Clinically Relevant Outcome Research in Individual Psychotherapy New models guide the researcher and clinician

Abstract

How can we design relevant psychotherapy research? The answer must be shaped by the objectives and potential consumers of such research. For over 40 years, “does psychotherapy work?” (Eysenck, 1952) held the attention of psychotherapy researchers, and randomised clinical trial methodology seemed the most appropriate empirical option for answering this question. There are now well over 500 studies that attest to the efficacy of psychotherapy (see Smith et al, 1980; Shapiro & Shapiro, 1982; Lipsey & Wilson, 1993, for meta-analytic research summaries); it seems that psychotherapy is one of the best documented medical interventions in history. But the conclusion that psychotherapy “works” is akin to finding that antibiotics “work”. We are left with the daunting task of determining which of the wide variety of treatments (psychotherapies, antibiotics) are appropriate for which variety of illnesses (psychopathologies, infections). Morris Parloff (1982) warned us of this need for specificity in his classic article, “Bambi meets Godzilla”, but our preoccupation with documenting the efficacy of psychotherapy has only recently abated enough to mount empirical studies of such specificity.