Details

Autor(en) / Beteiligte

• Kudler, Harold
• Hilsenroth, Mark J
• Brown, Laura S
• Courtois, Christine A

Titel

Clinical Practice Guidelines for Posttraumatic Stress Disorder: Are They Still Clinical?

Ist Teil von

• Psychotherapy (Chicago, Ill.), 2019-09, Vol.56 (3), p.383-390

Ort / Verlag

United States: Educational Publishing Foundation

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• This article traces the evolution of clinical practice guidelines (CPGs) for the treatment of Posttraumatic Stress Disorder (PTSD) to illustrate how their construction and use have become intertwined and often conflated with other pressing clinical and scientific controversies. This review locates critical analysis of key documents regarding PTSD CPG construction within the context of longstanding tensions and frank competition about the relative value of science and clinical experience in the effort to establish best practices. As is true of so many dichotomies, the competition between science and clinical practice is more apparent than real. The growing tendency of developers to exclude common clinical practices in the construction of (and within the discussion sections of) CPGs for PTSD imposes a false sense of precision and predictability on clinical practice, which is anything but precise or predictable. As such, it raises the question as to whether these CPGs are still clinical at all. It also distracts from critically important opportunities to harness the tension between competing perspectives and domains to significantly advance the care of patients. Clinical Impact Statement Question: The growing tendency of clinical practice guideline developers to impose a false sense of scientific precision and predictability on clinical practice-which is anything but precise or predictable, especially as it pertains to the treatment of psychological trauma-raises the question as to whether PTSD clinical practice guidelines are still clinical at all. Findings: The tension between clinical and scientific approaches to human health and illness cannot be resolved but can be harnessed to advance the prevention and treatment of mental illness. Meaning: The CPG enterprise in the field of psychological trauma, if mismanaged, can become self-defeating for science, clinical practice, and the public good. Balance is therefore essential in PTSD CPG development. Next Steps: To achieve this, clinicians and scientists must work together to rebalance and synthesize their overlapping yet still unique domains.