A critique of the methods and conclusions in the patient outcome research team (PORT) report on psychological treatments for schizophrenia.

Abstract

The schizophrenia Patient Outcome Research Team (PORT; Lehman and Steinwachs, 1998), a policy paper on the treatment of schizophrenia sponsored by the United States government Agency for Health Care Policy and Research, has minimized the efficacy and utility of psychological treatments for schizophrenia and concluded that some treatments like psychoanalytic psychotherapy are contraindicated and harmful. A critical review of Recommendations 22, 23, 24, 25, and 26 (those addressing the efficacy of psychological treatments) was undertaken. The purpose of this critique was to describe the threats to validity inherent in the PORT report's design and to demonstrate how those threats make the relevant recommendations specious. In addition, empirical evidence from meta-analytic reviews is described to show that, indeed, psychological treatments for schizophrenia are efficacious. Limitations of the available evidence and suggestions for a PORT revision are discussed.