The effectiveness of psychotherapy: Science and policy.

Sol Carfield agrees that we have psychological interventions with proven efficacy for a number of problems and disorders, but points out that among other problems, we know relatively little about the generality of effectiveness of these interventions across clients and therapists, and that we have a poor understanding of the mechanisms of action of many of these procedures. Thus, he concludes that dissemination of these procedures is premature. These knowledge gaps clearly exist, but from the point of view of policy, similar gaps in knowledge have not precluded the widespread dissemination of pharmacological treatments. It is suggested that if we do not communicate what we know about efficacy at this time (with appropriate caveats), psychotherapy may well be at a substantial disadvantage as clinical practice guidelines are prepared by government and private agencies. In addition, possible limitations regarding the generality and clinical utility of our interventions are currently hypotheses that need systematic evaluation, particularly since some existing evidence suggests that these limitations may be minor.