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Psychotherapy and Eclecticism

Alas, the latter definition doubtless more accurately describes psychotherapeutic eclecticism in practice. There is good reason for this. The evidence base for psychotherapy depends on carefully defined, manualized treatments that are monitored for therapist adherence. Research generally shows that adherence to one specific model yields better results than a muddied, mixed (read "eclectic") approach (2,3). That treatment purity matters makes sense, particularly in the context of short-term treatments. Therapists should equip patients with a kit of finely honed "tools" for handling symptoms and situations, rather than a hodgepodge of responses.

Moreover, no one is really "knowledgeable" about how best to combine differing treatments. Little evidence is available with which to inform eclecticism. Hence, although mixing techniques is a constant temptation in therapy sessions, it is best avoided. The risk inherent in eclecticism is that therapists will fall into idiosyncratic approaches, as they did in the pre-empirical past. It's important that psychiatric residents be trained in carefully defined treatments (psychodynamic, cognitive, and so forth) so that such eclecticism—a euphemism for entropy—is minimized.

John C. Markowitz, M.D.

Footnotes

Dr. Markowitz is a research psychiatrist at New York State Psychiatric Institute and clinical professor of psychiatry at Weill Medical College of Cornell University in New York City.

References

1. Goin MK: A current perspective on the psychotherapies. Psychiatric Services 56:255–257, 2005[Free Full Text]
2. Luborsky L, McLellan AT, Woody GE, et al: Therapist success and its determinants. Archives of General Psychiatry 42:602–611, 1985[Abstract]
3. Frank E, Kupfer DJ, Wagner EF, et al: Efficacy of interpersonal psychotherapy as a maintenance treatment of recurrent depression. Archives of General Psychiatry 48:1053–1059, 1991[Abstract]

Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via Google Scholar Articles by Markowitz, J. C. Search for Related Content PubMed Citation Articles by Markowitz, J. C. Mental Retardation Stigma, Discrimination Treatment Compliance Outcome and Process Assessment Quality of Care, Practice Guidelines Psychotherapies (General) Research Design, Methodology

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