Any integration of cost and effectiveness must be open and explicit. In addition to direct consequences of treatment such as symptom reduction or disease prevention, treatments may have indirect consequences as well. Comparing a treatment with nontreatment allows the determination not only of whether an intervention has any efficacy at all but also of whether it has adverse effects. In 2018, the American Psychological Association (APA) formally recognized group psychotherapy as a specialty. This document replaces as policy and is in part a revision of an earlier document, the Template for Developing Guidelines: Interventions for Mental Disorders and Psychosocial Aspects of Physical Disorders (APA, 1995), approved by the APA Council of Representatives in February 1995. (1994). Science of Psychology. A checklist for use in applying the criteria (PDF, 29KB) contained in this document to the evaluation of guidelines is available. The 1995 document was developed by the Task Force on Psychological Intervention Guidelines, which represented a collaborative effort of the APA Board of Professional Affairs (BPA), the APA Board of Scientific Affairs (BSA), and the APA Committee for the Advancement of Professional Practice (CAPP). Randomized controlled experiments are definitive only when all aspects of the experimental design, including the participant population, are fully representative of the phenomena of interest. World Health Organization. Principles for Training in Evidence-Based Psychology. Accredited Psychology Programs. Guidelines are promulgated to encourage high quality care. This summary includes key treatments, studies, manuals, and clinician-friendly clinical/training resources all published on a website patterned after the Society of Clinical Psychology website. The effectiveness of an intervention may, but not necessarily, be affected by differences in backgrounds or ethnicities of the health care professional and the patient. Find a Therapist specializing in Acceptance and Commitment Therapy for Chronic PainList your practice, Editors:Evan Forman, PhD; Joanna Kaye, BA, Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice. Different parties in an intervention may have different goals for treatment. Long-term consequences of treatment. It is recommended that the guideline panel specify the patient population(s) for whom the treatments under consideration are intended. Because the committee is a volunteer only board, the committee has not historically had the person power or funding to regularly revise existing ratings. Register now. In evaluating treatment outcomes, panels should consider attrition due to dropout or refusal. Evidence-based practice in psychology (EBPP) is based on the principle of the integration of the "best available research with clinical expertise in the context of patient characteristics, culture and preferences" (APA Presidential Task Force on Evidence-Based Practice, 2006, p. 280). Consequently, the extent of the available scientific literature may vary depending upon the ease with which the intervention can be tested using controlled clinical trials. These clinical observations may then form the basis for further systematic evaluation. For example, a corrective surgical procedure may enhance self-esteem and improve social functioning, or the choice of a behavioral rather than a pharmacological treatment may enhance feelings of personal control. Important components of this dimension include the generalizability of the intervention across settings and the feasibility of implementing the intervention with various types of patients and in various settings. Society for the Psychology of Aesthetics, Creativity and the Arts, 14. In this document, it is not presumed that guidelines are inherently either beneficial or detrimental, and the document is not intended either to encourage or to discourage their development. Patient-treatment matching may maximize efficacy. Similarly, the unwillingness of a patient to accept a specific treatment may preclude its administration, regardless of its proven efficacy with other patients. To encourage accountability, criteria for evaluating the process of guideline production are also provided. Clinical utility should also be evaluated through systematic feedback from health care professionals and perhaps from patients regarding their experiences related to the application of the guidelines. Psychotherapy, 53(4), 446461. Society for Sport, Exercise and Performance Psychology, 48. APA's 54 divisions are professional homes organized by members. Professional Home of Clinical & Health Service Psychologists. American Psychologist, 61(4), 271285. Historically, some interventions that were later proven by systematic evaluation to be very powerful have arisen from clinical innovations and case studies. Outcome differences between individual and group formats when identical and nonidentical treatments, patients, and doses are compared: A 25-year meta-analytic perspective. Guidelines should take available data regarding such indirectsequences into account. For more information on depression and its treatment, please visit theNational Institute of Mental Health website. Paxton, T., & Harrison, M. (2022, March 1). International statistical classification of diseases and related health problems (10th rev. A lack of treatments on this site specific to a diagnosis does not necessarily mean that there are no evidence-based treatments. The task force included David Barlow, chair; Susan Mineka, co-vice chair; Elizabeth Robinson, co-vice chair; Daniel J. Abrahamson; Sol Garfield; Mark S. Goldman; Steven D. Hollon; and George Stricker. The usual strategy in evaluating a psychological intervention involves creating a credible comparison treatment appropriate to the clinical trial, such as the provision of a caring relationship. Replication across multiple studies and multiple settings is desirable. Some sections also have membership categories for non-Division 12 members. