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

In this article, we examine the history and controversy of the placebo in psychotherapy. In medicine, beginning in the 1950s, the use of the placebo in double-blind randomized trials has allowed the identification of specific treatments. It seemed logical to researchers that this strategy could be fruitfully adapted for studying psychotherapy. However, Rosenthal and Frank (1956) noted that the analogy would likely fail because there is no such thing as an “inert psychotherapy.” Notwithstanding the problems with psychotherapy placebos, psychotherapy research moved forward with efforts to make inferences about specificity using placebo types control groups. The discussion of specificity and the therapeutic value of the common factors raise the issue of whether psychotherapy is in and of itself a placebo.

One explanation for differences in treatment effectiveness for targeted symptoms is that more-effective treatments are more focused on patients' problems than are less-effective treatments. This conjecture was examined meta-analytically. Comparisons of two treatments of adults with anxiety disorders were included. Effect sizes for targeted symptoms, nontargeted symptoms, and global outcomes (e.g., quality of life and well-being) as well as the relative focus on patients' problems and researcher allegiance were coded. Metaregressions were conducted to predict effect sizes from (a) variables related to the focus on patients' problems and (b) researcher allegiance. For symptom measures, the relative focus on patients' problems predicted the relative effectiveness of the treatments, with the expectations created by explanation appearing more predictive than specific therapeutic actions focused on patients' problems, although conclusions about relative importance were difficult to determine given collinearity of predictors. Researcher allegiance also predicted the effects of the comparisons. For global outcomes, both the focus on patients' problems and researcher allegiance seemed to have smaller roles. A focus on patients' problems appears to be important for the reductions of symptoms. Clinical trials comparing treatments need to balance the focus on patients' problems and reduce researcher allegiance. (PsycINFO Database Record

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