Psikoterapide Ortak Faktörler Yaklaşımı İçin Bir Çerçeve Olarak Motivasyonel Görüşme

Yıl 2018, Cilt: 1 Sayı: 2, 46 - 73, 05.08.2018

Yesim Keskin , Fred P. Piercy

Öz

Etkinliği kanıtlanan psikoterapi modellerinin sayısının 400'e ulaşmasıyla birlikte,
psikoterapide ortak faktörler yaklaşımı son on yıldır araştırmalarda önemli bir
yer edinmeye başladı. Bir yandan ortak faktörler yaklaşımını destekleyen
araştırmalar artarken diğer yandan bu yaklaşımı spekülatif olmakla ve bilimsel
temele dayanmamakla eleştiren yayınlar ortaya konmaktadır. Bu kavramsal
çalışmada, öncelikle ortak faktörler yaklaşımı ve motivasyonel görüşme
çerçevesinin ana hatlarını çizecek, ardından ortak faktörler yaklaşımı ve
motivasyonel görüşme çerçevesi arasındaki benzerlikleri tartışacak ve
motivasyonel görüşme çerçevesinin ortak faktörler yaklaşımı araştırmaları için
kanıt-temelli bir araştırma aracı ve teorik çerçeve olduğunu öne süreceğiz.
Sonuçta bu yaklaşımın çıkarımları ve eksiklerini tartışacağız.

Anahtar Kelimeler

Ortak Faktörler, Motivasyonel Görüşme, Psikoterapi

Motivational Interviewing as a Framework for Common Factors Approach in Psychotherapy

Öz

Along with reaching saturation in the field
of psychotherapy modalities which currently includes more than 400 models that are
proven to be effective, common factors approach has started to become one of
the hot topics of the psychotherapy debate in the last ten years. While there
is a growing literature taking a common factors proponent stance, there are
also criticisms including the common factors approach being speculative and not
having a scientific ground. In this conceptual paper, first we will outline the
common factors approach and motivational interviewing framework. Then, we will discuss
the overlapping between common factors perspective and motivational
interviewing framework and propose motivational interviewing as an evidence-based
research tool and empirically based theoretical framework for the common
factors research and theory. Finally, we will discuss the implications and
limitations of taking such a stance. 

