The Dodo verdict and the efficacy of psychotherapy
Psychology is a relatively young science (It would not create the first scientific laboratory of psychology until 1879) and that it evolves continuously, having emerged different schools of thought dedicated to different areas and conceptualizations of the human psyche. One of the most popular and popular areas is clinical psychology and psychotherapy, which greatly helps the improvement of those patients suffering from different ailments, difficulties and disorders.
However, treating a patient is not saying the first thing that comes to mind: it requires the use of different techniques that have been shown to have real and significant efficacy. Assessing the effectiveness of a technique requires assessing not only the possible improvement of a patient but also comparing it with the absence of therapy and other treatments and currents. The research carried out in this regard has generated great repercussions and ways of understanding psychotherapy and its effects. Even today there is debate about whether or not different types of therapy have significant differences in effectiveness, discussing something with a curious name: Dodo effect, related to a theme known as the Dodo verdict . Of these two concepts we will speak here.
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What is the Dodo effect?
The Dodo effect is called a hypothetical phenomenon that reflects that the efficacy of all psychotherapy techniques maintains an almost equivalent effectiveness , there are no significant differences between the multiple theoretical and methodological currents available. The Dodo verdict is the subject of debate that revolves around the existence or non-existence of this effect. Do the therapies work because of their effectiveness in order to activate the precise psychological mechanisms according to the theoretical model from which they start, or do they simply work due to other things that all the therapists apply without realizing?
Its denomination is a metaphor introduced by Rosenzweig in reference to Lewis Carroll's book, Alice in Wonderland . One of the characters of this narration is the Dodo bird, who considered at the end of the race without end the fact that "everyone has won and everyone must have prizes." The effect in question was suggested by this author in a publication in 1936, considering after the realization of some investigations that are the shared factors between the different perspectives and the operation of the therapy what really generates a change and allows the recovery of the patient.
If this effect really existed, the implications could be highly relevant for the application of practical clinical psychology : the development of different therapies between different currents of thought would become unnecessary and it would be advisable to investigate and generate strategies that focus on explaining and enhancing the elements they have in common (something that in reality is already done in practice, being the technical eclecticism quite common in the profession).
However, different investigations have questioned and denied its existence, observing that certain approaches work better in certain types of disorder and population.
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Two opposing poles: the Dodo verdict
Initial investigations that seemed to reflect the existence of the Dodo effect they found in their moment a strong opposition on the part of diverse professionals , who did their own research and found that there really are significant differences. However, in turn these investigations were later refuted by other authors, still finding us today with different investigations that suggest different conclusions.
In this way, we can find that there are mainly two sides in the consideration of whether there are statistically significant differences in the effectiveness of the different therapies.
The importance of the therapeutic relationship
On the one hand, those who defend the existence of the Dodo effect they claim that almost all therapies have a similar effectiveness to each other , not being the specific techniques of each theoretical current but the common elements underlying all of them that generate a real effect in the patients. The latter defend the need to investigate and reinforce these common elements.
Some authors such as Lambert defend that the recovery is due to non-specific effects: in part to factors of the therapeutic relationship, personal factors of the subject outside the therapy itself, the expectation of recovery and to be working for the improvement and, just one much more modest, to elements derived from the theoretical or technical model itself.
The truth is that in this sense have emerged different research that supports the great importance of these aspects, being some of the main the therapeutic relationship between professional and patient (something to which all disciplines have been given great importance) and the attitude of the therapist before the patient and their problems (empathy, active listening and unconditional acceptance among them). But this does not necessarily exclude the possibility that (as proposed by Lambert), there are differences between treatments at the time of being effective.
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The importance of the therapy model
Those who defend that there are significant differences between therapies, on the contrary, observe true differences in the effectiveness of the treatment and value that the basic functioning of the different intervention strategies used it is what generates behavioral and cognitive change in the patient, with some strategies having greater efficacy than others in certain disorders or alterations.
The different investigations carried out comparing treatments have shown different levels of effectiveness depending on the problem to be treated and the circumstances that surround it.
It has also been observed that Certain therapies may even be counterproductive depending on the disorder in which they are applied, something that has had to be controlled in order that patients can improve and not quite the opposite. Something like that would not happen if all the therapies worked the same. However, it is also true that this does not prevent the core of the change from being due to common factors between the different therapies.
And an intermediate consideration?
The truth is that the debate continues to this day being in force, and there is no clear consensus on the matter and the investigation is counted on whether the effect or verdict of the Dodo really is there or not. In both cases, different methodological aspects have been criticized that may cause doubts about the results obtained or have different implications to those initially considered.
Probably it can be considered that neither side has absolute reason, there are more appropriate procedures than others in certain situations and subjects (after all each subject and problem have their own ways of functioning and modification requires a more focused action in certain areas) but resulting the shared elements between the different therapies the main mechanism that allows the generation of change.
In any case, we must not forget that the clinical practice of psychotherapy it is done or should always be done for the benefit of the patient , who is the one who comes to consultation looking for professional help from a person prepared for it. And this implies both knowing specific techniques that can be used that have proven effective as developing and optimizing the basic therapeutic skills in such a way that a context that is, per se, beneficial to him can be maintained.
- Lambert, M.J. (1992). Implications of outcome research for psychotherapy integration. In Norcross JC and Goldfried MC (Eds.). Handbook of psychotherapy integration (pp.94-129). New York: Basic Books.
- Fernández, J.R. and Pérez, M. (2001). Separating the grain from the chaff in the psychological treatments. Psicothema Vol. 13 (3), 337-344.
- González-Blanch, C. and Carral-Fernández, L. (2017). Catch Dodo, please! The story that all psychotherapies are equally effective. Papers of the Psychologist, 38 (2): 94-106.