What builds the bond? Child and therapist behavior in a group intervention for aggression.

Introduction: Puppets are an important educational and therapeutic agent, and an impetus for creative expression in children. Therefore, educators in kindergarten should be familiar with puppets as a medium which is able to stimulate the development of the children. The main goal of this study was to answer the question: are there differences in prosocial and aggressive behavior in preschool children in relation to the frequency of the teacher’s use of puppets in her educational work? Materials and methods: Twenty teachers in kindegartens assessed the level of prosocial or aggressive behavior in 248 children, from kindergartens in the Split-Dalmatia County, aged 5.5 to 7 years (each teacher assessed the children in the educational groups of children in the study themselves). The children were placed in an experimental (in which the educator often uses a paper doll) or a control group (in which the educator very rarely used a paper doll). Teachers assessed the behavior of the children in their own educational group in the kindergarten using a scale for assessing prosocial and aggressive behavior in children (Žužul and Vlahovic-Štetić). Results: Results of the variance analysis showed that children in the experimental and control groups differed significantly in the prevalence of aggressive and prosocial behavior. Aggressive behavior was significantly more frequent in the control group and prosocial in the experimental group. In both groups, these two types of behaviors were negatively and significantly correlated. Discussion: The main finding of this research suggests that regular use of different methods of using puppets in educational work in kindergartens is correlated with the appearance of two forms of social behavior of children (prosocial and aggressive). These results can provide guidance for practical work, with a potential desirable impact on children, preferably using puppets in educational work. Conclusion: Children in the experimental group (more frequent use of puppets in educational work), were assessed by the teachers as more prosocial and less aggressive than in the control group of children. The relationship between prosocial and aggressive behavior in children is negative and statistically significant in the experimental, as well as in the control group.

Aggressive behaviors in schools have the potential to cause serious harm to students' emotional and social well-being and to limit their ability to achieve their full academic potential. Prevention programs developed to reduce children's aggressive behaviors in school settings can provide interventions at a universal or targeted level. The main aim of our randomized control study was to examine the efficacy of Coping Power, adapted as a universal prevention program, in reducing children's behavioral problems and improving school grades. Nine classes participated (184 students, mean age 91months) from two elementary state schools in Tuscany, Italy. Study findings showed a significant reduction in behavioral problems and an improvement in school grades for the intervention classes relative to the control classes. This study suggests the Coping Power program can be delivered in school settings at both universal and targeted prevention levels, and that in this multi-tiered prevention model, teachers, educators and school psychologists can learn a set of intervention skills which can be delivered with flexibility, thus reducing some of the complexity and costs of schools using multiple interventions.

