Also of interest
On Becoming a Better Therapist, Second Edition by Barry L. Duncan applies the ideas described in The Heart and Soul of Change, Second Edition.


Updating the classic first edition of The Heart and Soul of Change, editors Duncan, Miller, Wampold, and Hubble, have created a new and enriched volume that presents the most recent research on what works in therapeutic practice, a thorough analysis of this research, and practical guidance on how a therapist can truly "deliver what works in therapy." This volume examines the common factors underlying effective psychotherapy and brings the psychotherapist and the client–therapist relationship back into focus as key determinants of psychotherapy outcome.

The second edition of The Heart and Soul of Change also demonstrates the power of systematic client feedback to improve effectiveness and efficiency and legitimize psychotherapy services to third party payers. In this way, psychotherapy is implemented one person at a time, based on that unique individual's perceptions of the progress and fit of the therapy and therapist.

Readers familiar with the first edition will encounter the same pragmatic focus but with a larger breadth of coverage—this edition adds chapters on both youth psychotherapy and substance abuse treatment. Through reading The Heart and Soul of Change, Second Edition: Delivering What Works in Therapy clinicians of varied levels of experience will improve their understanding of what is truly therapeutic in the diverse forms of psychotherapy practiced today.

Table of Contents


—David E. Orlinsky


Prologue: Saul Rosenzweig: The Founder of Common Factors
—Barry L. Duncan

  1. Introduction
    —Mark A. Hubble, Barry L. Duncan, Scott D. Miller, and Bruce E. Wampold

I. What Works and What Does Not: The Empirical Foundations for the Common Factors

  1. The Research Evidence for Common Factors Models: A Historically Situated Perspective
    —Bruce E. Wampold
  2. Clients: The Neglected Common Factor in Psychotherapy
    —Arthur C. Bohart and Karen Tallman
  3. The Therapeutic Relationship
    —John C. Norcross
  4. Putting Models and Techniques in Context
    —Timothy Anderson, Kirk M. Lunnen, and Benjamin M. Ogles
  5. Evidence-Based Practice: Evidence or Orthodoxy?
    —Julia H. Littell
  6. Psychiatric Drugs and Common Factors: An Evaluation of Risks and Benefits for Clinical Practice
    —Jacqueline A. Sparks, Barry L. Duncan, David Cohen, and David O. Antonuccio

II. Delivering What Works: Practice-Based Evidence

  1. "Yes, It Is Time for Clinicians to Routinely Monitor Treatment Outcome"
    —Michael J. Lambert
  2. Outcomes Management, Reimbursement, and the Future of Psychotherapy
    —G. S. (Jeb) Brown and Takuya Minami
  3. Transforming Public Behavioral Health Care: A Case Example of Consumer-Directed Services, Recovery, and the Common Factors
    —Robert T. Bohanske and Michael Franczak

III. Special Populations

  1. Evidence-Based Treatments and Common Factors in Youth Psychotherapy
    —Susan Douglas Kelley, Leonard Bickman, and Earta Norwood
  2. Common Factors in Couple and Family Therapy: Must All Have Prizes?
    —Jacqueline A. Sparks and Barry L. Duncan
  3. What Works in Substance Abuse and Dependence Treatment
    —David Mee-Lee, A. Thomas McLellan, and Scott D. Miller

IV. Conclusions

  1. Delivering What Works
    —Scott D. Miller, Mark A. Hubble, Barry L. Duncan, and Bruce E. Wampold


About the Editors

Editor Bios

Barry L. Duncan, PsyD, is a therapist, trainer, and researcher with more than 17,000 hours of clinical experience. He is director of the Heart and Soul of Change Project, a practice-driven training and research initiative that focuses on what works in therapy and, more importantly, how to deliver it on the front lines via client-based outcome feedback.

Dr. Duncan received the Wright State University School of Professional Psychology's first annual Outstanding Alumnus Award for his contributions to the field, and the Psychotherapy Networker 20th Anniversary All Time Top Ten Award for the article "Exposing the Mythmakers."

