Therapeutic factors in treating anxiety disorders

Abstract

This article is a condensation of several chapters from Principles of Therapeutic Change That Work edited by L.G. Castonguay and L.E. Beutler. The authors present the work of M.G. Newman, W.B. Stiles, A. Janeck, and S.R. Woody (2006), who outline an integrative model for effective psychotherapy of anxiety disorders. The authors also summarize, review, and extend several chapters on the current knowledge about therapeutic technique factors (S.R. Woody & T.H. Ollendick, 2006), participant factors (M.G. Newman, P. Crits-Christoph, M.B. Connelly Gibbons, & T.M. Erickson, 2006), and relationship factors (W.B. Stiles & B.E. Wolfe, 2006), which are related to anxiety disorder treatment outcome. The authors then place these factors and their practice implications within a common framework. Their integration is based on (a) the concept of appropriate responsiveness, and (b) a distinction between actions and achievements.

The responsiveness problem in psychotherapy: A review of proposed solutions.

“…Conversely, evaluative measures implicitly incorporate responsiveness. A strong therapeutic alliance, for example, can be understood as an achievement, a result of appropriate responsive processes taking place in the interaction between client and therapist (Newman & Stiles, 2006; Stiles & Wolfe, 2006; see the illustration above by Anderson et al, 1999). If therapists and clients do the right thing at the right time, the alliance tends to be strong.…”

A quantitative method for the analysis of nomothetic relationships between idiographic structures: Dynamic patterns create attractor states for sustained posttreatment change.

“…It is the goal of psychotherapy to interrupt these patterns and replace them with more adaptive patterns of thought, affect, and action (Mahoney, 1991). Decades of psychotherapy outcome data have demonstrated that psychotherapy works, decreasing psychopathological symptomatology (Chambless & Ollendick, 2001;Newman & Stiles, 2006) and improving interpersonal functioning (Crits-Christoph, Gibbons, Narducci, Schamberger, & Gallop, 2005;Horowitz, Rosenberg, Baer, Uren ˜o, & Vilasenor, 1988;Newman et al, 2011), among other beneficial outcomes. However, many have called for the investigation of the mechanisms of psychotherapeutic action in order to ascertain how and why psychotherapy works (e.g., Kazdin, 2005Kazdin, , 2007Kraemer, Wilson, Fairburn, & Agras, 2002) and, in some cases, why it does not.…”