ArticleBehaviour research and therapy2018
What matters more? Common or specific factors in cognitive behavioral therapy for OCD: Therapeutic alliance and expectations as predictors of treatment outcome.
Article in Behaviour research and therapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The therapeutic alliance in cognitive-behavioral therapy for obsessive-compulsive disorder: A systematic review and meta-analysis.Frontiers in psychiatry · 2022Pooled it
- Characterizing Behavioral Engagement in Smartphone Cognitive Behavioral Therapy for Obsessive Compulsive Disorder: Secondary Analysis of a Randomized Controlled Trial.JMIR formative research · 2026Trial
- Motivation in the Bergen 4-day treatment for obsessive-compulsive disorder.BMC psychiatry · 2025Trial
- Treatment expectancy and credibility as predictors of concentrated exposure treatment outcomes in patients with difficult-to-treat obsessive-compulsive disorder.BMC psychiatry · 2025Trial
- Treatment-Specific Associations Between Brain Activation and Symptom Reduction in OCD Following CBT: A Randomized fMRI Trial.The American journal of psychiatry · 2021Trial
- Group cognitive behavioural therapy can reduce stigma and improve treatment compliance in major depressive disorder patients.Early intervention in psychiatry · 2020Trial
- The timing of symptom change and early treatment response in a self-guided digital treatment for obsessive-compulsive disorder.The British journal of clinical psychology · 2025Article
- Quality of the therapeutic working alliance as a factor in intensive residential treatment of obsessive-compulsive disorder.Psychotherapy research : journal of the Society for Psychotherapy Research · 2023Article
- Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive Disorder.Frontiers in psychiatry · 2022Article
- Forming a Doctor-Patient Alliance During COVID-19 to Enhance Treatment Outcomes for Obsessive-Compulsive Disorder.Focus (American Psychiatric Publishing) · 2021Article
- Therapist Behavior During Exposure Tasks Predicts Habituation and Clinical Outcome in Three Randomized Controlled Trials for Pediatric OCD.Behavior therapy · 2021Article
- Neurocognitive Predictors of Treatment Outcomes in Cognitive Processing Therapy for Post-traumatic Stress Disorder: Study Protocol.Frontiers in psychology · 2021Article
- What can clinicians do to improve outcomes across psychiatric treatments: a conceptual review of non-specific components.Epidemiology and psychiatric sciences · 2019Review
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
CBT for obsessive-compulsive disorder (OCD) is a strong challenge to the contention that common factors explain most of the variance in outcomes in all therapies and all disorders, given that the treatment is focused and placebo response is low. In this study, the relative contributions of expectancy and therapeutic alliance as predictors of outcome in the treatment of OCD are examined and compared to the contribution of specific treatment effects. One hundred and eight patients with OCD were randomly assigned to two forms of CBT: exposure and response prevention (EX/RP) or stress management training (SMT). Measures of OCD symptoms, quality of life, therapist and patient expectancy and alliance were collected at several timepoints. Treatment type was a substantially stronger predictor of symptom reduction compared to alliance and expectancy. However, neither specific nor common factors predicted improvement in quality of life very well. Only in EX/RP, symptom change was associated with subsequent changes in alliance. Finally, therapist effects were estimated using Bayesian methods and were negligible. In the context of CBT for OCD, the data support the specific factor model, and suggest that the relative contribution of common vs. specific factors likely varies by disorder and by treatment type.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.