Solving Problems With Randomized Clinical Trials Is Not Enough To Improve Psychotherapy Outcome: Comments on Krause

The problems noted by Krause (this issue, pp. 217-222) with regards to interpreting evidence from randomized clinical trials are discussed. It is suggested that some of these problems have already been addressed and improvements made by some researchers, mainly examining the changes made by every patient in the treatment groups through the use of clinically significant change. It is suggested that regardless of the evidence-behind treatments, maximal patient outcome can best be obtained through formally monitoring patient treatment response in real time, session-by-session.