The Dialectics of Psychotherapy: Philosophical and Empirical Debates

Abstract

How does the beginning therapist go about choosing a therapeutic approach when there are over 400 different systems available (Karasu, 1992)? Researchers have repeatedly failed to find consistent differences in client outcomes even with therapeutic approaches based on very different assumptions and using varied interventions (Luborsky et al., 2002; Shoham & Rohrbaugh, 1999; Wampold et al., 1997). Lambert and Ogles’ (2004) extensive literature review concluded: (a) therapy is superior to placebo or no treatment conditions and (b) all approaches are essentially equivalent when artifacts such as experimental demand characteristics and researcher’s theoretical allegiance are controlled.

[T]he Dodo suddenly called out “The race is over!” and they all crowded round it, panting, and asking “But who has won?” This question the Dodo could not answer without a great deal of thought and it stood around for a long time with one finger pressed upon its forehead …. At last the Dodo said “Everybody has won, and all must have prizes.”

(Alice’s Adventures in Wonderland, Lewis Carroll, 1832–1898)