***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: Abstract Objective : To explore hopes and expectations for therapy among a clinical population of depressed adolescents . Method : As part of a r and omized clinical trial , 77 adolescents aged 11–17 , with moderate to severe depression , were interviewed using a semi-structured interview schedule . The interviews were analysed qualitatively using framework analysis . Results : The findings are reported around five themes : “ the difficulty of imagining what will happen in therapy , ” “ the ‘ talking cure , ’ ” “ the therapist as doctor , ” “ therapy as a relationship , ” and “ regaining the old self or developing new capacities . ” Conclusions : Differing expectations are likely to have implication s for the way young people engage with treatment , and failure to identify these expectations may lead to a risk of treatment breakdown Although research supports the efficacy of exposure therapy for PTSD , some evidence suggests that exposure is under-utilized in general clinical practice . The purpose of this study was to assess licensed psychologists ' use of imaginal exposure for PTSD and to investigate perceived barriers to its implementation . A total of 852 psychologists from three states were r and omly selected and surveyed . An additional 50 members of a trauma special interest group of a national behavior therapy organization were also surveyed . The main survey results indicate that a large majority of licensed doctoral level psychologists do not report use of  exposure therapy  to treat patients with PTSD . Although approximately half of the main study sample reported that they were at least somewhat familiar with exposure for PTSD , only a small minority used it to treat PTSD in their clinical practice . Even among psychologists with strong interest and training in behavioral treatment for PTSD , exposure therapy is not completely accepted or widely used . Clinicians also appear to perceive a significant number of barriers to implementing exposure The paper describes the development of a cognitive therapy ( CT ) program for  post-traumatic stress disorder ( PTSD )  that is based on a recent cognitive model ( Behav . Res . Therapy 38 ( 2000 ) 319 ) . In a consecutive case series , 20 PTSD patients treated with CT showed highly significant improvement in symptoms of PTSD , depression and anxiety .  A subsequent r and omized controlled trial compared CT ( N = 14 ) and a 3-month waitlist condition ( WL , N = 14 ) . CT led to large reductions in PTSD symptoms , disability , depression and anxiety , whereas the waitlist group did not improve . In both studies , treatment gains were well maintained at 6-month follow-up . CT was highly acceptable , with an overall dropout rate of only 3 % . The intent-to-treat effect sizes for the degree of change in PTSD symptoms from pre to post-treatment were 2.70 - 2.82 ( self-report ) , and 2.07 ( assessor-rated ) . The controlled effect sizes for CT versus WL post-treatment scores were 2.25 ( self-report ) and 2.18 ( assessor-rated ) . As predicted by the cognitive model , good treatment outcome was related to greater changes in dysfunctional post-traumatic cognitions . Patient characteristics such as comorbidity , type of trauma , history of previous trauma , or time since the traumatic event did not predict treatment response , however , low educational attainment and low socioeconomic status were related to better outcome BACKGROUND Child sexual abuse ( CSA ) is associated with the development of a variety of mental health disorders , and Trauma-Focused Cognitive Behavioral Therapy ( TF-CBT ) is an established treatment for children who have experienced CSA . However , there are questions about how many TF-CBT sessions should be delivered to achieve clinical efficacy and whether a trauma narrative ( TN ) component is essential . This study examined the differential effects of TF-CBT with or without the TN component in 8 versus 16 sessions . METHODS Two hundred and ten children ( aged 4 - 11 years ) referred for CSA and posttraumatic stress disorder symptoms were r and omly assigned to one of the four treatment conditions : 8 sessions with no TN , 8 sessions with TN , 16 sessions with no TN , and 16 sessions with TN . RESULTS Mixed-model ANCOVAs demonstrated that significant posttreatment improvements had occurred with respect to 14 outcome measures across all conditions . Significant main and interactive effect differences were found across conditions with respect to specific outcomes . CONCLUSIONS TF-CBT , regardless of the number of sessions or the inclusion of a TN component , was effective in improving participant symptomatology as well as parenting skills and the children 's personal safety skills . The eight session condition that included the TN component seemed to be the most effective and efficient means of ameliorating parents ' abuse-specific distress as well as children 's abuse-related fear and general anxiety . On the other h and , parents assigned to the 16 session , no narrative condition reported greater increases in effective parenting practice s and fewer externalizing child behavioral problems at posttreatment To investigate when and why therapists opt for or rule out imaginal exposure ( IE ) for patients with posttraumatic stress disorder ( PTSD ) , 255 trauma experts were r and omized to two conditions in which they were presented with four cases in which the patients ' comorbidity and treatment preferences were manipulated . The results confirmed IE to be an underutilized approach , with the majority of professionals being undertrained in the technique . As predicted , the patient factors influenced the expert 's choice of therapy : in case of a comorbid depression ,  IE  was significantly less preferred than medication . Also ,  IE  was significantly more likely to be offered when patients expressed a preference for trauma-focused treatment . The therapist factors were also found to be importantly related to treatment preferences , with high credibility in the technique being positively related to the therapists ' preference for  IE .  Perceived barriers to  IE  , such as a fear of symptom exacerbation and dropout , were negatively related to the perceived suitability of the treatment when patients had suffered multiple traumas in childhood . The results are discussed in the light of clinical implication s and the need of exposure training for trauma professionals The efficacy of Trauma-Focused Cognitive Behavioral Therapy ( TF-CBT ) has been shown in several r and omized controlled trials . However , to our knowledge no one has studied the TF-CBT model from a user 's perspective . The objective of this study was to explore traumatized youths ' experiences of receiving TF-CBT .  Thirty youths between 11 and 17 years old ( M=15 , SD=1.8 ) were interviewed using a semi-structured interview guide after they had received TF-CBT as part of an effectiveness trial . The interviews were analyzed according to thematic analysis . The youths ' responses were grouped into four themes : ( 1 ) expectations , ( 2 ) experiences of talking to the therapist and sharing information , ( 3 ) experiences of trauma narrative work , and ( 4 ) experiences of change and change processes . Findings showed how an initial fear of talking about traumatic events and not knowing what to expect from therapy was reduced when the youth experienced the therapist as empathetic and knowledgeable . Talking to the therapist was experienced as positive because of the therapist 's expertise , neutrality , empathy , and confidentiality . Talking about the trauma was perceived as difficult but also as most helpful . Learning skills for reducing stress was also perceived as helpful . Important change processes were described as resuming normal functioning and getting " back on track , " , or as acquiring new perspectives and " moving forward . " Because TF-CBT is recommended as a first line treatment for traumatized youth and treating posttraumatic stress may entail special challenges , underst and ing more about how youths experience this mode of treatment contributes to our knowledge base and may help us tailor interventions 
    Output:
    
Youth were often unclear about what to expect from treatment and concerned about (in)compatibility with their therapist .
Youth reports indicated how such misgivings can be addressed through early psychoeducation and efforts to strengthen the therapeutic alliance .
Once underway , treatment was viewed as a place of refuge and validation , aided by therapist competence and confidentiality .
Youth and caregivers felt that constructing a trauma narrative was instrumental for recovery .
Cognitive-behavioural coping techniques were useful during treatment and in the long-term .
While participants in TF-CBT may begin treatment with unclear expectancies , careful attention to early engagement and other process issues can optimise process and outcomes .