***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Internet-delivered self-help programmes with added therapist guidance have shown efficacy in social anxiety disorder , but unguided self-help has been insufficiently studied . AIMS To evaluate the efficacy of guided and unguided self-help for social anxiety disorder . METHOD Participants followed a cognitive-behavioural self-help programme in the form of either pure bibliotherapy or an internet-based treatment with therapist guidance and online group discussion s. A subsequent trial was conducted to evaluate treatment specificity . Participants ( n = 235 ) were r and omised to one of three conditions in the first trial , or one of four conditions in the second . RESULTS Pure bibliotherapy and the internet-based treatment were better than waiting list on measures of social anxiety , general anxiety , depression and quality of life . The internet-based therapy had the highest effect sizes , but directly comparable effects were noted for bibliotherapy augmented with online group discussion s. Gains were well maintained a year later . CONCLUSIONS Unguided self-help through bibliotherapy can produce enduring improvement for individuals with social anxiety disorder Fifty-five people with panic disorder ( PD ) were r and omised to internet-based cognitive behavioural panic treatment ( CBT ) ( with email contact ) , therapist-assisted CBT manual or information-only control ( both with telephone contact ) . Both CBT treatments were more effective in reducing PD symptomatology , panic-related cognition , negative affect , and number of GP visits and improving physical health ratings . Internet treatment was more effective than CBT manual in reducing clinician-rated agoraphobia and number of GP visits at post- assessment . At follow-up , these effects were maintained for both CBT groups , with internet CBT better at improving physical health ratings and reducing GP visits . This study provides support for the efficacy of internet-based CBT Clinician-guided Internet-based cognitive behavioural therapy ( iCBT ) programs are clinical ly effective at treating specific anxiety disorders . The present study examined the efficacy of a transdiagnostic Internet-based cognitive behavioural treatment ( iCBT ) program to treat more than one anxiety disorder within the same program ( the Anxiety Program ) . Eighty six individuals meeting diagnostic criteria for generalized anxiety disorder ( GAD ) , panic disorder , and /or social phobia were r and omly assigned to a  treatment group  , or to a waitlist control group . Treatment consisted of CBT based online educational lessons and homework assignments , weekly email or telephone contact from a clinical psychologist , access to a moderated online discussion forum , and automated emails . An intention-to-treat model using the baseline-observation-carried-forward principle was employed for data analyses . Seventy-five percent of treatment group participants completed all 6 lessons within the 8 week program . Post-treatment data was collected from 38/40 treatment group and 38/38 control group participants , and 3-month follow-up data was collected from 32/40 treatment group participants . Relative to controls , treatment group participants reported significantly reduced symptoms of anxiety as measured by the Generalized Anxiety Disorder - 7 Item , Social Phobia Screening Question naire , and the Panic Disorder Severity Rating Scale - Self Report Scale , but not on the Penn State Worry Question naire , with corresponding between-groups effect sizes ( Cohen 's d ) at post-treatment of 0.78 , 0.43 , 0.43 , and 0.20 , respectively . The clinician spent a total mean time of 46min per person over the program , participants rated the procedure as moderately acceptable , and gains were sustained at follow-up . Modifications to the Anxiety program , based on post-treatment feedback from treatment group participants , were associated with improved outcomes in the control group . These results indicate that transdiagnostic programs for anxiety disorders may be successfully administered via the Internet This study investigated 2 methods of disseminating a cognitive-behavioral intervention for panic disorder ( PD ) . Thirty-six Ss who met diagnostic criteria for PD according to the Anxiety Disorders Interview Schedule-Revised were r and omly assigned to 1 of 3 conditions : bibliotherapy ( BT ) , group therapy ( GT ) , or a waiting-list control ( WL ) condition . Interventions lasted 8 weeks and were followed by a posttest , along with 3- and 6-month follow-up assessment s. Results indicated that both the BT and GT treatments were more effective than the WL condition in reducing frequency of panic attacks , severity of physical panic symptoms , catastrophic cognitions , agoraphobic avoidance , and depression and that the BT and GT treatments were more effective in increasing self-efficacy . Both