Oh G-d, A Borderline: Clinical Diagnostics As Fundamental Attribution Error Page: 9
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forward, then it might be time to take a moment to be sure it is not moving us backward.
Psychotherapy as Interpersonal Process
The interpersonal process of therapy is central to therapeutic approaches across the board.
Excepting perhaps traditional psychoanalysis - wherein the clinician is meant to be a blank slate
and does little in the way of providing support or empathy- every school of psychotherapy
acknowledges that the enterprise is futile if the interpersonal relationship lies undeveloped.
Psychotherapy is a multifaceted and dynamic process. Despite the myriad of different treatment
modalities available (e.g., psychodynamic, humanistic, cognitive-behavioral) offering their own
blend of specific techniques, forms of intervention, hypothesized etiological explanations, and
proposed mechanisms of change, the therapeutic relationship remains a central factor
consistently associated with positive outcomes (Martin, Garske, & Davis, 2000). "Common
factors" such as therapeutic alliance, warmth, and empathy account for twice as much observed
change in therapy as do orientation-specific techniques (Lambert & Barley, 2001).
The dodo bird effect is a phrase used to describe numerous findings that there are no
meaningful differences among any psychotherapy variations in techniques (Luborsky, Singer, &
Luborsky, 1975; Wampold, et al., 1997). A reference to Alice in Wonderland, the dodo bird effect
claims that all therapies must have prizes for their equivalent efficacies. Luborsky and colleagues
(1975) assert that the common factors of therapeutic kindness and alliance are the reason for the
Indeed, Zuroff and Blatt (2006) found that across 4 treatment conditions - cognitive
behavioral therapy, interpersonal psychotherapy, imipramine-clinical management, and placebo-
the therapeutic relationship is a consistent positive predictor of outcome for treatment of
depression. Watson and Geller (2005) similarly found the therapeutic relationship to be
Here’s what’s next.
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Schmalz, Jonathan. Oh G-d, A Borderline: Clinical Diagnostics As Fundamental Attribution Error, thesis, December 2011; Denton, Texas. (digital.library.unt.edu/ark:/67531/metadc103389/m1/15/: accessed June 24, 2017), University of North Texas Libraries, Digital Library, digital.library.unt.edu; .