Identifying mechanisms of change in psychotherapy: Mediators of treatment outcome

Abstract

Abstract We know that psychotherapy works, but the processes and mechanisms underlying therapeutic change are still largely unknown. The study of mediators and moderators of change in psychotherapy is one way to improve our understanding of mechanisms operating in psychotherapy. Consensus is slowly building on how to define both mediators and moderators of change, while there is still a controversy on strategic issues, e.g., criteria for demonstrating causality. The rationales for mediator research are discussed, as well as some of the major obstacles inherent in this research area. Finally, we present some strategic considerations for future research. Copyright © 2007 John Wiley & Sons, Ltd.