As in all randomized controlled trials, the nitty-gritty choices in study design help shape the findings. Which form of CBT to test in such an important study was self-evident: Clark and Wells’s cognitive therapy (3), a commonly practiced model that had been previously studied in clinical trials. No such simple solution attended the dynamic therapy condition, as no form of manualized psychodynamic therapy had been developed or tested for patients with social phobia. The investigators chose to use supportive-expressive therapy, newly modified for social phobia, an understandable choice with both strengths and limitations. An enormous strength is that supportive-expressive therapy has been successfully transported around the globe and used to treat multiple psychiatric conditions. The original development of supportive-expressive therapy in the 1970s was a groundbreaking achievement in psychodynamic psychotherapy research, establishing the first successfully manualized supportive dynamic treatment (4), enabling testing of this previously recalcitrant modality in randomized controlled trials. Supportive-expressive therapy focuses on articulating a core conflictual relationship theme, which relates to, yet lacks equivalence to, the transference relationship that forms a key interventional focus in many forms of psychoanalysis and psychoanalytic psychotherapy. Supportive-expressive therapy lacks the full psychodynamic focus on developmental relationships and events, formative attachments, and unraveling underlying fantasy structure. Elements of this therapy, as described in this study, appear alien to psychodynamic practitioners—for example, the inclusion of an exposure component.