“Clinical Practice Guideline for the Treatment of Obesity and Overweight in Children and Adolescents.” By the American Psychological Association; published 2018.

• OVERVIEW: The guideline recommends interventions for the treatment of overweight and obesity in children and adolescents aged 2–18. Recommendations are based on a systematic review of the scientific evidence, a weighing of the benefits and harms of interventions, consideration of what is known about patient values and preferences, and consideration of the applicability of the evidence across demographic groups and settings.

“Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults.” By the American Psychological Association; published 2017.

• OVERVIEW: The guideline recommends interventions for the treatment of PTSD in adults. Recommendations are based on a systematic review of the scientific evidence, a weighing of the benefits and harms of interventions, consideration of what is known about patient values and preferences, and consideration of the applicability of the evidence across demographic groups and settings.

Clinical Practice Guidelines: Directions for a New Program. By the Institute of Medicine; edited by Marilyn J. Field and Kathleen N. Lohr; published 1990 by The National Academies Press.

• OVERVIEW: Shortly after its creation, AHCPR requested advice from the Institute of Medicine (IOM) on how it might approach these new responsibilities for practice guidelines. The IOM agreed to appoint a study committee that would work quickly to provide technical assistance and advice on definition of terms, specification of key attributes of good guidelines, and certain aspects of planning for implementation and evaluation. This report largely confines itself to these fairly specific and limited tasks. It is not a how-to-do-it manual, a methodology text, a priority-setting exercise, or a primer on guidelines for those seeking an introduction to the subject. The report does, however, aim to encourage more standardization and consistency in guidelines development, whether such development is supported directly by the Forum or is undertaken independently by medical societies and other organizations.

“A critique of the American Psychological Association Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults.” By Barry V. Dauphin; published 2020 in Psychoanalytic Psychology.

• ABSTRACT: The American Psychological Association (APA) Guideline Development Panel for the Treatment of PTSD in Adults published the Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults in 2017, which is the first of a series of practice guidelines that will roll out over the next several years. Although the Guideline is the product of tremendous effort and expertise, it is problematic for several reasons, including hidden and flawed economic assumptions and consequences, exclusive reliance on evidence from randomized clinical trials (RCT), the limited definitions of critical outcomes, the unquestioned virtues of guidelines, inconsistencies with APA’s (2012) resolution Recognition of Psychotherapy Effectiveness and the emphasis on therapy packages/brands, the formulaic connection between diagnosis and treatment, among other issues. Psychoanalysts and psychoanalytic psychotherapists should be concerned about the absence of psychoanalytic/psychodynamic therapies from the Guideline, not only because of the long history psychoanalysis has with treating PTSD, but also because the Guideline could become a template for other guidelines and could limit psychoanalytic models of therapeutic practice, exert too powerful an influence over what constitutes ethical practice, and adversely affect funding (both third party payers as well as federal funding for research). Those invested in psychoanalysis must be active in the process of developing, reviewing and approving these guidelines.

“Guideline Orthodoxy and Resulting Limitations of the American Psychological Association’s Clinical Practice Guideline for the Treatment of PTSD in Adults.” By Christine A. Courtois and Laura S. Brown; published 2019 in Psychotherapy.

• ABSTRACT: This article introduces the special issue in which we explore problems and limitations inherent both in the development and implementation of the American Psychological Association’s (APA) Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults. As Chair (Christine A. Courtois) and member (Laura S. Brown) of the guideline development panel, we were in a unique position to observe how certain decisions made by the APA regarding how this guideline should be produced led to flaws in the final product. In this special issue, we address problems that may be inherent in many clinical practice guidelines for psychotherapists. Our authors explore the importance of a more ecologically-informed model for such guidelines, one that would take into account the body of research on the psychotherapy relationship, psychotherapy process, and a broad range of psychotherapy outcomes. We end with recommendations APA might take to generate future clinical practice guidelines that are well-founded in APA’s own definitions of evidence-based practice, and more attuned to APA’s increasing attention to the specialized concerns of clients who come from socially marginalized groups.

“The psychodynamic diagnostic manual – 2nd edition (PDM-2).” By Vittorio Lingiardi and Nancy McWilliams; published 2015 in World Psychiatry.

• OVERVIEW: For decades many clinicians, especially psychodynamic and humanistic therapists, have resisted thinking about their patients in terms of categorical diagnoses. In the current era, they find themselves having to choose between reluctantly “accepting” the DSM diagnostic labels, “denying” them, or developing alternatives more consistent with the dimensional, inferential, contextual, biopsychosocial diagnostic formulations characteristic of psychoanalytic and humanistic approaches. The Psychodynamic Diagnostic Manual (PDM) reflects an effort to articulate a psychodynamically oriented diagnosis that bridges the gap between clinical complexity and the need for empirical and methodological validity. It has been strongly influenced by a similar effort, the Shedler-Westen Assessment Procedure (SWAP-200), on which it has drawn extensively. The second edition of the PDM (PDM-2) will be published in 2016 by Guilford Press.

“Relationships and responsiveness in the psychological treatment of trauma: The tragedy of the APA Clinical Practice Guideline.” By John C. Norcross and Bruce E. Wampold; published 2019 in Psychotherapy.

• ABSTRACT: The therapeutic relationship and responsiveness/treatment adaptations rightfully occupy a prominent, evidence-based place in any guidelines for the psychological treatment of trauma. In this light, we critique the misguided efforts of the American Psychological Association’s (APA, 2017) Clinical Practice Guideline on Posttraumatic Stress Disorder in Adults to advance a biomedical model for psychotherapy and thus focus almost exclusively on treatment methods for particular disorders. Instead, the research evidence, clinical expertise, and patient preferences and culture (the necessary triumvirate of evidence-based practice) should converge on distinctive psychological guidelines that emphasize the therapy relationship, treatment adaptations, and individual therapist effects, all of which independently account for patient improvement more than the particular treatment method. Meta-analytic findings and several trauma-specific studies illustrate the thesis. Efforts to promulgate guidelines without including the relationship and responsiveness are seriously incomplete and potentially misleading. The net result is an APA Guideline that proves empirically dubious, clinically suspect, and marginally useful; moreover, it squanders a vital opportunity to identify what actually heals the scourge of trauma. We conclude with recommendations for moving forward with future APA practice guidelines.