Academic psychiatry in the USA in the Academic psychiatry in the USA in the decade after the Second World War was decade after the Second World War was dominated by psychoanalytic theory. dominated by psychoanalytic theory. Psychotherapy, most of it psychodynamic Psychotherapy, most of it psychodynamic in orientation, was the principal activity in orientation, was the principal activity of clinicians in office practice. Critics like of clinicians in office practice. Critics like myself who pointed out the lack of empiri-myself who pointed out the lack of empirical validation for the theory or the practice cal validation for the theory or the practice were unavailing (Eisenberg, 1962). were unavailing (Eisenberg, 1962). This is less surprising when considered This is less surprising when considered in context: there were in context: there were no no treatments of treatments of demonstrated effectiveness. Psychiatric demonstrated effectiveness. Psychiatric diagnosis had low interrater reliability.