Clinical practice guidelines in clinical psychology and psychotherapy

Abstract

Evidence-based clinical practice guidelines have proliferated over the past two decades. Few are limited to psychological therapies or are targeted at clinical psychologists and psychotherapists -the UK guideline Treatment Choice in Psychotherapy and Counselling is a major exception. However, psychological therapies will increasingly be considered alongside medical treatments in diagnosis-specific guidelines. There has been interest and debate about the place of guidelines in the psychological therapies, with views ranging from scepticism to enthusiasm. This paper defines clinical practice guidelines, describes major guideline programmes internationally, examines guidelines of specific interest to psychologists and psychotherapists, explores issues in their implementation, reviews evidence for their effectiveness in changing practice and improving therapy outcomes and draws out implications for practice. Guidelines are only one aspect of informing psychologists and psychotherapists about best practice. They need to be supplemented by other clinical support methods and with methods of monitoring what is actually done in practice.

Optimizing the language and format of guidelines to improve guideline uptake

“…13,61 This type of complexity hinders understanding and persuasiveness and may render recommendations more difficult to accept 22,62 and thus less likely to be implemented. 37,63 Managing this complexity to produce uncomplicated recommendations requires "atomization" -the process of extracting and presenting individual concepts from the complex recommendation. 64 The same recommendation refers to "high-risk features."…”

Prescriptive Play Therapy

“…Cognitive-behavioral therapy (Lochman, Fitzgerald, & Whidby, 1999) Autism Behavioral play therapy (Rogers, 1991; Integrated play group (Neufield & Wolfberg, 2010;Wolfberg & Schuler, 1993) Chronic illness Filial/family play therapy (Van Fleet, 2000) Children of divorce Play group therapy (Pedro-Carroll, 2005;Pedro-Carroll & Cowen, 1985), filial therapy (Bratton, 1998) Bereaved Play group therapy (Netel-Gilman, Siegner, & Gilman, 2000;Zambelli & DeRosa, 1992) Foster/adoptive Filial/family play therapy (Van Fleet, 1994 convened by a professional organization (Parry, 2003). The task force compiles the best practice list based upon a review of the current outcome research.…”

Help a Buddy Take a Knee: Creating Persuasive Messages for Military Service Members to Encourage Others to Seek Mental Health Help

“…As previously noted, multifaceted approaches to disseminating clinical-practice guidelines are important. These approaches ensure clinician training while providing clinical reminders to follow practice guidelines and audit compliance (Parry, Cape, and Pilling, 2003).…”

“…Multifaceted strategies are not simple to implement and often require additional staffing, along with organizational changes to the clinical practice (Parry, Cape, and Pilling, 2003). The Mental Health Task Force was correct to assert that "assuring these practices and guidelines are actually implemented throughout the system is a daunting challenge that requires significant attention by mental health providers" (Department of Defense Task Force on Mental Health, 2007a, p. 33).…”