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. About this resource. In examining the outcomes assessed in efficacy studies, guideline makers are encouraged to attend to the following important issues: Participant selection. Similarly, the provision of a placebo in a test of the efficacy of a pharmacological agent duplicates all the aspects of the medication regime except the medication itself. Costs of withholding or delaying treatment may include the patient's loss of time from work and disability costs. This makes group psychotherapy a defined area of practice requiring specific knowledge and skills gained through organized education and training (Rosendahl et al., 2021). It is recommended that guideline panels include one or more individuals with expertise in the scientific methodology of intervention evaluation in the diagnostic area or areas under consideration. Division 12: Society of Clinical Psychology includes APA members who are active in practice, research, teaching, administration, and/or study in the field of clinical psychology are invited to join the division. Bodies with appropriate oversight authority should evaluate these conflicts of interest and take steps to eliminate or minimize them. Even the most effective treatments do not work with every patient. The judgment of health care professionals, although always needed, is particularly important in the treatment of conditions for which research data are limited. It is recommended that guideline panels include members with expertise and sensitivity to relevant issues of diversity, including but not limited to sex, ethnicity, language, sexual orientation, age, and disability. For very infrequent behaviors and rare conditions, clinical consensus on appropriate treatment may be the only available data. Join us August 3-5 for APA 2023! (2001). Some represent subdisciplines of psychology (e.g., experimental, social or clinical) while others focus on topical areas such as aging, ethnic minorities or trauma. We recommend a consultation with a mental health professional for an accurate diagnosis and discussion of various treatment options. (2017). Some treatment interventions may require both in- and out-of-session activity on the part of the patient. Conflating them compromises the scientific foundation of the guidelines. Fellowship is a special distinction for members who have received a doctoral degree in psychology or a related field from a regionally accredited institution and can show evidence of unusual and outstanding contributions in the field of psychology. This document was approved as policy of the APA in August 2000. Washington, DC: Author. As these terms are used in APA policy, "guidelines" include pronouncements, statements or declarations that suggest or recommend specific professional behavior, endeavor or conduct for psychologists or for individuals or organizations that work with psychologists. Although costs can be partially reduced to monetary terms, some significant costs are not financial, including expenditure of patient time, suffering, and functional impairment. (1995). (2020). For example, clinical practitioners, clinical scientists, patients, family members, purchasers, and third-party payors may each value different results. These reasons may include such factors as pain, expense, duration, fear, side effects, adverse reactions, values, culture, and personal preferences. This determination is often an important part of the treatment evaluation process. Patient choice may increase the clinical utility of a given intervention. The costs associated with the administration of the intervention may also be considered. Finally, the work group expresses its deepest appreciation to Geoffrey M. Reed, without whose inspiration, intellectual challenge, sense of humor, and true leadership we could not have sustained this effort. (2002, December 1). Generally, health care guidelines are pronouncements, statements, or declarations that suggest or recommend specific professional behavior, endeavor, or conduct in the delivery of health care services. It is possible for this threshold to be met through a series of carefully controlled single-case studies. The information is presented so as to a wide audience, including the general public, clinicians, educators, researchers, and students. Washington, DC: Author. Efficacy of group psychotherapy for obsessive-compulsive disorder: A meta-analysis of randomized controlled trials. Efficacy of group psychotherapy for social anxiety disorder: A meta-analysis of randomized-controlled trials. The principles on which this method is based have been proven to make therapy more targeted and therefore more effective. Guidelines should take into consideration the nature of the comparisons identified in Criteria 3.1, 3.2, and 3.3 (below), which are listed in ascending order as to their contribution to the strength of a recommendation. More recently, an increase in carefully designed studies has led to sufficient empirical support to conduct eleven meta-analyses of group treatment efficacy (Burlingame et al., 2016; Rosendahl et al., 2021). Clinical Psychology: Science and Practice (quarterly), Advances in Psychotherapy Evidence-Based Practice (book series). (2020). (2019). Successful treatment of the individual may well require attention to each problem. It is recommended that guideline panels include one or more individuals with expertise in the delivery of services in the subject area or areas under consideration. Efficacy of group psychotherapy for panic disorder: Meta-analysis of randomized, controlled trials. This dimension asks the question, How