Treatment guidelines are invaluable tools for busy practitioners, said Bonnie Spring, PhD, a professor of preventive medicine at the Feinberg School of Medicine at Northwestern University, at APA's Annual Convention.
With thousands of new studies published annually, such guidelines can keep practitioners up to date on emerging clinical research, said Spring, a member of APA's Committee on Professional Practice and Standards who spoke at a Board of Professional Affairs-sponsored session on guidelines.
"Guidelines review the evidence about the major practice questions that come up, and they are updated regularly so that you don't have to disappear into the library for three days to do this review," said Spring. "So, you as a clinician can then spend your time determining how to apply the guideline in light of your patient's characteristics and resources."
Guidelines also expose gaps in the literature that researchers need to fill, Spring pointed out.
In malpractice cases, treatment guidelines can serve either as a "shield or a sword" for clinicians - protecting the practitioner if a guideline was followed or as ammunition for a plaintiff if one wasn't, said presenter Nathalie Gilfoyle, JD, APA's general counsel. But most juries and judges have placed only mild emphasis on their importance so far, Gilfoyle added.
However, practitioners should know and understand all the guidelines that potentially apply to their work, she said. If you don't know what they say, you might be working outside them, which can increase your legal risk, Gilfoyle said.
APA does not publish treatment guidelines, noted Lynn Bufka, PhD, APA's assistant executive director for professional development and training. APA does have practice guidelines intended to be "aspirational recommendations directed at practitioner behavior and decision-making," in particular areas of practice, such as child-custody evaluations or record-keeping, said Bufka.
APA's Practice Directorate Web site includes the association's practice guidelines on working with older adults, women and girls, and lesbian, gay and bisexual clients, as well as record-keeping and child-custody evaluations, among other topics. The site also includes a document to help psychologists evaluate treatment guidelines from other organizations.
To learn more about treatment guidelines, visit the Department of Health and Human Services' National Guideline Clearinghouse (www.guidelines.gov), which posts more than 2,000 guidelines from a variety of organizations including the American Medical Association and the U.S. Public Health Service, suggested Spring. Another site, www.ebbp.org, includes three free online training modules on the evidence-based practice process, library search strategies for finding guidelines and a primer on research reviews, said Spring. The site, funded by a contract to Spring and Northwestern University by the National Institutes of Health's Office of Behavioral and Social Science Research, will offer two more tutorials--one on critical appraisal and one on decision-making in practice--next year.
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