Causal effects in psychotherapy: counterfactuals counteract overgeneralization

Area of Science:

• Psychology
• Clinical Research
• Causal Inference

Background:

• Traditional psychotherapy research relies on internal/external validity, risking overgeneralization.
• This inductive approach often neglects specific clinical boundary conditions (treatment, setting, patient, therapist combinations).

Purpose of the Study:

• To propose counterfactual conceptualization as a strategy to counteract overgeneralization in psychotherapy research.
• To explore how this approach refines understanding of causality, average effects, bias, and study design in psychotherapy.

Main Methods:

• Utilizing counterfactuals to define causal effects based on individuals under two treatment conditions.
• Analyzing deductions for causality, average effects, bias, and study design from this conceptualization.

Main Results:

• Counterfactuals treat individuals at a fixed time under two conditions as basic units of causal effect.
• Causal effects are viewed as local components of a broader, global theory.

Conclusions:

• Counterfactual conceptualization offers a more nuanced approach to psychotherapy research, reducing overgeneralization.
• This framework enhances the understanding of causal effects, bias, and study design, addressing research controversies.