He has more than 100 publications, including 15 books, most recently Brief Intervention for School Problems (with John Murphy); What's Right With You; The Heroic Client (with Scott Miller and Jacqueline Sparks); and the forthcoming volume, On Becoming A Better Therapist.

He is the codeveloper of the Outcome Rating Scale (ORS), Session Rating Scale (SRS), Child ORS, and Child SRS, measures designed to give clients the voice they deserve as well as to provide clients, clinicians, administrators, and payers with feedback about the client's response to services, thus enabling more effective care tailored to client preferences.

Scott D. Miller, PhD, is a cofounder of the Center for Clinical Excellence, an international consortium of clinicians, researchers, and educators dedicated to promoting excellence in behavior health.

Dr. Miller conducts workshops and training in the United States and abroad, helping hundreds of agencies and organizations, both public and private, to achieve superior results. He is one of a handful of "invited faculty" whose work, thinking, and research are featured at the prestigious Evolution of Psychotherapy Conference. Over the past 20 years, his presentation style and command of the research literature have inspired practitioners, administrators, and policymakers to make effective changes in service delivery.

He is the author of numerous articles and a coauthor of Working With the Problem Drinker: A Solution-Focused Approach (with Insoo Berg); The "Miracle" Method: A Radically New Approach to Problem Drinking (with Insoo Kim Berg); Finding the Adult Within: A Solution-Focused Self-Help Guide (with Barbara McFarland); Handbook of Solution-Focused Brief Therapy: Foundations, Applications, and Research (with Mark Hubble and Barry Duncan); Escape From Babel: Toward a Unifying Language for Psychotherapy Practice (with Barry Duncan and Mark Hubble); Psychotherapy With Impossible Cases: Efficient Treatment of Therapy Veterans (with Barry Duncan and Mark Hubble); The Heart and Soul of Change: What Works in Therapy (with Mark Hubble and Barry Duncan); The Heroic Client: A Revolutionary Way to Improve Effectiveness Through Client-Directed, Outcome-Informed Therapy (with Barry Duncan and Jacqueline Sparks); and the forthcoming Achieving Clinical Excellence: Lessons From the Field's Most Effective Practitioners.

Bruce E. Wampold, PhD, ABPP, who was trained in mathematics (BA from the University of Washington) before earning his doctorate in counseling psychology (PhD from the University of California, Santa Barbara) is professor and chair of the Department of Counseling Psychology at the University of Wisconsin–Madison.

He is a fellow of the American Psychological Association (APA) Divisions 12 (Society of Clinical Psychology), 17 (Society of Counseling Psychology), and 29 (Psychotherapy); a diplomate in Counseling Psychology of the American Board of Professional Psychology; and a recipient of the APA Distinguished Professional Contributions to Applied Research Award.

Currently, his work involves understanding counseling and psychotherapy from empirical, historical, methodological, and anthropological perspectives. His analysis of empirical evidence, which led to the development of a contextual model from which to understand the benefits of counseling and psychotherapy, is found in The Great Psychotherapy Debate: Models, Methods, and Findings.

He is the author of more than 100 books, chapters, and articles related to counseling, psychotherapy, statistics, and research methods and has given lectures on these subjects nationally and internationally.

Mark A. Hubble, PhD, a national consultant, has coauthored and coedited several books, including The Handbook of Solution-Focused Brief Therapy, Escape From Babel: Toward a Unifying Language for Psychotherapy Practice, and Staying on Top and Keeping the Sand Out of Your Pants: A Surfer's Guide to the Good Life, and was the lead editor for the award-winning first edition of The Heart and Soul of Change: What Works in Therapy.

Dr. Hubble is a graduate of the postdoctoral fellowship in clinical psychology at Menninger and formerly served on the editorial review board for the Journal of Systemic Therapies. In years past, he founded and directed the Brief Therapy Clinic at the University of Missouri, Kansas City, and was a contributing editor for The Family Therapy Networker Beyond his consulting work with individuals and companies, he is a senior advisor and founding member of the International Center for Clinical Excellence, Chicago, Illinois.