In the context of the transformational processes of Ukrainian society, the problem of violent and aggressive behavior among adolescents is particularly acute nowadays. Domestic crime statistics shows that a significant proportion of crimes among minors belongs to violent crimes. The scientific problem is the need to explain the specific features of aggressive and violent behavior in adolescent children. The purpose of the article is to reveal some aspects of aggressive and violent behavior among adolescents. Most researchers identify aggression as an act or behavior aimed at causing harm to another being or object. It is difficult to determine the level of personal tendency of aggression. Only external manifesta- tions of aggression are available for observation and intervention, that is, aggressive behavior, which is in essence related to the concept of violence. According to Zmanovska E.V. and Rybnikova V.U., aggressive behavior includes: hostile setting, aggressive emotions, aggression and violence. The phenomenon of violence can take different forms, but is mainly represented through the interaction of two sides, a violatorIn the context of the transformational processes of Ukrainian society, the problem of violent and aggressive behavior among adolescents is particularly acute nowadays. Domestic crime statistics shows that a significant proportion of crimes among minors belongs to violent crimes. The scientific problem is the need to explain the specific features of aggressive and violent behavior in adolescent children. The purpose of the article is to reveal some aspects of aggressive and violent behavior among adolescents.Most researchers identify aggression as an act or behavior aimed at causing harm to another being or object. It is difficult to determine the level of personal tendency of aggression. Only external manifestations of aggression are available for observation and intervention, that is, aggressive behavior, which is in essence related to the concept of violence. According to Zmanovska E.V. and Rybnikova V.U., aggressive behavior includes: hostile setting, aggressive emotions, aggression and violence. The phenomenon of violence can take different forms, but is mainly represented through the interaction of two sides, a violator and a victim. The nature of violence, from the point of view of sociology, can be both a product of real con- tradictions and purely symbolic processes. Socio-cognitive explanations describe aggressive behavior as a deficit of social competence, which is based on the problems of information processing. The defining role in the use of violence, as it is defined by A. Bandura, is also played by the previous positive experience of the successful use of violence to meet their needs. A. Adler explained violent and aggressive behavior as a desire for domination and self – affirmation. It should be noted that juvenile tumors increase the desire to meet the ways and ideas about the success of the individual accepted in the society. According to the rep- resentatives of constructivism, physical violence, as well as other manifestations of deviant and delinquent behavior, is a social construct.The content of physical violence differs from its evaluation. The objective factor of violence is not the natural tendency of man, but social norms, artificially created barriers and the restriction of the freedom of people. The greatest number of barriers and constraints falls on adolescent children whose criminal activity has been increasing in recent years. Moreover, the nature of this activity has threatening features of insolence, cruelty, cynicism, and violence. The motive for breaking the taboo in the myth arises in close connection with the initiation motive. For a child, the violation of any social taboo turns into a phenomenon of demonstration acquired, due to initiation, maturity, of his/her new social status. H. Heckhauzen deter- mines that very often aggression serves other motives, such as power and dominance, that is, in essence, defined as instrumental aggression. Physical violence among teenagers is not merely a ritual of initiation, it is a construct or a "deconstruct of the masculinity of the victim."Boys who have not been initiated by phys- ical violence become the object of victimization. If they, being men biologically, can not represent specific masculinity in their everyday practices, members of youth groups do not consider them "real men". During initiation, there may be contradictions between the mythological notions of "normative masculinity" and the inability of the "victim" to pass the initiation test. Deconstruction of masculinity can mean temporary, but very difficult, personality reconstruction for boys. Manifestations of physical violence among children are formed not only by their propensity to direct violence but also structural violence, in particular, status inequality. Violent and aggressive actions are part of the ritual of a kind of initiation of adolescents and the establishment of their position in the social system.

<p id="p00015">Aggressive behavior plays an important role in the social, emotional and psychological adjustment of children and adolescents. Children and adolescents with aggressive behavior are prone to violate social moral norms, and even commit crimes in serious cases. It is noted that peer victimization is an important predictor of aggressive behavior. Peer victimization refers to that individuals have experienced attacks by peers, such as physical and verbal victimization, attacks on property and social manipulation. Children and adolescents who have been victimized by peers will characterize the attacker as hostility, which will be generalized to the whole peer group, thus showing more aggressive behavior in future interpersonal communication. Several previous studies have examined the relationship between peer victimization and aggressive behavior in children and adolescents. However, due to differences in research design and inconsistent results, there is still some uncertainty about the relationship between peer victimization and aggressive behavior in children and adolescents, and the moderating effect on this relationship is not fully clear. Therefore, the present study employed a three-level meta-analysis to quantitatively synthesize the results of original literatures to obtain reliable estimates of effect sizes and examined a range of moderators (sample, publication, study design, outcome, and assessment characteristics). Through the retrieval of articles published before October 2020, the current meta-analysis identified 40 studies, with 25,605 participants (range of mean age: 6 ~ 19 years) and 333 independent effect sizes. The funnel plot and Egger's test results suggested an absence of publication bias in current meta-analysis. Analysis revealed a significant positive association between peer victimization and aggressive behavior in children and adolescents (<italic>r</italic> = 0.295, <italic>p</italic> &lt; 0.001), implying that children and adolescents showed a higher level of aggressive behavior when they experienced higher level of peer victimization. In addition, the present study found a significant moderating effect of peer victimization variable. Compared with physical victimization (<italic>r</italic> = 0.219, <italic>p</italic> = 0.005), the association between relational victimization (<italic>r</italic> = 0.298, <italic>p</italic> = 0.005) and aggressive behavior in children and adolescents was stronger. Moreover, the overall association was influenced by region. Aggressive behavior in children and adolescents was more strongly associated with peer victimization in Asia (<italic>r</italic> = 0.351, <italic>p</italic> = 0.006) than in South America (<italic>r</italic> = 0.149, <italic>p</italic> = 0.006). Study design was also a significant moderator. The association between peer victimization and aggressive behavior in children and adolescents was smaller in longitudinal (<italic>r</italic> = 0.234, <italic>p</italic> = 0.014) than in cross-sectional studies (<italic>r</italic> = 0.339, <italic>p</italic> = 0.014). Finally, the moderator analyses also showed that the informant of peer victimization was a significant moderator. The strength of the association between peer victimization and aggressive behavior in children and adolescents was significantly stronger when peer victimization was reported by teachers (<italic>r</italic> = 0.476, <italic>p</italic> = 0.023) than by peers (<italic>r</italic> = 0.290, <italic>p</italic> = 0.023). In addition, the present study found that the overall association between peer victimization and aggressive behavior in children and adolescents did not differ in strength across gender, age, publication, variable and informant of aggressive behavior. Moreover, to eliminate the multicollinearity between moderators, the current study built a multivariate model by including all significant moderators that had been identified in the bivariate models. The result indicated that at least one of the regression coefficients of moderators significantly deviates from zero (<italic>F</italic> (12, 316) = 3.973, <italic>p </italic>&lt; 0.001). In sum, the results of the current meta-analysis contribute to a better understanding of the association between peer victimization and aggressive behavior in children and adolescents. These results also provide a reference for future empirical studies on explaining aggressive behavior in children and adolescents.

