ABSTRACT
This chapter focuses on moderators, mediators, and mechanisms and their roles in understanding psychotherapeutic change. The evaluation of mediators is not merely a matter of adding measures to a study. It is important that the time-line of assessment in the study allows for one to speak of mediation. Decades of research on therapy processes have identified many features of the client, the therapist, and their interaction as well as treatment activities that predict therapeutic outcome. Research on mechanisms reflects a more fine-grained focus than identifying the statistical relations that most mediation tests allow. Direct manipulation of a proposed mechanism is a powerful way to move one's understanding forward to explain how treatment works. Consider the work on fear conditioning and psychotherapy. Cognitive control of emotional reactions is closely related to strategies used in psychotherapy. More conceptual work on key processes is an excellent way to translate therapy into laboratory paradigms to investigate therapeutic strategies.
