Rolf Degen summarizing: After decades of research, we still don't have a clue about which specific components of psychotherapy are helpful for clients, or if there are even any

The Role of Common Factors in Psychotherapy Outcomes. Pim Cuijpers, Mirjam Reijnders, and Marcus J.H. Huibers. Annual Review of Clinical Psychology, Vol. 15:- (Volume publication date May 2019). https://doi.org/10.1146/annurev-clinpsy-050718-095424

Abstract: Psychotherapies may work through techniques that are specific to each therapy or through factors that all therapies have in common. Proponents of the common factors model often point to meta-analyses of comparative outcome studies that show all therapies have comparable effects. However, not all meta-analyses support the common factors model; the included studies often have several methodological problems; and there are alternative explanations for finding comparable outcomes. To date, research on the working mechanisms and mediators of therapies has always been correlational, and in order to establish that a mediator is indeed a causal factor in the recovery process of a patient, studies must show a temporal relationship between the mediator and an outcome, a dose–response association, evidence that no third variable causes changes in the mediator and the outcome, supportive experimental research, and have a strong theoretical framework. Currently, no common or specific factor meets these criteria and can be considered an empirically validated working mechanism. Therefore, it is still unknown whether therapies work through common or specific factors, or both.