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Originalarbeit

Klassen allgemeiner Wirkfaktoren der Psychotherapie und ihr Zusammenhang mit Therapietechniken

Published Online:April 22, 2016https://doi.org/10.1026/1616-3443/a000331

Abstract

Zusammenfassung.Theoretischer Hintergrund: Bis heute wird die Frage, welche Faktoren für die Wirkung von Psychotherapie verantwortlich sind, kontrovers diskutiert. Im Zentrum dieser Diskussion stehen zwei vermeintlich gegensätzliche Wirkmodelle – das Modell spezifisch wirksamer Therapietechniken und das allgemeine Wirkfaktorenmodell. Allgemeine Wirkfaktoren und Therapietechniken sind konzeptuell jedoch auf unterschiedlichen Ebenen des Psychotherapieprozesses angesiedelt. An Stelle der Entweder-oder-Debatte sollte deshalb die Analyse ihres Zusammenwirkens in den Vordergrund rücken. Fragestellung: Mit Hilfe von Expertenratings wurde untersucht, ob sich verschiedene allgemeine Wirkfaktoren durch typische Zusammenhänge mit bestimmten Therapietechniken zu übergeordneten Klassen zusammenfassen lassen. Methode: 68 deutschsprachige Psychotherapieexperten schätzten in einer internetbasierten Umfrage ein, mit welchen spezifischen Therapietechniken verschiedene allgemeine Wirkfaktoren zusammenhängen. Mittels Faktorenanalyse wurde dann geprüft, welche Klassen von allgemeinen Wirkfaktoren sich durch bestimmte Muster von Technikzusammenhängen abbilden. Durch eine hierarchische Regressionsanalyse wurden zudem die Stärke und Richtung der Zusammenhänge zwischen einzelnen Wirkfaktorenklassen und den verschiedenen Techniken untersucht. Ergebnisse: Die Faktorenanalyse zeigt, dass den Zusammenhängen zwischen allgemeinen Wirkfaktoren und Techniken eine vierdimensionale Struktur unterliegt. Die vier Klassen von allgemeinen Wirkfaktoren hängen jeweils mit einer bestimmten Gruppe von Therapietechniken zusammen. Schlussfolgerungen: Die Vielzahl allgemeiner Wirkfaktoren lässt sich mittels ihrer Operationalisierung durch Therapietechniken zusammenfassen.


Classes of Common Factors of Psychotherapy and Their Associations With Therapy Techniques

Abstract.Background: There is considerable disagreement as to what makes psychotherapy effective. The controversy about the comparative efficacy of different modalities of psychotherapy has generated two different major perspectives: the specific ingredients assumption and the common factors model. However, conceptual considerations suggest a synergistic view of common factors and specific techniques. Objective: Based on ratings of 68 German-speaking psychotherapy experts we examined whether the different common factors can be summarized among superordinate classes according to their associations with specific techniques. Method: Psychotherapy experts rated the degree of associations between various common factors and techniques in a web-based survey. A factor analysis was performed to analyze the dimensional structure of common factors, which underlies the rated associations between common factors and specific techniques. In addition, the strength, the direction, and the technical patterns of the different classes of common factors were analyzed by regression analysis. Results: The factor analysis revealed that common factors can be described by a four-dimensional structure. The four classes of common factors are characterized by a set of specifically associated techniques. Conclusion: The multitude of common factors can be reduced by a technique-related operationalization.

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