Trauma-focused cognitive-behavioral therapy (TF-CBT) is a recommended treatment for posttraumatic stress (PTS) in youth, and a strong therapeutic alliance predicts reductions of PTS in TF-CBT. However, little is known of how therapists can build a strong alliance. This study seeks to understand which therapist behaviors are associated with the strength of alliance in TF-CBT. Participants were 65 youth (M age = 15.1, SD = 2.19; 77% girls) engaged in TF-CBT and their therapists (n = 24). The alliance was assessed midtreatment using the Therapeutic Alliance Scale for Children-revised. Therapists' behaviors were coded using the Adolescent Alliance-Building Scale-revised, and youth engagement behavior was coded using the Behavioral Index of Disengagement Scale. Linear mixed-effects models were used to evaluate clients' and therapists' in-session behaviors as predictors of the alliance, in addition to assessing the potential moderating effects of youth behaviors. Rapport-building behaviors were significantly predictive of higher alliance scores (Est. = 1.81, 95% CI [0.11, 3.52], p = .038), whereas there was no predictive effect of treatment socialization or trauma-focusing behavior on alliance scores. Initial youth behavior significantly moderated the effect of trauma-focusing on the alliance (p = .007); greater focus on trauma was associated with higher alliance scores among passively disengaged youth (Est. = 4.92, 95% CI [1.80, 8.05], p = .003). Rapport-building behaviors are associated with a stronger alliance in TF-CBT. Gradual exposure through initial trauma-eliciting does not appear to undermine alliance formation but is rather associated with higher alliance-scores among passively disengaged youth. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Aggressive behavior can be understood as a behavior that aims to hurt others, both verbally and nonverbally, physically or psychologically and directly or indirectly. Aggressive behavior of school-age children that arise at the age of 6-14 years in the form of anger, irritation, envy, greed, jealousy, and likes to criticize. The purpose of this study was to determine the description of aggressive behavior in school-age children at SD Negeri 064990 Medan. The design used in this research is descriptive. The population in this study were school-aged children in grades IV, V, and VI at SD Negeri 064990 Medan. The sample is 180 respondents using total sampling technique. Data was collected using the Aggressive Behavior questionnaire. The results showed that most of the respondents had aggressive behavior in the moderate category as many as 98 students (54.4%). From the results of this study, it is hoped that the community and families will be better at providing education in the family as well as providing children with social skills and providing information about aggressive behavior to reduce the number of children who behave aggressively. Activities can be carried out through counseling to the community, especially families, to better understand aggressive behavior in children. From the results of this study, it is hoped that the community and families will be better at providing education in the family as well as providing children with social skills and providing information about aggressive behavior to reduce the number of children who behave aggressively. Activities can be carried out through counseling to the community, especially families, to better understand aggressive behavior in children. From the results of this study, it is hoped that the community and families will be better at providing education in the family as well as providing children with social skills and providing information about aggressive behavior to reduce the number of children who behave aggressively. Activities can be carried out through counseling to the community, especially families, to better understand aggressive behavior in children.

