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Introduction edit

The Dodo Bird Verdict: A Brief History edit

 
"Everybody has won and all must have prizes."

The "Dodo Bird Verdict" is one of the most hotly debated topics in all of psychology. According to the Dodo Bird Verdict, all psychotherapies, regardless of their specific components, produce equivalent outcomes. The Dodo Bird debate took flight in 1975 when Singer and Luborsky reported the results of one of the first comparative study demonstrating few significant differences in the outcomes among different psychotherapies [1]. This study has spurred a plethora of new studies in both opposition and support of the Dodo Bird Verdict [2].


The “Dodo Bird Verdict” terminology was first coined by Saul Rosenzweig (1936) to illustrate the notion that all therapies are equally effective [3][1][4]. Rosenzweig borrowed the phrase from Lewis Carroll's Alice's Adventures in Wonderland (1865), where, at a certain point, a number of characters become wet and in order to dry themselves, the Dodo Bird decided to issue a competition. Everyone was to run around the lake until they were dry. Nobody cared to measure how far each person had run, nor how long. When they asked the Dodo who had won, he thought long and hard and then said "Everybody has won and all must have prizes." Thus, in the case of psychotherapies, the Dodo Bird Verdict means that all therapies are winners, and thus, all must have prizes.


The Dodo Bird debate, in brief, is focused on whether or not the specific components of different treatments lead some treatments to outperform other treatments for specific disorders. Supporters of the Dodo Bird Verdict contend that all psychotherapies are equivalent because of "common factors" that are shared in all treatments (i.e., having a relationship with a therapist who is warm, respectful, and has high expectations for client success[5][6]. In contrast, critics of the Dodo Bird Verdict would argue that the specific techniques used in different therapies are important, and all therapies do not produce equivalent outcomes for specific disorders.

Controversy edit

Support for the Dodo Bird Verdict edit

The common factor theory states that all therapy in psychology is equally effective because of the common factors shared among all therapies in psychology. So the specific techniques or strategies that are unique to the individual studies are ineffective in the treatment outcome of the patient. Instead, the only causal agents in treatment are the common factors [7][8][9][10] So the specific techniques or strategies that are unique to the individual treatments are ineffective in the treatment outcome of the patient[11]


One common factor is the client-therapist interaction. A 1992 study by Lambert showed that nearly 40 percent of the improvement in psychotherapy is from these client-therapist variables[12]. Other researchers have further analyzed the importance of client-therapist variables in treatment. Researchers found that improvement in the patient was up to the patients themselves because the data showed that if patients were able to change their attitude they would improve[1][3][13]. Wamphold et al 2002, found that 7% of the variability in treatment outcome was due to the therapeutic alliance whereas 1% of the variability was due to a specific treatment [14][15] [13] [16] The therapists attitude is also a very important causal agent in positive patient change. Najavits and Strupp 1994, demonstrated that a positive, warm, caring, and genuine therapist generated statistically significant differences in patient outcome [17] This shows that basic human qualities, not specific treatment qualities, are the determining factor for client improvement. Wamphold et al 2002, also found that nearly 70% of the variability in treatment outcome was due to the therapist’s attitude toward the efficacy of the treatment[14]


Opposition to the Dodo Bird Verdict edit

In refutation of the Dodo Bird Verdict, there is strong evidence that some treatments are in fact better for particular disorders when compared to other treatments [18][19]. Here, in contrast to the common factor theory, qualitative components of the therapy have statistically significant results[20][21]Cite error: The <ref> tag has too many names (see the help page).. Luborsky, Singer, and Luborsky’s 1975 review on comparative outcomes of psychotherapies is one of the most well-known studies executed in the support of the Dodo Bird Verdict, however, although 30 years ago a general equivalency of the effect sizes of psychotherapies may have seemed accurate, that is not at all the case today, [22][23]. With the improvement of research and the growth of psychology as a field in general, the treatments used by clinicians have evolved as well. We are no longer in the practice of bloodletting and lobotomies. Today especially, with the evolution of empirically supported treatments, there is a greater emphasis on treatment integrity and specificity than what there had been early on in psychotherapy practices[23].


