The efficacy of evidence-based psychotherapies versus usual care for youths: controlling confounds in a meta-reanalysis.

In the present meta-analysis, the authors examined how several confounding moderator variables may relate to the advantage of evidence-based psychological treatments (EBTs) over usual care (UC) in the treatment of youths, including the extent to which each therapy was bona fide, supervision provided to therapists, therapist caseload, whether EBT was provided by research therapists, and whether specialized training was provided for EBT therapists. When comparing EBT with bona fide UC while controlling for each confound individually, the advantage for EBT was small and nearly always statistically nonsignificant. Additionally, an increasing total number of confounds favoring EBT was significantly predictive of a greater effect size advantage for EBT. The superior efficacy of EBTs for youths may be an artifact of confounded research designs.