Behavioral and cognitive treatment methods: a critical comparative review

Forty clinical outcome studies were selected using strict criteria in which standard behavior therapy (BT) procedures were compared with procedures considered cognitive. The question asked was whether the addition of cognitive therapy (CT) methods yielded more beneficial treatment outcomes. Most studies reflected an equivalence in outcome between cognitive-behavioral therapy (CBT) procedures and behavioral procedures alone. Behavior therapy was superior in two studies to treatments with a cognitive component. One finding was that cognitive therapy has shown promise in the areas of social anxiety. The behavioral aspect of CBT seemed central to its effectiveness, while the same cannot be said for the cognitive components. Given that only a modicum of clinical benefit has been added in twenty years of the cognitive therapy movement, it is suggested that the wholesale adoption of cognitive procedures is unmerited.