The outcome problem in psychotherapy revisited.

Abstract

This reprinted article originally appeared in Psychotherapy: Theory, Research, & Practice, 1963, 1 (1), 1-13. (The following abstract of the original article appeared in record 1965-15636-001) "… the therapeutic situation itself should be used to a much greater extent than has heretofore been the case to generate and develop criteria of outcome… . no-where else do we have an opportunity to make as penetrating, intensive, systematic, and undistorted observations as in the therapeutic situation… . transference is the most faithful replica of the patients' capacity for intimate interpersonal relatedness." Researchers should systematize and objectify intratherapeutic observations and where possible relate them to the patients' interpersonal performances outside therapy. There is a class association between quality of patients' relationship to the therapist and the quality of his relationship with others, including his adaptation to reality. Difficulties encountered in using the therapeutic situation as a criterion-generating situation are "(1) the problem of conceptualizing, specifying, and quantifying the multidimensional observations made in therapy; (2) the therapists reliability as on O (by which is meant more than countertransference); and (3) limitations inherent in the 2-person setting, which provide representative, but incomplete, data about the patients' interactions with others".

Narrative and Clinical Change in Cognitive-Behavior Therapy: A Comparison of Two Recovered Cases

“…Having these limitations in mind, the findings in these cases need to be replicated in other cases and samples, as this study also addresses an important question that has been challenging researchers in psychotherapy for at least 50 years (see Strupp, 1963Strupp, /2013: What do therapists and researchers mean when they refer to recovery or improvement? The field of psychotherapy outcome research has generally accepted the idea that outcomes should be measured at the symptom level (often with self-report measures).…”

Prática Baseada em Evidências em Psicologia e Idosos: Conceitos, Estudos e Perspectivas

“…Nos anos subsequentes à publicação do referido texto, diversos debates ocorreram na literatura, sendo que bons exemplos desses acalorados diálogos podem ser observados nas publicações de Rosenzweig (1954) e Strupp (1963Strupp ( , 1964, além das respostas de Eysenck (1955de Eysenck ( , 1964 (Barlow et al, 2013). Rosenzweig (1954) rotulou o estudo de Eysenck (1952) como tendencioso, criticando veementemente a conceituação de neurose utilizada no estudo, as diferenciações do autor acerca das psicoterapias psicanalíticas, ecléticas e clínicas gerais, além da dificuldade de se avaliar a recuperação de pacientes cujos méto-dos de tratamento se diferem entre si.…”

“…Em sua resposta, Eysenck (1955), dentre outros apontamentos, salientou que, ao se perceber que os dados discutidos, pobres como são, compunham todas as evidências disponíveis a respeito de um método de psicoterapia praticado há mais de 50 anos em centenas de milhares de pacientes, eles deveriam servir como estímulos para garantir o início de estudos experimentais devidamente planejados, rigidamente controlados, e cuidadosamente analisados nesta área. Strupp (1963;, dentre suas críticas, reagiu aos dados de Eysenck (1952), expondo que haviam observações clínicas que documentavam os benefí-cios da relação com um profissional, quando pacientes estão preocupados com dificuldades que vivenciam e buscam auxílio. Segundo o crítico, argumentar o contrário do exposto seria, simplesmente, fechar os olhos para os fatos, já que todos sabiam que a psicoterapia era efetiva.…”

The Efficacy of Psychotherapy: Focus on Psychodynamic Psychotherapy as an Example

“…Early on, there were a number of critiques of Eynseck's review. The most notable were by Christie (1956), Bergin (1971), Lambert (1976), Luborsky, Singer, and Luborsky (1975), Rosensweig (1954), and Strupp (1963). However, one critique in particular revolutionized not only the field of psychotherapy and psychotherapy research but all of science.…”