Practice guidelines - Not yet ideal

Efforts to identify empirically supported psychological treatments over the past half century have been strongly influenced by the development of more potent treatments and more effective outcome research methods. Practice guidelines incorporating empirically supported treatments proposed by the Agency for Health Care Policy and Research, the American Psychiatric Association, and the Division of Clinical Psychology of the American Psychological Association are described and critically assessed. Advocates for practice guidelines assert that they promote therapeutic accountability and motivate adoption of the best current practices; critics question their empirical bases, diverse standards of proof, and potential to constrain clinical decision making. These claims are critically examined, and when appropriate, solutions are suggested. It is clear, however that the one solution that will not work is a return to the preguideline era.