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A meta-analysis of outcome studies comparing bona fide psychotherapies: Empiricially, "all must have prizes."
Abstract
This recta-analysis tested the Dodo bird conjecture, which states that when psychotherapies intended to be therapeutic are compared, the true differences among all such treatments are 0. Based on comparisons between treatments culled from 6 journals, it was found that the effect sizes were homogeneously distributed about 0, as was expected under the Dodo bird conjecture, and that under the most liberal assumptions, the upper bound of the true effect was about .20. Moreover, the effect sizes (a) were not related positively to publication date, indicating that improving research methods were not detecting effects, and (b) were not related to the similarity of the treatments, indicating that more dissimilar treatments did not produce larger effects, as would be expected if the Dodo bird conjecture was false. The evidence from these analyses supports the conjecture that the efficacy of bona fide treatments are roughly equivalent. In 1936, Rosenzweig proposed that common factors were responsible for the efficacy of psychotherapy and used the conclusion of the Dodo bird from Alice in Wonderland (Carroll, 1865/1962) to emphasize this point: At last the Dodo said, 'Everybody has won, and all must have prizes' (p. 412). Later, Luborsky, Singer, and Luborsky ( 1975 ) reviewed the psychotherapy outcome literature, found that the psychotherapies reviewed were generally equivalent in terms of their outcomes, and decreed that the Dodo bird was correct. Since Luborsky et al.'s seminal review, the equivalence of outcome in psychotherapy has been called the Dodo bird effect. To many interested in the technical aspects of particular psychotherapies, the Dodo bird effect was distasteful and, on the face of it, unbelievable: If the indiscriminate distribution of prizes argument carried true conviction . . . we end up with the same advice for everyoneRegardless of the nature of your problem seek any form of psychotherapy. This is absurd. We doubt whether even the strongest advocates of the Dodo bird argument dispense this advice. (Rachman & Wilson, 1980, p. 167)
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“However, since then, so many more specific meta-analyses have been conducted that directly compare two therapies with each other that an overall meta-analysis using this methodology would be a huge enterprise and, to the best of our knowledge, this has not been done.”
From The Role of Common Factors in Psychotherapy Outcomes (2019) · cites this paper as Wampold et al. 1997
In the citing paper
“The original study that developed this method of meta-analysis showed no significant difference between therapies (Wampold et al. 1997).”
From The Role of Common Factors in Psychotherapy Outcomes (2019) · cites this paper as Wampold et al. 1997
In the citing paper
“RCTs directly comparing two or more forms of psychotherapy (such as comparisons between CBT and psychodynamic psychotherapy54) provide the strongest evidence for similar outcomes.”
From A common factors perspective on mindfulness-based interventions (2022) · cites this paper as [54]
In the citing paper
“Meta-analyses have concluded that differences between psychotherapies, when present, tend to be small (standardized mean differences ≤ 0.2042,54).”
From A common factors perspective on mindfulness-based interventions (2022) · cites this paper as [54]
In the citing paper
“The treatment manual is an essential base of psychotherapy, including CBT 76,77 .”
From The efficacy of cognitive behavioral therapy-based intervention on patients with diabetes: a meta-analysis (2022) · cites this paper as [77]
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Eells, T. D., Lombart, K. G., Kendjelic, E. M., Turner, L., & Lucas, C. P. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.4.579 · Cited by 175
The Evidence for Present‐Centered Therapy as a Treatment for Posttraumatic Stress Disorder
Frost, N. D., Laska, K. M., & Wampold, B. E. (2014) · Journal of Traumatic Stress · doi:10.1002/jts.21881 · Cited by 181
Self-citationAn internet-based self-help treatment for fear of public speaking: a controlled trial.
Botella, C., Gallego, M. J., Garcia-Palacios, A., Guillen, V., Baños, R. M., Quero, S., & Alcañiz, M. (2010) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2009.0224 · Cited by 169
Distinctions without a difference: Direct comparisons of psychotherapies for alcohol use disorders.
Imel, Z. E., Wampold, B. E., Miller, S. D., & Fleming, R. (2008) · Psychology of Addictive Behaviors · doi:10.1037/a0013171 · Cited by 181
Self-citationde Haan, E., Grant, A. M., Burger, Y. D., & Eriksson, P.-O. (2016) · Consulting psychology journal · doi:10.1037/cpb0000058 · Cited by 172
Metadata
- Authors
- Wampold, B. E., Mondin, G. W., Moody, M., Stich, F., Benson, K., & Ahn, H.-N.
- Affiliations
- University of Wisconsin–Madison (US)
- ORCID
- Wampold, Bruce E.
- Venue
- Psychological Bulletin
- Published
- 1997-11
- Volume
- 122
- Issue
- 3
- Pages
- 203-215
- ISSN
- 0033-2909 (ISSN-L)
- 1939-1455
- OpenAlex
- W2094838887
- Cited by
- 1,091
- References
- 145
- Citations by year
- 2026: 12 · 2025: 32 · 2024: 30 · 2023: 56 · 2022: 33 · 2021: 34 · 2020: 45 · 2019: 46 · 2018: 49 · 2017: 45 · 2016: 49 · 2015: 61 · 2014: 57 · 2013: 68 · 2012: 51
- FWCI
- 4.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Bulletin (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Psychology Research and Bibliometrics
- Keywords
- treatment effect size, common factors in psychotherapy, psychotherapy efficacy
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