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Julia Browne, Corinne Cather, and Kim T. Mueser

Common factors, or characteristics that are present across psychotherapies, have long been considered important to fostering positive psychotherapy outcomes. The contextual model offers an overarching theoretical framework for how common factors facilitate therapeutic change. Specifically, this model posits that improvements occur through three primary pathways: (a) the real relationship, (b) expectations, and (c) specific ingredients. The most-well-studied common factors, which also are described within the contextual model, include the therapeutic alliance, therapist empathy, positive regard, genuineness, and client expectations. Empirical studies have demonstrated that a strong therapeutic alliance, higher ratings of therapist empathy, positive regard, genuineness, and more favorable outcome expectations are related to improved treatment outcomes. Yet, the long-standing debate continues regarding whether psychotherapy outcomes are most heavily determined by these common factors or by factors specific to the type of therapy used. There have been calls for an integration of the two perspectives and a shift toward evaluating mechanisms as a way to move the field forward. Nonetheless, the common factors are valuable in treatment delivery and should be a focus in delivering psychotherapy.


Eric L. Stocks and David A. Lishner

The term empathy has been used as a label for a broad range of phenomena, including feeling what another person is feeling, understanding another person’s point of view, and imagining oneself in another person’s situation. However, perhaps the most widely researched phenomenon that goes by this label involves an other-oriented emotional state that is congruent with the perceived welfare of another person. The feelings associated with empathy include sympathy, tenderness, and warmth toward the other person. Other variations of empathic emotions have been investigated too, including empathic joy, empathic embarrassment, and empathic anger. The term altruism has also been used as a label for a broad range of phenomena, including any type of helping behavior, personality traits associated with helpful persons, and biological influences that spur protection of genetically related others. However, a particularly fruitful research tradition has focused on altruism as a motivational state with the ultimate goal of protecting or promoting the welfare of a valued other. For example, the empathy–altruism hypothesis claims that empathy (construed as an other-oriented emotional state) evokes altruism (construed as a motivational state). Empathy and altruism, regardless of how they are construed, have important consequences for understanding human behavior in general, and for understanding social relationships and well-being in particular.


Humans need other people to survive and thrive. Therefore, relatedness is a basic human need. However, relatedness can be conceived of very differently in different cultural environments, depending on the affordances and constraints of the particular context. Specifically, the level of formal education and, relatedly, the age of the mother at first birth, the number of children, and the household composition have proven to be contextual dimensions that are informative for norms and values, including the conception of relatedness. Higher formal education, late parenthood, few children, and a nuclear family drive relationships as emotional constructs between independent and self-contained individuals as adaptive in Western middle-class families. The perspective of the individual is primary and is organized by psychological autonomy. Lower formal education, early parenthood, with many children, and large multigenerational households, drive the conception of relationships as role-based networks of obligations that are adapted to non-Western rural farm life. The perspective of the social system is primary and organized by hierarchical relatedness. Social development as developmental science in general, represented in textbooks and handbooks, is based on the Western middle-class view of the independent individual. Accordingly, developmental milestones are rooted in the separation of the individual from the social environment. The traditional rural farmer child’s development is grounded in cultural emphases of communality which stress other developmental priorities than the Western view. Cross-cultural research is mainly interpreted against the Western standard as the normal case, but serious ethical challenges are involved in this practice. The consequence is that textbooks need to be rewritten to include multiple cultural perspectives with multiple developmental pathways.