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Motivational Interviewing and Behavior Change
Published in Carolyn Hilarski, Addiction, Assessment, and Treatment with Adolescents, Adults, and Families, 2013
There has been a call, not only in the MI intervention literature, but also in the psychotherapy literature writ large, for a more thorough investigation of the complex relationships between process, technique and outcome in psychotherapeutic interventions (Burke et al., 2002; Carroll, Nich, & Rounsaville, 1997; Dunn et al., 2001; Longabaugh, 2001; Miller, 1996; Miller & Rollnick, 2002). There is the question of common ingredients versus unique factors specific to individual types of treatments that needs to be answered (e.g., do therapies work more because of the ingredients common to each therapy or is there something unique to each therapy that makes it effective?). This question is leftover from the “dodo bird verdict” (a phrase borrowed from Alice in Wonderland stating, “Everyone has won and so all must have prizes.” [Hubble, Duncan, & Miller, 1999, p. 6]). In other words, we know psychotherapy is effective, and we also know that one type of psychotherapy is no more effective than all the rest (Llewelyn & Hardy, 2001). With well over three hundred different types of psychotherapy, ranging alphabetically from Active Analytical Psychotherapy to Zaraleya Psychoenergetic Technique (Gordon, 2000), and with the number of psychotherapy approaches and theories having grown by approximately 600% in 40 years (Hubble et al., 1999), it can be difficult for helping professionals to know what kind of intervention to use. This is especially true in the case of clinicians working with clients who have persistent and complex issues, such as substance dependence.
Borderline Personality Disorder: A Case for the Right Treatment, at the Right Dose, at the Right Time
Published in Issues in Mental Health Nursing, 2021
Katrina Campbell, Richard Lakeman
The dodo bird verdict refers to the observation that all schools of psychotherapies produce more or less equivalent outcomes, and this is probably due to non-specific or factors common to all kinds of therapies (Leder, 2019; Mansell, 2011). This observation was first made by Rosenzweig (1936) and revisited by Luborsky et al. (1975) in which they drew on the words of the dodo bird in Lewis Carroll’s novel, Alice in Wonderland, to declare “Everybody has won and all must have prizes” (Carroll, 1971, p. 26). For most conditions and most psychotherapies this rather uncomfortable truth remains undisputed. Although to draw on another literary metaphor, (this time, George Orwell’s ‘Animal farm’), “all animals are equal, but some are more equal than others” (Orwell, 1945, p. 112). Some schools of psychotherapy are rather privileged in being researched, promoted, more readily manualised and tested, or have higher status than others. The research evidence points to DBT and mentalisation based treatment being most researched and most likely to succeed (Storebø et al., 2020). However, it is probably true that if someone diagnosed with BPD engages with a skilled, empathic, warm, congruent therapist for a sufficient length of time they will get better. Some (as we are proposing) have asserted that an integrative approach to treatment for Borderline Personality Disorder is an alternative to the ‘specialised therapy’ approach, tailoring treatment to individual patients and their quite specific problems and psychotherapy (Livesley, 2012).
Integrating psychotherapy and psychopharmacology: psychedelic-assisted psychotherapy and other combined treatments
Published in Expert Review of Clinical Pharmacology, 2020
Kyle T. Greenway, Nicolas Garel, Lisa Jerome, Allison A. Feduccia
Modalities and techniques of psychotherapy are numerous and diverse. However, a significant portion of the therapeutic benefits of psychotherapy may be due to components that are generally shared amongst various approaches – the so-called common factors – rather than ingredients that are unique to a particular therapeutic model [84,85]. Indeed, the ‘dodo bird verdict’ postulates that all psychotherapeutic approaches are similarly efficacious in part because the systematic application of any therapeutic theory by a skilled therapist is beneficial regardless of that theory’s actual veracity [86]. It was first described in 1936 and remains an important topic today [87,88]. Some authors thus speak of the creation and application of a ‘therapeutic myth’ between patient and therapist as a key component of psychotherapy [78,89]. That is, establishing a mutually acceptable rationale that explains an individual’s psychopathology and guides its treatment.