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This article reconsiders the issue of clinical versus statistical prediction. The term clinical is widely used to denote 1 pole of 2 independent axes: the observer whose data are being aggregated (clinician/expert vs. lay) and the method of aggregating those data (impressionistic vs. statistical). Fifty years of research suggests that when formulas are available, statistical aggregation outperforms informal, subjective aggregation much of the time. However, these data have little bearing on the question of whether, or under what conditions, clinicians can make reliable and valid observations and inferences at a level of generality relevant to practice or useful as data to be aggregated statistically. An emerging body of research suggests that clinical observations, just like lay observations, can be quantified using standard psychometric procedures, so that clinical description becomes statistical prediction.

There is apparently little difference in the effectiveness of different kinds of psychotherapy. One explanation is that common factors cut across them. The major schools do not much attend to common factors, however, and it may be that outcome equivalence is due as much t o common neglect of common factors as t o their use. Five common factors are discussed: the therapeutic relationship, expectations, confronting problems, mastery, and attribution of outcome. Linear conceptions of causality seem to contribute t o the problem of selective neglect of common factors, and it is suggested that reciprocal interaction may constitute a more viable way of understanding therapeutic processes. Although technical eclecticism and therapy integration have been proposed as potentially integrating the common factors, eclecticism lacks theoretical coherence, and viable integrations have yet t o be offered, although statistical methods for testing them (causal modeling) may exist. To suggest what a productive integration could look like, a clinical example is connected metaphorically t o a developmental model of attachment.Strategies for further research are also suggested.

These data indicate that therapist facilitation of patient affective experience/expression is associated with patient improvement over the course of psychodynamic psychotherapy. Although the size of this relationship was not significantly related to methodological quality, results suggest the importance of close supervision of actual techniques through the use of audio- or videotapes. Additionally, results highlight the importance of defining outcome in a multidimensional way to properly assess theoretically relevant effects.