The Great Psychotherapy Debate: Models, Methods, and Findings

The Great Psychotherapy Debate: Models, Methods, and Findings

The Great Psychotherapy Debate: Models, Methods, and Findings

The Great Psychotherapy Debate: Models, Methods, and Findings

Synopsis

The Great Psychotherapy Debate: Models, Methods, and Findings comprehensively reviews the research on psychotherapy to dispute the commonly held view that the benefits of psychotherapy are derived from the specific ingredients contained in a given treatment (medical model). The author reviews the literature related to the absolute efficacy of psychotherapy, the relative efficacy of various treatments, the specificity of ingredients contained in established therapies, effects due to common factors, such as the working alliance, adherence and allegiance to the therapeutic protocol, and effects that are produced by different therapists. In each case, the evidence convincingly corroborates the contextual model and disconfirms the prevailing medical model.

Excerpt

The “common factors” position on the effectiveness of psychotherapy—whose lineaments were sketched between fifty and thirty years ago by such scholars as Jerome Frank, Hans Strupp, Victor Raimy, and Lester Luborsky among others, and whose empirical foundations were laid scarcely more than 25 years ago—here attains its most forceful expression; and Bruce Wampold dons the mantel of foremost defender of a position with enormously important implications for mental health training, treatment, and public policy.

The common factors position (namely, that all of the many specific types of psychotherapeutic treatment achieve virtually equal—or insignificantly different—benefits because of a common core of curative processes) can move the focus of psychotherapy training and theory itself from therapist to client, from how the therapist “cures” to how the client “heals.” The medical model of psychotherapy that Wampold so meticulously deconstructs in The Great Psychotherapy Debate has led us to accept a view of clients as inert and passive objects on whom we operate and whom we medicate. The implausibility that the great variety of specific ingredients in the multitude of psychotherapeutic approaches would yield indistinguishable outcomes is a strong clue that either it is instead a set of often unacknowledged common elements that is effective, or else it is a set of processes residing largely in the clients and merely mobilized by therapy that carries the power to improve clients' lives. This potential shift in perspective (from an emphasis on the differences among therapies to an awareness of the broad context in which therapeutic relationships are played out) can cause both therapists and theo— . . .

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