title: In pursuit of truth: A critical examination of meta-analyses of cognitive behavior therapy.
abstract: 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).
  
  
  
  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.
  
  
  
  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.
  
  
  
  Meta-analytic evidence for the superiority of CBT in the three meta-analysis are nonexistent or weak.
authors.affiliation: a Department of Counseling Psychology , University of Wisconsin-Madison , Madison , WI , USA.|b Research Institute, Modum Bad Psychiatric Center , Vikersund , Norway.
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Wampold
authors.affiliation: c Department of Psychology , University of Zürich , Zürich , Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Flückiger
authors.affiliation: d VA Palo Alto Health Care System , Palo Alto , CA , USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Del Re
authors.affiliation: a Department of Counseling Psychology , University of Wisconsin-Madison , Madison , WI , USA.
authors.forename: Noah E
authors.initials: NE
authors.lastname: Yulish
authors.affiliation: a Department of Counseling Psychology , University of Wisconsin-Madison , Madison , WI , USA.
authors.forename: Nickolas D
authors.initials: ND
authors.lastname: Frost
authors.affiliation: e Department of Educational Psychology , University of Utah , Salt Lake City , UT , USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Pace
authors.affiliation: a Department of Counseling Psychology , University of Wisconsin-Madison , Madison , WI , USA.
authors.forename: Simon B
authors.initials: SB
authors.lastname: Goldberg
authors.affiliation: f Center for Clinical Excellence , Chicago , IL , USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Miller
authors.affiliation: g Minneapolis VA Health Care System , Minneapolis , MN , USA.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Baardseth
authors.affiliation: h VA Salt Lake City Health Care System , Salt Lake City , UT , USA.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Laska
authors.affiliation: i Derner Institute, Adelphi University , Garden City , NY , USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Hilsenroth
mesh_terms: D002986:Clinical Trials as Topic; D015928:Cognitive Behavioral Therapy; D006801:Humans; D015201:Meta-Analysis as Topic; D017063:Outcome Assessment, Health Care
keywords: anxiety; cognitive behavioral therapy; meta-analysis; psychotherapy effectiveness