EFFECTIVE COMPONENTS OF CBTGiven the variety of treatment man- uals and methods, researchers have begun to examine the particular com- ponents of CBT that most directly con- tribute to symptom relief and positive treatment effects. To achieve favorable outcomes in CBT, patients need to at- tend an adequate number of sessions. In general, longer treatment protocols may have better outcomes than those with fewer scheduled sessions, with 16 sessions being the most common effec- tive length.25 In a study of treatment- resistant depression, adolescents who received nine or more sessions had a higher rate of response than those with fewer CBT sessions.26 Effective core skills tend to include an emphasis on cognitive restructuring and/or behavioral activation.25,27 Teaching problem-solving and social skills, espe- cially among treatment-resistant depressed youth, has also been found to be an im- portant component of CBT.26 Although some protocols rely more heavily on one or the other of these primary components, it appears that sufficient time must be spent on the teaching and practicing of any one component to yield positive results.25 Thus, youth appear to gain greater benefit with CBT when given sufficient time for skill acquisition, with the most effective skills being cognitive restructuring, behavioral activation, and problem-solving.