Specificity and Nonspecificity in Psychotherapy

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DeRubeis et al. (this issue) offer a data-based critique of two arguments frequently presented in support of the “nonspecifics” hypothesis. This commentary supports their report of superior effects for specific treatments for specific disorders and provides some additional data to support their position. We maintain, however, that current research has not adequately evaluated nonspecific effects so that theoretical conclusions can be drawn regarding the mechanisms of change of the superior treatments. DeRubeis et al. present some data to suggest that nonspecific effects, particularly the therapeutic alliance, are a result of therapy outcome rather than causal in therapeutic change. We argue, to the contrary, that adequate research remains to be done regarding nonspecific effects, and when that research is completed, what are now called nonspecific effects will be more aptly labeled previously unspecified effects.

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