Process and outcome in mental health care delivery: a model approach to treatment evaluation

In recent years, there has been a strong movement toward "evidence-based medicine," which has significantly affected approaches to the delivery of mental health care. The author highlights the cultural and socioeconomic context in which this trend has emerged. He also notes the resulting controversy over the emphasis on randomized controlled trials (RCTs). Although he does not reject the important role of such trials, he reviews some of their limitations and offers a rationale for the equally important role of naturalistic outcome studies. He concludes by introducing subsequent articles in the journal issue that describe a computerized, online approach for evaluating the effectiveness of mental health care delivery. This system, originally developed in the United Kingdom, has been adapted for use by The Menninger Clinic.