Outcomes, guidelines, and manuals: On leading horses to water

Addis, Wade, and Hatgis (this issue) identify practitioner concerns about m anual-based psychotherapies. Their conclusions are consistent with literatu re and experience regarding the use of outcome measurement and practice gui delines. It is not surprising, therefore, to find practitioners ar unwillin g and unable to use manual-bared psychotherapies as they are to use outcome s and guidelines. Increased attention to the reasons for this reluctance wi ll improve practitioner receptivity to these clinical resources. Careful at tention to the names and labels given to these tools and avoidance of their promotion to appease the managed care industry are essential. Those develo ping manual-bared psychotherapies must also heed the advice of Addis et al. regarding the need to take practitioner concerns seriously.