Despite frequent reliance on teacher and parent ratings of children's behavior for multi-informant assessment, agreement between teachers' and parents' ratings is low. This study examined the predictive utility of teacher and parent ratings for children's self-regulatory outcomes (i.e., executive function, continuous performance task) in four studies. Study 1 included 163 children ranging from 31 to 84 months of age (M = 55.58 months, SD = 8.43). Study 2 included 1,088 children ranging from 48 to 63 months of age (M = 55.15, SD = 3.65). Study 3 included 246 bilingual Spanish-speaking children ranging from 40 to 72 months of age (M = 56.66, SD = 6.06). Study 4 included 280 children ranging from 38 to 75 months of age (M = 55.92, SD = 4.16). Across studies, parents and teachers rated children's externalizing behaviors on the Conners' Rating Scale, the Strength and Weaknesses of ADHD-Symptoms and Normal Behavior Scale, or both; children completed a variety of performance-based self-regulation tasks. The strength of associations of parent and teacher ratings with self-regulatory outcomes was compared, and regression analyses determined the unique and overlapping variance accounted for by different raters. Teachers' ratings had larger associations with self-regulation than did parents' ratings across outcomes and studies-except for two instances in Study 4 where the associations for teachers' and parents' ratings were equal. These findings indicate that teachers supply more useful information than parents, possibly because teachers have better-informed expectations of children's behavior, and they raise questions about the utility of multi-informant assessment, at least with preschool children.

The effects of video game play on young children's aggression, fantasy, and prosocial behavior

Literature indicates that there existed only low agreement among different informants in the assessment of children's aggressive behavior(Karver,2006;Ladd Kochenderfer-Ladd,2002),which reflects the fact that each informant offers his or her unique perspective on the target children's behavior(Achenbach,1995;Loeber et al.,2000).With the awareness of the disadvantages inherent in the assessment using single informant,MTMM(multitrait-multimethod) design is becoming increasingly popular in research on human development in recent years.The present study investigated the convergent and discriminant validities of MTMM data on children's aggression during middle childhood and the extent to which the validities of assessment varied between peers and teachers as informants.The participants were 2695 children in their middle childhood(mean age = 10.06 ± 0.54 years) with approximately equal number of boys(51.87%) and girls(48.13%) and the children's head teachers(n = 50).These students and teachers were from 50 classrooms in 14 schools in Jinan,capital city of Shandong Province of China.The MTMM data on children's three types of aggression(i.e.physical,verbal and relational) was obtained from two types of informants(peer and teacher) and via three types of methods of data collection(i.e.peer nomination,peer rating and teacher rating).For peer nomination,the Children's Social Behavior Scale(Crick,1997) was used and the children were asked to nominate up to three children who best fitted thedescriptions of items of physical and relational aggression from within their class.Information about children's physical,verbal,and relational aggressions was also obtained via peer rating,in which children rated their peers on a 12-item Aggressive Behavior Questionnaire.In addition,teacher rating was conducted in which the head teacher of each of the participating classroom rated all the children in his/her class on the three types of aggression using a modified version of the aggressive behavior scale(Crick et al.,1997).All measures possessed acceptable reliabilities in this study.Moderate to high correlations existed between the same trait measured using different methods(rs = 0.35 to 0.74).The CFA analysis indicated that all of the loadings of trait factors in the MTMM model were significant,and that the MTMM model better fitted the data than did the method model,reflecting the fact that the indicators measured via different methods concurrently converged on the common trait factors and increased the model fitting.High correlations were found between the different traits measured using the same method(rs = 0.74 to 0.92).Results of the CFA analysis demonstrated high loadings of each method factors of MTMM model(λs 0.60),indicating a low discriminant validity of each of three assessment methods in assessing the three types of aggression.In MTMM model,the loadings of the peer-reported indicators on the aggression factors were higher and companied with smaller errors as compared with those of the teacher-reported indicators.In the two-order model,the method factors of peer report explained a larger proportion of the variations of the second-order factor of aggression than did that of teacher report.Putting together,these results suggested that peer report(peer rating and peer nomination) served as more valid assessment of children's aggression than teacher rating.Moreover,the method factor of peer rating explained a greater proportion of the variations of the second-order factor of aggression than did that of peer nomination,indicating that peer rating was more valid assessment than peer nomination.

