The role of the therapist: what effective therapists do

After expressing enthusiastic agreement with Blow, Davis, and Sprenkle's (in press) call for research focused on what effective therapists do in therapy, this article dissents from two notions that serve as the foundation for these authors' ongoing advocacy of client-worldview/model-worldview matching as a privileged means of enhancing therapeutic outcome. In response to their assumption that client-worldview/model-worldview dissonance almost inevitably produces a therapy-threatening disruption of the therapeutic alliance, two scenarios are described in which such dissonance can not only be compatible with, but might also even contribute to, positive therapeutic outcome. In response to Blow and colleagues' notion that extant research supports the superior efficacy of client-model matching, this article underlines that the research they cite is substantially mute on the matter of switching models in order to accommodate to client worldview.