Comparative designs

This difficulty in creating an adequate psychological 'placebo' has led some (16,> to suggest that psychotherapy research should largely focus on comparing active treatments rather than comparing active treatments to 'placebo' control groups. However, rather than solve the problem of how to evaluate the efficacy of a psychotherapeutic intervention, comparative designs simply change the scientific question from 'Is this treatment efficacious?' to 'Which treatment works best?' Comparative designs are generally only informative if one active treatment proves to be more effective than another. If, as is commonly the case in psychotherapy studies, both active treatments produce equivalent results, the investigator is left not knowing whether both treatments are effective, or whether both treatments are non-effective (beyond the effects of non-specific elements).

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