TREATMENT MANUALS IN CLINICAL-PRACTICE

Hickling and Blanchard (1997) [Behaviour Research and Therapy, 35, 191 -203] summarize the results of treating PTSD patients with a highly st ructured treatment manual. Presenting a 'clinician's reaction' they ar gue for the added value of modifying treatment manuals based on the th erapist's clinical experience and claim that manuals do not provide co mplete treatment of patients' multiple problems. In response, I reiter ate that actuarial prediction is usually superior to clinical judgment , address the treatment of co-morbid psychopathology, underscore the i mportance of specific therapist skills in implementing manual-based tr eatment, and point out ways in which manual-based treatment can be mor e flexible and individualized than Hickling and Blanchard imply. (C) 1 997 Elsevier Science Ltd. All rights reserved.