Common and specific factors in CBT: Theory and research from studies in the treatment of anxiety
The common vs. specific factors debate has been around for almost 90 years. Most advocates of CBT have suggested that common factors are necessary, but not sufficient. Others have argued that the Dodo Bird is alive and well, and that all treatments that are credible or bona fide yield similar results. In the current talk, I will review data from clinical trials of CBT for panic disorder, social anxiety disorder, and OCD in which common factors such as the therapist effects, working alliance, expectancy, and motivation have been examined along with specific factors such as changes in negative cognitions, attentional bias, interpretation bias, or emotion regulation (reappraisal, suppression). Overall, results suggest a more nuanced picture than either school typically advocates, such that the role of the common factors has an impact, as do specific techniques and mechanisms, partially depending on the disorder in question and potentially the difficulty of the case at hand. Advances in the field will come from careful, honest, and critical examination of the data, openness to data from other perspectives (for potential for integration), and with continued attempts to improve interventions as well as scaling them up via internet based and other low-intensity interventions.
Jonathan D. Huppert is Professor and Chair of the Department of Psychology at The Hebrew University of Jerusalem, Israel, where he holds the Sam and Helen Berber Chair of Clinical Psychology. Dr. Huppert specializes in the nature and treatment of anxiety and related disorders, and has worked on dissemination of CBT throughout Israel and beyond. He conducts research on the processes of cognitive behavioral therapy, to better understand its mechanisms.