The study of change in psychotherapy: a reexamination of the process-outcome correlation paradigm. Comment on Stiles and Shapiro (1994)
W.B. Stiles and D.A. Shapiro (1994) present a provocative argument that the yield of process research has been minimal because of researchers' overreliance on the drug metaphor and its corollary, the correlational design. Although Stiles and Shapiro raise excellent points regarding the possible misinterpretations of correlational research, their conclusion that the process-outcome correlation paradigm is flawed and has outlived its usefulness is questioned. The basic thesis is that Stiles and Shapiro did not provide a fair test of the correlation paradigm. The process variables used to test the paradigm do not have the strong theoretical and empirical grounding necessary to support the assumption that they should be related to outcome. In this article, examples are described, of programmatic process research that has used the correlation paradigm, along with other methods of inquiry, to advance the understanding of how change occurs and to improve treatment efficacy. It is contended that the correlational method is one useful tool of discovery and that it has contributed significantly to the advancement of the field when the process variables studied are grounded in solid theory and research.
Hayes
A M
AM
Department of Psychology, University of Miami, Florida, USA.
Castonguay
L G
LG
Goldfried
M R
MR
D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy; D005544:Forecasting; D006801:Humans; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care / Q000639:trends*; D011613:Psychotherapy / Q000639:trends*; D012107:Research Design