Researcher allegiance and meta-analysis: The case of cognitive therapy for depression.

Gaffan, E. A.; Tsaousis, Joannis; Kemp-Wheeler, S.M.

doi:10.1037/0022-006x.63.6.966

Cited by 180 publications

(141 citation statements)

References 64 publications

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“…Dobson (1989) conducted the first meta-analysis on this topic and found CT to be superior to untreated controls, wait list, pharmacotherapy, behavior therapy, and a heterogeneous group other therapies. Gaffan, Tsaousis, and Kemp-Wheeler (1995) hypothesized that Dobson's findings were positively biased toward CBT by researcher allegiance; the tendency for authors to prefer one therapy to another. They reanalyzed the same set of studies reviewed by Dobson while controlling for researcher allegiance and found that researcher allegiance accounted for half the difference between CBT and other treatments.…”

Section: Depressionmentioning

confidence: 99%

The empirical status of cognitive-behavioral therapy: A review of meta-analyses

Butler

Chapman

Forman

et al. 2006

Clinical Psychology Review

2,702

1,541

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This review summarizes the current meta-analysis literature on treatment outcomes of CBT for a wide range of psychiatric disorders. A search of the literature resulted in a total of 16 methodologically rigorous meta-analyses. Our review focuses on effect sizes that contrast outcomes for CBT with outcomes for various control groups for each disorder, which provides an overview of the effectiveness of cognitive therapy as quantified by meta-analysis. Large effect sizes were found for CBT for unipolar depression, generalized anxiety disorder, panic disorder with or without agoraphobia, social phobia, posttraumatic stress disorder, and childhood depressive and anxiety disorders. Effect sizes for CBT of marital distress, anger, childhood somatic disorders, and chronic pain were in the moderate range. CBT was somewhat superior to antidepressants in the treatment of adult depression. CBT was equally effective as behavior therapy in the treatment of adult depression and obsessive-compulsive disorder. Large uncontrolled effect sizes were found for bulimia nervosa and schizophrenia. The 16 meta-analyses we reviewed support the efficacy of CBT for many disorders. While limitations of the meta-analytic approach need to be considered in interpreting the results of this review, our findings are consistent with other review methodologies that also provide support for the efficacy CBT. D 2005 Elsevier Ltd. All rights reserved.Cognitive-behavioral therapy is one of the most extensively researched forms of psychotherapy. Over 120 controlled clinical trials were added to the literature in the eight years between 1986(Hollon & Beck, 1994 and this proliferation has continued (Dobson, 2001). There are now over 325 published outcome studies on cognitive-behavioral interventions. This growth is due in part to the ongoing adaptation of CBT for an increasingly wider range of disorders and problems (Beck, 1997;Salkovskis, 1996). Yet, many questions remain regarding the overall effectiveness of CBT, its differential effectiveness by disorder, the nature of the control groups by which its effectiveness has been established, and the extent to which its effects persist following the cessation of treatment. In this paper we review evidence from meta-analyses that address these questions. Our approach is unique in that we systematically summarize findings across high-quality meta-analyses for 16 different disorders. We focus on direct comparisons of CBT to alternative treatments wherever possible.A review of meta-analyses on CBT outcomes is particularly relevant to the ongoing debate about the comparative efficacy of different treatments (Rounsaville & Carroll, 2002). For instance, a recent review of meta-analyses and 0272-7358/$ -see front matter D

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Section: Depressionmentioning

confidence: 99%

The empirical status of cognitive-behavioral therapy: A review of meta-analyses

Butler

Chapman

Forman

et al. 2006

Clinical Psychology Review

2,702

1,541

View full text Add to dashboard Cite

show abstract

“…Early meta-analyses all showed CBT to be more effective than no treatment for people with depression, [4][5][6][7][8] although no firm evidence was found that CBT was any more or less efficacious than other psychotherapies or pharmacotherapy. No recent meta-analysis has specifically focused on effect studies of CBT, and examined potential effect moderators and other sources of heterogeneity.…”

