Is divergence in outcome evaluation paradoxical? Towards validating multiple perspectives on psychotherapy practice

Abstract

ABSTRACT The concept of ‘paradoxical outcome’ refers to instances of differences in evaluation of the outcome of psychotherapy when taken from different sources and/or by different modes of evaluation. Paradoxical outcome has become a central issue in psychotherapy practice and research because of its prevalence as well as its implications for the aims and process of therapy. The concept of paradoxical outcome treats discrepancies in the evaluation of psychotherapy as problematic, indicating that the underlying expectation is that the outcome of psychotherapy should be consistent. In this commentary to the special issue, I propose that this assumption that the outcome of psychotherapy is a unified construct that is agreed among interested parties, that underlies the concept of paradoxical outcome, is a fundamental fallacy. Moreover, I argue that it is important to recognize that the outcome of psychotherapy is a complex notion that has different meanings for the various agents implicated in it. This recognition may in turn open the way to exploring the function and goal of psychotherapy for each of the different agents involved in it, and this will highlight its central role as a social and institutional practice that regulates contemporary subjectivities and practices.