Treatment integrity of studies that compare short-term psychodynamic psychotherapy with cognitive-behavior therapy

In their meta-analysis, Leichsenring, Rabung, and Leibing (2004) found that short-term psychoanalytic psychotherapy (STPP) and cognitive-behavior therapy (CBT) were equally efficacious. However, they did not examine whether the treatments were delivered as intended. In our review of nine studies comparing STPP and CBT, we found that most did not adequately implement treatment integrity procedures. Leichsenring and colleagues' contention that CBT and STPP are equally efficacious is therefore based on studies without adequate procedures to monitor treatment adherence or therapist competence. The neglect of treatment integrity procedures in these studies leaves open the possibility that the absence of comparative treatment effects may be due to the manner in which the treatments were operationalized.