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Although psychotherapy research is not a new endeavor, publications describing this type of research have been on the increase. Studies such as the NIMH-sponsored multi-center collaborative depression studies and the McLean Hospital schizophrenia treatment study, as well as reports such as those of the APA Commission on Psychiatric Therapies, make an ever-strengthening case in favor of the efficacy of psychotherapy as an active agent of therapeutic change. Clinicians would likely say that they have known this fact all along, and that any well-trained therapist spending a few years working with patients would reach the same conclusion. Perhaps so, but not with the persuasiveness necessary to justify such a costly form of treatment to its consumers or to third-party payors, given the confusing array of types of therapies advertised today (as many as 250 forms of psychotherapy have been identified). As important, however, is the need to establish scientifically the validity, or the lack of it, of any form of medical intervention heralded as a legitimate treatment intended to alleviate suffering or illness. Only through ongoing efforts scientifically to validate or discard treatment methods do we advance beyond admixtures of theory, compassionate intuition, and folk remedies.
Patterns of Change is a welcome addition to the psychotherapy research literature. Drawing from works by researchers with such disparate theoretical frameworks as Rogerian client-centered therapy, Gestalt therapy based on the work of Fritz Perls, experiential psychotherapy, and psychoanalytically oriented psychotherapy, the authors propose a "new research paradigm," in which the "central focus is on the client rather than the therapist. It is the client who changes …" (p. 21).
For years, psychotherapy researchers have been grappling with a bewildering array of data. Among the ingredients to be studied are: defining the therapeutic technique to be utilized; developing reliable scales to de