Manualized Treatment Programs for FSD: Research Challenges and Recommendations

Abstract

Introduction The use of manualized treatment programs offers a useful research framework for assessing psychotherapeutic interventions for female sexual dysfunctions (FSDs), but it does not address all issues related to methodological rigor and replication, and raises new research issues in need of discussion. Aims The goals of this manuscript are to review the literature on treatment trials utilizing manualized psychotherapy treatments for FSD and to explore the benefits and research issues associated with the flexible use of treatment manuals. Methods The method used was the review of the relevant literature. Results While the use of manualized treatments for FSDs can address certain methodological issues inherent in psychotherapy research, flexibility in manual administration is necessary in order to allow tailoring for individual needs that can be beneficial to both the participant and the research. The flexible use of manuals, as opposed to strict manual adherence, may also be more relevant for clinical utility. Conclusions In order to administer manualized treatments for FSDs with appropriate flexibility, while also maximizing internal validity and replicability, the authors recommend that predetermined decision rules be utilized to guide individual tailoring, that potential gaps in the manual be identified and addressed, and that differing levels of motivation and readiness for treatment be taken into consideration in the treatment protocol.

Psychological Treatment Trials for Hypoactive Sexual Desire Disorder: A Sexual Medicine Critique and Perspective

“…These results seem to be generalizable because instructions in the method can be transmitted to other practitioners. Hucker and McCabe [30] concluded that converting their program of CBT for FSD into a manual is feasible.…”

Hypoactive Sexual Desire Disorder in Women: Physiology, Assessment, Diagnosis, and Treatment

“…Mindfulness‐based therapies and cognitive behavioral therapy designed specifically for HSDD have demonstrated preliminary evidence for efficacy in the treatment of HSDD 45 . Although cognitive behavioral therapy for HSDD is effective, 46 the availability to women in many communities may be limited. Research continues in this area to determine if mindfulness‐based cognitive therapy for sexuality that is delivered remotely via the internet is effective at improving sexual desire and decreasing distress 47 .…”

To manualize, or not to manualize: Is that still the question? A systematic review of empirical evidence for manual superiority in psychological treatment

“…First, clinicians have argued that a standardized approach might render it impossible to act on the individual characteristics of different clients (Garfield, ). While some studies indeed point to difficulties in adapting manual‐based treatments to the needs of individual clients (see Hucker & McCabe, ; Marshall, ), other research shows that an appropriate amount of attention to the individual client is possible (Jones & McCabe, ). Indeed, increasing attention is given to the “flexibility within fidelity principle,” which addresses individualization within manual training (Hamilton, Kendall, Gosch, Furr, & Sood, ).…”