Is Cognitive-Behavioral Therapy a Clinically Effective Treatment for Anxiety?

In the world of psychotherapy, Cognitive-Behavioral Therapy (CBT) reigns supreme. It receives far more attention from researchers than any other form of therapy. This is partially because it is easier to study compared to other forms of therapy (e.g. psycho-analysis) and partially because it most often provides promising results. Due to this, there is a massive amount of experimental evidence concerning the efficacy of Cognitive-Behavioral Therapy.

But can the efficacy of Cognitive-Behavioral Therapy in research settings be translated into effectiveness in clinical practice? This issue involves external validity: the ability of an experiment to be generalized beyond its own setting.

A recent article in the Journal of Consulting and Clinical Psychology tries to tackle this issue. The article is entitled "Cognitive-Behavioral Therapy for Adult Anxiety Disorders in Clinical Practice: A Meta-Analysis of Effectiveness Studies" and is authored by Rebecca Stewart and Dianne Chambless from the University of Pennsylvania.

Using a statistical procedure called meta-analysis, which combines the data from multiple studies, the researchers analyzed fifty-six effectiveness studies. These studies all assessed whether Cognitive-Behavioral Therapy was an effective treatment for anxiety disorders. Unlike other studies of Cognitive-Behavioral Therapy, which the authors refer to as "efficacy trials," effectiveness trials utilize quasi-experimental designs that are more like actual clinical practice. The downside to this is that it is harder to control all the variables in the experiment and thus harder to obtain reliable results. The upside is that these trials generally have greater amounts of external validity, which is why the researchers choose to analyze them.

The results of the meta-analysis showed that Cognitive-Behavioral Therapy is a clinically effective treatment for anxiety. Although this study provides evidence for the effectiveness of Cognitive-Behavioral Therapy, critics might not be convinced. Some argue that no empirical and quantitative analysis can properly examine the fundamentally qualitative process of psychotherapy. Others may have doubts about the qualities of the studies included in the meta-analysis itself.

Even though Cognitive-Behavioral Therapy has its critics, not only of the methodology of studying it, but also the therapy itself, it is still the prominent type of therapy for both practicing clinical psychologists and research psychologists.

Reference:
Stewart, R.E. & Chambless, D.L. (2009). Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: A meta-analysis of effectiveness studies. Journal of Consulting and Clinical Psychology, 77(3), 595-606.