Feature

It's become more important than ever for psychologists to pay attention to mental health treatment guidelines, and, fortunately, practitioners now have a tool to help them determine which guidelines are useful and which may be wolves in sheep's clothing.

At its August meeting, APA's Council of Representatives approved the document, "Criteria for evaluating treatment guidelines," making it official APA policy. The document--developed by the Template Implementation Work Group, a continuing collaboration of the Board of Professional Affairs, the Board of Scientific Affairs and the Committee for the Advancement of Professional Psychology--presents criteria for assessing treatment guidelines, focusing on such issues as the quality and scope of research reviewed, the effectiveness and viability of recommended approaches and the structure of the panel that produced the guideline.

The culmination of seven years of writing and revising, the document can help practitioners identify, for example, quality containment methods being disguised as treatment guidelines, said Daniel J. Abrahamson, PhD, who chaired the collaborative work group, and announced the document's approval at the session, "Treatment guidelines in health care," at the convention.

Now that psychologists have this tool, said symposium speaker Suzanne Bennett Johnson, PhD, chair of APA's Board of Professional Affairs, it's time for them to expand their knowledge about treatment guidelines.

"Practice guidelines in the health arena are not going away," she said. "If anything, they are increasing."

Between October 1999 and July 2000, Johnson reported, there was a 33 percent increase in the number of treatment guidelines for mental health posted on the National Guidelines Clearinghouse, a Web site on practice and treatment guidelines run by the U.S. Department of Health and Human Services. The greatest increases have been in the areas of dementia, mood disorders and substance abuse, she noted.

But just because guidelines are becoming more common, said Johnson, doesn't mean that psychologists are receptive to them.

"Psychologists get very nervous about them," said Johnson. "They feel, somehow, that they are going to restrict their practices."

But guidelines are not required, Johnson explained, they are no more than recommendations. "They are providing education and are for your information," she said. "They are not intended to remove the importance of professional judgment."

What's more, there are advantages to the good quality guidelines, Johnson pointed out. "If psychologists know, based on our scientific evidence and clinical experience, what are good practices, and they apply these practices in terms of use of practice guidelines, it should improve quality of care," she said. "It should also improve efficiency of care, reduce risk to the patient and protect the provider from cost-cutting efforts that make delivering good treatment impossible."

Guidelines can also expand scientific knowledge relevant to health care, Johnson added. "If you've reviewed the scientific literature and have some information about evidence-based treatment, treatment approaches that would be helpful, a practice guideline can educate and disseminate that information to a large group of professionals."

Furthermore, Johnson said, psychology has a wealth of expertise and science to offer to the development of treatment guidelines and guideline use.

"Treatment guidelines are a part of health care," said Johnson. "If we really want to be health-care professionals, we need to respond to this issue by getting into the business of addressing practice guidelines."

The newly approved APA document helps psychologists to do that. For a copy of "Criteria for evaluating treatment guidelines," contact APA's Practice Directorate at (202) 336-5800 or by e-mail at Practice.