There is a clear consensus that psychotherapy works. Simultaneously, there is considerable disagreement as to what makes psychotherapy work: specific techniques or common factors. However, this dichotomy of specific techniques and common factors is not justified. Conceptual considerations and empirical data rather suggest an integrative view.

The present study empirically analyses the relationships between specific techniques, common factors and the outcome of psychotherapy.

After each psychotherapy session the patients of a psychiatric outpatient clinic completed a questionnaire, which evaluated the implementation of common factors. Likewise, the therapists rated the techniques they had applied during the session on a technique questionnaire at the end of each session. In addition, measurements of patient characteristics as well as pre- and post-treatment assessments of their psychopathology, social functioning, resources, coping style and quality of life were accomplished. Hierarchical regression analyses (mixed models) were then performed to analyze the associations between techniques, common factors and outcome variables.

Results indicate that patterns of specific techniques are associated with the implementation of different common factors. In addition, specific associations of therapy techniques and common factors are related to distinct outcome variables.

The identification of the active therapeutic ingredients and work mechanisms facilitates the development of integrated personalized psychotherapeutic interventions, which are tailored to the particular problems, needs and resources of the individual patient. This would allow for moving away from delivering standardized treatment packages with different untested elements and, thereby, might enhance the effectiveness and efficient implementation of evidence-based psychotherapy approaches.