interventions maintained their effects throughout the follow-up periods and produced clinical ly significant levels of change among the majority of treated Ss Cognitive behavioral bibliotherapy for panic disorder has been found to be less effective without therapist support . In this study , participants were r and omized to either unassisted bibliotherapy ( n=20 ) with a scheduled follow-up telephone interview or to a waiting list control group ( n=19 ) . Following a structured psychiatric interview , participants in the treatment group were sent a self-help book consisting of 10 chapters based on cognitive behavioral strategies for the treatment of panic disorder . No therapist contact of any kind was provided during the treatment phase , which lasted for 10 weeks . Results showed that the treatment group had , in comparison to the control group , improved on all outcome measures at posttreatment and at 3-month follow-up . The tentative conclusion drawn from these results is that pure bibliotherapy with a clear deadline can be effective for people suffering from panic disorder with or without agoraphobia This study compared Panic Online ( PO ) , an internet-based CBT intervention , to best- practice face-to-face CBT for people with panic disorder with or without agoraphobia . Eighty-six people with a primary diagnosis of panic disorder were recruited from Victoria , Australia . Participants were r and omly assigned to either PO ( n=46 ) or best practice face-to-face CBT ( n=40 ) . Effects of the internet-based CBT program were found to be comparable to those of face-to-face CBT . Both interventions produced significant reductions in panic disorder and agoraphobia clinician severity ratings , self reported panic disorder severity and panic attack frequency , measures of depression , anxiety , stress and panic related cognitions , and displayed improvements in quality of life . Participants rated both treatment conditions as equally credible and satisfying . Participants in the face-to-face CBT treatment group cited higher enjoyment with communicating with their therapist . Consistent with this , therapists ' ratings for compliance to treatment and underst and ing of the CBT material was higher in the face-to-face CBT treatment group . PO required significantly less therapist time than the face-to-face CBT condition BACKGROUND Self-help for social phobia has not received controlled empirical evaluation . AIMS To evaluate the efficacy of pure self-help through written material s for severe social phobia  and self-help augmented by five group sessions with a therapist . These conditions were compared with a waiting-list control and st and ard , therapist-led group therapy . METHOD Participants with severe generalised social phobia ( n=224 ) were r and omised to one of four conditions . Assessment included diagnoses , symptoms and life interference at pretreatment , 12 weeks and at 24 weeks . RESULTS A larger percentage of patients no longer had a diagnosis of social phobia at post-intervention in the pure self-help group than in the waiting-list group , although this percentage decreased slightly over the next 3 months . Symptoms of social anxiety and life interference did not differ significantly between these groups . Augmented self-help was better than waiting list on all measures and did not differ significantly from group treatment . CONCLUSIONS Self-help augmented by therapist assistance shows promise as a less re source -intensive method for the management of social phobia . Pure self-help shows limited efficacy for this disorder Objective : In two previous r and omized controlled trials Titov et al. demonstrated significant benefit from an Internet- and email-based treatment programme for  social phobia .  The present study ( Shyness 3 ) explores whether participants are able to complete this programme independently . Method : A total of 98 individuals with social phobia were r and omly assigned to a clinician-assisted computerized cognitive behavioural treatment ( CaCCBT ) group , a self-guided computerized CBT ( CCBT ) group , or to a waitlist control group . CaCCBT group participants completed the usual Shyness programme consisting of six online lessons , cognitive behavioural homework assignments , email contact with a therapist , and participation in an online discussion forum . CCBT group participants accessed the same re sources except for therapist emails . An intention-to-treat model was used for data analyses . Results : A total of 77 % of CaCCBT and 33 % of CCBT group participants completed all lessons . Significant differences were found after treatment between CaCCBT and control groups ( mean between-groups effect size ( ES ) for the social phobia measures = 1.04 ) , and between the CaCCBT and CCBT groups ( mean between-groups ES for the social phobia measures = 0.66 ) . No significant differences were found after treatment between the