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Specific vs Nonspecific Factors in Psychotherapy and the Problem of Control

Hans H. Strupp, PhD
Arch Gen Psychiatry. 1970;23(5):393-401. doi:10.1001/archpsyc.1970.01750050009002.
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THIS communication represents a renewed attempt to examine the nature of the psychotherapeutic influence and to point the way toward investigative efforts designed to elucidate the relative contributions of techniques and nonspecific interpersonal factors. The long-range quest is for precision and specificity of our therapeutic endeavors.

Problem of Control  One of the chief purposes of psychotherapy, if not the primary purpose, is to promote the acquisition of self-control. Terms like mastery, ability to cope, competence, independence, autonomy, etc, refer to the same phenomenon. Freud's capsule summary of psychoanalytic psychotherapy, "Where id was, there shall ego be," while anchored to assumptions and conceptualizations which are in need of thorough revamping, essentially describes the same process.The course of therapy, in general terms, follows two courses of action which are usually intertwined: (1) to help the patient achieve greater control or mastery; (2) to help


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