Researching Abnormality 177
has more attrition than a group receiving a placebo (and not experiencing any
side effects). To determine the medication’s effects, should the researcher com-
pare the placebo group to all those who started in the medication group (and
thus include those who dropped out of the study), or should the researcher com-
pare the placebo group only to those who completed the medication treatment?
If you compare those who took the placebo to those who completed the medica-
tion treatment, the medication might look very promising. But if you compare the
placebo group to all those who started the medication, the medication might not
appear more effective than the placebo. This question of whether to include the
results of those who drop out applies to research on all types of treatment—it isn’t
limited to research on biomedical treatments.
Researching Treatments That Target
Psychological Factors
Many of the research issues that arise with biomedical treatments also arise in
research on treatments that target psychological factors. In addition, as shown
in Table 5.3, research on treatments that target psychological factors may be
designed to investigate which aspects of therapy in general, or of particular types of
therapy—such as your grief box therapy—are most helpful. Let’s consider the sorts
of factors that underlie the effects of treatments that targets psychological factors,
how researchers control for confounding factors when they study such treatments,
whether therapy is better than no treatment, whether one type of therapy is gener-
ally best, and which types of therapy are better for treating specifi c disorders.
Common factors
Helpful aspects of therapy that are shared by
virtually all types of psychotherapy.Therapy Variables Patient Variables Therapist Variables Patient-Therapist Interaction
Variables- Theoretical orientation
- Specifi c techniques used
- Level of motivation and ability to
change - Belief in the ability of treatment
to help - Community resources available
(social and fi nancial support) - Preferred style of coping and
relating to others - Preferred treatment focus: on symp-
toms (as in CBT) or on their meaning
(as in psychodynamic therapy) - Personality traits
- Enthusiasm for and belief in the
treatment - Usual style of interacting (such as
supportive or challenging) - Treatment focus: on symptoms or
on their meaning - Empathic ability
- Personality traits
- Experience with the particular
type of treatment- Structure of the relationship
(therapist as expert vs. therapist
as coach) - Fit between patient’s and therapist’s
personalities - Fit between patient’s and therapist’s
treatment focus (symptoms vs. their
meaning) - Sense of alliance between patient
and therapist
- Structure of the relationship
- Enthusiasm for and belief in the
- Level of motivation and ability to
Table 5.3 • Treatment-Related Variables
Common Factors
Just as placebos can provide relief even though they lack medically beneficial
ingredients, the very act of seeing a therapist or counselor—or even setting up a
meeting with one—may provide relief for some disorders (regardless of the specifi c
techniques or theoretical approach of the therapist or counselor). Such relief may
be due, at least in part, to common factors, which are helpful aspects of therapy
that are shared by virtually all types of psychotherapy. According to results from
numerous studies (Garfi eld & Bergin, 1994; Lambert & Ogles, 2004; Weinberger,
1995), common factors can include:
- opportunities to express problems;
- some explanation and understanding of the problems;