Interventions in Psychotherapy

Abstract

Analogous to the hierarchy of dimensional variables in psychopathology, we postulate that there is also a hierarchical system of psychotherapeutic interventions. Therapeutic techniques (specific factors of intervention) make up the bottom level of this hierarchy; at an upper level, we place the common (unspecific) factors, and classes of common factors comprise the top level. This model of psychotherapy deviates from the supposed antagonism of either common factors or techniques as the most effective interventions. We argue instead that both types of interventions depend on each other in that the common factors are implemented by techniques and both must therefore be positioned at different levels of a hierarchy. Both types are deterministic interventions yet with a different profile of action. Common factors address the affordances (in terms of synergetics, the control parameters) of the therapy system, which can lead to new pattern formation by self-organizational dynamics. Common factors are thus contextual interventions, in reference to Wampold’s contextual model of psychotherapy. In addition, we emphasize the importance of therapist effects. Recent research has shown that therapists’ resilience and mindfulness are systematically linked with higher effectiveness of these therapists.