Prospects for future comparisons between drugs and psychotherapy: lessons from the CBT-versus-pharmacotherapy exchange.

In these concluding comments to the exchange among N. S. Jacobson and S. D. Hollon (1996), D. F. Klein (1996), I. Elkin, R. D. Gibbons, M. T. Shea, and B. F. Shaw (1996), and R. J. McNally (1996) issues of continuing controversy are highlighted: the best ways to control for the allegiance effect, the complexities of assessing competence, and the role of pill placebos in comparisons between cognitive-behavior therapy (CBT) and pharmacotherapy. It is concluded that controlling for allegiance within site is the optimal strategy, that measures of competence must take context into account, and that pill placebo controls are optimal but not essential to comparisons between CBT and pharmacotherapy.