***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 Although literature provides support for cognitive behavioral therapy ( CBT ) as an efficacious intervention for social phobia , more research is needed to improve treatments for children . Methods Forty four Caucasian children ( ages 8 - 14 ) meeting diagnostic criteria of social phobia according to the Diagnostic and Statistical Manual of Mental Disorders ( 4th ed . ; APA , 1994 ) were r and omly allocated to either a newly developed CBT program focusing on cognition according to the model of Clark and Wells ( n = 21 ) or a wait-list control group ( n = 23 ) . The primary outcome measure was clinical improvement . Secondary outcomes included improvements in anxiety coping , dysfunctional cognitions , interaction frequency and comorbid symptoms . Outcome measures included child report and clinican completed measures as well as a diagnostic interview . Results Significant differences between treatment participants ( 4 dropouts ) and controls ( 2 dropouts ) were observed at post test on the German version of the Social Phobia and Anxiety Inventory for Children . Furthermore , in the treatment group , significantly more children were free of diagnosis than in wait-list group at post-test . Additional child completed and clinician completed measures support the results . Discussion The study is a first step towards investigating whether CBT focusing on cognition is efficacious in treating children with social phobia .  Future research will need to compare this treatment to an active treatment group . There remain the questions of whether the effect of the treatment is specific to the disorder and whether the underlying theoretical model is adequate . Conclusion Preliminary support is provided for the efficacy of the cognitive behavioral treatment focusing on cognition in socially phobic children . Active comparators should be established with other evidence -based CBT programs for anxiety disorders , which differ significantly in their dosage and type of cognitive interventions from those of the manual under evaluation ( e.g. Coping Cat ) Most r and omized controlled trials of cognitive-behavioral therapy ( CBT ) for children with anxiety disorders have evaluated treatment efficacy using recruited sample s treated in research setting s. Clinical trials in school setting s are needed to determine if CBT can be effective when delivered in real world setting s. This study evaluated a modular CBT program for childhood anxiety disorders in two elementary schools . Forty children ( 5 - 12 years old ) with anxiety disorders , referred by teachers and school staff , were r and omly assigned to modular CBT or a 3-month waitlist . Clinicians worked with individual families as well as teachers and school staff . Evaluators blind to treatment condition conducted structured diagnostic interviews and caregivers and children completed symptom checklists at pre- and posttreatment . The primary study outcome , the Clinical Global Impressions-Improvement scale , yielded a positive treatment response at posttreatment for 95.0 % of CBT participants , as compared with only 16.7 % of the waitlist participants . CBT also outperformed the waitlist on diagnostic outcomes and caregiver-report measures of anxiety . Treatment effects did not extend beyond anxiety diagnoses and symptoms . Results suggest that modular CBT delivered within the elementary school setting may be effective for the treatment of  child anxiety disorders .  A replication of the study results with a larger sample is indicated This study evaluated the effectiveness of cognitive-behavioral treatment  for  childhood anxiety  in a community clinic setting in Hong Kong , China . Forty-five clinical ly-referred children ( age 6 - 11 years ) were r and omly assigned to either a cognitive-behavioral treatment program or a waitlist-control condition . Children in the treatment condition showed significant reduction in anxiety symptoms-both statistically and clinical ly-whereas children in the waitlist condition did not . After the waitlist period was over , the control group also received the treatment program and showed a similar reduction in symptoms . For the full sample of 45 children , the effectiveness of the intervention was significant immediately after treatment and in 3- and 6-month follow-ups . In addition , children 's anxiety cognition and their ability to cope with anxiety-provoking situations fully mediated the treatment gains . These results offer empirical support for cognitive-behavioral treatment programs in a non-Western cultural context and plausible mediators for how cognitive-behavioral therapy works OBJECTIVE Examine the efficacy of a personalized , modular cognitive-behavioral therapy ( CBT ) protocol among early adolescents with high-functioning autism spectrum disorders ( ASDs ) and co-occurring anxiety relative to treatment as usual ( TAU ) . METHOD Thirty-one children ( 11 - 16 years ) with ASD and clinical ly significant anxiety were r and omly assigned to receive 16 weekly CBT