To manualize, or not to manualize: Is that still the question?

To manualize, or not to manualize: Is that still the question? A systematic review of empirical evidence for manual superiority in psychological treatment

Abstract
Objective: Institutional promotion of psychotherapy man- uals as a requirement for evidence‐based treatments (EBTs) yields the assumption that manualized treatment is more effective than nonmanualized treatment. This systematic review examines empirical evidence for this claim.
Methods: An electronic database search identified studies that directly or indirectly compared manual‐based and non‐manual‐based treatment.
Results: Six studies directly compared manualized and nonmanualized treatment (Hypothesis 1). None support manual superiority. Eight meta‐analyses indirectly assessed effect sizes of manual‐based treatment and control groups (Hypothesis 2). Three support manual superiority, five do not. One meta‐analysis and 15 further studies addressed manual adherence as an indirect indicator of manual efficacy (Hypothesis 3). The meta‐analysis concluded that manual adherence does not affect outcome, additional studies provided inconclusive results.
Conclusions: Manualized treatment is not empirically supported as more effective than nonmanualized treatment. While manual‐based treatment may be attractive as a research tool, it should not be promoted as being superior to nonmanualized psychotherapy for clinical practice.

Keywords
empirically supported treatment, evidence‐based treatment, manual‐based treatment, manualization, psychotherapy, treatment efficacy

Persbericht (In Dutch)
Persbericht To manualize or not to manualize, is that still the question

To cite this article
Truijens, F., Zühlke-van Hulzen, L., & Vanheule, S. (2018). To manualize, or not to manualize: Is that still the question? A systematic review of empirical evidence for manual superiority in psychological treatment. Journal of Clinical Psychology, DOI: 10.1002/jclp.22712.

 

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