Objective and subjective evaluation of psychotherapy outcomes: a new perspective on the concept of effectiveness

This article presents the results of a narrative scientific data review addressing the problem of evaluating psychotherapy effectiveness. The traditional evidence-based approach commonly used in medicine is analyzed, and the methodological challenges of applying it to the study of psychotherapy outcomes and other psychological interventions are described. At present, the need for strictly implementing evidence-based principles in psychotherapy is being cautiously reconsidered. Researchers are shifting the focus from attempts to objectify psychotherapy effectiveness toward examining client satisfaction with the quality of psychological care. Researchers have shown increasing interest in subjective measures of psychotherapy effectiveness, focusing on such evaluation aspects as satisfaction with the therapeutic process, enhanced self-understanding, increased autonomy, and greater social engagement. The significance of client and therapist expectations regarding psychotherapy outcomes, as well as the impact of anticipatory (predictive) abilities, is highlighted. It is concluded that a new perspective on the concept of psychotherapy effectiveness should include not only objective assessments of changes in a client’s psychological state but also the client’s subjective perception of these changes. In this regard, the development and adaptation of feedback scales (the Outcome Rating Scale and the Session Rating Scale) are considered important for monitoring the effectiveness of psychotherapeutic work with clients.