Anahtar Kelimeler

Common Factors, Motivational Interviewing, Psychotherapy

Kaynakça

• Ackerman, S. J., & Hilsenroth, M. J. (2001). A review of therapist characteristics and techniques negatively impacting the therapeutic alliance. Psychotherapy, 38, 171-185.
• Anderson, T., McClintock, A. S., Himawan, L., Song, X., & Patterson, C. L. (2016). A prospective study of therapist facilitative interpersonal skills as a predictor of treatment outcome. Journal of Consulting and Clinical Psychology, 84(1), 57.
• Arkowitz, H., Miller, W. R., & Rollnick, S. (Eds.). (2015). Motivational interviewing in the treatment of psychological problems. New York: Guilford.
• Asnaani, A., & Foa, E. B. (2014). Expanding the lens of evidence-based practice in psychotherapy to include a common factors perspective: Comment on Laska, Gurman, and Wampold. Psychotherapy, 51, 487–490.
• Baker, T. B., McFall, R. M., & Shoham, V. (2008). Current status and future prospects of clinical psychology toward a scientifically principled approach to mental and behavioral health care. Psychological Science in the Public Interest, 9, 67-103.
• Baldwin, S. A., & Imel, Z. E. (2013). Therapist effects: Findings and methods. Bergin and Garfield’s handbook of psychotherapy and behavior change, 6, 258-297.
• Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychological review, 84(2), 191.
• Beutler, L. E. Malik, M., Alimohamed, S., Harwood, T. M., Talebi, H., Noble, S., et al. (2004). Therapist variables. In M. J. Lambert (Ed.), Bergin and Garfield's handbook of psychotherapy and behavior change (5th ed., pp. 227-306). New York: Wiley
• Blow, A. J., Sprenkle, D. H., & Davis, S. D. (2007). Is who delivers the treatment more important than the treatment itself? The role of the therapist in common factors. Journal of marital and family therapy, 33(3), 298-317.
• Bohart, A. C, & Tallman, K. (1999). How clients make therapy work: The process of active self-healing. Washington, DC: American Psychological Association.
• Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, research & practice, 16(3), 252.
• Breuk, R. E., Sexton, T. L., van Dam, A., Disse, C., Doreleijers, T. A. H., Slot, W. N., et al. (2006). The imple-mentation and cultural adjustment of functional family therapy in a Dutch psychiatric day-treatment center. Journal of Marital and Family Therapy, 32, 515–530.
• Carroll, K. M., Ball, S. A., Nich, C., Martino, S., Frankforter, T. L., Farentinos, C., ... & Polcin, D. (2006). Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: A multisite effectiveness study. Drug & Alcohol Dependence, 81(3), 301-312.
• Chow, D. L., Miller, S. D., Seidel, J. A., Kane, R. T., Thornton, J. A., & Andrews, W. P. (2015). The role of deliberate practice in the development of highly effective psychotherapists. Psychotherapy, 52(3), 337.
• Creed, T. A., & Kendall, P. C. (2005). Therapist alliance-building behavior within a cognitive-behavioral treatment for anxiety in youth. Journal of consulting and clinical psychology, 73(3), 498.
• D'Aniello, C., Nguyen, H. N., & Piercy, F. P. (2016). Cultural Sensitivity as an MFT Common Factor. The American Journal of Family Therapy, 44, 234-244.
• Davis, S. D., & Piercy, F. P. (2007a). What clients of couple therapy model developers and their former students say about change, part I: Model-dependent common factors across three models. Journal of Marital and Family Therapy, 33, 318–343.
• Davis, S. D., & Piercy, F. P. (2007b). What clients of couple therapy model developers and their former students say about change, part II: Model-independent common factors and an integrative framework. Journal of Marital and Family Therapy, 33, 344–363.
• Dragioti, E., Dimoliatis, I., Fountoulakis, K. N., & Evangelou, E. (2015). A systematic appraisal of allegiance effect in randomized controlled trials of psychotherapy. Annals of General Psychiatry, 14, 1.
• Duncan, B. L., Miller, S. D., & Sparks, J. A. (2004). The heroic client: A revolutionary way to improve effectiveness through client-directed, outcome-informed therapy (Rev. ed.). San Francisco: Jossey-Bass.
• Duncan, B. L., Solovey, A., & Rusk, G. (1992). Changing the rules: A client-directed approach. New York: Guilford Press.
• Elliott, R., Bohart, A. C., Watson, J. C., & Greenberg, L. S. (2011). Empathy. Psychotherapy, 48, 43.
• Ericsson, K. A., & Lehmann, A. C. (1996). Expert and exceptional performance: Evidence of maximal adaptation to task constraints. Annual review of psychology, 47(1), 273-305.
• Farber, B. A., & Doolin, E. M. (2011). Positive regard and affirmation. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Evidence-based responsiveness (pp. 168–186). USA: Oxford University Press.
