The "Expert Consensus Guideline" series (March et al. 1997) and the American Academy of Child and Adolescent Psychiatry (1997), (1998) practice parameters also provide important information about treatment. Based on these guidelines, only two treatment modalities have been shown empirically to be effective in treating OCD symptomatology: 1) cognitive-behavioral therapy (CBT; specifically the technique of exposure with response prevention) and 2) pharmacological treatment with serotonin reuptake inhibitors (SRIs)—or a combination of the two. Cognitive-behavioral treatment has the advantages of apparent durability of treatment effects and avoidance of potential side effects of medication. In specific cases, however, an antiobsessional medication may be the initial treatment method because of concerns with urgency, expense, anxiety associated with behavioral treatment, lack of trained clinicians, insufficient cognitive ability to participate in CBT, lack of family support, or individual factors.