***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 and Aims Cognitive behavioral group therapy ( CBGT ) is an effective , well-established , but not widely available treatment for  social anxiety disorder ( SAD ) .  Internet-based cognitive behavior therapy ( ICBT ) has the potential to increase availability and facilitate dissemination of therapeutic services for SAD . However , ICBT for SAD has not been directly compared with in-person treatments such as CBGT and few studies investigating ICBT have been conducted in clinical setting s. Our aim was to investigate if ICBT is at least as effective as CBGT for SAD when treatments are delivered in a psychiatric setting . Methods We conducted a r and omized controlled non-inferiority trial with allocation to ICBT ( n = 64 ) or CBGT ( n = 62 ) with blinded assessment immediately following treatment and six months post-treatment . Participants were 126 individuals with SAD who received CBGT or ICBT for a duration of 15 weeks . The Liebowitz Social Anxiety Scale ( LSAS ) was the main outcome measure . The following non-inferiority margin was set : following treatment , the lower bound of the 95 % confidence interval ( CI ) of the mean difference between groups should be less than 10 LSAS-points . Results Both groups made large improvements . At follow-up , 41 ( 64 % ) participants in the ICBT group were classified as responders ( 95 % CI , 52%–76 % ) . In the CBGT group , 28 participants ( 45 % ) responded to the treatment ( 95 % CI , 33%–58 % ) . At post-treatment and follow-up respectively , the 95 % CI of the LSAS mean difference was 0.68–17.66 ( Cohen ’s d between group = 0.41 ) and −2.51–15.69 ( Cohen ’s d between group = 0.36 ) favoring ICBT , which was well within the non-inferiority margin . Mixed effects models analyses showed no significant interaction effect for LSAS , indicating similar improvement across treatments ( F = 1.58 ; df = 2 , 219 ; p = .21 ) . Conclusions ICBT delivered in a psychiatric setting can be as effective as CBGT in the treatment of SAD and could be used to increase availability to CBT . Trial Registration Clinical Trials.gov In web-based health promotion programs , large variations in participant engagement are common . The aim was to investigate determinants of high use of a  worksite self-help web-based program for  stress management . Two versions of the program were offered to r and omly selected departments in IT and media companies . A static version of the program including health screening tool , diary and information about stress was offered to the control group . Additional material s , i.e. interactive , cognitive-based and classical stress management exercises and a chat room , were offered to the intervention group . Baseline data regarding participants ' demographics , health ( self-ratings and biological measures ) , lifestyle , work-related factors and group membership were analyzed to study determinants of employees ' participation in the program during a period of 12 months . Multiple logistic regression analysis was used and found intervention group membership , being a woman , having at most a secondary education , regular physical exercise habits and having positive expectations of the program were significant predictors of high use . The findings demonstrate that the interactivity of a web-based program is an important factor for determining participation in a web-based worksite stress management  program . Implication s for those developing and implementing future web-based health promotion activities are discussed Background Social anxiety disorder ( SAD ) is one of the most common anxiety disorders and is associated with marked impairments . However , a small proportion of individuals with SAD seek and receive treatment . Internet-administrated cognitive behavior therapy ( iCBT ) has been found to be an effective treatment for SAD . This trial will be the first Internet-delivered guided self-help intervention for SAD in Romania . Methods Participants with social anxiety disorder ( N = 96 ) will be recruited via newspapers , online banners and Facebook . Participants will be r and omized to either : a ) an active treatment , or b ) a waiting list control group . The treatment will have a guided iCBT format and will last for nine weeks . Self-report question naires on social phobia , anxiety , depression , treatment credibility and irrational thinking will be used . All assessment s will be collected pre , post and at follow-up ( six months after intervention ) . Liebowitz Social Anxiety Scale – Self-Report version ( LSAS-SR ) will be the primary outcome measure and will be administrated on a weekly basis in both conditions . Discussion The present r and omized controlled trial investigates the efficacy of an Internet-administered intervention in reducing social anxiety symptoms in a culture where this form of treatment has not been tested . This trial will add to the body of knowledge on the efficacy of iCBT , and the results might lead to an increase of the accessibility