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Characteristics of Proven Psychotherapies

What are the hallmarks of contemporary psychotherapeutic practice? These investigators mailed questionnaires to authors of research studies in order to assess the characteristics of 76 empirically supported treatments (ESTs) that were identified as established or probably efficacious therapies in 1995 and 1998 by American Psychological Association task forces, which had judged the research evidence on efficacy. Well-established ESTs included behavior therapy for erectile dysfunction, cognitive-behavioral therapy (CBT) for depression and panic and anxietydisorders, and interpersonal therapy for depression; probably efficacious ESTs included CBT for benzodiazepine withdrawal in panic disorder patients, exposure for simple phobia, and dialectical behavior therapy for borderline personality disorder.

Interrater reliability was 70%, ascertained by duplicate questionnaires received for 11 ESTs. Significant characteristics of ESTs involved skill building rather than insight or catharsis, a specific problem focus, continual assessment of progress, and brief treatment lasting 20 or fewer sessions. According to 54% of investigators, knowing a client's history was not important; 61% believed that diagnosis was not essential for making treatment decisions, and only 38% felt that a DSM-IV diagnosis was important in treatment planning. According to 54%, formation of the therapeutic relationship was an important mechanism of change.

Comment: Although this study aimed partly to educate potential clients, third-party payers, and providers who might become involved in treatment, it also highlighted important differences between treatment and the diagnostic process. Once a diagnosis is made, different information apparently is necessary for psychotherapeutic treatments: Although diagnosis very much guides psychopharmacological treatment, it would seem that diagnosis is less important to the psychotherapeutic process.

— G Tucker

Published in Journal Watch Psychiatry July 1, 2000

Citation(s):

O'Donohue W et al. Characteristics of empirically supported treatments. J Psychother Pract Res 2000 9 69-74.

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