Method: A literature review on a) the general effectiveness of therapies, and b) the "common factors" across models of therapy was undertaken over the past decade in four major social work research journals..
Findings: The recent social work literature was found to ignore an extensive literature on the overall effectiveness of psychotherapies. This "common factors" research indicates that up to 40% of variance in outcomes is due to environmental factors, another 30% to the therapeutic relationship, and 15% to client expectancies (Lambert, 1992). Only 15% of variance appears due to differences in therapeutic techniques.
Implications: While efforts to define best practices are valuable in today's managed care environment, attention to therapeutic action is also necessary. Research on how therapy works will provide a more complete and valid foundation for developing effective interventions. It is also important in orienting social work education. For example, Castonguay and colleagues (1993) found that even cognitive-behavioral therapy for depressed clients was effective only when the therapeutic relationship was strong and the client was emotional involved. Lacking these factors, the technique alone was not effective. The common factors literature both supports and affirms social work's historical perspective on persons in environments as well as our professional value on the centrality of relationship.