A Social Constructionist Model of Therapeutic Factors

Evidentiary support for the efficacy of therapeutic models has been a contentious issue since the professionalization of psychology. Despite advances in evidence-based practices in psychology and common factors research, discontent still exists among postmodern psychotherapists in that evidence is mainly defined in modernist/positivistic terms, thereby excluding therapeutic models based on alternative nonpositivistic epistemologies. I proposes a model, which is based on social constructionist theories, for investigating the therapeutic efficacy of various approaches. This article evaluates and differentiates between two models for viewing the efficacy of psychotherapy, namely outcome versus process efficacy. A social constructionist model of therapeutic factors is proposed as a means to incorporate therapeutic factors into psychotherapy processes that are consistent with a social constructionist theory of change. Three main therapeutic elements, which are identified as central to an effective psychotherapy process, are outlined in the model. The proposed model may be useful as a guide to efficacious psychotherapy and as a means for investigating the efficacy of social constructionist therapies.