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Psychother Res. 2017 Jan;27(1):14-32.

In pursuit of truth: A critical examination of meta-analyses of cognitive behavior therapy.

Author information

1
a Department of Counseling Psychology , University of Wisconsin-Madison , Madison , WI , USA.
2
b Research Institute, Modum Bad Psychiatric Center , Vikersund , Norway.
3
c Department of Psychology , University of Zürich , Zürich , Switzerland.
4
d VA Palo Alto Health Care System , Palo Alto , CA , USA.
5
e Department of Educational Psychology , University of Utah , Salt Lake City , UT , USA.
6
f Center for Clinical Excellence , Chicago , IL , USA.
7
g Minneapolis VA Health Care System , Minneapolis , MN , USA.
8
h VA Salt Lake City Health Care System , Salt Lake City , UT , USA.
9
i Derner Institute, Adelphi University , Garden City , NY , USA.

Abstract

OBJECTIVE:

Three recent meta-analyses have made the claim, albeit with some caveats, that cognitive-behavioral treatments (CBT) are superior to other psychotherapies, in general or for specific disorders (e.g., social phobia).

METHOD:

The purpose of the present article was to examine four issues in meta-analysis that mitigate claims of CBT superiority: (a) effect size, power, and statistical significance, (b) focusing on disorder-specific symptom measures and ignoring other important indicators of psychological functioning, (c) problems inherent in classifying treatments provided in primary studies into classes of treatments, and (d) the inclusion of problematic trials, which biases the results, and the exclusion of trials that fail to find differences among treatments.

RESULTS:

When these issues are examined, the effects demonstrating the superiority of CBT are small, nonsignificant for the most part, limited to targeted symptoms, or are due to flawed primary studies.

CONCLUSION:

Meta-analytic evidence for the superiority of CBT in the three meta-analysis are nonexistent or weak.

KEYWORDS:

anxiety; cognitive behavioral therapy; meta-analysis; psychotherapy effectiveness

PMID:
27884095
DOI:
10.1080/10503307.2016.1249433
[Indexed for MEDLINE]

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