Miles to Go Before We Sleep: Advancing the Understanding of Psychotherapy by Modeling Complex Processes

One of the main debates in the study of psychotherapy is whether specific techniques are best indicated for different problems or whether “common factors” better account for the efficacy of psychotherapy. Evidence for the superiority of specific techniques is mixed and limited to a handful of diagnoses. By contrast, evidence for the importance of common factors is riddled with methodological weaknesses and may be of limited clinical utility. The stagnation in this debate may reflect that the research methods heretofore employed have reached a plateau in their ability to advance knowledge regarding psychotherapy processes. The articles of the special issue move beyond simple bivariate relationship and attempt to model the real-world complexity involved in the process of psychotherapy. It is argued that these types of investigations, which model the interactions of patient characteristics as well as multiple specific and “common factors,” are the best way to advance the state of knowledge regarding psychotherapy processes.