How to use the allegiance effect to maximize competence and therapeutic outcomes

Psychotherapy scientists have been prone to allegiance effects in psychothe rapy reviews and original research. This commentary discusses issues of bia s/allegiance with specific reference to cognitive behavior therapy for depr ession. Depression researchers have confidence in a range of effective trea tments but a relative lack of appreciation of how poorly we are doing in su staining our treatment effects. If allegiance to a treatment affects the ou tcome of treatment ("Mecca effect") and these effects are reproducible and measurable when conducted by "therapist-students," then we would be wise to maximize these results for the betterment of our patients.