• Farber, B. A., & Lane, J. S. (2001). Positive regard. Psychotherapy: Theory, Research, Practice, Training, 38(4), 390.
• Festinger, L. (1957). A theory of cognitive dissonance, Evanston, IL: Row & Peterson.
• Fife, S. T., Whiting, J. B., Bradford, K., & Davis, S. (2014). The therapeutic pyramid: A common factors synthesis of techniques, alliance, and way of being. Journal of Marital and Family Therapy, 40, 20-33.
• Frank, J. D. (1961). Persuasion and healing. Baltimore: Johns Hopkins University Press.
• Friedlander, M. L., Escudero, V., & Heatherington, L. (2006). Therapeutic alliances with couples and families: An empirically informed guide to practice. Washington, DC: American Psychological Association.
• Gaston, L., Marmar, C. R., Gallagher, D., & Thompson, L. W. (1991). Alliance prediction of outcome beyond in-treatment symptomatic change as psychotherapy processes. Psychotherapy Research, 1, 104-112.
• Gellatly, J., Bower, P., Hennessy, S., Richards, D., Gilbody, S., & Lovell, K. (2007). What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychological Medicine, 37, 1217-1228.
• Hayes, J. A., Owen, J., & Bieschke, K. J. (2015). Therapist differences in symptom change with racial and ethnic minority clients. Psychotherapy, 52, 308 –314.
• Horvath, A. O., & Bedi, B. P. (2002). The alliance. In J. C. Norcross (Ed.), Psychotherapy relationships that work (pp. 37-70). New York: Oxford University Press.
• Hubble, M. A., Duncan, B. L., & Miller, S. D. (1999). The heart and soul of change: What works in therapy. Washington, DC: American Psychological Association.
• Kamo, M. P. &. Longabaugh, R. (2005). Less directiveness by therapists improves drinking outcomes of reactant clients in alcoholism treatment. Journal of Consulting and Clinical Psychology, 72, 262-267.
• Karam, E. A., Blow, A. J., Sprenkle, D. H., & Davis, S. D. (2015). Strengthening the systemic ties that bind: Integrating common factors into marriage and family therapy curricula. Journal of Marital and Family Therapy, 41(2), 136-149.
• Karimi, H. (2015). Contribution of common factors to therapeutic outcomes from the clinician’s perspective: a mixed method study to explore common mechanisms of change. (Unpublished Dissertation). Virginia Tech, Blacksburg, VA.
• Klein, M. H., Michels, J. L., Kolden, G. G., & Chisolm-Stockard, S. (2001). Congruence or genuineness. Psychotherapy: Theory, Research, Practice, Training, 38(4), 396.
• Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of general psychiatry, 59(10), 877-883.
• Kraus, D. R., Castonguay, L., Boswell, J. F., Nordberg, S. S., & Hayes, J. A. (2011). Therapist effectiveness: Implications for accountability and patient care. Psychotherapy Research, 21, 267–276. http://dx.doi.org/10 .1080/10503307.2011.563249
• Lambert, M. J. (1992). Psychotherapy outcome research: Implications for integrative and eclectic therapists. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration, (pp. 94-129). New York: Basic.
• Lambert, M. J., & Barley, D. E. (2002). Research summary on the therapeutic relationship and psychotherapy outcome. In J. C. Norcross (Ed.), Psychotherapy relationships that work (pp. 17-32). New York: Oxford University Press.
• Laska, K. M., Gurman, A. S., & Wampold, B. E. (2014). Expanding the lens of evidence-based practice in psychotherapy: A common factors perspective. Psychotherapy, 51(4), 467.
• Laurenceau, J. P., Hayes, A. M., & Feldman, G. C. (2007). Some methodological and statistical issues in the study of change processes in psychotherapy. Clinical psychology review, 27(6), 682-695.
• Lebow, J., Kelly, J., Knobloch-Fedders, L., & Moos, R. (2006). Relationship factors in treating substance use disorders. Principles of therapeutic change that work, 293-317.
• Levitt, H., Butler, M., & Hill, T. (2006). What clients find helpful in psychotherapy: Developing principles for facilitating moment-to-moment change. Journal of Counseling Psychology, 53, 314-324.
• Leykin, Y., & DeRubeis, R. J. (2009). Allegiance in psychotherapy outcome research: Separating association from bias. Clinical Psychology: Science and Practice, 16, 54-65.
• Linden, A., Butterworth, S. W., & Prochaska, J. O. (2010). Motivational interviewing‐based health coaching as a chronic care intervention. Journal of evaluation in clinical practice, 16(1), 166-174.
• Luborsky, L., Diguer, L., Seligman, D. A., Rosenthal, R., Krause, E. D., Johnson, S., et al. (1999). The researcher’s own therapy allegiances: A “wild card” in comparisons of treatment efficacy. Clinical Psychology: Science and Practice, 6, 95–106.
