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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 (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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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Goodman, L. A., Epstein, D., & Sullivan, C. M. (2017) · American Journal of Evaluation · doi:10.1177/1098214017721008 · Cited by 31
Ramos, G., Brookman-Frazee, L., Kodish, T., Rodriguez, A., & Lau, A. S. (2021) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/cdp0000357 · Cited by 30
“these findings suggest that EBP adaptations—changes that Latinx therapists mostly consider cultural in nature—are strategies consistent with overall clinical competency (Laska et al., 2014; Wampold, 2015).”
BackgroundNissen‐Lie, H. A., Goldberg, S. B., Hoyt, W. T., Falkenström, F., Holmqvist, R., Nielsen, S. L., & Wampold, B. E. (2016) · Journal of Counseling Psychology · doi:10.1037/cou0000151 · Cited by 36
Self-citationEisler, I., Simic, M., Fonagy, P., & Bryant‐Waugh, R. (2022) · Journal of Eating Disorders · doi:10.1186/s40337-022-00665-z · Cited by 31
Placebo effects in psychotherapy: A flawed concept and a contorted history.
Wampold, B. E., Frost, N. D., & Yulish, N. E. (2016) · Psychology of Consciousness Theory Research and Practice · doi:10.1037/cns0000045 · Cited by 32
Self-citationZamaria, J. A., Fernandes-Osterhold, G., Shedler, J., & Yehuda, R. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1505894 · Cited by 29
“…replicated finding in psychotherapy research is that all bona fide forms of therapy yield equivalent benefits (Budd and Hughes, 2009; Lambert, 2013; Laska et al., 2014; Shedler, 2015; Smith and Glass, 1977; Stiles et al., 1986; Wampold and Imel, 2015); CBT is only with respect to quantity of…”
Weinberger, J. L. (2014) · Psychotherapy · doi:10.1037/a0037092 · Cited by 29
“Laska et al. (2014) compare the EST approach and its preferred RCT methodology with their common factors (CF) approach.”
BackgroundMethodInfluentialAmerongen-Meeuse, J. C. V. N., Schaap‐Jonker, H., Schuhmann, C. M., Anbeek, C., & Braam, A. W. (2018) · Mental Health Religion & Culture · doi:10.1080/13674676.2018.1553029 · Cited by 35
Religious/spiritual care needs and treatment alliance among clinical mental health patients.
Amerongen-Meeuse, J. C. V. N., Schaap-Jonker, H., Anbeek, C., & Braam, A. (2020) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12685 · Cited by 23
Lorenzo‐Luaces, L., Driessen, E., DeRubeis, R. J., Van, H. L., Keefe, J. R., Hendriksen, M., & Dekker, J. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.11.011 · Cited by 29
Flentje, A. (2019) · Psychotherapy · doi:10.1037/pst0000243 · Cited by 34
Baier‐Mosch, F., Weiher, G. M., & Kananian, S. (2025) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-025-09664-y · Cited by 26
“The therapeutic alliance is traditionally defined as the most impor - tant therapeutic relationship variable (Cuijpers et al., 2019; Laska et al., 2014), focusing not only on the emotional bond between therapist and patient but also on the working bond that includes consensus about therapeutic…”
Whitehouse, J. (2019) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2019.03.002 · Cited by 27
Training in psychotherapy: a call for embodied and psychophysiological approaches
Gennaro, A., Kleinbub, J. R., Mannarini, S., Salvatore, S., & Palmieri, A. (2019) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2019.395 · Cited by 28
Critical thinking as cooperation and its relation to mental health and social welfare
Ollinheimo, A., & Hakkarainen, K. (2022) · New Ideas in Psychology · doi:10.1016/j.newideapsych.2022.100988 · Cited by 29
Hart, T., & Ehde, D. M. (2015) · Rehabilitation Psychology · doi:10.1037/rep0000031 · Cited by 26
Luyten, P., Lowyck, B., & Blatt, S. J. (2017) · Psychoanalytic Inquiry · doi:10.1080/07351690.2017.1285187 · Cited by 30
“…approach, that is, that factors that are shared by different types of psychotherapy (such as providing hope, an illness theory, and a warm and understanding therapeutic relationship), are mainly responsible for therapeutic change (Ahn and Wampold, 2001; Laska, Gurman, and Wampold, 2014).”
BackgroundOf Dodo birds and common factors: A scoping review of direct comparison trials in adventure therapy
Dobud, W. W., & Harper, N. J. (2018) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2018.01.005 · Cited by 27
Animal models in addiction research: A dimensional approach
Lamontagne, S. J., & Olmstead, M. C. (2018) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.06.005 · Cited by 25
Metadata
- 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 › Clinical 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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