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Common versus Specific Factors and the Future of Psychotherapy: A Response to Siev and Chambless

October 31, 2009 By scottdm 4 Comments

Early last summer, I received an email from my long time friend and colleague Don Meichenbaum alerting me to an article published in the April 2009 edition of the Behavior Therapist–the official “newsletter” of the Association for Behavioral and Cognitive Therapies–critical of the work that I and others have done on the common factors.

Briefly, the article, written by two proponents of the “specific treatments for specific disorders” approach to “evidence-based practice” in psychology, argued that the common factors position–the idea that the efficacy of psychotherapy is largely due to shared rather than unique or model-specific factors–was growing in popularity despite being based on “fallacious reasoning” and a misinterpretation of the research.

Although the article claimed to provide an update on research bearing directly on the validity of the “dodo verdict”–the idea that all treatment approaches work equally well–it simply repeated old criticisms and ignored contradictory, and at times, vast evidence.  Said another way, rather than seizing the opportunity they were given to educate clinicians and address the complex issues involved in questions surrounding evidence-based practice, Siev and Chambless instead wrote to “shore up the faithful.”  “Do not doubt,” authors Siev and Chambless were counseling their adherents, “science is on our side.”

That differences and tensions exist in the interpretation of the evidence is clear and important.  At the same time, more should be expected from those who lead the field.  You read the articles and decide.  The issues at stake are critical to the future of psychotherapy.  As I will blog about next week, there are forces at work in the United States and abroad that are currently working to limit the types of approaches clinicians can employ when working with clients.  While well-intentioned, available evidence indicates they are horribly misguided.  Once again, the question clinicians and consumers face is not “which treatment is best for that problem,” but rather “which approach “fits with, engages, and helps” the particular consumer at this moment in time?”

Behavior Therapist (April 2009) from Scott Miller

Dissemination of EST’s (November 2009) from Scott Miller

Filed Under: Dodo Verdict, evidence-based practice, Practice Based Evidence Tagged With: Association for Behavioral and Cognitive Therapies, behavior therapist, Don Meichenbaum, evidence based medicine, evidence based practice, psychology, psychotherapy

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