Title

The Therapeutic Pyramid: A Common Factors Synthesis of Techniques, Alliance, and Way of Being

Keywords

therapeutic alliance, client motivation, meta-models, interventions

Abstract

Common factors in therapy such as the therapeutic alliance and client motivation have been found to account for more change than therapy models. But common factors have been critiqued as only lists of variables that provide little practical guidance. Some researchers have demonstrated that certain common elements (e.g., the therapeutic alliance) account for more variance than others (e.g., techniques), suggesting that some factors should be emphasized over others. Such findings suggest the need for alternatives to model‐based therapy, with one alternative being meta‐models, or “models of models,” that focus on how therapeutic factors interact with each other to produce change. The purpose of this article is to propose a meta‐model describing the relationship between two specific common factors—the therapeutic alliance and interventions. We also propose a new factor—a therapist's way of being—that we believe is foundational to effective therapy. The model is proposed in pyramid format, with techniques on top, the therapeutic alliance in the middle, and therapist way of being as the foundation. The hierarchical relationships between these three concepts are discussed, along with implications for training, research, and therapy.

Original Publication Citation

Fife, S. T., Whiting, J. B., Bradford, K. P. & Davis, S. D. (2014). The therapeutic pyramid: A common factors synthesis of techniques, alliance, and way of being. Journal of Marital and Family Therapy, 40, 20-33. doi: doi.org/10.1111/jmft.12041

Document Type

Peer-Reviewed Article

Publication Date

2013-07-30

Publisher

Journal of Marital and Family Therapy

Language

English

College

Family, Home, and Social Sciences

Department

Family Life

University Standing at Time of Publication

Full Professor

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