The Scientific Review of Mental Health Practice: Implications for Psychology and Psychoanalysis

Freud's “talking cure” has become big business. What began as an esoteric treatment available to a select few has evolved into a well-known, widely accepted method for enhancing adaptation and reducing psychological symptoms. The growth of psychotherapy during the past century has been nothing short of remarkable, but as any marketing expert can attest, growth entails risk. Clinical researchers estimate that there are over 400 different types of therapy in use today, with more appearing every year (Corsini, 2000). Evidence supporting the efficacy of these therapeutic approaches varies considerably, with some forms of treatment (e.g., systematic desensitization for phobias) receiving strong empirical support (Barlow, 2002), others (e.g., antidepressant management of depression) receiving mixed support (Greenberg, Bornstein, Greenberg, & Fisher, 1992), and still others (e.g., primal scream therapy) receiving no support at all.

Freud's (1937/1964) protestations notwithstanding, controlled empirical testing has always been critical for the development of effective psychological treatments. As the number of available therapies increases, rigorous testing of therapeutic efficacy becomes even more important, with implications in at least three domains. First, such research is critical in establishing the clinical utility of a given intervention. Managed care, for all its flaws, has focused our attention on the necessity of documenting that what we do actually works. Treatment efficacy studies are also germane from an ethical perspective. In one form or another, the ethical principles of every mental health profession dictate that only those interventions that have proven effective may be used to treat mental disorders (e.g., American Psychological Association [APA], 2002). Finally, empirical assessment of therapy outcome is important in the legal arena. Certain forms of treatment that have not been tested adequately (e.g., rebirthing therapy for reactive attachment disorder