This paper reviews the ways in which the recent outcome research literature in the psychological therapies may facilitate understanding of the potent factors in treating alcohol problems. It discusses some critiques and some ideas which emerge for improving practice. Relevant outcome literature is identified and the predominant methodologies discussed, together with some of the key research conclusions. Recent critiques are outlined, in relation to epistemological questions and relevance to clinical practice. These are linked, with examples, to alcohol treatment effectiveness research. In conclusion, suggestions are made for broadening the methodological base for outcome research, with alcohol treatment as exemplar for the psychological therapies, and ideas are put forward for how service planners and practitioners can themselves find out, document and replicate ‘what works’.