The status of empirically supported therapies: comment on Westen and Morrison's (2001) multidimensional meta-analysis.

In this commentary, a meta-analytic review by D. Westen and K. Morrison (2001) is put in a historical context of the controversies over the effects of psychotherapy. It is suggested that recalculations of the effects of psychotherapy have been common in past debates and that Westen and Morrison's estimates understate the effects of therapy. Data are summarized that suggest that outcomes in clinical practice are equivalent to clinical trials research, but only when patients receive similar levels of treatment and regardless of whether empirically supported therapies are offered. Treatment gains are generally maintained. It is suggested that outcomes management strategies would be far more efficient than efficacy and effectiveness research in maximizing patient outcomes.