The Role of Common Factors in Psychotherapy Outcomes
The Role of Common Factors in Psychotherapy Outcomes
复制标题
DOI：
10.1146/annurev-clinpsy-050718-095424
复制
发表时间：
2019-01-01
期刊：
影响因子：
--
通讯作者：
Huibers, Marcus J. H.
中科院分区：
文献类型：
--
作者：
Cuijpers, Pim;Reijnders, Mirjam;Huibers, Marcus J. H.
心理治疗可以通过特定于每种疗法的技术或通过所有疗法共有的因素来起作用。共同因素模型的支持者经常指出，比较结果研究的荟萃分析表明，所有治疗方法都具有可比性的效果。然而，并非所有的元分析都支持共同因素模型；纳入的研究通常有几个方法上的问题；对于找到可比较的结果，还有其他的解释。迄今为止，关于治疗的工作机制和介质的研究一直是相关的，为了确定介质确实是患者康复过程中的因果因素，研究必须显示介质和结果之间的时间关系，剂量-反应关联，没有第三变量导致介质和结果变化的证据，支持性的实验研究，并具有强大的理论框架。目前，没有共同的或特定的因素符合这些标准，可以被认为是经验验证的工作机制。因此，目前尚不清楚治疗是通过共同因素还是特定因素起作用，还是两者兼而有之。
Psychotherapies may work through techniques that are specific to each therapy or through factors that all therapies have in common. Proponents of the common factors model often point to meta-analyses of comparative outcome studies that show all therapies have comparable effects. However, not all meta-analyses support the common factors model; the included studies often have several methodological problems; and there are alternative explanations for finding comparable outcomes. To date, research on the working mechanisms and mediators of therapies has always been correlational, and in order to establish that a mediator is indeed a causal factor in the recovery process of a patient, studies must show a temporal relationship between the mediator and an outcome, a dose-response association, evidence that no third variable causes changes in the mediator and the outcome, supportive experimental research, and have a strong theoretical framework. Currently, no common or specific factor meets these criteria and can be considered an empirically validated working mechanism. Therefore, it is still unknown whether therapies work through common or specific factors, or both.