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COMMON FACTORS IN EFFECTIVE TREATMENT A great deal of attention has been paid during the past 15 years to identifying important commonalities in successful treatment. Research and clinical experience increasingly confirm the existence of common factors in counseling and psychotherapy, overriding characteristics associated with successful treatment, regardless of clinician’s theoretical orientation. Chapter 2 considered desirable characteristics of the clinician and the client, as well as of the treatment context. Now that you know about a broad range of treatment systems and strategies, you probably have realized that beneficial commonalities in treatment approaches also play an important part in determining treatment outcome. In a study of the ingredients of psychotherapeutic change, Hanna and Ritchie ( 1995 ) found that treatment is likely to be effective if it helps people to: 1.Acquire insight and new understanding 2.Face up to and confront problems 3.Develop new perceptions or views of their stressors and problems Treatment is further enhanced if it helps people to exert effort and persistence in addressing difficulties, believe that change is needed, and accept some discomfort to achieve eventual treatment benefits. The research and thinking of Lambert ( 1992 ) and Lambert and Bergin ( 1994 ) on common factors accounting for client improvement yielded three common factors: 1. Support factors , including a positive, reassuring, and trusting therapeutic alliance and a clinician who communicates warmth, respect, empathy, genuineness, and acceptance 2. Learning factors , including changes in clients’ thinking and perceptions, receiving advice, acquisition of insight, corrective emotional experiences, and increased self-acceptance and expectations for personal effectiveness 3. Action factors , including an expectation for positive change, improved behavioral regulation, reality testing, modeling, practicing, completing homework tasks, receiving suggestions, confronting fears and problems, processing, working through, and having success experiences In Lambert and Bergin’s framework, as in Hanna and Ritchie’s, emotions, thoughts, and actions all play essential roles in the process of successful treatment. Frank and Frank ( 1991 , pp. 42–44) suggested that common factors in effective treatment include: •An emotionally involving, confiding relationship with a helping person •A healing setting that provides safety •A rationale that provides a plausible explanation for the client’s problems •A ritual or procedure for change that requires the active participation of both client and clinician Kleinke ( 1994 , p. viii) offered yet another perspective, suggesting that treatment encompasses five common therapeutic goals: 1.Overcoming demoralization and gaining hope 2.Enhancing mastery and self-efficacy 3.Overcoming avoidance 4.Accepting life’s realities 5.Achieving insight Grencavage and Norcross (
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