The latest meta-analysis seems to have definitively answered this question.
Cognitive Behavioral Therapy, or CBT, pioneered by Aaron Beck, targets distorted thinking and leads to behavioral change. After developing CBT techniques, Beck sought to prove the effectiveness of the therapy through rigorous, well-designed studies. By 2021, CBT had been put to the test in over 2000 clinical trials, and Beck had published over 600 articles and 25 books on the subject[i].
In reference to the extensive evidence previously published on CBT, the authors explained that the last comprehensive meta-analysis was published in 2013. They touted the present meta-analysis as “the largest meta-analysis ever of a specific type of psychotherapy for a mental disorder” (p. 111). The goals of the present meta-analysis were to include more recently published randomized controlled trials of CBT, to include studies of children and adolescents, to examine its effectiveness in the short and long term, to examine its effectiveness compared to other psychotherapies, and to look at its effectiveness compared to and combined with pharmacotherapy.
This meta-analysis included an impressive 409 clinical trials and 52,702 patients! Interestingly, they included trials in which CBT was administered in any format, including in groups, online, or self-help.
Summary of results:
- CBT was significantly more effective than other types of psychotherapy, but only marginally so
- When compared to control conditions (not other psychotherapies), CBT had a very large, significant effect
- There was no significant difference in effectiveness for CBT compared to medications, except in long-term follow-up (6-12 months) in which CBT was superior
- CBT combined with pharmacotherapy was superior to pharmacotherapy alone, but no more effective than CBT alone
- Even unguided self-help CBT (no counselor interactions) was more effective than control conditions
Takeaway: many decades of research and thousands of RCTs have demonstrated the effectiveness of CBT at treating depression. This latest meta-analysis shows that CBT edges out other psychotherapies in effectiveness, but with a small effect. CBT is also as effective as medications and CBT plus medication is more effective than medication alone. Remember that, unlike pharmaceuticals, there are no negative side effects to CBT. It also appears to lead to better long-term outcomes, up to 12 months following treatment, and can be used to treat depression in children and adolescents.
Citation: Cuijpers, P., Miguel, C., Harrer, M., Plessen, C. Y., Ciharova, M., Ebert, D., & Karyotaki, E. (2023). Cognitive behavior therapy vs. control conditions, other psychotherapies, pharmacotherapies and combined treatment for depression: A comprehensive meta-analysis including 409 trials with 52,702 patients. World Psychiatry, 22(1), 105-115. https://doi.org/10.1002/wps.21069.
©Jennie Dilworth, Ph.D
[i] Beck, J. S., & Fleming, S. (2021). A brief history of Aaron T Beck, MD, and cognitive behavior therapy. Clinical Psychology in Europe, 3(2), e6701. doi: 10.32872/cpe.6701