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In Reply: Psychotherapy research is challenging because of the absence of simple placebos used in medication trials. In response to Dr Spielmans and Ms Gatlin, all psychotherapies contain nonspecific elements that occur within the context of a positive psychotherapeutic relationship, including emotional support, decreased isolation, mobilization of hope, and an increased sense of mastery.¹ Controlling for these factors when studying the effects of a particular treatment is essential to determine whether there are specific effects of that treatment beyond the effects of these often-powerful elements. This was the intent of present-centered therapy. Thus, Spielmans and Gatlin are correct in saying that present-centered therapy did not specifically reference any established therapeutic approach, although we note that present-centered therapy contained elements of supportive therapy, one of the most commonly practiced treatments.²

However, other aspects of their characterization are incorrect. Present-centered therapy was based on psychological process, allowed discussion of relevant issues (current . . . [Full Text of this Article]

Paula P. Schnurr, PhD
paula.schnurr@dartmouth.edu
National Center for PTSD
White River Junction, Vt

M. Tracie Shea, PhD
VA Medical Center
Brown University School of Medicine
Providence, RI

Matthew J. Friedman, MD, PhD
National Center for PTSD
White River Junction, Vt

Charles C. Engel, MD, MPH
Uniformed Services University of the Health Sciences
Washington, DC

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