What is it about?

To determine if a particular type of therapy is effective, treatment research often compares an experimental treatment to an active but theoretically neutral control treatment condition (e.g. supportive therapy). More active control conditions are expected to account for common therapeutic factors that cannot be accounted for in non-active control conditions (e.g., no-treatment controls). In fact, they are often considered to be “common factor control” conditions. Common factor interventions include therapists’ support, attention, outcome expectancies, credibility, and the working alliance. This study compared therapists’ use of common factor (and theory-specific) techniques in the early phase of treatment across three treatments for generalized anxiety disorder – cognitive-behavioral (CBT), interpersonal/emotional processing, and supportive therapy control. Contrary to widely held assumptions in psychotherapy research, common factors were more typical in CBT than in supportive listening.

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Why is it important?

Researchers frequently assume in active treatment comparisons that there will be equivalent levels of common factors among the conditions. This study suggests that common factor prevalence in early treatment may not be equivalent across treatment conditions, including so-called common factor control treatments. It is possible that more active, theory-specific approaches that involve more therapist engagement and directiveness may create more opportunities to use and harness common factors. It will be important for future studies to examine common factor prevalence beyond early treatment working alliance and refrain from assuming similar degrees of common factor prevalence across active treatment conditions.


Our findings suggest that common factor control treatments may not function in the way we imagined, which has important research implications. Furthermore, the results indicate that active treatment may provide more opportunity for common factor interventions, which may challenge previously held beliefs about more active, directive approaches.

Brittany King
University at Albany State University of New York

Read the Original

This page is a summary of: Use of common and unique techniques in the early treatment phase for cognitive-behavioral, interpersonal/emotional, and supportive listening interventions for generalized anxiety disorder., Psychotherapy, September 2020, American Psychological Association (APA),
DOI: 10.1037/pst0000277.
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