One of the more common critiques against evidence in support of the Dodo Bird Verdict has to do with the legitimacy of the meta-analyses used in the study. These meta-analysis comparative tests unfortunately are not invulnerable to the subjective agenda of many psychologists[24]. Arguments have proposed that the specific meta-analysis the Dodo Bird Verdict is based on (Luborsky, Singer, Luborsky 1975) could possibly produce misleading results because of the type of studies combine in the comparison, [22][25][26]. A startling 43% of studies that support the Dodo Bird Verdict, yielding a report that concludes no outcome difference, are found not to have the sensitivity to detect differences in therapies even if they did exist [27] Some meta-analyses constructed are not sensitive to the subtle distinctions between treatment effects, especially among comparative studies of highly similar treatments [22][27][28]

Issues in Testing edit

The heart of the controversy over this theory lies precisely in the mechanism used to evaluate it. The controversy of the Dodo Bird Verdict essentially originates from the fundamental problems of Meta-analyses[29] The obvious lack of clear psychotherapeutic evidence for the support of either side in the debate comes from the fundamental problems of Meta-analyses when used for comparing treatments “head to head”[29]. These massive comparative studies have been used to compare the effect sizes of different treatments. Unfortunately, there ability in finding a reliable and valid effect size is heavily scrutinized by some[2]. This is because many researchers are said to have an agenda when conducting a meta analysis. Thus, they hand select which experiments they want to use in their study to product the end result that they want, not what would be best represented scientifically[24] This incites bias and should be discarded. Unfortunately, it is difficult to filter through valid and invalid science.


This seems to be the difficulty with a clear answer to the Dodo Bird Verdict. For example, Wampold 2009, found Siev et al 2007 study whose research for significancy of CBT versus RT was resting on one experiment with a uncharacteristically large effect size (1.02) by Clark et al 1994[30]. Wampold 2009 found this effect size to be invalid because of the biases of the study. When this flawed experiment was removed, the effect size was not statistically significant for the use of CBT over RT in panic disorder therapy. On contrary to The Verdict, Chambless 2002, found that “errors in data analysis, exclusion of research on many types of cients, faulty generalization to comparisons between therapies that have never been made, and erroneous sorts of treatments for all sorts of problems can be assumed to represent the difference between any two types of treatment for a given problem.”[31] Here, Chambless 2002 forcefully critiques many Dodo Bird supporting studies. It is clear that meta-analyses need to be conducted carefully for them to be taken seriously. In support of the anti-Dodo Bird side, Hunsley 2007 says that when “measurement quality is controlled for and when treatments are appropriately categorized, there is consistent evidence in both treatment outcome and comparative treatment research that cognitive and behavioral treatments are superior to other treatments for a wide range of conditions, in both adult and child samples.”[29]

Conclusion edit

Importance of the Verdict edit

The outcome of the Dodo Bird Debate has extremely important implications for the future of clinical psychology. Indeed, policymakers have to decide on the usefulness of investing in the diversity of psychotherapies that exist. If the Dodo Bird is thought to be true, then many clinicians would feel free to use any therapy they seem fit. However, if the Dodo Bird is put to rest, then clinicians would likely have to use empirically supported therapies when treating their clients.


Although recent research appears to support both sides of the debate, many clinical scientists have begun to declare the Dodo bird verdict to be statistically and clinically inappropriate[22] For example, the use of CBT-based therapies for treating panic disorder (PD) cases are clearly a winner [32][33] They found that CBT does improve patient pathology in five panic related symptom domains. There are many studies that echo similar results brought about by Sieve 2010[34] [35]. Despite this strong evidence in refutation of the Dodo BIrd Verdict, debate rages on.


Perhaps the greatest illustration of the current state of the Dodo Bird Verdict is seen in meta-analyses of Wampold and Barlow and response to it. In these meta-analyses, researchers on both sides point out weaknesses and inconsistencies. Although both sides are both trying to improve psychology in their perspective ways, the disagreement and lack of consistent evidence for the Dodo Bird Verdict may in fact be weakening people’s views of the field. For example, these overall inconsistencies in the scientific plausibility may lead governmental officials to cut funding for psychological treatments and other public health measures[36][37][38] Another possible consequence of the debate could be the increase of public doubt of the field. Generally speaking in present day, the public does not regard psychology as a hard and applied science[39][40] [41] Although this is what these researchers are trying to obtain, they may be doing more harm than good, because as of now, clinical psychology is failing as an applied science.[42]

