[Evaluation of paradoxical interventions]

In anecdotal, uncontrolled case reports the threats to internal and external validity cannot be ruled out and the drawing of valid conclusions are prevented. These limits the usefulness of the "impressive" results of anecdotal case reports of paradoxical interventions. The few of controlled single case experimental and group designs permit valid conclusions and prove the efficacy of paradoxical interventions, but not their general superiority over other treatments. Meta-analysis also point to efficacy but not to the superiority of paradoxical interventions over other procedures. The combinations of paradoxical and behavioral procedures seem to enhance efficacy. What is missing in paradoxical treatment studies is the clear and detailed description of the specific interventions as well as the proof of the treatment's integrity. What is still unclear is the range of indications for paradoxical interventions, the clients' satisfaction and acceptability of the paradoxical interventions and ethical issues.