To the Editor: Dr. Clark raises several concerns concerning our trial (1). First, cognitive therapy was implemented by German experts in cognitive therapy (Drs. Stangier, Hiller, Hoyer, Willutzki, and Leibing), and it strictly followed the manual by Stangier, Clark, and Ehlers. No changes were made in the delivery of cognitive therapy to match psychodynamic therapy. Furthermore, the study by Herbert et al, cited by Dr. Clark, examined the Heimberg approach, not that by Clark, and the extended treatment for the completers did not show a smaller, but a descriptively larger, pre-post effect size (1.95 compared with 1.83).