Methodological controversies in the treatment of panic disorder

Although the National Institutes of Health Consensus Development Conference on the Treatment of Panic Disorder endorsed the effectiveness of cognitive-behavior therapy (CBT), D. F. Klein (1996) argues that fatal flaws in all but one (negative) CBT study undermine claims about the effectiveness of CBT for panic disorder. He holds that methodologically sound CBT trials must include a drug condition and a pill placebo condition and must demonstrate the superiority of drug versus placebo; otherwise researchers are debarred from making comparative statements about the effectiveness of CBT versus drug (or placebo). The purpose of the present article is to provide a critique of Klein's arguments and to provide suggestions for resolving methodological disputes in the panic disorder field.