Practice guidelines and empirically validated psychosocial treatments: ships passing in the night?

As outcomes research and clinical practice guidelines are more widely disseminated throughout the healthcare industry, what will happen to scientifically validated but less widely recognized psychosocial interventions? The authors critically review the issues involved in guideline development, primarily in terms of the criteria used for this development and the research available to determine which interventions should be included or excluded. Evidence is presented for the cost effectiveness of psychosocial treatments in areas ranging from schizophrenia, bulimia, borderline personality and panic disorder to the psychological aspects of such physical disorders as myocardial infarction and breast cancer.