Market-Driven Treatment Development

In my last column I tried to make the case that behavior therapy had to learn to fit within an industrialized health care delivery system. I suggested several tasks, other than psychotherapy delivery, that, despite their economic relevance to the delivery system, are being largely ignored by clinical researchers. We also need to rethink our role in traditional psychotherapy services. There is scant evidence that doctoral-level providers are more successful than nondoctoral therapists, but this does not tell the whole story. A major purpose for hiring doctoral-level therapists to deliver services (and for demanding evaluation data on services delivered anywhere in the system) is treatment development. Simply put, we need to use the delivery system itself as an important way of learning how best to make it effective and efficient.