Hot debates about the comparative effectiveness of psychological treatments have led us to an impasse. This is analyzed from
two perspectives: a) an academic debate, where the most acknowledged proposal (evidence-based treatments) is compared
with a number of alternative ones (common factors models, psychotherapy relationships, expertise in psychotherapy); b) the
emotional impact on
... [Show full abstract] practitioners, who can feel overwhelmed by the huge number of models, the mismatch between them and
the typical work environments, and disappointments after committing allegiance to therapies that turn out to be fallible. In order to overcome this stalemate in a fruitful way, a new approach is suggested, which involves applying a certain amount of
irreverence, accepting epistemological limitations, valuing practical wisdom, tolerating a certain ingenuity, and developing some of the attitudes we recommend to our patients.