You can't step into the same river twice, but you can stub your toes on the same rock: psychotherapy outcome from a 50-year perspective.

H.H. Strupp's 1963 article, The Outcome Problem in Psychotherapy Revisited, and the exchange between Eysenck and Strupp that followed the article were reexamined to answer the question: What, if anything, has changed in the world of psychotherapy research over half a century since the article was originally published? Many of the issues that provided the impetus for the article and the focal point of the passionate debate between Strupp and Eysenck have been long put to rest. Much has been accomplished: Debates in the literature have became more civil, generic factors such as the therapy relationship have received strong empirical support, and researchers' attention has shifted from the broad question whether psychotherapy offers real benefits to patients to providing empirical support for closely prescribed treatments for specific disorders. However, some of the core issues raised in the article concerning how to measure and meaningfully appraise the benefits of psychotherapy are still a challenge today. Some possible avenues for future developments are explored.