I was impressed by Suzanne's thoughtful and clear attempt to demonstrate the importance of plans in treatment. However, I don't think that clinical examples, no matter how compelling to us, will convince clinicians who have a different theory of why patients behave as they do. This is especially true when there is a great deal of overlap between the predictions made by the different theories. For example, I'm sure that Wachtel would agree that Suzanne's cases had good outcomes, and he might even agree with the techniques that she used. But he would probably still feel that he could explain her results without accepting the idea of the patient's plan. A stronger demonstration of the plan concept would require something like George's research on "key tests." If examples could be isolated in which control-mastery theory predicts one outcome and Wachtel predicts another, and the results support the control-mastery explanation, it would be harder for Wachtel (or anyone) to discount the control-mastery explanation. This may not be possible using clinical examples alone. It may require the kind of empirical research that has been carried out by various members of the group.

Cynthia (& Bob) Shilkret