Koch, Sabine

Fighting windmills: how therapeutic factors research makes us humble


Windmühlenkämpfe in den Künstlerische Therapien: Die therapeutische Wirkfaktorenforschung lehrt uns Demut


Sabine Koch

Co-author: Lily Martin


Psychotherapy research has been demonstrating that common factors and external factors in psychotherapy are a lot more powerful than the specific contribution of the single therapy modalities (e.g. music therapy).

(1) Specific therapeutic factors of arts therapies will explain 1-15% of the change that clients experience (e.g., Lambert & Barley, 2001; Wambold & Irmel, 2015).

(2) The therapeutic relationship contributes about 30% of the therapy success: learn your Rogers well, it provides you with a highly effective therapeutic attitude (more than technique) consisting of “letting the client be/grow”, treating him/her with love and respect, unconditional positive regard, authenticity, and empathy.

(3) Expectations (the so-called placebo effects) can do powerful work: they contribute another 15% (i.e., as much as your specific technique) to the change process and your therapy success. Therapists should state their goals and show that they believe that they can achieve those goals with their technique.  Before every intervention, explain to the client why you do it and show your belief in it.  This will activate the placebo or expectancy effect.

(4) The rest of the clients’ improvement is mostly influenced by extra-therapeutic factors (40%), i.e., factors outside of therapy: clients moving in or out, losing or finding a partner, losing or finding a job, birth of a child, etc.

We thus need to learn to be humble with regard to what our actual therapeutic technique can do; and not to fight neighboring disciplines with effects of the same therapeutic factors.

However, there are specific factors of arts therapies that we should also be aware of: aesthetics, play, symbol, enactive transitional space, and creation (Koch, 2017), being seen in a resourceful activity, being moved, and appropriately mirrored. Instead of fighting windmills in neighboring disciplines, we can relax, since we have much more in common, than we actually may have thought.



Prof. Dr. Sabine C. Koch, Psychologist and Dance Movement Therapist, BC-DMT, Director of the Research Institute for Creative Arts Therapies at Alanus University Alfter, Head of the DMT Master Program at SRH University Heidelberg, Germany. Specialized in embodiment research, evidence-based research, Kestenberg Movement Profiling (KMP), and active factors across the creative arts therapies. Meta analyses and RCT studies on DMT for schizophrenia, autism, and depression. Research in dance movement therapy (DMT), body-mind approaches, embodiment, nonverbal communication, body memory, movement and meaning, DMT for trauma, dance for Parkinson's disease, Phenomenological Body Psychotherapy, Creative Arts Therapies. Contact: sabine.koch@alanus.edu / skoch@srh.de

Lily Martin is a clinical Psychologist working at the Research Institute for Creative Arts Therapies at Alanus University in Alfter/Bonn. She is pursuing a PhD. researching movement characteristics of people with schizophrenia in collaboration with Heidelberg University (Prof. Dr. Thomas Fuchs). Her research interests include the effect of psychiatric illnesses on movement and embodiment as well as the development of embodied and arts-based research methods.

Recent Presentations

Sabine Koch

2018: (September) German Psychological Association (DGPs; Frankfurt): Psychology of the Embrace: What body rhythms signal on the need to indulge or separate

2018: (October) Nordic Arts Therapies Conference (Iceland): Evidence based state-of-the-art in dance therapy

2018: (October) European Dance Movement Therapy Conference (Athens)

2018: (November) International Phenomenology Conference (Paris)

2018: (November) National Arts Therapies Conference (Bern)

Lily Martin

First Author

Martin, L. / Oepen, R. / Bauer, K. / Nottensteiner, A. / Mergheim, K. / Gruber, H. / Koch, S. C. (2018). Creative Arts Interventions for Stress Management and Prevention - A Systematic Review. Behavioral Science, 8(2), 25.

Martin, L. / Pohlmann, V. / Koch, S. C. / Fuchs, T. (2016): Back into Life: Effects of Embodied Therapies on Patients with Schizophrenia. European Psychotherapy, 13.

Martin, L. / Koch, S. / Hirjak, D. / Fuchs, S. d. H. T. (2016): Overcoming Disembodiment: The Effect of Movement Therapy on Negative Symptoms in Schizophrenia - A Multicenter Randomized Controlled Trial. Frontiers in Psychology.


Koch, S. C. / Martin, L. A. (2017). Verkörperte Ästhetik: Ein identitätsstiftender Wirkfaktor der Künstlerischen Therapien? In: Tüpker, R. / Gruber, H. (Hrsg.): Spezifisches und Unspezifisches in den Künstlerischen Therapien. Hamburg: HPB University Press.

Koch, S. C. / Gruber, H. / Kortum R. / Reichelt, S. / Martin, L. / Warth, M. / Radbruch, L. (2016): Künstlerische Therapien in der Palliativversorgung - Ein Review. Hospizzeitschrift, 2016/1.

Steinhäuser, T. / Martin, L. / von Lersner, U. / Auckenthaler, A. (2014): Konzeptionen von "transkultureller Kompetenz" und ihre Relevanz für die psychiatrisch-psychotherapeutische Versorgung. Ergebnisse eines disziplinübergreifenden Literaturreviews. PPmP-Psychotherapie • Psychosomatik• Medizinische Psychologie, 64(09/10), 345-353.


Koch, S. C. / Martin, L. / Tschacher, W. / Fuchs, T. (2017). Embodied Aesthetics and Interpersonal Resonance, Special Issue in Behavioral Sciences (Open Access): http://www.mdpi.com/ journal/behavsci/special_issues/interpersonal_resonance.