Problems With New American Evidence-Based Guidelines for Therapy With Survivors of Trauma, Part II.

Back in November, I posted an article from Psychology Today by Jonathan Shedler from the University of Colorado School of Medicine. Shedler was highly critical of the new American Psychological Association's (APA) guidelines for treating survivors of psychological trauma. He argued that therapists should be highly sceptical of the guidelines and the evidence relied upon in developing these guidelines. Furthermore, Shedler asserted that the evidence relied upon in the development of these new guidelines not only ignored a lot of good evidence available, they even contradicted a lot of the available evidence on what makes therapy work well. This article certainly has set the cat amongst the pigeons, so to speak, with a number of other well-known figures in psychology stepping in to defend the guidelines. Several of these figures have good reason to want to defend the guidelines, as these people were involved in the development of the new APA guidelines. Now another leading figure in the world of psychotherapy research and training, Dr Scott D. Miller co-founder of the International Centre for Clinical Excellence and the Institute for the Study of Therapeutic Change, has weighed in on the debate. Miller has taken a detailed and critical look at the new APA guidelines. Not only has Miller echoed may of Shedler's criticisms of the new APA guidelines, he has gone even further, noting that the recomended treatments in the new APA guidelines were not even compared to another type of psychotherapy, but were only compared to a relaxation script, where research participants simply listened to a relaxation script each day and were not permitted to talk about their experience with a therapist. Miller was also critical of the assertion made by the APA guidelines that recommend  only "trauma-focussed" therapies be used in the treatment of psychological trauma. According to Miller, most of the available research evidence overall has found that trauma-focussed therapies are no better in the treatent of psychological trauma than other therapies. Miller has also highlighted that some of the arguments in favour of developing the new guidelines have more to do with political issues within the APA than what is actually needed in providing quality care. You can read Miller's critique of the new APA guidelines by clicking the link below.

Clinical Practice guidelines: Beneficial Development or Bad therapy?