The ways that basic theories and findings in cognitive and social psychology (including attribution, decision-making, and information-processing theories) have been applied to the study of aggressive behavior problems in children are described. Following an overview of each of these theories, a social information-processing model of children's aggressive behavior is outlined. According to this model, a child's behavioral response to a problematic social stimulus is a function of five: steps of processing: encoding of social cues, interpretation of social cues, response search, response evaluation, and enactment. Skillful processing at each step is hypothesized to lead to competent performance within a situation, whereas biased or deficient processing is hypothesized to lead to deviant social behavior Empirical studies are described in which children's patterns of processing have been found to predict individual differences in their aggressive behavior The implications of this body of work for empirically based interventions aimed at reducing children's aggressive behavior are discussed.

Methylphenidate (MPH), the most commonly prescribed drug for attention-deficit/hyperactivity disorder (ADHD), has a short half-life, which necessitates multiple daily doses. The need for multiple doses produces problems with medication administration during school and after-school hours, and therefore with compliance. Previous long-acting stimulants and preparations have shown effects equivalent to twice-daily dosing of MPH. This study tests the efficacy and duration of action, in natural and laboratory settings, of an extended-release MPH preparation designed to last 12 hours and therefore be equivalent to 3-times-daily dosing. Sixty-eight children with ADHD, 6 to 12 years old, participated in a within-subject, double-blind comparison of placebo, immediate-release (IR) MPH 3 times a day (tid), and Concerta, a once-daily MPH formulation. Three dosing levels of medication were used: 5 mg IR MPH tid/18 mg Concerta once a day (qd); 10 mg IR MPH tid/36 mg Concerta qd; and 15 mg IR MPH tid/54 mg Concerta qd. All children were currently medicated with MPH at enrollment, and each child's dose level was based on that child's MPH dosing before the study. The doses of Concerta were selected to be comparable to the daily doses of MPH that each child received. To achieve the ascending rate of MPH delivery determined by initial investigations to provide the necessary continuous coverage, Concerta doses were 20% higher on a daily basis than a comparable tid regimen of IR MPH. Children received each medication condition for 7 days. The investigation was conducted in the context of a background clinical behavioral intervention in both the natural environment and the laboratory setting. Parents received behavioral parent training and teachers were taught to establish a school-home daily report card (DRC). A DRC is a list of individual target behaviors that represent a child's most salient areas of impairment. Teachers set daily goals for each child's impairment targets, and parents provided rewards at home for goal attainment. Each weekday, teachers completed the DRC, and it was used as a dependent measure of individualized medication response. Teachers and parents also completed weekly standardized ratings of behavior and treatment effectiveness. To evaluate the time course of medication effects, children spent 12 hours in a laboratory setting on Saturdays and medication effects were measured using procedures and methods adapted from our summer treatment program. Measures of classroom behavior and academic productivity/accuracy were taken in a laboratory classroom setting during which children completed independent math and reading worksheets. Measures of social behavior were taken in structured, small-group board game settings and unstructured recess settings. Measures included behavior frequency counts, academic problems completed and accuracy, independent observations, teacher and counselor ratings, and individualized behavioral target goals. Reports of adverse events, sleep quality, and appetite were collected. On virtually all measures in all settings, both drug conditions were significantly different from placebo, and the 2 drugs were not different from each other. In children's regular school settings, both medications improved behavior as measured by teacher ratings and individualized target behaviors (the DRC); these effects were seen into the evening as measured by parent ratings. In the laboratory setting, effects of Concerta were equivalent to tid MPH and lasted at least through 12 hours after dosing. Concerta was significantly superior to tid MPH on 2 parent rating scores, and when asked, more parents preferred Concerta than preferred tid IR MPH or placebo. Side effects on children's sleep and appetite were similar for the 2 preparations. In the lab setting, both medications improved productivity and accuracy on arithmetic seatwork assignments, disruptive and on-task behavior, and classroom rule following. Both medications improved children's rule following and negative behavior in small group board games, as well as in unstructured recess settings. Individual target behaviors also showed significant improvement with medication across domains in the laboratory setting. Children's behavior across settings deteriorated across the laboratory day, and the primary effect of medication was to prevent this deterioration as the day wore on. Results support the use of background behavioral treatment in clinical trials of stimulant medication, and illustrate the utility of a measure of individualized daily target goals (ie, the DRC) as an objective measure of medication response in both the laboratory and natural school settings. This investigation clearly supports the efficacy of the Concerta long-acting formulation of MPH for parents who desire to have medication benefits for their child throughout the day and early evening. (ABSTRACT TRUNCATED)

