There is the real possibility that practitioners and students in mental health fields accept the Dodo bird verdict simply because it appears to be generally and uncritically accepted by others. - Hunsley & DiGiulio, 2002, p. 13
Wow. How distressing is that idea? Therapists and researchers and students, all eagerly swallowing a particular verdict on a subject, simply because they've heard it repeated enough times, not because they've actually seen a preponderance of empirical evidence to support it.
I have to believe that adherence to the notion of psychotherapy equivalence cannot possibly be all that widespread--even though I heard it declaimed to me as fact during my undergraduate experience. I would certainly doubt that most persons who assent to the notion of psychotherapy equivalence have really thought through what this would mean.
Given that most clinicians (and research groups!) have definite allegiances to particular classes of therapy, such allegiances would suggest a belief that certain types of therapy are more efficacious, effective, and/or efficient than others. I doubt that many who maintained such an allegiance could really bring themselves to wholeheartedly endorse every other possible kind of therapy as well. Hunsley and DiGiulio seem concerned that proponents of "esoteric" therapies might use the Dodo bird verdict to their advantage by "claim[ing] clinical legitimacy for their treatments by relying on the results of research conducted on other forms of psychotherapy" (2002, p. 17). However, anyone promoting their "pet" therapy based on the claim of psychotherapy equivalence would be undermining such a claim in the moment they made it--if all psychotherapies are equivalent, why develop new ones? Why attempt to develop more efficient and effective forms of treatment? If the therapeutic alliance is the only important element, why not just throw all clients in with kindly college professors?
Whether we own up to it or not, I'd say that very few of us actually believe in psychotherapy equivalence. Propagating the myth of equivalence might be more a way of ducking the time- and resource-consuming realities of empirically validating a treatment than anything else.
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Picture from Project Gutenberg.
1 comment:
I think one of the pressures to accept the Dodo Verdict is coming from the APA. They must appeal to their constituents, many of whom are practitioners who do forms of therapy that, if not on the EST list, can "probably" be considered no worse than anything else. I mentioned this in response to someone else's blog, too: It reminds me of Sechrest's idea of "incremental validity" (an optional reading this week). You said, "if all psychotherapies are equivalent, why develop new ones?" This is incremental validity in a nutshell. It asks not just whether a therapy works, but also whether it works better or more efficiently than what we already have. It is an important distinction.
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