of evidence -based psychological treatment in Romania . Trial registration Clinical Trials.gov : The mental health challenges of some vocations present a challenge for current intervention models . Bibliotherapy focused on transdiagnostic processes that might both prevent and alleviate a range of mental health distress could be an effective and practical approach . K-12 school personnel ( N = 236 ; 91 % female ; 30 - 60 years old ) responding to a wellness-oriented program announcement  were r and omized to receive an Acceptance and Commitment Therapy ( ACT ) self-help volume or to a waitlist . Three-fourths were above clinical cutoffs in general mental health , depression , anxiety , or stress . Participants read the book for two months , completed exercises and quizzes , and after post assessment were followed for 10 weeks ; waitlist participants were then also given the book with two months to complete it . Overall , participants showed significant improvement in psychological health . Significant preventive effects for depression and anxiety were observed along with significant ameliorative effects for those in the clinical ranges of depression , anxiety and stress . Follow up general mental health , depression , and anxiety outcomes were related to the manner in which participants used the workbook and to post levels of psychological flexibility Bibliotherapy is potentially effective in the treatment of panic disorder ( PD ) . A still unanswered question is whether pacing is important . This study was design ed to test whether there is a difference between being assigned a full book as therapy and receiving one individual chapter every week ( i.e. pacing ) . A total of 28 participants were r and omized to either 10 paced chapters or one book with 10 chapters . To maximize compliance , short weekly telephone calls were added in both conditions ( M = 17.8 min , SD = 4.2 ) . Both treatments showed promising results , with effects maintained up to 2 years and with within-group effect sizes ( Cohen 's d ) between 0.95 and 1.11 . Pretreatment ratings of credibility were positively correlated with the change scores at both posttest and 2-year follow-up for three panic measures . Pacing of text material in bibliotherapy for PD is not needed , and all material can be provided at once when the treatment is guided by a therapist BACKGROUND Although effective therapies for social phobia exist , many individuals refrain from seeking treatment owing to the embarrassment associated with help-seeking . Internet-based cognitive-behavioural self-help can be an alternative , but adherence is a problem . AIMS To evaluate a 9-week programme of internet-based therapy design ed to increase treatment adherence by the addition of short weekly telephone calls , nine in all , with a total duration of 95 min . METHOD In a r and omised controlled trial the effects of internet-based cognitive-behavioural therapy in the treatment group ( n=29 ) were compared with a waiting-list control group ( n=28 ) . RESULTS Compared with the control group the treated participants experienced greater reductions on measures of general and social anxiety , avoidance and depression . Adherence to treatment was high , with 93 % finishing the complete treatment package . One year later all improvements were maintained . CONCLUSIONS This study provides evidence to support the use of internet-based treatment supplemented by short , weekly telephone calls Objective : This study aim ed to compare the effectiveness of computerised cognitive behaviour therapy ( CCBT ) with a wait list control ( WLC ) for the treatment of patients with an anxiety disorder ( social phobia , panic disorder , generalised anxiety disorder ) referred to a specialist , publically funded , outpatient anxiety service . Method : Patients with social phobia ( n = 37 ) , panic disorder ( n = 32 ) or generalised anxiety disorder ( n = 14 ) were r and omised to treatment with either  CCBT  ( n = 40 ) or  WLC  ( n = 43 ) .  Self-report rating scale assessment s were conducted at baseline , 12 and 24 weeks . Results : Compared with WLC , the CCBT group improved significantly on approximately half of the self-report primary ( the Work and Social Adjustment Scale ) and approximately half of the secondary measures at both 12 and 24 weeks ( the Liebowitz Social Anxiety Scale , the Penn State Worry Question naire , the Generalised Anxiety inventory and the Fear Question naire ) . Effect sizes in this study were moderate . Conclusion : This is one of the few studies to investigate CCBT for anxiety disorders in patients in a secondary care service . The results show that CCBT in this secondary care setting has the potential to be beneficial and confirms and extends the findings from previous studies of self-referral or primary care setting Background Phobic disorders are highly prevalent and constitute a considerable burden for patients and society . As patients wait for face-to-face psychotherapy for phobic disorders in outpatient clinics , this time can be used for