Journal of Psychotherapy Integration, Vol 34(3), Sep 2024, 246-264; doi:10.1037/int0000333
This article considers issues pertinent to achieving a consensus about mechanisms of change as a vital element of both a consensual core and the unification of our field while emphasizing that the process of reaching consensus also raises ineluctable epistemological issues. Our overarching question is this: In the context of its potential contributions to a core body of consensual knowledge about psychotherapy, can there be a unifying consensus about mechanisms of change? We begin by discussing psychotherapy’s preparadigmatic status (stasis), then proceed to overview the field of principles of change, as well as a variety of epistemological issues associated with the pursuit of a consensual core. We then examine the field of mechanisms of change and the significant benefits that ensue from understanding them more deeply. This is followed by a deliberation of hurdles that must be cleared to reach a consensus regarding mechanisms of change; for instance, can we have a consensus even on terminology and definitions of mechanisms of change? This involves distinguishing between mechanisms of change and principles of change; describing the similarities and differences between mechanisms of change and change processes; and distinguishing mediators from mechanisms of change, which, surprisingly, many scholars and researchers in this area conflate. We offer concluding recommendations that we hope can facilitate getting closer to a consensus regarding mechanisms and processes of change that appear to be essential elements of unifying the field of psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved)