The Efficacy of Psychotherapeutic Outcome Studies

To the Editor.—  In his commentary on psychotherapy,¹ Dr Glass was rather sanguine about the demonstrated efficacy of psychotherapy outcome studies. He stated that "the question of whether psychotherapy really 'works' has been answered in the affirmative by an impressive number of controlled clinical trials." I believe that such a statement might best be tempered considering the conclusion of a recent relevant article not mentioned by Dr Glass. Prioleau et al² reviewed the outcome of 32 studies that compared psychotherapy with placebo treatment.Their conclusion was "that for real patients there is no evidence that the benefits of psychotherapy are greater than those of placebo treatment." However, the article by Prioleau et al² was itself followed by both positive and negative commentaries, as would be expected from such a polarizing report. Nonetheless, it seems that placebo psychotherapy needs to be added to the list of "effective" psychotherapies.