Academic journal article American Journal of Psychotherapy

Specific Techniques vs. Common Factors? Psychotherapy Integration and Its Role in Ethical Practice

Academic journal article American Journal of Psychotherapy

Specific Techniques vs. Common Factors? Psychotherapy Integration and Its Role in Ethical Practice

Article excerpt

INTRODUCTION

Providing the best evidence-based practice is becoming increasingly important when considering the ethics of informed consent, professional competence, and continuing professional development. The American Psychological Association (2012) requires psychologists to provide information to their clients on ". . . the nature and anticipated course of therapy" (p 13) at the earliest opportunity in treatment. In the complex world of therapy, therapists re admonished to make a choice in treating clients by ". . . basing . . . (their) . . . service on the established knowledge of the discipline and profession of psychology (Australian Psychological Society, 2012, p 18). Psychologists are encouraged to use ". . . [methods] based upon established scientific and professional knowledge of the discipline generally recognized techniques and procedures" (American Psychological Association, 2012, Standard 2, http:// www.apa.org/ethics/code/). One of the most direct references to evidence-based practice is in the policy statement accepted by the American Psychological Association, which defined evidence-based practice as using the best research together with clinical experience in the context of individual clients and their wishes and needs (APA Presidential Task Force on EvidenceBased Practice, 2006). The guidelines for continuing professional development (CPD) in Australia, which were developed with the formation of a nation-wide accreditation and registration body for psychologists, makes explicit reference for therapists "to provide optimal evidence-based services to clients" (Psychology Board of Australia, 2012, p. 2). Thus, there is increasing emphasis on evidence-based practice as an ethical imperative. Perhaps the somewhat softer expression, evidence-supported practice, is a more accurate description of what we all try to do.

For professionals considering the role of specific techniques and common factors, the literature on evidence-supported therapies is often confusing. There have been attempts to simplify the search for the most up-to-date evidence-based practice strategies for individual clinicians (e.g. Falzon, Davidson, & Bruns, 2010). Other works described the process of an entire organization moving from an eclectic approach to an evidencebased practice, as being driven by a number of factors, including funding arrangements (e.g. Williams, Rogers, Carson, Sherer, & Hudson, 2011). Then there are others who argue that some cases are so complex that a single evidence-based approach is not feasible (e.g. Magnavita, Levy, Critchfield, & Lebow, 2010). There are useful strategies for determining the best evidence-based practice with specific diagnoses (Falzon et al., 2010)-though this approach relies upon an assumption that each client has only one relevant diagnosis. There is also considerable evidence that the commonalities among therapies may outweigh the differences (e.g. Laska, Gurman, & Wampold, 2014; Wampold, 2000). This paper summarizes literature related to evidence-based practice in the interests of advocating an approach that pragmatically embraces ideas related to specific techniques and common factors. The discussion is then related to the psychotherapy integration movement, which is highlighted in the case study of integration within a range of therapies that have developed an impressive widely accepted literature demonstrating an evidence base, the three waves of behavior therapy. The discussion then relates to the psychotherapy integration movement (highlighted in the case study of integration) within a range of therapies that have developed a widely accepted literature demonstrating an evidence base: the three waves of behavior therapy. Finally, within this context, implications are drawn within the current literature on evidence-based practice.

EVIDENCE-SUPPORTED THERAPIES: SPECIFIC TECHNIQUES

A brief review of the literature comparing the two major forms of therapy related to specific techniques will be presented. …

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