An appraisal of the American Psychological Association's Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder

Abstract

In 2017, the American Psychological Association published the Clinical Practice Guidelines for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. Although the Guideline Development Panel aimed to produce guidelines based on the best available scientific evidence, concerns were raised that the guidelines would constrain the implementation of some effective psychotherapies and limit clinician autonomy, potentially leading to coverage for only manualized, time-limited, cognitive-behavioral treatments. The following article reviews the PTSD guidelines in light of the evidence-based practice in psychology policy adopted by the American Psychological Association in 2006. We highlight the strengths of the guidelines as currently written while recognizing areas in which the guidelines do not meet evidence-based practice in psychology recommendations. A clinical vignette of the treatment of a complex patient with PTSD and significant comorbidities is provided to illustrate the difficulty of clinical decision-making and how the guidelines may complicate the delivery of effective treatments. We conclude with recommendations on how to consider a broad range of research evidence, appropriately integrate clinician expertise, and better appreciate the role of patient values and preferences in PTSD treatment decision-making. (PsycINFO Database Record (c) 2019 APA, all rights reserved).