The Outcome Problem in Psychotherapy Research

This paper is an attempt to summarize aspects of the history of psychotherapy research, with special reference to dynamic psychotherapy, during the past 20 years. A prominent feature has been the inability to demonstrate that psychotherapy is effective; another has been the lack of impact of research on clinical practice. I do not share the resulting state of disillusion and despair. A thorough examination of the literature suggests that evidence for the effectiveness of psychotherapy, and even of dynamic psychotherapy, is stronger than is generally supposed. Recent studies, based on outcome criteria that do justice to the complexity of psychodynamic change, have begun to heal the split between research and practice and offer renewed hope for the future.