Dr. Pretzer--I do understand that you are a very busy psychologist!! My query about us being 'finished' was only because I noted that you had posted quite a number of other replies since we last corresponded.

Has it ever become an issue in conducting CBT research, that individual therapists because of their own particular communicative styles and qualities of relatedness to other people, end up producing quite different outcomes (because of these nonspecific effects?). Is CBT standardized enough so that these therapist variables don't confound outcome studies? I suspect that university supervisors have asked themselves this question many times. Is the CBT being practiced 'out there' close enough to what supervisors want?? Do we know? Are training centers confident that once certain procedures are consistently applied that CBT is really the 'same thing' depending on who is doing it!! My long held suspicion even with CBT is that these 'non-specific' factors may end up being critically important, and that we need to spend much more time looking at what factors make for good matching between patient and therapist.

The more CBT pays attention to 'communicative' issues within the therapy, the more this question will be raised. The patient's 'perception' of the relationship was, of course a major area of concern to the analytically trained therapist, as was whether the patients 'psychological defenses' were being respected in the conduct of the therapy. I hope we will discuss more here, what you will be presenting at Cape Cod. I wish I could attend, but don't think that will happen.

Again--I very much appreciate the time you take out of your schedule to participate here.

Oh--Please!! If there are students currently in training, your comments here would greatly enrich this discussion!! The questions I raise here, should be ones that any of you could meaningfully comment about! So please participate!!

-Doug