Research on psychotherapy efficacy and effectiveness: Between Scylla and Charybdis?
Abstract
Clinical researchers have recently begun to explore differences between psychotherapy outcome studies that focus on efficacy and those that focus on effectiveness. The authors provide concise descriptions of these research models, followed by more extended consideration of the most important conceptual and empirical distinctions between the two. Research on the efficacy/effectiveness distinction is then put into context: The common treatment variables that also influence treatment outcomes are reviewed. Fifty years of research on psychotherapy outcomes are next considered; contemporary research on the efficacy and effectiveness research models is emphasized. A description and evaluation of current efforts to heighten the value of technique-focused research to clinicians follow. The authors conclude by anticipating some promising future directions in this research domain.
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A limitation of this study was the lack of an active comparator, such as treatment-as-usual.
“A limitation of this study was the lack of an active comparator, such as treatment-as-usual (Hanna, 2003; Nathan et al., 2000).”
From Effectiveness of web-based guided self-help cognitive behavioral therapy-enhanced for binge-eating disorder: An implementation study (2024) · cites this paper as Nathan et al., 2000
The randomized controlled design and the equivalence between the intervention groups are important factors enhancing the internal validity of a study.
“The randomized controlled design and the equivalence between the intervention groups are important factors enhancing the internal validity of a study [71].”
From Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: Randomized controlled trial (2018) · cites this paper as [71]
Although primarily an efficacy study, the generous inclusion of participants and the naturalistic setting resemble the prioritizations of effectiveness studies, resulting in a reduced level of control regarding potential confounding variables.
“Second, although primarily an efficacy study, the generous inclusion of participants and the naturalistic setting of this study resemble the prioritizations of effectiveness studies [71], resulting in a reduced level of control regarding potential confounding variables (eg, heterogeneity within the sample in terms of the symptom severity, comorbidity, and concurrent treatments).”
From Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: Randomized controlled trial (2018) · cites this paper as [71]
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- Authors
- Nathan, P. E., Stuart, S. P., & Dolan, S. L.
- Affiliations
- University of Iowa (US)
- Venue
- Psychological Bulletin
- Published
- 2000
- Volume
- 126
- Issue
- 6
- Pages
- 964-981
- ISSN
- 0033-2909 (ISSN-L)
- 1939-1455
- OpenAlex
- W1994615242
- Cited by
- 258
- References
- 153
- Citations by year
- 2026: 4 · 2025: 2 · 2023: 8 · 2022: 8 · 2021: 10 · 2020: 11 · 2019: 4 · 2018: 4 · 2017: 9 · 2016: 9 · 2015: 7 · 2014: 8 · 2013: 11 · 2012: 16
- FWCI
- 14.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Bulletin (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- psychotherapy efficacy, psychotherapy effectiveness, treatment outcome research, treatment variables
- MeSH terms
- Forecasting, Health Services Research, Humans, Psychotherapy, United States, Randomized Controlled Trials as Topic, Treatment Outcome, Outcome Assessment, Health Care
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