From the Literature

摘要: WILLIAM C. SANDERSON, Ph.D.* One contemporary issue in the area of psychotherapy which has received increasing attention concerns advantages and disadvantages treatmentguideline development.1-3 The discussion treatment-guideline development appears to be fueled, for most part, by changes healthcare delivery system United States. It seems safe say that past, practitioners many forms were less concerned than now about scientific evaluation accountability. Accountability was desirable, but not necessary. However, need accountability sharply increased, as treatments without supporting efficacy data are unlikely survive. Indeed, noted Trabin,4 "the an accountable, science-based model behavioral may catalyzed on a broad scale competitive pressures from marketplace government" (p. 8). Recognizing importance establishing body identify promote empirically supported psychotherapeutic treatments, Division Clinical Psychology (Division 12) American Psychological Association assembled Task Force accomplish goal.5 Based upon specific review process, list identified.5 report acknowledged is never final, must maintained updated regular basis include new they emerge (in fact, recent represents third "update"). During time sweeping changes, crucial step identification promotion proven-effective psychotherapies, with overall mission making these more widely available.6 Several authors have raised important criticisms7-9 regarding therapies. In I agree there difficulties risks guidelines-or any treatment guidelines matter.lo strongly disagree premise evidence-based ". . self-destructive behavior, consequences will degrade our calling far worse anything government or managed costs corporations ever conceive"8 136). To contrary, it my opinion failure develop result psychotherapists being own worst enemy.3 Unfortunately, date, taken active role promulgating guidelines. guidelines, other organizations, such Psychiatric Association, accelerated process. Dr. Harold Pincus,lo who been member committee overseeing Associations Guidelines noted: "In absence standards, what cheapest best.... Evidence-based developed professional organizations assist clinicians asserting values face economic pressures" 45). From vantage point, question whether we should whenever possible, instead, already missed boat? danger creating obvious Persons, Thase, Crits-Christoph's11 analysis AHCPR12 report.13 Essentially, conclude both understate value and, particular, Association's does reflect balanced assessment available empirical evidence cognitive, behavioral, brief psychodynamic, group psychotherapy. Clearly, having "other" groups (i.e., those primarily involved providing evaluating psychotherapy) construct psychotherapists' best interest. Of course, drawbacks developing …