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The effectiveness of psychotherapy: the Consumer Reports study
Abstract
Consumer Reports (1995, November) published an article which concluded that patients benefited very substantially from psychotherapy, that long-term treatment did considerably better than short-term treatment, and that psychotherapy alone did not differ in effectiveness from medication plus psychotherapy. Furthermore, no specific modality of psychotherapy did better than any other for any disorder; psychologists, psychiatrists, and social workers did not differ in their effectiveness as treaters; and all did better than marriage counselors and long-term family doctoring. Patients whose length of therapy or choice of therapist was limited by insurance or managed care did worse. The methodological virtues and drawbacks of this large-scale survey are examined and contrasted with the more traditional efficacy study, in which patients are randomized into a manualized, fixed duration treatment or into control groups. I conclude that the Consumer Reports survey complements the efficacy method, and that the best features of these two methods can be combined into a more ideal method that will best provide empirical validation of psychotherapy.
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“Psychological interventions have a long history of success in management of both mental illness and chronic medical symptoms and conditions, including depression, migraine headache, chronic pain, and inflammatory bowel disease [1, 2].”
From Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. (2017) · cites this paper as [2]
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“In fact, the question of how to assess therapy outcome is controversial and has received attention from government institutions, managed-care organizations, and traditional scientific organizations (see Andrews, 1995; Seligman, 1995; Strupp, Horowitz, & Lambert, 1997).”
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“It complements randomized controlled trials with their highly selective samples (Seligman, 1995; 1996).”
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“For example, the system strongly favors the randomized clinical trial, which itself has been the center of some controversy (see Seligman, 1995).”
BackgroundBehavioral treatment of insomnia in older adults: an open clinical trial comparing two interventions
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Reese, R. J., Conoley, C. W., & Brossart, D. F. (2006) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2006.tb00379.x · Cited by 64
Benefit–cost analysis of a modified therapeutic community for mentally ill chemical abusers
French, M. T., McCollister, K. E., Sacks, S., McKendrick, K., & Leon, G. D. (2002) · Evaluation and Program Planning · doi:10.1016/s0149-7189(02)00006-x · Cited by 64
Psychotherapy Outcome Research
Behar, E., & Borkovec, T. (2003) · Handbook of Psychology · doi:10.1002/0471264385.wei0209 · Cited by 113
Kodituwakku, P. W., & Kodituwakku, E. L. (2011) · Neuropsychology Review · doi:10.1007/s11065-011-9170-1 · Cited by 78
“…pointed out that the findings from RCTs that administer manualized procedures to well-diagnosed volunteers over a fixed number of trials may lack external validity because therapists in the real world use therapies in a flexible manner to address complex problems of their clients (Seligman 1995).”
BackgroundHypnotic control of pain: Historical perspectives and future prospects
Chaves, J. F., & Dworkin, S. F. (1997) · International Journal of Clinical and Experimental Hypnosis · doi:10.1080/00207149708416138 · Cited by 62
Schulberg, H. C., Raue, P. J., & Rollman, B. L. (2002) · General Hospital Psychiatry · doi:10.1016/s0163-8343(02)00175-5 · Cited by 62
“[29] Seligman M.”
BackgroundDesign of Department of Veterans Affairs Cooperative Study No. 420
Schnurr, P. P., Friedman, M. J., Lavori, P. W., & Hsieh, F. Y. (2001) · Controlled Clinical Trials · doi:10.1016/s0197-2456(00)00118-5 · Cited by 63
Systemic Family Therapy for Families who have Experienced Trauma: A Randomised Controlled Trial
Coulter, S. (2010) · The British Journal of Social Work · doi:10.1093/bjsw/bcq132 · Cited by 62
Dose Response in Child and Adolescent Mental Health Services
Bickman, L., de Andrade, A. R. V., & Lambert, E. (2002) · Mental Health Services Research · doi:10.1023/a:1015210332175 · Cited by 61
“There are advocates who have used positive dose‐response findings with adult clients to argue against limits on care (e.g., Miller, 1996; Seligman, 1995; Stern, 1993).”
BackgroundMethodA Naturalistic Study of Psychotherapy for Bulimia Nervosa, Part 1
Thompson‐Brenner, H., & Westen, D. (2005) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000178843.81100.eb · Cited by 62
“In addition, the finding that longer treatments were associated with better outcomes across theoretical orientations is consistent with naturalistic data in which patients, not clinicians, were informants (e.g., Seligman, 1995).”
ResultKandel, E. R. (2002) · L Évolution Psychiatrique · doi:10.1016/s0014-3855(02)00105-6 · Cited by 68
“[126] Seligman MEP.”
Psychotherapy for patients with complex disorders and chronic symptoms
Guthrie, E. (2000) · The British Journal of Psychiatry · doi:10.1192/bjp.177.2.131 · Cited by 61
The Diminished Resistance to Medicalization in Psychiatry
Smith, D. T. (2014) · Society and Mental Health · doi:10.1177/2156869313512211 · Cited by 24
Metadata
- Authors
- Seligman, M. E. P.
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- Seligman, Martin E. P.
- Venue
- American Psychologist
- Published
- 1995-12
- Volume
- 50
- Issue
- 12
- Pages
- 965-974
- ISSN
- 0003-066X (ISSN-L)
- 1935-990X
- OpenAlex
- W2121827944
- Cited by
- 1,608
- References
- 0
- Citations by year
- 2026: 6 · 2025: 16 · 2024: 15 · 2023: 21 · 2022: 30 · 2021: 48 · 2020: 35 · 2019: 26 · 2018: 59 · 2017: 35 · 2016: 27 · 2015: 54 · 2014: 46 · 2013: 57 · 2012: 75
- FWCI
- 75.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Psychologist (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH 19604)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Keywords
- psychotherapy effectiveness, psychotherapy outcome, managed care, efficacy studies, randomized controlled trials, treatment comparison
- MeSH terms
- Consumer Behavior, Humans, Managed Care Programs, Outcome and Process Assessment, Health Care, Psychotherapy, Randomized Controlled Trials as Topic, Treatment Outcome
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