Specifi c Effects: Where Are They?
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Specifi c Effects: Where Are They? book
In this chapter we examine the evidence for specifi c ingredients-are the purported ingredients of an effective treatment responsible for the benefi ts of the treatment? The most direct way to examine the importance of a specifi c ingredient is in a component study, in which a critical ingredient is removed from an existing treatment or a component is added to an existing treatment to determine the effects of the deleted or added component. Next, designs that attempt to use some type of “placebo” control to examine the specifi c effects are reviewed, but it will become apparent that these placebo-type designs are inadequate for this purpose. Then, designs that attempt to match treatments to patients with a particular psychological defi cit are reviewed. We also examine adherence and competence, as these are important auxiliaries in the Medical Model related to specifi c ingredients. Finally, we will look at attempts to identify mediating processes for specifi c treatments, including adherence to the treatment protocol, although there have been few attempts to synthesize this literature, which makes it diffi cult to present.