Guideline orthodoxy and resulting limitations of the American psychological association's clinical practice guideline for the treatment of PTSD in adults

Abstract

This article introduces the special issue in which we explore problems and limitations inherent both in the development and implementation of the American Psychological Association's (APA) Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults. As Chair (Christine A. Courtois) and member (Laura S. Brown) of the guideline development panel, we were in a unique position to observe how certain decisions made by the APA regarding how this guideline should be produced led to flaws in the final product. In this special issue, we address problems that may be inherent in many clinical practice guidelines for psychotherapists. Our authors explore the importance of a more ecologically-informed model for such guidelines, one that would take into account the body of research on the psychotherapy relationship, psychotherapy process, and a broad range of psychotherapy outcomes. We end with recommendations APA might take to generate future clinical practice guidelines that are well-founded in APA's own definitions of evidence-based practice, and more attuned to APA's increasing attention to the specialized concerns of clients who come from socially marginalized groups.