Outcome in psychotherapy: the past and important advances

Abstract

Fifty years after the 1963 debate between Strupp and Eysenck, as recorded in their articles in Psychotherapy, it is clear that Eysenck overstated the case against psychoanalysis and dynamic psychotherapy (Bergin, 1971), while inflating the magnitude of improvement in untreated individuals (Lambert, 1976). Eysenck was probably correct about the beneficial effects of behavior therapies, but did not foresee that behavior therapy would be supplanted by cognitive behavior therapies (CBT) and eclectic mixtures of CBT that incorporate elements of eastern religion, humanistic interventions, and psychodynamic constructs. Fortunately, most of the treatments that have been tested in rigorous investigations have been found to be effective, but few have distinguished themselves as uniquely superior. Many of the problems of how to measure the effects of treatment have been solved and suggest that about two thirds of treated individuals improve or recover. This leaves a sizable portion of nonresponding individuals, but emerging methods involving in tracking treatment response are being used to decrease deterioration and enhance positive outcomes.