The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses

Abstract

Cognitive behavioral therapy (CBT) refers to a popular therapeutic approach that has been applied to a variety of problems. The goal of this review was to provide a comprehensive survey of meta-analyses examining the efficacy of CBT. We identified 269 meta-analytic studies and reviewed of those a representative sample of 106 meta-analyses examining CBT for the following problems: substance use disorder, schizophrenia and other psychotic disorders, depression and dysthymia, bipolar disorder, anxiety disorders, somatoform disorders, eating disorders, insomnia, personality disorders, anger and aggression, criminal behaviors, general stress, distress due to general medical conditions, chronic pain and fatigue, distress related to pregnancy complications and female hormonal conditions. Additional meta-analytic reviews examined the efficacy of CBT for various problems in children and elderly adults. The strongest support exists for CBT of anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in seven of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on specific subgroups, such as ethnic minorities and low income samples.

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Acknowledgments

The authors would like to acknowledge the following research assistants who provided crucial and much-appreciated assistance with background literature reviews, initial identification of articles, and obtained articles for use by the authors: Dan Brager, Rachel Kaufmann, Rebecca Grossman, and Brian Hall. This study was partially supported by NIMH grants MH-078308 and MH-081116 awarded to Dr. Hofmann and MH-73937.

Conflict of interest

Dr. Hofmann is a paid consultant of Merck Pharmaceutical (Schering-Plough) for work unrelated to this study.

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Correspondence to Stefan G. Hofmann.

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An erratum to this article is available at http://dx.doi.org/10.1007/s10608-013-9595-3.

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Hofmann, S.G., Asnaani, A., Vonk, I.J.J. et al. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cogn Ther Res 36, 427–440 (2012). https://doi.org/10.1007/s10608-012-9476-1

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Keywords

  • CBT
  • Efficacy
  • Meta-analyses
  • Comprehensive review