What Makes a Quality Therapy? A Consideration of Parsimony, Ease, and Efficiency

Evaluations of psychotherapy have traditionally focused on symptom reduction as the primary standard by which their value is determined. This has contributed to the appearance of equivalence between many therapies that may differ considerably in complexity, feasibility, amount of homework and therapist contact required, expected cost, speed of symptom decline, and transdiagnostic utility. In the current paper, I make the case that these are fundamental features related to quality that should be considered in psychotherapy development, randomized controlled trials, and dissemination efforts. Empirically supported treatments for different disorders are evaluated based on these criteria, and special consideration is given to cognitive-behavioral treatments for anxiety disorders. Specific recommendations for a quality-oriented clinical research agenda are also provided.

Research highlights
► Evaluations of psychotherapy have primarily focused on symptom reduction.
► Many treatments lead to equivalent reductions in symptoms, but other characteristics may make one treatment preferable to another.
► I focus on parsimony, ease, and efficiency as additional characteristics of therapy that are important to consider.
► Empirically supported treatments for different disorders are evaluated based on these criteria.
► Specific recommendations for a quality-oriented clinical research agenda are provided.