in psychotherapy: A common factors perspective.
Abstract
In this article, we examine the science and policy implications of the common factors perspective (CF; Frank & Frank, 1993; Wampold, 2007). As the empirically supported treatment (EST) approach, grounded in randomized controlled trials (RCTs), is the received view (see Baker, McFall, & Shoham, 2008; McHugh & Barlow, 2012), we make the case for the CF perspective as an additional evidence-based approach for understanding how therapy works, but also as a basis for improving the quality of mental health services. Finally, we argue that it is time to integrate the 2 perspectives, and we challenge the field to do so.
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The therapeutic alliance is the most extensively studied common factor.
“The therapeutic alliance (the affective bond between therapist and patient, and agreement on the tasks and goals of therapy) is the most widely studied common factor.46,52”
From A common factors perspective on mindfulness-based interventions (2022) · cites this paper as [46]
Existing work only focuses on GenAI's capacity to produce responses high in perceived empathy, one of the five key elements of the therapeutic process according to the common factor metatheory.
“existing work only focuses on GenAI’s capacity to produce responses high in perceived empathy, one of the five key elements of the therapeutic process according to the common factor metatheory.”
From When ELIZA meets therapists: a Turing test for the heart and mind (2025) · cites this paper as [27]
The common factors metatheory stipulates that successful therapies share at least five common ingredients: therapeutic alliance, empathy, expectations, cultural competence, and therapist effects.
“The common factors metatheory describes how different therapeutic orientations produce similar results for clients, stipulating that successful therapies share at least five common “ingredients:” therapeutic alliance, empathy, expectations, cultural competence, and therapist effects [27, 28, 31–33].”
From When ELIZA meets therapists: a Turing test for the heart and mind (2025) · cites this paper as [27]
Common factors undergird and act as a mechanism for much of the evidence-based treatment literature.
“Given that common factors undergird and act as a mechanism for much of the evidence-based treatment literature [27, 28], and the direction and size of the effects, consulting with ChatGPT may be a way to improve declining or stagnating effect sizes within the evidence-based clinical psychological sciences [34, 35].”
From When ELIZA meets therapists: a Turing test for the heart and mind (2025) · cites this paper as [27]
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Self-citationDifferent processes for different therapies: Therapist actions, therapeutic bond, and outcome.
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Self-citationThe investigation of exposure and cognitive therapy: Comment on Tarrier et al. (1999).
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Self-citationPsychotherapy for social phobia: How do alliance and cognitive process interact to produce outcome?
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Self-citationPatient early session experience and treatment outcome
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Self-citationMeta-analytic methods to test relative efficacy
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How important are the common factors in psychotherapy? An update
Wampold, B. E. (2015) · World Psychiatry · doi:10.1002/wps.20238 · Cited by 1,728 · see citing works
Self-citationSynchrony in Psychotherapy: A Review and an Integrative Framework for the Therapeutic Alliance
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“Consistent with this, there is a growing consensus in clinical psychology that common and specific factors jointly shape therapeutic outcomes (Hofmann and Barlow, 2014; Laska et al., 2014).”
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Expertise in psychotherapy: An elusive goal?
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Self-citationA qualitative meta-analysis examining clients’ experiences of psychotherapy: A new agenda.
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Clashing diagnostic approaches: DSM-ICD versus RDoC
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Evidence-Based Psychotherapy: Advantages and Challenges
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Love Yourself as a Person, Doubt Yourself as a Therapist?
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Psychodynamic therapy meets evidence-based medicine: a systematic review using updated criteria.
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The Treatment of Internet Gaming Disorder: a Brief Overview of the PIPATIC Program
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In pursuit of truth: A critical examination of meta-analyses of cognitive behavior therapy
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Self-citationResearch on psychotherapy integration: Building on the past, looking to the future
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Schema therapy for chronic depression: results of a multiple single case series
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Treatment efficacy of a specialized psychotherapy program for Internet Gaming Disorder
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A common factors perspective on mindfulness-based interventions
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Routine outcome monitoring: Coming of age—With the usual developmental challenges.
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Self-citationPsychedelics and psychotherapy
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Ten things to remember about common factor theory.
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Self-citationWhen ELIZA meets therapists: a Turing test for the heart and mind
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Psychosocial interventions enhance HIV medication adherence: A systematic review and meta-analysis
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Good-enough level and dose-effect models: variation among outcomes and therapists
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Self-citationAffect regulation training reduces symptom severity in depression – A randomized controlled trial
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The Central Role of Relationships With Trauma-Informed Integrated Care for Children and Youth
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Fidelity vs. flexibility in the implementation of psychotherapies: time to move on
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Common Factors Affecting Psychotherapy Outcomes
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White coat hypertension: improving the patient–health care practitioner relationship
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Preferences for trauma treatment: A systematic review of the empirical literature.
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Consensus Guidelines for the Assessments of Individuals Who Stutter Across the Lifespan
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Skills and Competencies for Effective Academic Advising and Personal Tutoring
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Common Factors in Community Mental Health Intervention: A Scoping Review
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Autism spectrum disorder and evidence‐based practice in psychology.
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Changes in General and Specific Psychopathology Factors Over a Psychosocial Intervention
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Controlling for the placebo effect in psychotherapy: Noble quest or tilting at windmills?
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- Authors
- Laska, K. M., Gurman, A. S., & Wampold, B. E.
- Affiliations
- Edith Nourse Rogers Memorial Veterans Hospital (US)
- Northwestern University (US)
- University of Wisconsin–Madison (US)
- ORCID
- Wampold, Bruce E.
- Venue
- Psychotherapy
- Published
- 2014
- Volume
- 51
- Issue
- 4
- Pages
- 467-481
- ISSN
- 0033-3204 (ISSN-L)
- 1939-1536
- OpenAlex
- W2327281039
- Semantic Scholar
- 6006f594d7a6fd3ad956dd7da833c59f1d33be41
- Cited by
- 443
- References
- 151
- Citations by year
- 2026: 15 · 2025: 27 · 2024: 30 · 2023: 24 · 2022: 30 · 2021: 34 · 2020: 47 · 2019: 51 · 2018: 37 · 2017: 53 · 2016: 44 · 2015: 36 · 2014: 15
- FWCI
- 34.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- empirically supported treatments, evidence-based practice, psychotherapy outcome, randomized controlled trials, mental health care quality, treatment integration
- MeSH terms
- Mental Disorders, Humans, Psychotherapy, Evidence-Based Medicine, Empirical Research
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