Is the Impact of Psychotherapy Processes on Outcomes Already Quacking and Waddling? Comment “A Primer on Psychotherapy Process Research (Pfeifer & Strunk, 2015)”

Abstract

The article by Pfeifer and Strunk on psychotherapy process research offers a highly thoughtful review on the state of psychotherapy process research in cognitive therapy for depression, and the inherent challenges in establishing causal relationships between process and outcomes. In this commentary, I argue that the goal of internal validity in psychotherapy process research may be unattainable, and possibly unnecessary. Finally, I suggest that psychotherapy process research should shift from “does it affect change?” to “how does it affect change?”, “when does it affect change?”, and “for whom does it affect change?”

Key words:

• cognitive behavior therapy
• depression
• internal validity
• psychotherapy process
• therapeutic alliance