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Update on Empirically Validated Therapies, II

This recta-analysis tested the Dodo bird conjecture, which states that when psychotherapies intended to be therapeutic are compared, the true differences among all such treatments are 0. Based on comparisons between treatments culled from 6 journals, it was found that the effect sizes were homogeneously distributed about 0, as was expected under the Dodo bird conjecture, and that under the most liberal assumptions, the upper bound of the true effect was about .20. Moreover, the effect sizes (a) were not related positively to publication date, indicating that improving research methods were not detecting effects, and (b) were not related to the similarity of the treatments, indicating that more dissimilar treatments did not produce larger effects, as would be expected if the Dodo bird conjecture was false. The evidence from these analyses supports the conjecture that the efficacy of bona fide treatments are roughly equivalent. In 1936, Rosenzweig proposed that common factors were responsible for the efficacy of psychotherapy and used the conclusion of the Dodo bird from Alice in Wonderland (Carroll, 1865/1962) to emphasize this point: "At last the Dodo said, 'Everybody has won, and all must have prizes' " (p. 412). Later, Luborsky, Singer, and Luborsky ( 1975 ) reviewed the psychotherapy outcome literature, found that the psychotherapies reviewed were generally equivalent in terms of their outcomes, and decreed that the Dodo bird was correct. Since Luborsky et al.'s seminal review, the equivalence of outcome in psychotherapy has been called the Dodo bird effect. To many interested in the technical aspects of particular psychotherapies, the Dodo bird effect was distasteful and, on the face of it, unbelievable: If the indiscriminate distribution of prizes argument carried true conviction . . . we end up with the same advice for everyone"Regardless of the nature of your problem seek any form of psychotherapy." This is absurd. We doubt whether even the strongest advocates of the Dodo bird argument dispense this advice. (Rachman & Wilson, 1980, p. 167)

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A meta-analysis of outcome studies comparing bona fide psychotherapies: Empiricially, "all must have prizes."

At the request of David Barlow, President of Division 12, and under the aegis of Section I I I , this task force was constituted to consider methods for educating clinical psychologists, third party payors, and the public about effective psychotherapies. Lacking the enormous promotional budgets,arid sales staff of pharmaceutical companies, clinical psychologists labor at a disadvantage to disseminate irnportant findings about innovations in psychological procedures. Despite the great strides in the development and validation of effective treatments, it is not clear that the benefit of our approaches is widely appreciated, even by other clinical psychologists. We believe that, i f the public is to benefit from the availability of effective psychotherapies, and i f clinical psychology is to survive in this heyday of biological psychiatry, APA must act to emphasize the strength of what we have to offer — a variety of psychotherapies of proven efficacy. We suggest that psychologists hold an advantage in being the primary scientists in the

Training in and Dissemination of Empirically-Validated Psychological Treatments: Report and Recommendations

https://www.drexel.edu/~/media/Files/psychology/labs/innovation/Behavioral%20Treatment%20for%20Obesity.ashx

Behavioral Treatment of Obesity

Objective: The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), harms associated with treatments, factors associated with treatment efficacy, and differential outcome by sociodemographic characteristics. Method: We searched six major databases for studies on the treatment of AN from 1980 to September 2005, in all languages against a priori inclusion/exclusion criteria focusing on eating, psychiatric or psychological, or biomarker outcomes. Results: Thirty-two treatment studies involved only medications, only behavioral interventions, and medication plus behavioral interventions for adults or adolescents. The literature on medication treatments and behavioral treatments for adults with AN is sparse and inconclusive. Cognitive behavioral therapy may reduce relapse risk for adults with AN after weight restoration, although its efficacy in the underweight state remains unknown. Variants of family therapy are efficacious in adolescents, but not in

/pdf/bulimia-nervosa-treatment-a-systematic-review-of-randomized-3yrhetqpf2.pdf

Bulimia nervosa treatment: A systematic review of randomized controlled trials

This study evaluated the effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating. Fifty-six women with nonpurging bulimia were randomly assigned to 1 of 3 groups: CBT, IPT, or a wait-list control (WL). Treatment was administered in small groups that met for 16 weekly sessions. At posttreatment, both group CBT and group IPT treatment conditions showed significant improvement in reducing binge eating, whereas the WL condition did not. Binge eating remained significantly below baseline levels for both treatment conditions at 6-month and 1-year follow-ups. These data support the central role of both eating behavior and interpersonal factors in the understanding and treatment of bulimia.

S. D. Raeburn

Papers

Group Cognitive—Behavioral Therapy and Group Interpersonal Psychotherapy for the Nonpurging Bulimic Individual A Controlled Comparison