The Round Table Discussion on “What is effective in the therapeutic process?” was held at the 1956 Annual Meeting of the American Psychiatric Association. It was moderated by Bella S. Van Bark, M.D., who outlined in her introduction the existence of a variety of opinions on what kind of help leads to effective therapy. Effectiveness is defined in terms of personality change and growth. Dr. Van Bark acknowledged that different theoretical approaches would consider different factors of primary importance in the effectiveness of the process: doctor-patient relationship; personality of the therapist; the activation of the constructive forces in the patient; diminishing of the destructive forces in the patient. She focused the discussion by posing some poignant questions regarding the forces at play in the therapeutic process.