Section: Limitationsmentioning

confidence: 99%

A Meta-Analysis of Cognitive-Behavioural Therapy for Adult Depression, Alone and in Comparison with other Treatments

et al. 2013

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Objective:No recent meta-analysis has examined the effects of cognitive-behavioural therapy (CBT) for adult depression. We decided to conduct such an updated meta-analysis.Methods: Studies were identified through systematic searches in bibliographical databases (PubMed, PsycINFO, Embase, and the Cochrane library). We included studies examining the effects of CBT, compared with control groups, other psychotherapies, and pharmacotherapy.Results: A total of 115 studies met inclusion criteria. The mean effect size (ES) of 94 comparisons from 75 studies of CBT and control groups was Hedges g = 0.71 (95% CI 0.62 to 0.79), which corresponds with a number needed to treat of 2.6. However, this may be an overestimation of the true ES as we found strong indications for publication bias (ES after adjustment for bias was g = 0.53), and because the ES of higher-quality studies was significantly lower (g = 0.53) than for lower-quality studies (g = 0.90). The difference between high-and low-quality studies remained significant after adjustment for other study characteristics in a multivariate meta-regression analysis. We did not find any indication that CBT was more or less effective than other psychotherapies or pharmacotherapy. Combined treatment was significantly more effective than pharmacotherapy alone (g = 0.49). Conclusions:There is no doubt that CBT is an effective treatment for adult depression, although the effects may have been overestimated until now. CBT is also the most studied psychotherapy for depression, and thus has the greatest weight of evidence. However, other treatments approach its overall efficacy. W W WUne méta-analyse de la thérapie cognitivo-comportementale pour la dépression adulte, seule et en comparaison avec d'autres traitements Objectif : Aucune méta-analyse récente n'a examiné les effets de la thérapie cognitivocomportementale (TCC) sur la dépression adulte. Nous avons décidé de mener cette mise à jour de méta-analyses.Méthodes : Des études ont été identifiées lors de recherches systématiques dans les bases de données bibliographiques (PubMed, PsycINFO, Embase, et Cochrane library). Nous avons inclus des études qui examinent les effets de la TCC, comparé à des groupes témoins, d'autres psychothérapies, et la pharmacothérapie.Résultats : Un total de 115 études satisfaisaient aux critères d'inclusion. L'ampleur (AE) moyenne de l'effet de 94 comparaisons dans 75 études de TCC et de groupes témoins

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“…1,[3][4][5] If the intervention, especially if it corresponds to the diagnosis, would determine the outcome, this should not be so, and it also should not be that practically all therapeutic procedures, tested against each other in direct experimental comparisons, lead to very similar effects (the so-called Dodo bird effect). [5][6][7][8][9][10] This is particularly true when (i) only bona fide therapies were included, i.e. treatment procedures that are wellintentioned and realized by competent therapists as probably effective treatment methods (not only as half-hearted control conditions); and when (ii) the 'affiliation', i.e.…”

Section: Treatment Techniques and Technique-specific Factors Of Effecmentioning

confidence: 99%

Complexity and Nonlinear Dynamics in Psychotherapy

Schiepek¹

2009

European Review

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Human life changes with time. It seems therefore obvious that most of the phenomena that psychology and psychotherapy are concerned with are dynamic in nature. For human development processes, human change and learning processes, the dynamics and prognosis of mental disorders, problems manifesting in social systems such as couples, families, teams, or the question of how psychotherapy works, self-organization is ubiquitous. In the context of self-organization, complexity is a quality of changing patterns and patterns of change, produced by nonlinear coupled systems. Anomalies of the linear input-output model of psychotherapyA huge amount of empirical outcome studies and reviews (meta-analyses) supports the evidence that psychotherapy works -its efficacy is comparable to other medical treatments. The usual conception is that it works due to the applied methods of treatment. The input makes the output, and the treatment causes the effect. The specific factors producing the effect should exist within the treatment techniques; everything else is used only to fill in the blanks and is therefore non-specific. Against this background, for the purpose of proving the efficiency of psychotherapies, the execution of randomized controlled trials is regarded as the 'gold standard'. It makes use of experimental designs where treatment systematically varies and confusing variables are to be excluded (e.g. by randomization of patients to treatment modalities). The effect should be attributed to the employed treatment as clearly as possible. To describe this dominating paradigm, Wampold 1 used the term 'medical model', or -since it also dominates in the field of psychology as well and corresponds to the methodological canon of the general linear model -'standard model'.

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Researcher allegiance and meta-analysis: The case of cognitive therapy for depression.

Cited by 180 publications

References 64 publications

The empirical status of cognitive-behavioral therapy: A review of meta-analyses

The empirical status of cognitive-behavioral therapy: A review of meta-analyses

A Meta-Analysis of Cognitive-Behavioural Therapy for Adult Depression, Alone and in Comparison with other Treatments

Complexity and Nonlinear Dynamics in Psychotherapy

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