• Luborsky, L., Rosenthal, R., Diguer, L., Andrusyna, T. P., Berman, J. S., Levitt, J. T., et al. (2002). The dodo bird verdict is alive and well—mostly. Clinical Psychology: Science and Practice, 9, 2–12.
• Luborsky, L., Singer, B., & Luborsky, L. (1975). Comparative studies of psychotherapies. Is it true that “everyone has won and all must have prizes”? Archives of General Psychiatry, 32, 995–1008.
• Macdonald, P., Hibbs, R., Corfield, F., & Treasure, J. (2012). The use of motivational interviewing in eating disorders: a systematic review. Psychiatry research, 200(1), 1-11.
• Mackrill, T. (2011). Differentiating life goals and therapeutic goals: Expanding our understanding of the working alliance. British Journal of Guidance & Counselling, 39(1), 25-39.
• Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438.
• Messer, S. B., & Wampold, B. E. (2002). Let's face facts: Common factors are more potent than specific therapy ingredients. Clinical Psychology: Science and Practice, 9, 21-25.
• Miller, S. D., Duncan, B. L, & Hubble, M. A. (1997). Escape from Babel: Toward a unifying language for psychotherapy practice. New York: Norton.
• Miller, S. D., Duncan, B. L, Sorrell, R., & Brown, G. S. (2005). The partners for change outcome management system. Journal of Clinical Psychology: In Session, 61, 199-208.
• Miller, S. D., Duncan, B., & Hubble, M. (2008). Supershrinks: What is the secret of their success?. Psychotherapy in Australia, 14(4), 14.
• Miller, W. R. & Rollnick, S.(1991) Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford Press.
• Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change. 3. New York: Guilford.
• Miller, W. R., & Rollnick, S. (2014). The effectiveness and ineffectiveness of complex behavioral interventions: impact of treatment fidelity. Contemporary clinical trials, 37(2), 234-241.
• Miller, W. R., & Rose, G. S. (2009). Toward a theory of motivational interviewing. American psychologist, 64, 527.
• Miller, W. R., Wilboume, P. L, & Hettema, J. E. (2003). What works? A summary of alcohol treatment outcome research. In R. K. Hester & W. R. Miller (Eds.), Handbook of alcoholism treatment approaches: Effective alternatives (3rd ed., pp. 13-63). Boston: Allyn & Bacon.
• Miller, W.R., Moyers, T.B., Ernst, D. & Amrhein. (2008). Manual for motivational interviewing skill code. (MISC) Version 2.1. Retrieved November 12, 2010, from http://casaa.unm.edu/download/misc.pdf
• Moyers, T. B., & Martin, T. (2006). Therapist influence on client language during motivational interviewing sessions: Support for a potential causal mechanism. Journal of Substance Abuse Treatment, 30, 245–251.
• Moyers, T. B., Martin, T., Manuel, J. K., Hendrickson, S. M., & Miller, W. R. (2005). Assessing competence in the use of motivational interviewing. Journal of Substance Abuse Treatment, 28, 19-26.
• Moyers, T. B., Rowell, L. N., Manuel, J. K., Ernst, D., & Houck, J. M. (2016). The Motivational Interviewing Treatment Integrity Code (MITI 4): Rationale, preliminary reliability and validity. Journal of Substance Abuse Treatment, 65, 36-42.
• Munder, T., Brütsch, O., Leonhart, R., Gerger, H., & Barth, J. (2013). Researcher allegiance in psychotherapy outcome research: an overview of reviews. Clinical Psychology Review, 33, 501-511.
• Nissen-Lie, H., Goldberg, S., Hoyt, W., Falkenström, F., Holmqvist, R., Nielsen, S., Wampold, B. (2016). Are Therapists Uniformly Effective across Patient Outcome Domains? A Study on Therapist Effectiveness in Two Different Treatment Contexts. Journal of Counseling Psychology, 63, 367-378.
• Norcross, J. C, Koocher, G. P., & Garofalo, A. (2006). Discredited psychological treatments and tests: A Delphi poll. Professional Psychology: Research & Practice, 37, 515-522.
• Norcross, J. C. (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. Oxford University Press.
• O'Brien, C. P., Childress, A. R., Ehrman, R., & Robbins, S. J. (1998). Conditioning factors in drug abuse: can they explain compulsion?. Journal of psychopharmacology, 12(1), 15-22.
• Okiishi, J. C., Lambert, M. J., Eggett, D., Nielsen, L., Dayton, D. D., & Vermeersch, D. A. (2006). An analysis of therapist treatment effects: Toward providing feedback to individual therapists on their clients' psychotherapy outcome. Journal of clinical psychology, 62, 1157-1172.
• Orlinsky D, & Howard K. (1987). A generic model of psychotherapy. Journal of Integrative and Eclectic psychotherapy, 6, 6–27.
• Orlinsky, D. E., Ronnestad, M. H., & Willutzki, U. (2004). Fifty years of psychotherapy process-outcome research: Continuity and change. In M. J. Lambert (Ed.), Handbook of psychotherapy and behavior change (5th ed.). New York: Wiley.
