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Alan E. Kazdin, PhD; G. Terence Wilson, PhD

Arch Gen Psychiatry. 1978;35(4):407-416.

Abstract
• The efficacy of psychotherapy and the relative efficacy of different therapies are important issues that continue to receive attention in the literature. Questions about the efficacy of treatment usually are addressed by comparing groups that receive different treatment (or control) conditions. Comparisons are made on the basis of measures administered at the end of treatment and reflect the mean (average) amount of patient change across groups. Additional criteria to evaluate therapy and the relative value of different techniques include alternate measures of outcome and measures related to efficiency, cost, and patient evaluation of treatment. This article discusses such patient-related criteria as the clinical importance of therapeutic change, the proportion of patients who improve, and the breadth and durability of the improvements. Aside from these criteria, the evaluation of different therapies depends on the duration of different treatments, efficiency and costs of administering treatment, the financial and emotional costs to the patients, and cost considerations in relation to overall effectiveness. Finally, the acceptability of treatment to patients is an important consideration in evaluating treatment. Multiple criteria need to be used to evaluate treatment and the value of different treatments. The focus on narrowly circumscribed measures of average patient performance obscures the potential value of different treatments in relation to specific therapeutic and social goals.

Author Affiliations
From the Center for Advanced Study in the Behavioral Sciences, Stanford, Calif. Dr Kazdin is now with the Department of Psychology, Pennsylvania State University, University Park. Dr Wilson is now with the Department of Psychology, Rutgers University, New Brunswick, NJ.

Footnotes
Accepted for publication Oct 7, 1977.

Reprint requests to Department of Psychology, Pennsylvania State University, University Park, PA 16802 (Dr Kazdin).

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