State Leadership Conference

If psychologists don’t work together to develop clinical treatment guidelines that synthesize the best psychological research and practitioner expertise, someone else will do it for them, stressed speakers at a State Leadership Conference workshop.

“We can let somebody else define how we do our work, or we can take this thing on and define it ourselves,” said APA 2009 President James H. Bray, PhD.

He emphasized that the guidelines are crucial in a health-care marketplace in which health-insurance representatives and policymakers want psychologists to show accountability for their work and to define the best ways to deliver patient care.

Clinical treatment guidelines are consistent with APA’s Strategic Plan goal of expanding psychology’s role in promoting health, Bray said.

The guidelines will also advance APA’s goal of advocating for the science of psychology and translating research results into clinical practice, said Katherine C. Nordal, PhD, APA executive director for professional practice.

Other benefits for psychology, she said, include:

  • Giving practitioners a framework for providing the best clinical care.

  • Establishing benchmarks that will enable practitioners to evaluate patient outcomes.

  • Helping practitioners and researchers identify gaps in knowledge about effective treatments for specific populations.

Nordal also emphasized that the guidelines will not be a “cookbook” of interventions dictating what practitioners must do without regard for their experience and judgment. “They will be flexible, useful and transparent tools, and the process to develop them will be a very transparent one,” Nordal said.

Steven Breckler, PhD, APA executive director for science, emphasized that the guidelines can also help bridge the science-practitioner gulf by getting information about empirically supported treatments and interventions that work into practitioners’ hands. What’s needed, he said, is a systematic review of the psychological research that is more comprehensive than the research reflected in existing treatment guidelines. For example, some treatment guidelines synthesize the research on medication treatment, but provide very little information about effective behavioral interventions, Breckler said.

“What we’re proposing to do is produce the equivalent of this document on behalf of what psychological science has to say, and what psychological practitioners need to know,” he said.

As the Monitor went to press, nominations for a six-member advisory steering committee of psychologists were being sought from APA boards and committees and the general psychology community. Once approved by the association’s Board of Directors, the group will finalize the process for developing clinical treatment guidelines. As part of the process, the committee will oversee the work of treatment guideline development panels. The number of guidelines (and guideline development panels) has not yet been determined. Consistent with current APA policy and Institute of Medicine standards, panel members will commission comprehensive, systematic reviews of the research and write evidence-based guidelines for specific clinical populations, said Daniel Galper, PhD, APA director for practice research and policy demonstration projects.

APA is seeking to expedite the process and hopes to complete the first set of guidelines, subject to approval from APA’s Council of Representatives, within the next two years. n