This article discusses the epistemological underpinnings of the use of the randomized controlled clinical trial (RCT) in psychotherapy research. It is argued that underlying the therapy-choice dispute overtly targeted by the RCT is an epistemologically controversial (and covert) theory-choice dispute. Furthermore, the RCT is not a theory-neutral evaluative method but rather a research method shaped by assumptions that originate in behaviorist theories of therapy. Because there is no neutral language or basic vocabulary shared by the competing theories that would enable the comparison of their observation reports and because behaviorist and nonbehaviorist therapies are grounded in incommensurable theories, an RCT cannot be used to compare them. Therefore, RCT cannot be held up as the definitive method for investigating psychotherapy. The current perspective of sociology of science is provided to explain the social factors embedded in the use of the RCT to generate lists of empirically supported treatments
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