Much of the criticism of psychology may derive from the current crisis in one of its higher profile branches, psychotherapy. The pre-paradigmatic stasis in a discipline more utilized by the general public, and therefore more “visible,” may be tainting the field of psychology as a whole. Moreover, since natural phenomena have empirical basis, what may be unintentionally delaying progress in establishing psychotherapy’s scientific foundations is the employment by clinicians of Routine Outcome Monitoring and/or Alliance Rupture Monitoring (repeated assessment of client progress), temporary but important stopgap measures which offer no explanation for their therapeutic effects. What may be at play here is the fact that negative patient feedback understandably captures therapists’ attention and, in an attempt to help, they likely increase attentive nonverbal therapeutic behaviors such as those detailed in Beyond the Therapeutic Relationship: Behavioral, Biological, and Cognitive Foundations of Psychotherapyopens in new window.
Toward ending psychotherapy’s pre-paradigmatic redundant phase, some prominent Society for the Exploration of Psychotherapy Integration (SEPI) members now acknowledge the existence of universal nonspecific clinical phenomena, that may explicate the so-called “black box” of unknowns in psychotherapy. The crucial omission of procedural nonverbal communication and interpersonal knowledge by the major therapies, requires therapists to compensate as best they can for this deficiency, which may further account for the well-documented varying effectiveness across and within therapists. Toward explicating this inconsistent efficacy phenomenon, the enclosed book reveals a serious research limitation perpetuating our science/research gap, a critical oversight that has limited replication and impeded verification of therapeutic change factors and hampered meta-analytic efforts.
Demonstrating how insight, meaning, and corrective emotional experiences are generated within the patient/client, as facilitated by the therapist, the book was peer reviewed by two leading scientist-practitioners, Sol Garfield and Arnold Lazarus. After a twenty-year delay, the enclosed evidence-based, holistic, integrative theory of psychotherapy is now listed on the APA Listserv (under SEPI): The First Scientifically Integrated Theory of Psychotherapy, March 2017.
Addressing this striking oversight in psychotherapy research, possibly sustaining the redundant proliferation of therapies on the market, none reportedly significantly more effective than others, the enclosed evidence-based book demonstrates how the lack of consistent efficacy and quality control in psychotherapy results from the omission of procedural nonverbal behavior. It does so by including both verbal and nonverbal channels of therapist/client interpersonal communication, as opposed to solely the verbal channel. In the process, it identifies mechanisms of change within the alliance, facilitated by currently nonspecific universal therapist/client interpersonal behaviors, that cut across bona fide therapies to effect change.
The detrimental delay in including the nonverbal channel in psychotherapy research is underlined by more impartial assessments of the indefinite state of the field, such as that of NDPLS editors, David Pincus and Stephen Gaustello, who state: “Nowhere in clinical psychology is the science-practice gap more visible than in the field of psychotherapy.” The editors further accurately observe that the lack of a scientifically grounded theory of psychological change is what has stifled progress in this field.
Clarifying this amorphous state, what the above editors describe requires acknowledging that fueling inter-school rivalry, fragmenting the field, and delaying paradigmatic realization (not to mention damaging Psychology’s reputation), could be the observable fact that while most process and outcome research in psychotherapy has traditionally included the verbal behavioral content of interpersonal interaction between therapist and client, the nonverbal behavioral procedural component has been omitted. Consequently, the confounded results from this omission severely limit generalization. Because, just as verbal behavior can have either growth-enhancing or growth-inhibiting effects, so can nonverbal behavior. Moreover, nonverbal behavior, having been allowed to vary indiscriminately across therapies, most likely accounts for the well-documented varying effectiveness across therapists.
Toward addressing this serious omission, and incorporating all channels of interpersonal communication, the enclosed book offers a holistic blueprint for research and practice that includes all relevant therapist/client interpersonal behaviors -- the full range of behaviors normally universally exhibited in psychotherapy. This is important because given the conspicuous omission of nonverbal behavior, the other related factor specifically hampering meta-analytic research and limiting growth in the field, is the continuing overabundance of gross outcome studies that misleadingly presuppose therapies and therapists to be interchangeable, and psychotherapy to only involve a standard set of procedures. As the above editors explain, while this kind of limited research has confirmed the efficacy of psychotherapy, it has failed in establishing its probable cause. Thus, there exists a need for process research to verify causal change mechanisms, i.e., those supported by empirical research from Psychology and allied fields of human behavior. In the interim, an ethically-required acknowledgement of the nonverbal behavior omission, qualifying future research omitting it, would help bridge the science/practice gap by impelling holistic scientific direction to foster practical relevance and applicability, and reduce redundancy, confusion and stasis.
The book was published shortly after SEPI’s inception which, despite Lazarus’s warning, is unfortunately devolving into another school of therapy, mainly combining incommensurate therapies/theories and/or defining types of integration, rather than fostering the coherent scientific integration of empirically-grounded universal therapist/client interpersonal therapeutic behaviors. Consequently, as mentioned above, therapists and researchers must now circumvent the lack of scientific integration through such interventions as Lambert’s Routine Outcome Monitoring (ROM) and Muran’s Alliance-rupture Monitoring. While these legitimate instruments may support the current inchoate therapeutic process (by helping to compensate for the lack of knowledge concerning how psychotherapy works), used solely as stop-gap measures, they also unintentionally sidestep and prolong the science/practice gap by their inability, alone, to explicate the therapeutic process – a quest that should not be abandoned contrary to the short-sighted naysayers.