Are we getting better? Psychotherapy dose-response effect: A clinician's comments.

Hansen, Lambert, and Forman (this issue) find that clinicians cannot be fully effective in treatment because they are deprived access to a sufficient number of sessions. Using clinical significance methodology, they found that only 35% of patients were better at treatment completion, most often after only three sessions. Although their recommendation to extend treatment length may be appropriate for many patients, other patients can be successfully treated in a few sessions. Before changing practices, we will need individualized, subjective outcomes data that identify specific markers of poor prognosis that can be easily assessed early in treatment. Lacking these data, in most cases, I still prefer to empower patients to decide when treatment is complete.