The active, and sometimes It provides a balanced, heated, controversy between objective, and informative look at advocates of these two modes of both sides of one of the most controtherapy has raged despite a versial issues in psychiatry today, shortage of solid information. R. Bruce Sloane, M.D., is But now we have the results chairman of the Department of of a rigorously controlled study Psychiatry, School of Medicine, with actual patients, experienced University of Southern California, therapists, and frequent Commonwealth Fund.

The purpose of this study was to investigate the efficacy of a specifically designed group support program for relatives of patients with Alzheimer's disease and related disorders. The group program included educational/supportive activities and used basic principles of the cognitive-behavioral approach. Twenty-two subjects participated in an eight-session program. Eighteen control subjects received no treatment. Measures of family burden, levels of depression, and knowledge of dementia were obtained. Experimental subjects showed a significant decrease in total family burden, whereas control subjects actually showed a significant increase, experimental subjects also showed reduction in their levels of depression. Experimental subjects showed a significantly greater improvement than did control subjects on knowledge of dementia. The acquisition of new knowledge was an important ingredient in reducing perception of burden and levels of depression, but other facets of the intervention also accounted for the improvement. Results indicated that a relatively short but intensive support experience can have a positive effect in reducing some of the burden and depression associated with the care of a demented relative.

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Three behavior therapists and three analytically oriented psychotherapists treated a total of CO neurotic outpatients for 4 months. Measures of Rogers-Truax factors, nonlcxical speech characteristics, therapist informational specificity, and a content analysis of therapist activity were taken from recordings of the fifth interview. Therapists rated their feelings toward their patients, and patients completed the Relationship Questionnaire and the Lorr Inventory. In psychotherapy, patients who were most liked by their therapists and those with greater total speech time showed greatest symptomatic improvement. Patients who used longer average speech durations improved most in both treatments. It was concluded that patient improvement was more a function of patient characteristics than of specific therapist interventions.Controversy over the effective ingredients of psychotherapy has long been a characteristic feature of the field. Clinical beliefs predominate since research studies have not isolated those therapist behaviors that lead to improved outcome with sufficient consistency or precision. Even the apparently wellestablished triumvirate of accurate empathy, unconditional positive regard, and therapist self-congruence is currently undergoing critical reevaluation (Bergin & Suinn, 1975;Mitchell, Truax, Bozarth, & Krauft, 1973).The question is confounded by the plethora of different therapies, each with idiosyncratic treatment strategies. Do the different therapies share some common features that lead to success regardless of theoretical differences? Or has each grasped some unique therapeutic truth sufficiently potent by itself to produce improvement?We found behavior therapy and analyti-