Ms. Adams met with Jeremy when he was in her second-grade class to select some reinforcers that would increase his time on task. Jeremy quickly offered several suggestions. He wanted time to look through books about dinosaurs, to read joke books, and to play with blocks. He also wanted time for drawing and art projects. Ms. Adams explained that each morning they would decide what assignments needed to be completed before break. When he completed the assignments, he could choose his reward. Ms. Adams also adapted the assignments. Jeremy was expected to write in his journal, but he could answer the questions about his reading orally.
A 2010 meta-analysis found that no trial employing both blinding and psychological placebo has shown CBT to be effective in either schizophrenia or bipolar disorder, and that the effect size of CBT was small in major depressive disorder. They also found a lack of evidence to conclude that CBT was effective in preventing relapses in bipolar disorder.  Evidence that severe depression is mitigated by CBT is also lacking, with anti-depressant medications still viewed as significantly more effective than CBT,  although success with CBT for depression was observed beginning in the 1990s.