sessions or an equivalent duration of TAU . Participants were assessed by blinded raters at screening , posttreatment , and 1-month follow-up . RESULTS Youth r and omized to CBT demonstrated superior improvement across primary outcomes relative to those receiving TAU . Eleven of 16 adolescents r and omized to CBT were treatment responders , versus 4 of 15 in the TAU condition . Gains were maintained at 1-month follow-up for CBT responders . CONCLUSIONS These data extend findings of the promising effects of CBT in anxious youth with ASD to early adolescents Acceptance and Commitment Therapy ( ACT ) has a growing empirical base in the treatment of anxiety among adults and children with other concerns . This study reports on the main outcomes of a r and omized controlled trial of ACT and traditional cognitive behavioral therapy ( CBT ) in children with a Diagnostic and Statistical Manual of Mental Disorders ( 4th ed . ) anxiety disorder . Participants were 193 children from urban Sydney , Australia , who were block-r and omized to a 10-week group-based program of ACT or CBT or a 10-week waitlist control ( WLC ) .  Completers included 157 children ( ACT = 54 , CBT = 57 , WLC = 46 ; M = 11 years , SD = 2.76 ; 78 % Caucasian , 58 % female ) . Pretreatment , posttreatment , and 3 months posttreatment assessment s included clinician/self/parent-reported measures of anxiety , quality of life ( QOL ; anxiety interference , psychosocial and physical health-related QOL ) , and acceptance/defusion outcomes . Completer and intention-to-treat analyses revealed that ACT and CBT were both superior to WLC across outcomes , reflecting statistically and clinical ly significant differences , with gains maintained at 3 months posttreatment . Both completer and intention-to-treat analyses found ACT and CBT to produce similar outcomes . There was some support for ACT having greater effect sizes for QOL outcomes but not for avoidance/fusion . Although this study does not suggest that ACT is equivalent to CBT or should be adopted in its place , it does provide evidence that ACT might be another empirically supported treatment option for anxious youth . Further research is needed to replicate these findings This study compared individual cognitive behavioral therapy ( CBT ) and a supportive child-centered therapy ( CCT ) for child anxiety disorders on rates of treatment response and recovery at posttreatment and 1-year follow-up , as well as on real-world measures of emotional functioning . Youth ( N = 133 ; ages 9–14 ) with anxiety disorders ( generalized , separation , and /or social anxiety ) were r and omized using a 2:1 ratio to CBT ( n = 90 ) or CCT ( n = 43 ) , which served as an active comparison . Treatment response and recovery at posttreatment and 1-year follow-up were assessed by Independent Evaluators , and youth completed ecological momentary assessment of daily emotions throughout treatment . The majority of youth in both CBT and CCT were classified as treatment responders ( 71.1 % for CBT , 55.8 % for CCT ) , but youth treated with CBT were significantly more likely to fully recover , no longer meeting diagnostic criteria for any of the targeted anxiety disorders and no longer showing residual symptoms ( 66.7 % for CBT vs. 46.5 % for CCT ) . Youth treated with CBT also reported significantly lower negative emotions associated with recent negative events experienced in daily life during the latter stages of treatment relative to youth treated with CCT . Furthermore , a significantly higher percentage of youth treated with CBT compared to CCT were in recovery at 1-year follow-up ( 82.2 % for CBT vs. 65.1 % for CCT ) . These findings indicate potential benefits of CBT above and beyond supportive therapy on the breadth , generalizability , and durability of treatment-related gains Individual cognitive-behavioral therapy ( CBT ) provides anxious youth with skills and experiences to increase " brave " behavior in the face of feared situations . This study addresses whether parental encouragement of bravery during an anxiety provoking and potentially avoidable naturalistic speech task ( a ) differs between parents of youth ( ages 9 - 13 ) with anxiety disorders ( N=47 ) and parents of healthy non-anxious controls ( N=20 ) ; ( b ) influences response to treatment ; and ( c ) changes during treatment for anxious youth r and omized to receive CBT ( N=30 ) or Child-Centered Therapy ( CCT ; a non-directive active comparison treatment ; N=17 ) . Parent-child dyads were videotaped during a discussion of whether or not the child should complete an optional speech task . Parents of anxious youth showed less encouragement of bravery than parents of controls .  