The Dodo verdict and the efficacy of psychotherapy

Psychology is a relatively young science. (the first scientific psychology laboratory would not be created until 1879) and which is continually evolving, having emerged different schools of thought dedicated to different fields and conceptualizations of human psyche. One of the best known and most popular fields is clinical psychology and psychotherapy, which helps in greatly to the improvement of those patients suffering from different ailments, difficulties and disorders.

However, treating a patient is not the first thing that comes to mind: it requires the use of different techniques that have been shown to have real and significant efficacy. Assessing the effectiveness of a technique requires assessing not only the possible improvement of a patient but also comparing it with the absence of therapy and with other treatments and currents. The research carried out in this sense has generated great repercussions and ways of understanding psychotherapy and its effects. Even today there is debate as to whether or not the different types of therapy present significant differences in terms of effectiveness, discussing something with a curious name: the

Dodo effect, related to a topic known as the Dodo verdict. We will talk about these two concepts here.

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What is the Dodo effect?

The Dodo effect is a hypothetical phenomenon that reflects that the efficacy of all psychotherapy techniques maintain an almost equivalent effectiveness, there being no significant differences between the multiple theoretical and methodological currents available. The Dodo verdict is the subject of debate that revolves around the existence or non-existence of this effect. Do the therapies work because of their effectiveness in triggering the precise psychological mechanisms according to the model? theory from which one starts, or they simply work due to other things that all therapists apply without realizing account?

His name is a metaphor introduced by Rosenzweig referring to Lewis Carrol's book, Alice in Wonderland. One of the characters in this narrative is the Dodo bird, who considered at the end of the endless race the fact that "everyone has won and everyone should have prizes." The effect in question was suggested by this author in a publication in 1936, considering after carrying out some investigations that they are the factors shared between the different perspectives and the functioning of the therapy that really generates a change and allows the recovery of the patient.

If this effect really exists, the implications could be highly relevant to the application of practical clinical psychology: the development of different therapies between the different currents of thought would become unnecessary and it would be advisable to investigate and generate strategies that are focused on explaining and enhancing the elements they have in common (something that actually is usually done in practice, technical eclecticism being quite common in the profession).

However, different investigations have questioned and denied its existence, observing that certain approaches work better in certain types of disorder and population.

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Two opposing poles: the verdict of the Dodo

Initial investigations that seemed to reflect the existence of the Dodo effect found at the time fierce opposition from various professionals, who conducted their own investigations and found that there really are significant differences. However, in turn, these investigations were later refuted by other authors, still finding ourselves today with different investigations that suggest different conclusions.

Thus, we can find that there are mainly two sides in the consideration of whether there are statistically significant differences regarding the effectiveness of the different therapies.

The importance of the therapeutic relationship

On the one hand, those who defend the existence of the Dodo effect state that almost all therapies have a similar effectiveness to each other, not being so much the specific techniques of each theoretical current but the common elements underlying all of them that generate a real effect on patients. The latter defend the need to investigate and reinforce these common elements.

Some authors, such as Lambert, defend that recovery is due to non-specific effects: in part to factors of the therapeutic relationship, personal factors of the subject unrelated to the own therapy, the expectation of recovery and of being working for improvement and, only in a much more modest way, to elements derived from the theoretical model or technique in Yeah.

The truth is that in this sense different investigations have emerged that support the great importance of these aspects, some of the main ones being the therapeutic relationship between professional and patient (something to which all disciplines have given great importance) and the attitude of the therapist before the patient and her problems (empathy, active listening and unconditional acceptance between them). But this does not necessarily exclude the possibility that (as Lambert proposes) there are differences between treatments when it comes to being effective.

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The importance of the therapy model

Those who defend that there are significant differences between therapies, on the other hand, observe true differences in the effectiveness of the treatments and assess that the basic functioning of the different intervention strategies used it is what generates the behavioral and cognitive change in the patient, with some strategies being more effective than others in certain disorders or alterations.

The different investigations carried out comparing treatments have shown different levels of effectiveness depending on the problem to be treated and the circumstances that surround it.

Also, it has been observed that certain therapies may even be counterproductive depending on the disorder in which they are applied, something that has had to be controlled so that patients can improve and not the opposite. Something like this would not happen if all therapies worked the same. However, it is also true that this does not prevent the core of the change from being due to common factors between the different therapies.

And an intermediate consideration?

The truth is that the debate continues today to be in force, and there is no clear consensus on regarding and telling the investigation regarding whether the effect or verdict of the Dodo is really there or not. In both cases, different methodological aspects have been criticized, which may cast doubt on the results obtained or have implications other than those initially considered.

Probably it can be considered that neither side is absolutely right, there being more appropriate procedures than others in certain situations and subjects (after all, each subject and problem has its own ways of functioning and its modification requires a more focused on certain areas) but the elements shared between the different therapies are the main mechanism that allows the generation of the change.

In any case, it must not be forgotten that the clinical practice of psychotherapy is or should always be done for the benefit of the patient, who is the one who goes to the consultation looking for professional help from a person prepared for it. And this implies both knowing specific techniques to be able to use that have proven to be effective and developing and optimize basic therapeutic skills in such a way that a context that is, per se, beneficial can be maintained for him.

Bibliographic references

• Lambert, M.J. (1992). Implications of outcome research for psychotherapy integration. In Norcross JC and Goldfried MC (Eds.). Handbook of psychotherapy integration (pp.94-129). New York: Basic Books.
• Fernandez, J.R. and Perez, M. (2001). Separating the wheat from the chaff in psychological treatments. Psychothema Vol. 13(3), 337-344.
• González-Blanch, C. and Carral-Fernández, L. (2017). Cage Dodo, please! The story that all psychotherapies are equally effective. Papeles del Psicólogo, 38 (2): 94-106.