Design characteristics in therapy outcome research were evaluated for their inherent potential in responding to questions raised by clinicians, consumers, and policymakers. Attention was directed at the generalizability of findings, the assessment and definition of benefit, and the cost involved. A review of 302 outcome studies published in 3 clinical journals from 1978/1979 and 1986/1987 indicated that the number of published outcome studies has decreased over time, that the experimental designs used are largely unable to provide answers for policymakers, and that it is primarily the quality of measurement and documentation of change that has improved. Publication trends reflect a continuing lack of replication studies, insufficient attempts to describe the clinical meaning of findings, and a widespread disregard for considerations of statistical power. WOLFGANG LINDEN, PhD, received his doctorate from McGill University in 1981. He is currently an associate professor in the clinical psychology program at the University of British Columbia. Although his clinical research focuses on cardiovascular disease, he maintains an active interest in professional issues.