Most of the earlier studies com- pared CBT to treatment as usual, wait- list controls, or to alternative CBT formats (eg, with or without parent training). Reviewers have noted the need for additional studies with the following aims: to assess the compar- ative efficacy of CBT, medication, and their combination; to provide a better understanding of characteristics that might influence treatment response; to investigate the effective components of CBT; and to demonstrate the long- term effects of CBT and subsequent effect on relapse and recurrence.14,15 This article outlines initial findings related to these important areas iden- tified for further research.On the other hand, estimates from a meta-analysis of randomized con- trolled trials indicate that the effects of psychotherapy for the treatment of depression in youth were modest (mean effect size = 0.34), across all types of psychotherapy.10