References edit

  1. ^ a b c Luborsky, L; Singer, B; Luborsky, L (1975). "Is it true that 'everyone has won and all must have prizes?'". Archives of General Psychology 32: 995-1008.
  2. ^ a b Tarrier, N (2002). "Yes, cognitive behaviour therapy may be all you need". British Medical Journal 324: 291-292.
  3. ^ a b Luborsky, L (1999). "The researcher's own therapeutic allegiances: a 'wild card' in comparisons of treatment efficacy". Clinical Psychology:Science and Practice 6: 49-62.
  4. ^ Luborsky,L;Rosenthal,R;Diguer,L;Andrusyna,TP;Berman,JS;Levitt,JT;Seligman,DA;Krause,ED (2002). "The dodo bird verdict is alive and well-Mostly.". Clinical Psychology-Science and Practice 9: 2-12.
  5. ^ Frank, JD (1961). Persuasion and healing: A comparative study of psychotherapy.
  6. ^ Wampold, BE (2007). "Psychotherapy: The hu- manistic (and effective) treatment". American Psychologist 62: 857-873.
  7. ^ Wampold, BE (2001). The great psychotherapy debate:models, methods, and findings.
  8. ^ Mahwah,NJ;Erlbaum,L;Horvath,AO;Bedi,RP (2002). The al-liance.
  9. ^ Martin,DJ;Garske,JP;Davis,MK (2000). "Relation of the therapeutic alliance with outcome and other variables: A meta- analytic review". Journal of Consulting and Clinical Psychology: 438-450.
  10. ^ Baldwin,SA;Wampold,BE;Imel,ZE (2007). "Untangling the alliance-outcome correlation: Exploring the relative importance of therapist and patient variability in the alliance". Journal of Consulting and Clinical Psychology 75: 842-852.
  11. ^ Klein,D.N., Schwartz,J.E., Santiago,N.J., Vivian,D., Vocisano,C., Castonguay,L.G., et al. (2003). "Therapeutic alliance in depres- sion treatment: Controlling for prior change and patient characteristics". Journal of Consulting and Clinical Psychology 71: 997-1006.
  12. ^ Lambert, M. (1992). Implications for outcome research for psychotherapy integration. In J. C. Norcross & M. R. Goldstein (Eds.), Handbook of psychotherapy integration (pp. 94–129). New York: Basic Books
  13. ^ a b Wampold, B. E. (1997). Methodological problems in identifying efficacious psychotherapies, Psychotherapy Research, 7, 21-43. Cite error: The named reference "Wampold97" was defined multiple times with different content (see the help page).
  14. ^ a b Wampold, B. E., Minami, T., Baskin, T. W., & Tierney, S. C. (2002). A meta-(re)analysis of the effects of cognitive therapy versus “other therapies” for depression. Journal of Affective Disorders, 68, 159-165.
  15. ^ Wampold, B. E., Mondin, G. W., Moody, M., & Ahn, H. (1997). The flat earth as a metaphor for the evidence for uniform efficacy of bina fide psychotherapies: Reply to Crits- Christoph (1997) and Howard et al. (1997). Psychological Bulletin, 122, 226-230.
  16. ^ Wampold,B.E.,&Serlin,R.C.(2000).Thecon- sequences of ignoring a nested factor on mea- sures of effect size in analysis of variance. Psychological Methods, 5, 425-433.
  17. ^ NAJAVITS, L. M., & STRUPP, H. H. (1994). Differences in the effectiveness of psychodynamic therapies: A process-outcome study. Psychotherapy, 31(1), 114-123.
  18. ^ Siev,J;Chambless,DL (2007). "Specificity of treatment effects: Cognitive therapy and re- laxation for generalized anxiety and panic disorders". Journal of Consulting and Clinical Psychology 75: 513-522.
  19. ^ Siev,J;Chambless,DL (2009). "The dodo bird, treatment technique, and dis- seminating empirically supported treat- ments". The Behavior Therapist 32: 69-75.
  20. ^ DeRubeis,RJ'Brotman,MA;Gibbons,CJ (2005). "A conceptual and methodological analysis of the nonspecifics argument". Clinical Psychology: Science and Practice 12: 174-183.
  21. ^ Clark,DM;Ehlers,A;Hackmann,A;McManus,F;Fennell,M;Grey,N;et al. (2006). "Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial". Journal of Consulting and Clinical Psychology 74: 568-578.
  22. ^ a b c d Norcross, J.C. (1995). Dispelling the dodo bird verdict and the exclusivity myth in psychotherapy. Psychotherapy, 32, 500-504.
