The methodological difficulties of robustly testing this question indicate that we need large multisite studies to ensure expert pharmacotherapy and psychotherapy. Considering the enormous use of psychotherapy, it seems odd that in the 21st century we still lack good evidence for its efficacy for the many mental disorders for which we have substantial, pivotal evidence for the efficacy of drug treatment. I cannot imagine that the proponents of psychotherapy would object to such studies. We cannot depend on drug companies to fund such studies (although that would be nice), so that leaves it up to the National Institute of Mental Health. Perhaps we need a Food and Drug Administration (FDA) counterpart for psychotherapy. Doesn’t the public deserve to know that psychotherapy is safe and effective and how it compares to drug treatment?