Evaluating Effective Interventions in Social Work Practice: An Ecological Common Factors Approach for Working with Male Survivors of Sexual Abuse

Background & Purpose: Common factors refer to all techniques and therapeutic change mechanisms that transcend theoretical models and techniques related to successful therapeutic outcomes (Wampold, 2015). The common factors perspective contends that psychotherapy works predominantly not because of the unique contributions of any particular model or unique set of interventions but rather because of other commonalities that cut across all effective therapies (Karam & Blow, 2020). Social work agencies often use eclectic counseling approaches and lack time and resources to conduct highly controlled studies (e.g., RCTs) to evaluate therapeutic effectiveness with male survivors of sexual abuse (MSSA). The authors hypothesize that research using an ecological common factor model can provide practitioners and researchers with an implementable framework to evaluate therapeutic effectiveness across modalities, agencies, therapists, and clientele. These evaluations can inform best-practice with vulnerable populations by identifying common factors crucial to the population’s needs. This study aims to introduce an ecological common factors model and identify how helping professionals and researchers can use this framework to assess best-practice interventions when working with MSSA.

Methods: A comprehensive literature review was conducted that searched for articles noting the common factor model and its evidence base (e.g., Google Scholar and ProQuest database). Special attention was paid to meta-analysis and systematic literature reviews that made a note of common factors empirically significant in affecting treatment outcomes. After the exclusion of several non-peer-reviewed studies, a total of 24 peer-reviewed articles were analyzed to develop the ecological common factors model.

Results: This research produced an integrative framework for evaluating therapeutic intervention by categorizing four common factors: (1) client factors, (2) therapist factors, (3) therapeutic relation factors, and (4) extra-therapeutic context factors. Client factors include client willingness and ability to be actively involved, open to change, client expectations, and overall confidence in therapy. Therapist factors include therapists’ professional status, reputation, competencies, and interpersonal skills (e.g., empathy, warmth, unconditional positive regard, and genuineness). Therapeutic relation factors include therapeutic alliance, quality of the therapeutic relationship, goal consensus, collaboration, and a cultural match between the therapist and client, particularly regarding their language and therapy style.

The ecological common factors model highlights extra-therapeutic context factors subcategorized into client context and agency/therapy context. Client context factors consist of the intricate relationships in clients’ lives, including clients’ social support networks—family and significant others—and financial and housing security. Agency/therapist context factors include the supportive values, funding, policies, procedures, and practice guidelines that shape therapists’ actions and treatment.

Conclusion and Implications: The extra-therapeutic context factors and the client, therapist, and therapeutic relationship factors work simultaneously to create therapeutic change. By measuring these identified common factors during interventions and comparing the results with similar population findings, practitioners in grassroots social service agencies can evaluate their practice effectiveness and adjust them for better client outcomes with little cost and time needed for more controlled studies. Identifying the common factors important to therapeutic change among MSSA can lead to a more effective and beneficial change experience.