لایب سان

Author(s): Douglas H. Sprenkle, Sean D. Davis, Jay L. Lebow PhD

Publisher: The Guilford Press, Year: 2009

ISBN: 1606233254,9781606233252

ix Contents 1 What Is Responsible for Therapeutic Change?: 1 Two Paradigms Two Paradigms of Therapeutic Change 3 The Broad and Narrow Conceptualizations of Common Factors 9 Resistance to Common Factors among Relational Therapists 10 The Plan for This Book 11 2 A Brief History of Common Factors 14 Early School-Based Theories 15 First-Generation Family Therapies 16 Beginnings in the Understanding of Common Factors: Early Stirrings 18 Jerome Frank 19 Carl Rogers 19 The Generic Model 21 Luborsky and the Dodo Bird Verdict 23 Karasu, Gurman, and Goldfried’s Classifications of Change Agents 23 Results from Meta-Analyses of the Impact of Psychotherapy 24 Lambert’s Analysis 26 The Great Psychotherapy Debate 27 The Heart and Soul of Change 27 The American Psychological Association Division of Psychotherapy Report 29 The Integrative Movement in Psychotherapy and Family Therapy 30 Sprenkle and Blow’s Moderate Common Factors Approach 32 3 Common Factors Unique to Couple and Family Therapy 34 Conceptualizing Difficulties in Relational Terms 35 Disrupting Dysfunctional Relational Patterns 37 Expanding the Direct Treatment System 38 Expanding the Therapeutic Alliance 42 x Contents 4 The Big-Picture View of Common Factors 45 Client Characteristics as Common Factors 46 Therapist Characteristics as Common Factors 49 Dimensions of the Therapeutic Relationship as Common Factors 53 Dimensions of Expectancy as Common Factors 53 Nonspecific Mechanisms of Change as Common Factors 54 Other Mediating and Moderating Variables as Common Factors 55 5 A Moderate View of Common Factors 60 Believes One Treatment Is as Good as Another versus Questions Claims about Relative Efficacy 61 Disparages Effective Models versus Supports Them 64 Sees the Therapeutic Relationship as All There Is versus Views the Relationship as Only One Aspect of Change 65 Minimizes Clinical Trials Research versus Supports It 66 Supports Either–Or versus Both–And in the Common Factors and Specific Factors Debate 67 6 Getting Clients Fired Up for a Change: 69 Matching Therapist Behavior with Client Motivation Clients as the Most Important Common Factor 69 Transtheoretical Stages-of-Change Model 73 Facilitating Client Engagement through Motivational Interviewing 78 Facilitating Client Engagement and Motivation in Relational Therapy: Functional Family Therapy 81 Applying Principles of Motivation to Relational Therapy: A Clinical Vignette 82 7 A Strong Therapeutic Alliance 87 Understanding the Therapeutic Alliance 88 Establishing and Maintaining an Alliance in Couple or Family Therapy 98 Intervention as a Method of Building Alliance 105 The Significance of the Therapeutic Alliance 105 8 Models: All Roads Lead to Rome 107 Common Distressed Relational Processes and Treatment Goals: Interactional Cycles and Patterns 110 Model-Specific Conceptualizations of Common Distressed Relationship Processes 112 Additional Common Processes of Distressed and Healthy Relationships 122 Contents xi 9 A Meta-Model of Change in Couple Therapy 123 The Need for a Meta-Model of Change 123 Empirical Development of the Model 125 How Narrow and Broad Common Factors Interact to Produce Change in Couple Therapy: A Meta-Model 126 Strengths and Limitations 142 Special Considerations for Family Therapy 142 10 The Case against Common Factors 144 11 Common Factors Training and Supervision 159 Assumptions Underlying Common-Factors-Driven and Model-Driven Change Training Approaches 161 Components of a Common Factors Training Program 163 Practical Examples of Our Common Factors Training Approach 165 Implications for Supervision 167 A Climate of Reflective Theoretical Inclusivity 168 12 Implications for Clinicians and Researchers 170 General Implications for Clinicians 171 Specific Implications for Clinicians 174 General Implications for Researchers 177 Specific Implications for Researchers 180 Appendix A: Moderate Common Factors 183 Supervision Checklist Appendix B: Instruments from Other Authors Related 192 to Common Factors References 199 Index 219

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