Another RCT assessing the effi- cacy of combination treatment com- pared with medication alone was conducted in adolescents with treat- ment-resistant depression, defined as those youth who had not responded to an initial adequate trial of a selective serotonin reuptake inhibitor (SSRI). In the Treatment of Resistant Depres- sion in Adolescents (TORDIA), 334 adolescents were randomly assigned to receive either a medication switch (a different SSRI or venlafaxine) or a medication switch plus CBT.The addition of CBT resulted in a higher rate of treatment response(55%) as compared with a switch in medication only (41%).18 Although TADS and TORDIA demonstrated superiority of combination treatment for the primary outcomes, other stud- ies have found that combination treat- ment may not be more effective than medication plus good clinical manage- ment.19-21 However, negative results in these studies may be the result of too few CBT sessions, inadequate doses of medication, and the inclusion of a more severe sample.