www.psychspace.com心理学空间网
The Effects of Psychotherapy—An Evaluation
H. J. EYSENCK
Institute of Psychiatry, University of London, England
THE recommendation of the Committee on Training in Clinical Psychologyof the American Psychological Association regarding the training of clinicalpsychologists in the field of psychotherapy has been criticized by the writerin a series of papers [10, 11, 12]. Of the arguments presented in favor ofthe policy advocated by the Committee, the most cogent one is perhapsthat which refers to the social need for the skills possessed by the psychotherapist.In view of the importance of the issues involved, it seemed worthwhile to examine the evidence relating to the actual effects of psychotherapy,in an attempt to seek clarification on a point of fact.
BASE LINE AND UNIT OF MEASUREMENT
In the only previous attempt to carry out such an evaluation, Landis haspointed out that "before any sort of measurement can be made, it is necessaryto establish a base line and a common unit of measure. The only unitof measure available is the report made by the physician stating that thepatient has recovered, is much improved, is improved or unimproved. Thisunit is probably as satisfactory as any type of human subjective judgment,partaking of both the good and bad points of such judgments" (26, p. 156).For a unit Landis suggests "that of expressing therapeutic results in termsof the number of patients recovered or improved per 100 cases admitted tothe hospital." As an alternative, he suggests "the statement of therapeuticoutcome for some given group of patients during some stated interval oftime."
Landis realized quite clearly that in order to evaluate the effectiveness ofany form of therapy, data from a control group of nontreated patientswould be required in order to compare the effects of therapy with the spontaneousremission rate. In the absence of anything better, he used the ameliorationrate in state mental hospitals for patients diagnosed under the headingof "neuroses." As he points out:
There are several objections to the use of the consolidated amelioration rate . . . ofthe . . . state hospitals . . . as a base rate for spontaneous recovery. The fact that psychoneuroticcases are not usually committed to state hospitals unless in a very bad condition ;the relatively small number of voluntary patients in the group ; the fact that such patientsdo get some degree of psychotherapy especially in the reception hospitals ; and the probablyquite different economic, educational, and social status of the State Hospital groupcompared to the patients reported from each of the other hospitals—all argue againstthe acceptance of [this] figure . . . as a truly satisfactory base line, but in the absence ofany other better figure this must serve (26, p. 168).