Common Factors Therapy in Practice

Common factors therapy initially derived from the idea that the techniques and goals that therapists have in common—such as building an alliance with the client, identifying client motivations, and evoking change—might be what makes therapy effective. Decades of research offer supporting evidence for this theory. Common factors therapy now works from a strong evidence base to provide not only a metatheory for why so many approaches work, but also a practical therapy approach in and of itself. In this video, Dr. Russell Bailey discusses this approach to therapy with approach codeveloper Dr. Benjamin Ogles and then demonstrates common factors therapy in a full session. The video closes with a discussion of highlights from the demonstration that show how focusing on key change principles helps clients move toward improving their lives.

Common factors (CF) therapy presents a framework for psychotherapy while relying on concepts that have been debated, discussed, and researched for decades. The common factors hypothesis, first posed in the 1930s by Rosenzweig, pointed to the recognition that therapists from different theoretical orientations really share more than one might expect and what is shared may be what makes them effective. For decades since, researchers and theorists have found evidence for many change principles that are transtheoretical and have demonstrated common factors as a metatheory to explain how so many therapies are effective. CF therapy moves this idea forward one more crucial step, making the metatheory more concrete and actionable as its own theoretical orientation. The change principles of CF therapy include the therapeutic relationship, motivation, corrective experiencing, insight, and self-efficacy.

The change principles provide a lens for the CF therapist to select interventions in a transtheoretical manner to facilitate change with their clients. First, the foundation is built on the therapeutic relationship, where the CF therapist emphasizes the therapeutic bond, task, and goal. Taking a multicultural orientation is essential to the therapeutic relationship as the therapist practices cultural humility. The therapist also watches for ruptures within the relationship in order to intervene with repairs. Moving into the second change principle, the therapist addresses the client’s motivation by attuning to expectations, including the need to notice ambivalence and evoke change talk with motivational interviewing.

Emotions and cognitions form the target for the next two change principles: corrective experiencing and insight. The CF therapist promotes emotional change by addressing how the client is experiencing emotions and facilitates novel, contrasting experiences in several potential ways. The client may benefit from confronting difficult emotional content, such as by exposure practices or chair work. Alternatively, the therapist may facilitate openly expressing emotions or supporting the client with learning to regulate their emotional states. To address cognitions, the CF therapist may help the client to learn new information, such as with psychoeducation or instructive content. Facilitating increased awareness or providing valuable feedback to the client may also provide the client with new ways of thinking or insights.

The final change principle in CF therapy, self-efficacy, refers to the ways the therapist supports the client’s application of therapy content outside the therapy setting. Supporting the client’s empowerment through self-liberation or social liberation and encouraging experiences toward mastery can help a client build their overall sense of self-efficacy in their lives.

Russ Bailey, PhD, is an associate professor in the psychology and counseling department at Utah Valley University, where he teaches courses in psychology and counseling and where he supports the training of clinical mental health counselors. He completed a PhD in clinical psychology in 2010 and has worked in private practice, veteran affairs, hospital, residential, juvenile justice, and university counseling center settings. He continues to research mental health treatment outcomes and process and maintains a small private practice with Full Color Psychology. He coauthored Common Factors Therapy: A Principle-Based Treatment Framework (2023) and works toward practical tools for treatment providers.

Ben Ogles is a professor in the department of psychology and licensed clinical psychologist. He studies psychotherapy outcome, process, and training and is a strong believer in the benefits of common principles of change that operate across various modes and models of therapy. He is a coauthor on several books, a dozen chapters, and many articles about measuring change in psychotherapy, clinically significant change, therapist effects, and the process of change in psychotherapy, such as Common Factors Therapy: A Principle-Based Treatment Framework, published by APA, and a recent article on client’s negative experiences in psychotherapy (Vybiral et al., 2023). Some of his recent work explores the use of deliberate practice for training beginning graduate students to handle basic, yet challenging, ethical situations in therapy.

APA Videos

Integrative Therapy
John C. Norcross, PhD

The Therapy Relationship
Charles J. Gelso, PhD

Relational Psychotherapy
Jeremy D. Safran, PhD

Integrative Systemic Therapy With Couples
William M. Pinsof, PhD, ABPP, LMFT

The Process of Change in Integrative Therapy
J. Scott Fraser, PhD

Client-Centered Therapy
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Comparing Models of Emotion in Therapy
Leslie S. Greenberg, PhD, Norka T. Malberg, PsyD, and Michael A. Tompkins, PhD

APA Books

Common Factors Therapy
Russell J. Bailey, PhD, and Benjamin M. Ogles, PhD

Psychotherapy Integration
George Stricker, PhD

Integrative Systemic Therapy: Metaframeworks for Problem Solving With Individuals, Couples, and Families
William M. Pinsof, PhD, Douglas Breunlin, PhD, William Russell, PhD, Jay L. Lebow, PhD, Anthony L. Chambers, PhD, and Cheryl Rampage, PhD

Working With Emotion in Psychodynamic, Cognitive Behavior, and Emotion-Focused Psychotherapy
Leslie S. Greenberg, PhD, Norka Malberg, PhD, and Michael A. Tompkins, PhD

Transformation in Psychotherapy: Corrective Experiences Across Cognitive Behavioral, Humanistic, and Psychodynamic Approaches
Louis G. Castonguay, PhD, and Clara E. Hill, PhD

Rupture and Repair in Psychotherapy: A Critical Process for Change
Catherine F. Eubanks, PhD, Lisa Wallner Samstag, PhD, and J. Christopher Muran, PhD

Other related titles

Bailey, R. J., & Ogles, B. M. (2019). Common Factors as a therapeutic approach: What is required? Practice Innovations, 4, 241-254. https://doi.org/10.1037/pri0000100opens in new window

Eubanks, C. F., & Goldfried, M. R. (2019). A principle-based approach to psychotherapy integration. In J. C. Norcross, & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (3rd edition), (pp. 88-105). Oxford University Press.

Frank, J. D. & Frank, J. B. (1991). Persuasion and healing: A comparative study of psychotherapy (3rd ed.). Johns Hopkins University Press.

Fraser, J. S., & Solovey, A. D. (2007). Second-order change in psychotherapy: The golden thread that unifies effective treatments. American Psychological Association. https://doi.org/10.1037/11499-000opens in new window

Goldfried, M. R. (1980). Toward the delineation of therapeutic change principles. American Psychologist, 35, 991–999. https://dx.doi.org/10.1037/0003-066X.35.11.991opens in new window

Goldfried, M. R. (2019). Obtaining consensus in psychotherapy: What holds us back? American Psychologist, 74(4), 484–496. https://doi.org/10.1037/amp0000365opens in new window

Norcross, J. C. (2005). A primer on psychotherapy integration. In M. R. Goldfried & J. C. Norcross (Eds.), Handbook of psychotherapy integration (2nd ed., pp. 3–23). Oxford University Press.

Twomey, C., O'Reilly, G., & Goldfried, M. R. (2023). Consensus on the perceived presence of transtheoretical principles of change in routine psychotherapy practice: A survey of clinicians and researchers. Psychotherapy (Chicago, Ill.), 60(2), 219–224. https://doi.org/10.1037/pst0000489opens in new window