Although we take it as a given that many psy-chotherapies are efficacious, form a cornerstone of much current practice, and are valued by many patients, there is a dissonance in the way in which physical therapies and psychotherapies are considered in terms of their cost-benefit ratio. Any potent intervention has both the capacity to cure and to harm. For drug-based therapeutic trials, adverse event monitoring is mandatory. By contrast, evaluation of psychotherapy has historically weighted the 'benefit' side of the equation. For example, is a particular type of psychotherapy effective, is one psychotherapy superior to another, or does psychotherapy benefit a particular condition?
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