guided self-help interventions . The aim of this study is to investigate a five week internet-based guided self-help programme of exposure therapy in terms of clinical effectiveness and impact on speed of recovery in psychiatric out patients , as well as the cost-effectiveness of this pre-treatment waiting list intervention . Methods / design A r and omised controlled trial will be conducted among 244 Dutch adult patients recruited from waiting lists of outpatient clinics for face-to-face psychotherapy for phobic disorders . Patients suffering from at least one DSM-IV classified phobic disorder ( social phobia , agoraphobia or specific phobia ) are r and omly allocated ( at a 1:1 ratio ) to either a five-week internet-based guided self-help program followed by face-to-face psychotherapy , or a control group followed by face-to-face psychotherapy . Waiting list status and duration are unchanged and actual need for further treatment is evaluated prior to face-to-face psychotherapy .  Clinical and economic self- assessment measurements take place at baseline , post-test ( five weeks after baseline ) and at 3 , 6 , 9 and 12 months after baseline . Discussion Offering pre-treatment internet-based guided self-help efficiently uses time otherwise lost on a waiting list and may increase patient satisfaction . Patients are expected to need fewer face-to-face sessions , reducing total treatment cost and increasing speed of recovery .  Internet-delivered treatment for phobias may be a valuable addition to psychotherapy as dem and for outpatient treatment increases while budgets decrease . Trial registration Netherl and s Trial Register Background Internet support groups ( ISGs ) are popular , particularly among people with depression , but there is little high quality evidence concerning their effectiveness . Aim The study aim ed to evaluate the efficacy of an ISG for reducing depressive symptoms among community members when used alone and in combination with an automated Internet-based psychotherapy training program . Method Volunteers with elevated psychological distress were identified using a community-based screening postal survey . Participants were r and omised to one of four 12-week conditions : depression Internet Support Group ( ISG ) , automated depression Internet Training Program ( ITP ) , combination of the two ( ITP+ISG ) , or a control website with delayed access to e-couch at 6 months . Assessment s were conducted at baseline , post-intervention , 6 and 12 months . Results There was no change in depressive symptoms relative to control after 3 months of exposure to the ISG . However , both the ISG alone and the combined ISG+ITP group showed significantly greater reduction in depressive symptoms at 6 and 12 months follow-up than the control group . The ITP program was effective relative to control at post-intervention but not at 6 months . Conclusions ISGs for depression are promising and warrant further empirical investigation . Trial Registration Controlled-Trials.com IS RCT BRUCE BAKERHarvard UniversityPhobic Ss were r and omly assigned to 1 of 2 treatment groups : ( 1 ) a " conven-tional desensitization " group , which was treated by a therapist in the labora-tory , or ( 2 ) a " do-it-yourself " group , which carried out the desensitizationprocess at home . For the latter , the only therapist contact was an initialinterview and a weekly progress-check phone call . According to Ss ' reportsof success , both groups did equally well . These results are discussed withrespect to the relative importance of relationship and content in the therapeuticprocess Background Interventions to promote mental well-being can bring benefits to the individual and to society . The Internet can facilitate the large-scale and low-cost delivery of individually targeted health promoting interventions . Objective To evaluate the effectiveness of a self-directed Internet-delivered cognitive-behavioral skills training tool in improving mental well-being in a population sample . Methods This was a r and omized trial with a waiting-list control . Using advertisements on a national health portal and through its mailing list , we recruited 3070 participants aged 18 or over , resident in Engl and , and willing to give their email address and access a fully automated Web-based intervention . The intervention ( MoodGYM ) consisted of 5 interactive modules that teach cognitive-behavioral principles . Participants in the intervention arm received weekly email reminders to access the intervention 
    Output:
    
Self-help may be useful for people who are not able or are not willing to use other services for people with anxiety disorders ; for people who can access it , face-to-face cognitive behavioural therapy is probably clinical ly superior .
Recent interventions for specific problems that incorporate clinician support may be more effective than transdiagnostic interventions ( i.e. interventions for multiple disorders ) provided with no guidance , but these issues are confounded in the available trials .