The Great Psychotherapy Debate: Models, Methods, and Findings

By Bruce E. Wampold | Go to book overview

1
Competing Meta-Models:
The Medical Model Versus the Contextual Model

Understanding the nature of psychotherapy is a daunting task. There are over 250 distinct psychotherapeutic approaches, which are described, in one way or another, in over 10,000 books. Moreover, tens of thousands of books, book chapters, and journal articles have reported research conducted to understand psychotherapy and to test whether it works. It is no wonder, that faced with the literature on psychotherapy, confusion reigns, controversy flourishes, converging evidence is sparse, and recognition of psychotherapy as a science is tenuous.

Any scientific endeavor will seem chaotic if the explanatory models are insufficient to explain the accumulation of facts. If one were to ask prominent researchers to list important psychotherapeutic principles that have been scientifically established and generally accepted by most psychotherapy researchers, the list would indeed be short. On the other hand, an enumeration of the results of psychotherapy studies would be voluminous. How is it that so much research has yielded so little knowledge? The thesis of this book is that there is a remarkable convergence of research findings, provided the evidence is viewed at the proper level of abstraction.

Discovering the scientific basis of psychotherapy is vital to the efficient and humane design of mental health services. In the United States, psychotherapeutic services occupy a small niche in the enormous universe of health service delivery systems. The forces within this universe are com—

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