Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, Alberta, Canada.
Behav Res Ther. 2011 Nov;49(11):815-20. doi: 10.1016/j.brat.2011.09.002. Epub 2011 Sep 14.
As psychology has moved toward emphasizing evidence-based practice, use of treatment manuals has extended from research trials into clinical practice. Minimal research has directly evaluated use of manuals in clinical practice. This survey of international eating disorder professionals examined use of manuals with 259 clinicians' most recent client with bulimia nervosa. Although evidence-based manuals for bulimia nervosa exist, only 35.9% of clinicians reported using a manual. Clinicians were more likely to use a manual if they were younger; were treating an adult client; were clinical psychologists; were involved in research related to eating disorders; and endorsed a cognitive-behavioral orientation. Clinicians were less likely to use a manual if they provided eclectic psychotherapy that incorporated multiple psychotherapeutic approaches. We conclude that psychotherapy provided in clinical practice often does not align with the specific form validated in research trials, and "eclecticism" is at odds with efforts to disseminate manuals into clinical practice.
随着心理学向强调基于证据的实践方向发展，治疗手册的使用范围已经从研究试验扩展到临床实践。很少有研究直接评估手册在临床实践中的使用情况。这项对国际饮食障碍专业人士的调查研究了 259 名临床医生最近治疗的神经性贪食症患者使用手册的情况。尽管存在针对神经性贪食症的循证手册，但只有 35.9%的临床医生报告使用了手册。如果临床医生更年轻、治疗成年患者、是临床心理学家、参与与饮食障碍相关的研究、并认同认知行为取向，他们更有可能使用手册。如果临床医生提供的是包含多种心理治疗方法的折衷心理治疗，他们使用手册的可能性就较小。我们的结论是，临床实践中提供的心理治疗通常与在研究试验中验证的特定形式不相符，而“折衷主义”与将手册推广到临床实践的努力相悖。