CCBT and control groups ( mean between-groups ES for the social phobia measures = 0.38 ) . CCBT participants , however , who completed the six lessons made good progress ( mean within-group ES for the social phobia measures = 0.62 ) . Quantitative and qualitative data indicate that both the CaCCBT and CCBT procedures were acceptable to participants . Conclusions : The reliability of this Internet-based treatment programme for social phobia has been confirmed . The therapist-guided condition was superior to the self-guided condition , but a subgroup of participants still benefited considerably from the latter . These data confirm that self-guided education or treatment programmes for common anxiety disorders can result in significant improvements BACKGROUND It is unclear what psychological help should be offered in the aftermath of traumatic events . Similarly , there is a lack of clarity about the best way of identifying people who are unlikely to recover from early posttraumatic symptoms without intervention . OBJECTIVE To determine whether cognitive therapy or a self-help booklet given in the initial months after a traumatic event is more effective in preventing chronic posttraumatic stress disorder ( PTSD ) than repeated assessment s. DESIGN R and omized controlled trial . Patients Motor vehicle accident survivors ( n = 97 ) who had PTSD in the initial months after the accident and met symptom criteria that had predicted persistent PTSD in a large naturalistic prospect i ve study of a comparable population . SETTING Patients were recruited from attendees at local accident and emergency departments . INTERVENTIONS Patients completed a 3-week self-monitoring phase . Those who did not recover with self-monitoring ( n = 85 ) were r and omly assigned to receive cognitive therapy ( n = 28 ) , a self-help booklet based on principles of cognitive behavioral therapy ( n = 28 ) , or repeated assessment s ( n = 29 ) . MAIN OUTCOME MEASURES Symptoms of PTSD as assessed by self-report and independent assessors unaware of the patient 's allocation . Main assessment s were at 3 months ( posttreatment , n = 80 ) and 9 months ( follow-up , n = 79 ) . RESULTS Twelve percent ( n = 12 ) of patients recovered with self-monitoring .  Cognitive therapy was more effective in reducing symptoms of PTSD , depression , anxiety , and disability than the self-help booklet or repeated assessment s. At follow-up , fewer cognitive therapy patients ( 3 [ 11 % ] ) had PTSD compared with those receiving the self-help booklet ( 17 [ 61 % ] ; odds ratio , 12.9 ; 95 % confidence interval , 3.1 - 53.1 ) or repeated assessment s ( 16 [ 55 % ] ; odds ratio , 10.3 ; 95 % confidence interval , 2.5 - 41.7 ) . There was no indication that the self-help booklet was superior to repeated assessment s. On 2 measures , high end-state functioning at follow-up and request for treatment , the outcome for the self-help group was worse than for the repeated assessment s group . CONCLUSIONS Cognitive therapy is an effective intervention for recent-onset PTSD . A self-help booklet was not effective . The combination of an elevated initial symptom score and failure to improve with self-monitoring was effective in identifying a group of patients with early PTSD symptoms who were unlikely to recover without intervention This study compared the relative short- and longer-term efficacy of therapist-guided and unguided use of a cognitive behavioral self-help manual for binge eating [ Fairburn , C. G. ( 1995 ) . Overcome binge eating . New York : The Guilford Press . ] Forty women ( 82.5 % with binge eating disorder ) were r and omized to one of the two treatment levels . Results indicate that both conditions represent viable means of treating binge eating . Overall , patients improved their eating behavior , eliminated any inappropriate compensatory behaviors , reduced their shape concern , weight concern , and other symptoms of eating-related psychopathology , and improved their general psychological functioning . The guided self-help condition was notably superior in reducing the occurrence of binge eating and its associated symptomatology , as well as lowering interpersonal sensitivity . A high degree of general psychopathology was a negative prognostic indicator . The implication s for a stepped-care approach to treating binge eating are discussed Due to treatment accessibility and cost issues , interest in self-help programs ( e.g. , bibliotherapy , telehealth ) for common psychological disorders is growing . Research supporting the efficacy of such a program for social anxiety , however , is limited . The present study examined the efficacy of an 8- 
    Output:
    
The addition of guidance and the presentation of multimedia or web-based self-help material s improved treatment outcome .
Self-help interventions appear to be an effective way of treating individuals diagnosed with social phobia and panic disorder .