Encouragement of bravery increased from pre- to post-treatment for youth who received CBT but not CCT , and pre-treatment encouragement of bravery predicted a better response to treatment , particularly for youth receiving CBT BACKGROUND Social anxiety disorder ( SAD ) typically onsets in adolescence and is associated with multiple impairments . Despite promising clinical interventions , most socially anxious adolescents remain untreated . To address this clinical neglect , we developed a school-based , 12-week group intervention for youth with SAD , Skills for Academic and Social Success ( SASS ) . When implemented by psychologists , SASS has been found effective . To promote dissemination and optimize treatment access , we tested whether school counselors could be effective treatment providers . METHOD We r and omized 138 , ninth through 11th grade rs with SAD to one of three conditions : ( a ) SASS delivered by school counselors ( C-SASS ) , ( b ) SASS delivered by psychologists ( P-SASS ) , or ( c ) a control condition , Skills for Life ( SFL ) , a nonspecific counseling program . Blind , independent , evaluations were conducted with parents and adolescents at baseline , post-intervention , and 5 months beyond treatment completion . We hypothesized that C-SASS and P-SASS would be superior to the control , immediately after treatment and at follow-up . No prediction was made about the relative efficacy of C-SASS and P-SASS . RESULTS Compared to controls , adolescents treated with C-SASS or  P-SASS  experienced significantly greater improvement and reductions of anxiety at the end of treatment and follow-up . There were no significant differences between SASS delivered by school counselors and psychologists . CONCLUSION With training , school counselors are effective treatment providers to adolescents with social anxiety , yielding benefits comparable to those obtained by specialized psychologists . Questions remain regarding means to maintain counselors ' practice st and ards without external support Background : Very few studies have investigated the effects of individual disorder-specific treatment of social phobia ( SP ) in adolescents . The objective of this study was to compare the effects of individual cognitive therapy for SP , group cognitive behavioural therapy ( CBTG ) and attentional placebo ( AP ) among adolescents with a primary diagnosis of SP . Methods : A r and omized controlled design was used , and a total of 279 adolescents were assessed . Fifty-seven adolescents , between 13 and 16 years old , were allocated to individual cognitive therapy , CBTG or AP . The participants were assessed before treatment , at the end of treatment and at a 12-month follow-up using both self-report and a semi-structured interview . Results : The individual cognitive therapy showed significant reductions in symptoms , impairment and diagnostic criteria both at the end of treatment and at the 12-month follow-up . Compared with CBTG and AP , the individual cognitive therapy group demonstrated significantly greater effects on both symptom reduction and impairment . There were no significant differences between CBTG and AP . Conclusions : In a direct comparison between the most commonly used treatments for adolescent SP , we found that individual therapy was the most effective , yielding better effects than both CBTG and AP OBJECTIVE Most tests of cognitive behavioral therapy ( CBT ) for youth anxiety disorders have shown beneficial effects , but these have been efficacy trials with recruited youths treated by research er-employed therapists . One previous ( nonr and omized ) trial in community clinics found that CBT did not outperform usual care ( UC ) . The present study used a more stringent effectiveness design to test CBT versus UC in youths referred to community clinics , with all treatment provided by therapists employed in the clinics . METHOD A r and omized controlled trial methodology was used . Therapists were r and omized to training and supervision in the Coping Cat CBT program or UC .  Forty-eight youths ( 56 % girls , 8 to 15 years of age , 38 % Caucasian , 33 % Latino , 15 % African-American ) diagnosed with DSM-IV anxiety disorders were r and omized to CBT or UC . RESULTS At the end of treatment more than half the youths no longer met criteria for their primary anxiety disorder , but the groups did not differ significantly on symptom ( e.g. , parent report , eta-square = 0.0001 ; child report , eta-square = 0.09 ; both differences favoring UC ) or diagnostic ( C 
    Output:
    
The overall results indicated that CBT is an effective treatment for childhood AD .
The results showed that individual-based CBT is superior to wait-list and attention control .
Group-based CBT is superior to wait-list control and treatment as usual .
Remote-based CBT was superior to attention control and wait-list control .
Family-based CBT was superior to treatment as usual , wait-list control , and attention control .
Selective serotonin reuptake inhibitors  were no more effective than individual-based CBT .
Combination treatment  was , however , more effective than individual-based CBT .
Conclusion : To the best of our knowledge , no meta- analysis has thus far disentangled the effects of CBT modalities across various comparisons .
This meta- analysis hence provides an important up date to the literature on the efficacy of CBT for treating anxiety disorders in young people