well does the intervention work? Institutional goals such as rationing services, minimizing legal liability exposure, and containing costs should be explicit. The systematic application of these research strategies also promotes the welfare of patients. There are two versions of criteria reflected in this list. Graduate students in APA approved or regionally accredited doctoral programs may become student affiliate members at a reduced rate. Good guidelines allow for flexibility in treatment selection so as to maximize the range of choices among effective treatment alternatives. Interventions that are of demonstrable efficacy with one ethnic, cultural, or linguistic group may not be equally applicable to patients from other groups. The evaluation of clinical utility involves the assessment of interventions as they are delivered in real-world clinical settings. APA members and division members who have made outstanding and unusual contributions to psychology with a national or international impact can be nominated for fellow status. Society for Theoretical and Philosophical Psychology, 26. Group therapy for schizophrenia: A meta-analysis. Some medical and psychological practices that initially appeared helpful and became widely accepted were subsequently found ineffective or even harmful. Journal of Obsessive-Compulsive and Related Disorders, 10, 4961. Group Dynamics: Theory, Research, and Practice, 21(2), 7793. Another common assumption is that standardizing treatment via guidelines will always be beneficial because it reduces practice variation. Websites serve as convenient repositories for gathering and tracking evidence-based treatment. Cost savings associated with an intervention may include prevention of future disorders, as when an early intervention with a childhood disorder obviates the need for treatment later on. Savings may also accrue when an intervention makes other treatments unnecessary. In contrast to standards, guidelines are aspirational in intent. Some guidelines may be broadly targeted to health care professionals and consumers as well as to administrative agencies involved in the delivery of health care. Moreover, failure to disclose the scientific justification for a guideline violates a basic principle of science, which requires open scrutiny and debate. Those interested should refer to the, In addition, there are some treatments that have been developed with strong evidentiary support that are not on this list. Society for the Advancement of Psychotherapy, 31. Resources provided by APA for division officers and leaders. All Rights Reserved. The process by which guidelines are developed includes not only the deliberations of the guideline panel, discussed above, but also the steps by which the panel was formed and guideline development was undertaken. Atlanta, GA 30359 The outcomes selected should be consistent with the goals and orientation of the treatment. Moreover, some questions are easier than others to address in controlled clinical experiments. Advancing psychology to benefit society and improve lives. Compulsions & Obsessive Behaviors Drug & Alcohol Abuse Eating & Body Image Problems Factors such as age, gender, language, and ethnicity can all affect treatment outcomes. Advancing psychology to benefit society and improve lives. Mission When you meet with a professional, be sure to work together to establish clear treatment goals and to monitor progress toward those goals. It is recommended that the panel specify a time frame for a revision of the guidelines. The disorder-based approach has limitations: Patients3 commonly present issues that cut across diagnostic lines, dual diagnoses (comorbidity) are common, and disorder-based diagnosis is often a weak basis for determining appropriate levels of care and other characteristics of treatment. Background: Prefrontal Transcranial Magnetic Stimulation (TMS) therapy repeated daily over 4-6 weeks (20-30 sessions) is US Food and Drug Administration (FDA) approved for treating Major Depressive Disorder in adults who have not responded to prior antidepressant medications. https://doi.org/10.1037/gdn0000064, Schwartze, D., Barkowski, S., Burlingame, G. M., Strauss, B., & Rosendahl, J. delivery system that psychological treatments for particular disorders were either ineffective or inferior to pharmaco-logical treatment. For more information on depression and its treatment, please visit the National Institute of Mental Health website. It is recommended that guideline panels include experts from a broad range of relevant disciplines (e.g., the health care professions, health care economics, public health). (2021). (2016). For example, short-term, problem-focused treatments lend themselves more readily to controlled experimentation than do longer term interventions aimed at more multifaceted concerns. Principles for Training in Evidence-Based Psychology, The American Psychological Association (APA) has identified , There are two versions of criteria reflected in this list. These factors may or may not have been assessed in the outcome literature for the treatment under consideration. The primary purpose of this document is to assist in the evaluation of treatment guidelines. 4062 Peachtree Road NE Suite A526 The mandate for a particular intervention is enhanced if it normalizes functioning. ABOUT PSYCHOLOGY. American Psychological Association. This site aims to provide useful information to clinicians and clients about the state of evidence for group treatments by common psychological disorders. The work group included Daniel J. Abrahamson, chair; Nancy C. Bologna; Steven D. Hollon; Ivan J. Miller; Elizabeth Robinson; and George Stricker. Society for the Psychology of Sexual Orientation and Gender Diversity, 45.
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