Technology that is currently developing has an influence on aggressive behavior in children, so there needs to be prevention efforts in this deviant behavior. The purpose of this study was to determine the influence of gadgets and the factors that cause aggressive behavior, forms of aggressive behavior, the impact of aggressive behavior, and efforts to handle aggressive behavior in early childhood. The method used in this research is a case study which is presented with a qualitative descriptive research type by presenting the data in a narrative manner, as well as data obtained through observation. In this study, the subject is one girl who behaves aggressively aged 5-6 years because of the influence of unlimited gadgets. The results of the research obtained are the influence of the use of gadgets that are not restricted and supervised. This causes aggressive behavior in children who find it difficult to control their desire to convey messages, such as shouting, crying, and making physical contact when someone interferes with playing gadgets. The influence of gadgets on aggressive behavior in children requires serious efforts for parents or adults who are around children so that they do not have a negative impact on children's development in the future.

Media and Child Health

Introduction. At present, the causes and methods of manifestation of aggression in children with hearing impairment are considered as an insufficiently studied problem, and the available studies are contradictory: the unified principles, methods and techniques for diagnosing and correcting aggressive behavior in children are insufficiently developed and substantiated. Severe emotional states, including aggression, are a fairly common occurrence in older preschool children with hearing impairment, when they realize their difference from their normal hearing peers. Household methods of dealing with aggression do not always help, often exacerbate the problem. Preventive and corrective work should be based on the means available for understanding by children of preschool age. Fairy tale therapy has effective methods and techniques in correctional and developmental work with children with hearing impairment in work with manifestations of aggression.Materials and Methods. Review and critical analysis of scientific literature. Empirical research methods: study of medical records, experiment. Method of mathematical processing of research results.Results. Methods for diagnosing aggressive behavior and methods for its correction in preschool children with hearing impairment are analyzed. The initial level of manifestation of aggression in children of senior preschool age with hearing impairment was revealed. A program and methodological recommendations for the correction of aggressive behavior in senior preschool children with hearing impairment by means of fairy tale therapy in the conditions of a preschool educational organization have been developed. During the analysis of the results of the study of children in the experimental and control groups, a decrease in the indicators of the manifestation of aggressive behavior was observed, which confirms the effectiveness of the developed program.Discussion and Conclusions. The implementation of the program for the correction of aggressive behavior in children of senior preschool age with hearing impairments by means of fairy tale therapy should be carried out in the conditions of a preschool educational organization and boarding schools, when methods and techniques for preventing and correcting aggressive behavior of children based on fairy tales are included in the correctional and developmental lesson. taking into account in the process of its implementation the structure of hearing impairment, the psychological characteristics of preschool children with hearing impairment.

Although in-session factors of CBT for youth anxiety (e.g., youth involvement; therapist behaviors) have demonstrated significant associations with treatment outcomes, no study has examined the role of concurrent selective-serotonin reuptake inhibitors (SSRI) on in-session behavior affecting youth outcomes. The combination of SSRI and CBT have demonstrated robust outcomes over either treatment alone. Research has also neglected to examine in-session behavior based on treatment phase (i.e., psychoeducation, exposure) and the association between in-session factors and treatment outcome. Youth (N = 190) were participants in the Children/Adolescent Anxiety Multimodal Study (Walkup et al. New England Journal of Medicine, 359, 2753-2766, 2008) who completed CBT; of these, n = 94 received concurrent sertraline. Tapes of psychoeducation/skill-building (first half) and exposure sessions (second half) were rated by reliable coders for positive youth involvement (e.g., participation, understanding), negative youth involvement (e.g., safety-behaviors, negative affect), and therapist behaviors. Youth and therapist in-session behaviors were examined as predictors of the trajectory of anxiety outcomes using multilevel modeling. Medication (sertraline) was examined as a moderator. Results indicated that positive and negative youth involvement in CBT was significantly associated with outcomes. Positive youth involvement during psychoeducation and exposure sessions predicted better outcomes, and negative youth involvement during psychoeducation sessions predicted less favorable outcomes. Sertraline did not moderate these findings. Therapist behaviors were not significantly associated with outcomes, likely due to limited variability and low frequency of observed behaviors. Youth in-sessions behaviors are associated with treatment outcomes in anxiety treatment. However, medication does not appear to have a differential impact on youth in-session behaviors.