We can’t say we didn’t see this coming. In the first edition of The Heart and Soul of Change: What Works in Therapy, published in 1999, authors Mark Hubble, Barry Duncan, and Scott Miller predicted that psychotherapists would soon be facing a new era of accountability for their work. Clients, payors, and policymakers would all demand hard evidence that psychotherapy was effective. That era is well underway, and so far we have provided a wealth of the kind of information these parties have demanded.
We can demonstrate that therapy works as an overall conclusion, and within the contexts of specific problems and populations. Proving the effectiveness of specific models has been helpful in many ways (showing that model-based treatment is superior to no treatment) and enlightening in others (showing that, for most problems, the model of therapy has little to no impact on outcome). The brain research discussed by Siegel, Cozolino, and others explains why therapy works. Psychotherapy in general is being held accountable, and it is passing the test with flying colors.
The same cannot be said of specific therapists, or of therapy training programs – yet.