• Pederson, L. L., & Lefcoe, N. M. (1976). A psychological and behavioural comparison of ex-smokers and smokers. Journal of Chronic Diseases, 29(7), 431-434.
• Philips, B., Wennberg, P., & Werbart, A. (2007). Ideas of cure as a predictor of premature termination, early alliance and outcome in psychoanalytic psychotherapy. Psychology and Psychotherapy: Theory, Research and Practice, 80(2), 229-245.
• Prochaska, J. O. & DiClemente, C. C. (1983) Stages and processes of self-change of smoking: Toward an integrative model of Change. Journal of Consulting and Clinical Psychology, 51, 390–395.
• Prochaska, J. O. (1999). How do people change, and how can we change to help many more people? In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 227-258). Washington, DC: American Psychological Association.
• Prochaska, J. O., & DiClemente, C. C. (1986). Toward a comprehensive model of change. In Treating addictive behaviors (pp. 3-27). Springer US.
• Prochaska, J.O., DiClemente, C.C., & Norcross, J.C. (1992). In search of how people change: Applications to the addictive behaviors. American Psychologist, 47, 1102-1114.
• Ricks, D. F. (1974). Supershrink: Methods of a therapist judged successful on the basis of adult outcomes of adolescent patients. In D. F. Ricks, A. Thomas, & M.
• Roff (Eds.), Life history research in psychopathology: III. Minneapolis, MN, US: University of Minnesota Press.
• Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 95.
• Rosenzweig, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry, 6, 412-415.
• Safran, J. D., Muran, J. C, Samstag, L. W., & Stevens, C. (2002). Repairing alliance ruptures. In J. C. Norcross (Ed.), Psychotherapy relationships that work (pp. 235-253). New York: Oxford University Press.
• Safran, J. D., Muran, J. C., & Eubanks-Carter, C. (2011). Repairing alliance ruptures. Psychotherapy, 48, 80.
• Schnur, J. B., & Montgomery, G. H. (2010). A systematic review of therapeutic alliance, group cohesion, empathy, and goal consensus/collaboration in psychotherapeutic interventions in cancer: Uncommon factors?. Clinical Psychology Review, 30, 238-247.
• Sexton, T. L., Ridley, C. R., & Kleiner, A. J. (2004). Beyond common factors: multilevel‐process models of therapeutic change in marriage and family therapy. Journal of Marital and Family Therapy, 30(2), 131-149.
• Sharf, J., Primavera, L. H., & Diener, M. J. (2010). Dropout and therapeutic alliance: A meta-analysis of adult individual psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 47, 637–645.
• Sprenkle, D. H., & Blow, A. J. (2004a). Common factors and our sacred models. Journal of Marital and Family Therapy, 30, 113–129.
• Sprenkle, D. H., & Blow, A. J. (2004b). Common factors are not islands – they work through models: A response to Sexton, Ridley, and Kleiner. Journal of Marital and Family Therapy, 30, 151–158.
• Sprenkle, D. H., Davis, S. D., & Lebow, J. (2009) Common factors in couple and family therapy: The overlooked foundation for effective practice. New York: Guilford Press.
• Stewart-Donaldson, C. (2012). The impact of motivational interviewing feedback and coaching on school counseling motivational interviewing skills. (Unpublished Dissertation). Oregon State University, Corvallis, OR.
• Stolk, Y., & Perlesz, A. J. (1990). Do better trainees make worse therapists? A follow-up study of client families. Family Process, 29, 45–58.
• Thomas, S. E. G., Werner-Wilson, R. J., & Murphy, M. J. (2005). Influence of therapist and client behaviors on therapy alliance. Contemporary Family Therapy: An International Journal, 27, 19–35.
• Titov, N., Andrews, G., Schwencke, G., Solley, K., Johnston, L., & Robinson, E. (2009). An RCT comparing effect of two types of support on severity of symptoms for people completing Internet-based cognitive behaviour therapy for social phobia. Australian and New Zealand Journal of Psychiatry, 43, 920-926.
• Tryon, G. S., & Winograd, G. (2002). Goal consensus and collaboration. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness of patients (pp. 3 – 16). New York7 Oxford University Press.
• Wampold, B. E. (2001). The great psychotherapy debate: Models, methods and findings. Mahwah, NJ: Lawrence Erlbaum.
• Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14, 270-277.
• Wampold, B. E., & Brown, G. S. (2005). Estimating variability in outcomes attributable to therapists: A naturalistic study of outcomes in managed care. Journal of Consulting and Clinical Psychology, 73, 914 –923.
• Westra, H. A., Arkowitz, H., & Dozois, D. J. (2009). Adding a motivational interviewing pretreatment to cognitive behavioral therapy for generalized anxiety disorder: A preliminary randomized controlled trial. Journal of Anxiety Disorders, 23, 1106-1117.