Disabuse of the drug metaphor: psychotherapy process-outcome correlations.
The drug metaphor suggests that if a process component (e.g., interpretation) is an active ingredient of a successful psychotherapy, then administering a relatively high level of it should yield a relatively positive outcome, and levels of the process component and the outcome should be correlated across clients. Measures of 5 theoretically relevant, reliably measured verbal process components were compared with the rate of change in 3 standard symptom intensity measures across the brief treatments of 39 (mainly depressed) psychotherapy clients. The expected significant process-outcome correlations were not found. These results are discussed as they illuminate some misleading assumptions that underlie many conventional studies of psychotherapy process and outcome.
Stiles
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WB
Department of Psychology, Miami University, Oxford, Ohio 45056.
Shapiro
D A
DA
D000328:Adult; D015928:Cognitive Behavioral Therapy; D018592:Cross-Over Studies; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome