The Dodo bird verdict (or Dodo bird conjecture) is a controversial topic in psychotherapy,For an overview of the controversy, see: And: referring to the claim that all empirically validated psychotherapies, regardless of their specific components, produce equivalent outcomes. It is named after the Dodo character in Alice in Wonderland. The conjecture was introduced by Saul Rosenzweig in 1936, drawing on imagery from Lewis Carroll's novel Alice's Adventures in Wonderland, but only came into prominence with the emergence of new research evidence in the 1970s..
The surrounding debate is primarily centered around whether the differences in treatments contribute to their success/failure or if all therapies are equally effective. The importance of this continuing debate surrounding the Dodo bird verdict stems from its implications for professionals involved in the field of psychotherapy and the psychotherapies made available to clients.
History
The Dodo bird verdict terminology was coined by Saul Rosenzweig in 1936 to illustrate the notion that all therapies are equally effective... Rosenzweig borrowed the phrase from Lewis Carroll's 1865 book, Alice in Wonderland, wherein a number of characters become wet and, in order to dry themselves, the Dodo Bird decided to issue a competition: everyone was to run around the lake until they were dry. Nobody cared to measure how far each person had run, nor how long. When they asked the Dodo who had won, he thought long and hard and then said, "Everybody has won and all must have prizes." In the case of psychotherapies, Rosenzweig argued that common factors were more important than specific technical differences, so that (on the Dodo bird conjecture) all therapies are winners; they all produce equally effective outcomes.
The Dodo bird debate only took flight in 1975 when Lester Luborsky, Barton Singer and Lise Luborsky reported the results of one of the first comparative studies demonstrating few significant differences in the outcomes among different psychotherapies. This study spurred a plethora of new studies in both opposition to and support of the Dodo bird verdict..
The Dodo bird debate, in brief, is focused on whether the specific components of different treatments are what make some therapies more effective than others for specific disorders, or if all treatments are equally effective, regardless of their specific techniques. Supporters of the Dodo bird verdict contend that all psychotherapies are equivalent because of "common factors" that are shared in all treatments (i.e. having a relationship with a therapist who is warm, respectful, and has high expectations for client success)... In contrast, critics of the Dodo bird verdict would argue that the specific techniques used in different therapies are important, and all therapies do not produce equivalent outcomes for specific disorders.
Support Common factors theory states that if certain therapies in psychology are equally effective, it is because of the common factors they share. The most important causal agents in treatment are the common factors; the specific techniques that are unique to treatment strategies have only minor importance......
There is research to support common factors theory. One common factor is the client–therapist interaction, also known as the therapeutic alliance. A 1992 paper by Michael J. Lambert showed that nearly 40% of the improvement in psychotherapy is from these client–therapist variables.. Other researchers have further analyzed the importance of client–therapist variables in treatment. They found that improvement in the patient was due to extra-therapeutic factors, for example patients' thought processes. Data shows that patients with more positive attitudes will have a better chance of experiencing clinical improvement, regardless of the therapist's actions.. Furthermore, in a meta-analysis of many studies of psychotherapy, Wampold et al. 2002, found that 70% of the variability in treatment outcome was due to the therapeutic alliance whereas 10% of the variability was due to a specific treatment..... The therapist's attitude is also a very important causal agent in positive patient change. Najavits and Strupp (1994) demonstrated that a positive, warm, caring, and genuine therapist generated statistically significant differences in patient outcome.. Wampold et al. 2002, also found that nearly 70% of the variability in treatment outcome was due to the therapist's attitude toward the efficacy of the treatment. Specific components of therapy are concluded to be relatively frivolous when compared with the more profound and directly patient affecting common factors.
Researchers have studied common factors in detail. Lisa Grencavage and John C. Norcross (1990) identified 35 common factors in published sources. The identified common factors were categorized into five main groups: client characteristics, therapist qualities, change processes, treatment structures and relationship elements. Examples of some of the common factors included within these broad categories are persuasion, a healing setting, engagement, the use of rituals and techniques, suggestion, and emotional learning. Tracey et al. 2003, examined deeper relationships among the categories and common factors. They concluded that there are two dimensions of therapy: feeling and thinking. Within each of the two dimensions are three clusters: bond, information, and role..
Data provide evidence for the Dodo bird verdict. Generally speaking, common factors are responsible for patient improvement instead of any component of a specific treatment. Researchers such as Wampold and Luborsky continue to support this claim in recent articles published in Behavioral Therapy. Wampold et al. 2010 refutes claims made by Siev et al. 2009 that Wampold 2009 made errors in research. Wampold et al. 2009, suggests that people need to "accept the importance of the alliance and therapists and remain committed to developing and improving treatments." Wampold continues by saying that techniques could be beneficial in psychotherapy because they are the easiest variables to manipulate. These variables can act to change alliance and other common factors. Common factors can then be closely monitored and carefully distributed to patients via the therapist.
Some researchers have pointed out that there are many reasons to study common factors among different psychotherapies, and some of those reasons may have nothing to do with the Dodo bird verdict. Regardless of whether or not certain psychotherapies are roughly equally effective, studying the commonalities among treatments can lead to a better understanding of why the treatments are effective.
Opposition In opposition to the Dodo bird verdict, there are a growing number of studies demonstrating that some treatments produce better outcomes for particular disorders when compared to other treatments.. Here, in contrast to the common factor theory, specific components of the therapy have shown predictive power... The most compelling evidence against the Dodo bird verdict is illustrated by the research done on anxiety disorders. Many studies have found specific treatment modalities to be beneficial when treating anxiety disorders, specifically cognitive behavioral therapy (CBT). Other studies, however, do not show evidence for cognitive-behavioural and focus on different topics..
CBT uses techniques from both cognitive therapy and behavioral therapy to modify maladaptive thoughts and behaviors. One challenge to the opposition, however, is that some studies were conducted with waiting lists or against medication and criticism can arise as the therapeutic relationship is known to be a factor which influences outcomes. This means the control group may not experience the human condition, whereby the experimental group have an advantage when analysing differences. In addition, comparator trials with other modalities have been known to have unfair training standards between therapies, with some counsellors being given brief workshops over several days to evaluate the efficacy of an approach during trials. Humanistic therapies are also notably difficult to examine due to having less measurable factors that do not fare well under randomised controlled trials. Many of the more extensive studies using different research methodologies with larger sample sizes are overlooked for the perceived gold standard in research. Cognitive-behavioural therapy has indeed been the most examined counselling method; but, to visualise this, you may wish to see them as the big fish in a small pond.
Numerous meta-analyses have shown that CBT yields significantly superior results in the treatment of psychological disorders, most notably, anxiety disorders. However, CBT also plays a positive role in treating depression, eating disorders, substance abuse disorders, and obsessive-compulsive disorder (OCD). In meta-analytic reviews, there is generally a larger effect size when CBT is used to treat anxiety disorders. Recent studies show that when treating generalized anxiety disorder, CBT generated an effect size of 0.51, which indicates a medium effect. That is a much larger effect compared to supportive therapy and other treatments. Similarly, when treating social anxiety disorder, CBT produced an effect size of 0.62, which again supports the evidence that CBT does in fact yield significantly better results than other therapies. Those supporting the Dodo bird verdict often use meta-analyses to compare multiple treatments in order to illustrate that these treatments have no really significant differences. Some critics claim that if comparisons are made between treatments that already have empirical support (empirically supported treatments, or ESTs) then this will tend to reduce estimates of variability. Nonetheless, Wampold's criteria for including treatments in meta analyses of treatment variability do not require prior empirical support; rather, they must be "intended to be therapeutic".
Research supporting differences among different treatments for specific disorders is now reflected in the latest EST guidelines. ESTs are developed from multiple control trial tests to evaluate which therapies yield the best results for specific disorders. These disorders include, but are not limited to, major depressive disorder, anxiety disorder, panic disorder, and OCD. According to the Ethics Code of the American Psychological Association (APA), psychologists and therapists have an obligation to avoid harming their clients in any way. ESTs are a major component in this movement. By using specific therapies clinically proven to improve certain disorders, therapists are avoiding further damage to their patients. However, supporting the idea of ESTs inevitably implies that some therapies are in fact more efficacious than others for particular disorders.