AFAIK there are no perfect solutions. But I believe that talk therapy is - statistically - a far, far, far better solution than drugs and surgeries.
I have no idea why you are speaking as if people had to stick to one single procedure. I am in favor of talk therapy, as the first line of care. But if talk therapy doesn't work after some time, and particularly if the very own professional administering it sees it is not going to work properly, then further measures must be taken.
I am going to give you a personal example. I used to go to a psychologist many years ago, and among the many things we talked about I mentioned I felt upset because I still had acne past my teen years. He already knew me for many months when I brought this up. It wasn't anything severe, but it annoyed me quite a bunch. The literal first he said was: "Have you tried isotretinoin?". Simple as that, he figured that this was a much simpler and efficient solution than using up our time together trying to deal with that problem. And it was! That's what I did, and problem solved. Obviously he wasn't the one who prescribed the medication. I went to a dermatologist and he agreed isotretinoin was my best chance.
The point here is that we ought to let medical professionals evaluate the patients individually to determine what is the best treatment, rather than trying to fix everything with a broad brush.
Have you consumed the links I gave you? I believe meta-studies are referred to several times.
I saw no link to them, even though you mentioned them.