Individual psychotherapy outcome and process research: Challenges leading to greater turmoil or a positive transition?

Psychotherapy is facing challenges that relate to the emergence of managed health care, the possibility of a national health care system, and advances in biological psychiatry. These situations have created pressure to achiev e a more accurate assessment of psychotherapeutic effectiveness. Psychother apy has been proven to be generally effective; however, there is uncertaint y as to why. The field is currently experiencing apparent turmoil in three areas: (a) theory development for psychotherapeutic effectiveness, (b) rese arch design, and (c) treatment technique. This chapter reviews the dynamics within each of the areas and highlights the progress made in treating ment al disorders. We conclude that recent advances in research design may provi de a transition that will bring psychotherapy closer to becoming a unified paradigm with an acceptable theory of effectiveness.