David and Goliath -: When empirical and clinical standards of practice meet

Traditional clinical methods of assessing the effectiveness of psychological treatments have come under attack. Experience and strong belief frequently lead to false confidence in treatments and sometimes result in damage to patients. Advocates have called for a scientific standard to replace the extant standards based on expert opinion and cost. Yet there are costs to the use of both the old standards and scientific standards based on manualized treatments and associated research. This article proposes a set of criteria for determining whether a treatment is scientifically credible based on empirically informed principles rather than on techniques or single-theory formulations. This proposal offers a way to overcome the problems of rigid manuals as well as those associated with forcing clinicians to adhere to theories and practices that are outside of their interest, experience, and expertise. Instead, scientifically sound, cross-cutting principles of treatment selection are proposed by which a treatment could be evaluated for scientific credibility and applied from a number of theoretical frameworks.