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When talking therapies are succeeding in producing helpful change there will be what are widely known as common factors present in the process.
The four major ones are:
The therapeutic alliance between client and practitioner — how they get on together with the work, the connection they can make between them. Usually, participants describe this as feeling they are listened to, acknowledged, respected, allowed to show themselves in lots of ways including letting down their guard to talk over vulnerabilities. There’s room for getting it wrong and it becomes easier to share alternative thoughts because there is a sense that all viewpoints count. Participants offer feedback that it is not like having a friend but it is like having a supportive anchor or influence in their routine lives. Research shows this factor to be the most positive of the big four on getting a good outcome.
The theory of practice refers to the knowledge base behind the therapist and is important too; it provides a structure to work from and check in to — outcome research concludes that the major therapy theories provide a similar benefit to each other. With careful assessment and thorough knowledge, drawing on more than one of these theories at the most appropriate moment can truly match client needs for change.
Extra-therapeutic factors relate to those things outside of therapy such as social support, hobbies, family, friends, health. Paying consistent attention to the missing elements or benefits of these components also pays dividends.
The presence of hope and expectancy. Perhaps most simply this gives a most logical voice for our “best hopes” of the past, present, future. These are small words to convey wide-reaching ideas and resources and are not to be underestimated in their ability to move participants to find more resourceful emotions, thinking and actions. It is a less thoroughly researched area than the previous three common factors, nevertheless experience shows that tapping into it can provide the vital fuel for making helpful change.
It comes in many guises but can include a feeling of empowerment, or the will to imagine and achieve certain goals or finally bringing to the surface what will give a person’s life health and quality — not a picture given to a client by the “expert” but discovered between the participants as a joint task. At the very least being with a therapist willing to focus in this way brings a complimentary break from and balance to looking solely at our problems and its causes. Seeing and feeling that hope and hopelessness exist together can be the opening to better experiences.