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When does modifying the protocol go too far? Considerations for implementing evidence-based treatment in practice.

Clair Cassiello-Robbins1, Jessica R Dietch2, Kirk D Mochrie1

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Adapting evidence-based psychological treatments (EBTs) requires careful consideration to maintain efficacy. This article explores challenges and proposes future research for effective EBT adaptation in clinical practice.

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Area of Science:

  • Psychology
  • Clinical Psychology
  • Psychotherapy Research

Background:

  • Evidence-based psychological treatments (EBTs) are typically manualized for consistent delivery.
  • Clinical practice often requires adapting EBTs to meet diverse patient and setting needs.
  • Adaptation of EBTs raises questions about preserving their evidence-based integrity.

Purpose of the Study:

  • To discuss challenges associated with adapting EBTs.
  • To highlight clinical considerations for modifying EBTs.
  • To propose future research directions for EBT adaptation guidelines.

Main Methods:

  • Literature review and conceptual analysis of EBT adaptation.
  • Discussion of factors influencing EBT modification.
  • Identification of research gaps in EBT adaptation.

Main Results:

  • Adaptation of EBTs is complex, balancing fidelity with flexibility.
  • Clinicians face dilemmas regarding the extent of treatment modification.
  • Current guidelines for adapting EBTs are limited.

Conclusions:

  • Further research is needed to establish clear guidelines for adapting EBTs.
  • Balancing treatment integrity with clinical flexibility is crucial for effective EBT implementation.
  • Future research should focus on empirical investigation of adaptation strategies.