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

Addis, Wade, and Hatgis (this issue) identify practitioner concerns about manual-based psychotherapies. Their conclusions are consistent with literature and experience regarding the use of outcome measurement and practice guidelines. It is not surprising, therefore, to find practitioners ar unwilling and unable to use manual-bared psychotherapies as they are to use outcomes and guidelines. Increased attention to the reasons for this reluctance will improve practitioner receptivity to these clinical resources. Careful attention to the names and labels given to these tools and avoidance of their promotion to appease the managed care industry are essential. Those developing manual-bared psychotherapies must also heed the advice of Addis et al. regarding the need to take practitioner concerns seriously.