studies also included youth who experienced psy-
chological symptoms with a wide range of severity
and samples of youth from varied ethnic back-
grounds. This meta-analysis therefore allowed for
an examination of whether evidence-based practice
offers advantages over other therapeutic approaches,
as well as whether the proposed benefits of
evidence-based approaches remained even among
youth who experienced severe psychopathology,
among youth from ethnic minority backgrounds,
and among youth who received treatment in differ-
ent types of settings. Main findings included:
■ Youth who received evidence-based treatment
had better outcomes than 62% of youth who
received usual care.
■ At long-term follow-up (up to 2 years later),
the better outcomes for youth who received
evidence-based practice were maintained as
compared to youth who received other thera-
peutic approaches
■ The differences in effects between evidence-
based treatments and other approaches were not
due to the tendency for studies of evidence-
based approaches to involve (1) more active
homework assignments; (2) research therapists;
(3) fewer comorbid samples; (4) university-based
settings; (5) samples with less severe psychopa-
thology; or (6) fewer ethnic minority youth.
Research findings such as these suggest that
there are several psychological treatments that
indeed seem to“work.”Moreover, there is good
reason to suspect that some approaches to treatment
may be more efficacious than others. However,
there is still much work to be done to determine
whether specific treatments may be particularly
effective for some individuals, diagnoses, or con-
texts than others (Kazdin, 2008).
Features Common to Many Therapies
The apparent diversity among psychotherapies can
sometimes lead us to overlook the marked
similarities among them. One reason is that the pur-
veyor of a new brand of psychotherapy must
emphasize the special features of the new product.
Bringing forth a minor variation of an old thera-
peutic theme would be unlikely to capture any-
one’s interest. Yet most psychotherapies have a
great deal in common.
Hundreds of“brands”of psychotherapy have
been identified. Some work, whereas others proba-
bly do not. Nevertheless, most involve a set ofcom-
mon factorsthat cuts across various theoretical and
therapeutic boundaries. Researchers may disagree
as to how influential common factors are in effect-
ing therapeutic change in patients (Bjornsson, 2011;
David & Montgomery, 2011; Wampold, 2001).
For example, Wampold (2001) suggests that com-
mon factors account for the overwhelming majority
of effects attributed to psychotherapy. Others,
while acknowledging that common factors do
play a major role in therapeutic change, argue that
factors specific to particular types of intervention
(e.g., changing cognitions and thoughts in
cognitive-behavioral therapy for depression) are
responsible for significant therapeutic change
above and beyond what can be accounted for by
common factors. As we mentioned previously, our
focus in this chapter primarily will be on common
factors, whereas factors specific to particular brands
of therapy will be discussed later in their own
respective chapters.
Lambert and Ogles (2004) provide a list of com-
mon factors categorized according to a sequential
process that they believe is associated with positive
outcome. Briefly, they propose thatsupportive factors
(e.g., positive relationship, trust) lay the groundwork
for changes in clients’beliefs and attitudes (learning
factors, e.g., cognitive learning, insight), which then
lead to behavioral change (action factors, e.g., mastery,
taking risks). Although a detailed discussion of
each of the common factors, such as those listed in
Table 11-2, is beyond the scope of this book, it may
be instructive to discuss a few of them briefly.Relationship/Therapeutic Alliance. Research
suggests that the nature of the relationship, ortherapeu-
tic alliance, between patient and therapist, is anPSYCHOLOGICAL INTERVENTIONS 317