Between the Past and the Future of Psychotherapy Research

THE overarching goal of psychotherapy research is to understand the mechanisms through which such treatment operates and to assess the impact of moderating influences on maladaptive and adaptive functioning. During the past two decades, there has been a dramatic increase in empirically based outcome- and process-oriented psychotherapy research. Outcomeoriented research 1-4 concerns itself with the scientific evaluation of the effectiveness of psychotherapy. Moving beyond this approach, processoriented psychotherapy research 5-9 investigates the extent to which outcome is determined by the interaction of the patients' psychopathologic characteristics and personality on the one hand, and the therapists' skills, personality, and particularly their technique on the other. See also pages 625, 633, 637, 639, 645, 646, 649, 651, and 654 Both approaches have contributed much to our understanding in this realm. At the same time, both have demonstrated the difficulties inherent in the systematic investigation of psychotherapy, an enterprise that subsumes over 400