  23. ^ a b Carroll, K.M., Roundsaville, B.J. (2010). Perhaps it is the dodo bird verdict that should be extinct. Addiction, 105, 18-20.
  24. ^ a b Barlow, D. H. (2010). The dodo bird – again – and again. The Behavior Therapist, 33, 15–16.
  25. ^ Reid, W.J. (1997). Evaluating the dodo bird verdict: Do all interventions have equivalent outcomes? Social Work Research, 21, 5-16.
  26. ^ Wilson G.T., Rachman S.J. (1983). Meta-analysis and the evaluation of psychotherapy outcome: Limitations and liabilities. Journal of Consulting and Clinical Psychology, 51, 54-64
  27. ^ a b Kazdin, A.E., Bass, D. (1989). Power to detect difference between alternative treatments in comparative psychotherapy outcome research. Journal of Consulting and Clinical Pyschology, 57, 138-147.
  28. ^ Norcross, J.C., Rossi, J.S. (1994). Looking weakly in all the wrong places? Comment of Shapiro et al. (1994). Journal of Consulting and Clinical Psychology, 62, 535-538
  29. ^ a b c Hunsley, J., & Di Giulio, G. (2002). Dodo bird, phoenix, or urban legend? The question of psychotherapy equivalence. The Scientific Review of Mental Health Practice, 1, 11-22.
  30. ^ Wampold, B. E., Imel, Z. E. & Miller, S. D. (2009). Barriers to the dissemination of empirically supported treatments: Matching evidence to messages. The Behavior Therapist, 32, 144-155.
  31. ^ Chambless, Dianne (2002). "(commentaries) Beware the Dodo Bird: the dangers of overgeneralization". Clinical Psychology: Science and Practice 9: 13–16. doi:10.1093/clipsy/9.1.13.
  32. ^ Treatment specificity for panic disorder: A reply to Wampold, Imel, and Miller (2009). Siev, Jedidiah;Huppert, Jonathan D.;Chambless, Dianne. the Behavior Therapist, Vol 33(1), Jan 2010, 12-14.
  33. ^ Watson, D., O’Hara, M.W., & Stuart, S. (2008). Hierar- chical structures of affect and psychopathology and their implications for the classification of emotional disorders. Anxiety and. Anxiety and Depression, 25, 282–288.
  34. ^ Franklin, M.E., Abramowitz, J.S., Kozak, M.J., Levitt, J.T., & Foa, E.B. (2000). Effectiveness of exposure and response prevention for obsessive-compulsive disorder: Randomized compared with non- randomized samples. Journal of Consulting and Clinical Psychology, 68, 594–602.
  35. ^ Franklin, M.E., & DeRubeis, R.J. (2006). Efficacious laboratory vali- dated treatments are generally transportable to clinical practice. In J.C. Norcross, L.E. Beutler, & R.F. Levant (Eds.), Evidence- based practices in mental health: Debate and dialogue on the fundamental questions (pp. 375–383). Washington, DC: American Psychological Association.
  36. ^ Beecham, J., Hallam, A., Knapp, M., Baines, B., Fenyo, A., & Ashbury, M. (1997). Costing care in hospital and in the community. In J. Leff (Ed.), Care in the community: Illusion or Reality? (pp. 93–108).
  37. ^ Chichester, England: Wiley. Glasgow, R.E., Klesges, L.M., Dzewaltowski, D.A., Bull, S.S., & Esta- brooks, P. (2004) The future of health behavior change research: What is needed to improve translation of research into health promotion practice? Annals of Behavioral Medicine, 27, 3–12.
  38. ^ Woolf, S.H. (2008). The meaning of translational research and why it matters. Journal of the American Medical Association, 299, 211– 213.
  39. ^ Hill, G.B. (2000). Archie Cochrane and his legacy. An internal chal- lenge to physicians’ autonomy? Journal of Clinical Epidemiology, 53, 1189–1192.
  40. ^ Chambless, D.L., & Ollendick, T.H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.
  41. ^ Howard, K.I., Cornille, T.A., Lyons, J.S., Vessey, J.T., Lueger, R.J., & Saunders, S.M. (1996). Patterns of mental health service utiliza- tion. Archives of General Psychiatry, 53, 696–703.
  42. ^ Baker, B.T., McFall, M.R., Shoham, V. Current status and future prospects of clinical psychology. A Journal of the Association for Psychological Science, 9, 2, 67-103
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