Re:Effective learning of Cognitive Therapy

From “Empirically Supported Treatments: Cautionary Notes,” Stanley B. Messer, PhD, Medscape General Medicine 4(4), 2002. © 2002 Medscape:

“One might think from the way in which ESTs [empirically supported treatments, which are largely behavioral or cognitive-behavioral (CB)] are being promulgated...that their superiority to other familiar forms of treatment has been proven. Here are some relevant facts: study after study, meta-analysis after meta-analysis, and even meta-analyses of meta-analyses (called mega-analyses) have repeatedly produced the same result: there are very few differences among bona fide therapies. By bona fide, I mean therapies that are guided by a coherent theoretical structure, have been widely practiced for a long time, and have a research foundation, even if this foundation does not include the randomized control trials or single-case design sanctioned by the Task Force on ESTs of the American Psychological Association's Division of Clinical Psychology. Examples are the psychodynamic, client or person-centered, and family or marital therapies.”

Messer also writes: “Common factors and therapist variability far outweigh specific ingredients [i.e., the specific techniques or ingredients characteristic of a treatment] in accounting for the benefits of psychotherapy. The proportion of variance contributed by common factors such as placebo effects, working alliance, therapist allegiance and competence are much greater than the variance stemming from specific ingredients or effects.”

Not surprisingly then, it seems that old fashion attributes like faith, love, and hope end up being the key factors in predicting and determining whether one will be an effective therapist, regardless of the particular psychotherapy theory being utilized. Fred H.

Replies:

Re Messer's conclusion that all "bona fide" therapies are equally effective, by Jim Pretzer, 01/11/03 Specificity of treatment, by Carl Robbins, 01/14/03 Is it true that "All have won and deserve prizes"? , by Jim Pretzer, 04/26/04 Re:Effective learning of Cognitive Therapy, by Eddy, 01/14/03

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