How helpful are treatment manuals to practicing psychotherapists? A survey of 47 cognitive-behavioral therapists explored their overall responses to manuals (e.g., number read, favorite manuals) and their descriptions of the ideal manual (ratings of 20 features). Findings indicated a very positive view of manuals, extensive use, and few concerns. Ratings of the ideal manual emphasized practical advice, the notion that more is better, and endorsement of some features that are typically not included (e.g., illustrations). Implications for practice are discussed, including ways that therapists can make the best use of manuals and awareness of limitations of manuals for mastering a treatment.How helpful are treatment manuals to practicing psychotherapists? What do clinicians like and dislike about them? What manuals are most popular? Are there features they want to see that are not currently part of the typical manual? Although treatment manuals are one of the major innovations in psychotherapy practice of the past several decades (Addis, 1997), there has been little exploration of how therapists actually view them.The idea behind treatment manuals is that by specifying the theory and techniques of a treatment in written form, manuals can inspire therapists toward use of a broader array of interventions, standardize treatment implementation and training, and increase

Clinicians' impact on substance use disorder treatment has been much less studied than therapy and patient variables. Yet, in this selective review of literature, a growing body of empirical work on clinicians' impact highlights several key issues that have relevance both to clinical practice and future research. These issues include clinicians' effect on treatment retention and outcome, professional characteristics, recovery status, adherence to protocols, counter-transference, alliance, personality, beliefs about treatment, and professional practice issues. Specific recommendations are offered to help improve the quality of care clinicians provide. In particular, it is suggested that greater accountability for clinicians' performance be balanced with increased support for their very difficult role. Methodological issues in studying clinicians are also addressed.

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This randomized study examined whether narrative emotional disclosure improves mindfulness, experiential avoidance, and mental health, and how baseline levels of and changes in mindfulness and experiential avoidance relate to mental health. Participants (N = 233) wrote repeated traumatic (experimental condition) or unemotional daily events narratives (control condition). Regression analyses showed neither condition nor gender effects on mental health or experiential avoidance at a 1-month follow-up, although the control condition significantly increased in one component of mindfulness. Decreased experiential avoidance (across conditions) and increased mindfulness (in the experimental condition) significantly predicted improved mental health. Narrative disclosure thus did not improve outcomes measured here. However, increasing mindfulness when writing narratives with traumatic content, and decreasing experiential avoidance regardless of writing content, was associated with improved mental health.