Practice guidelines: What’s been done and what’s coming

Since 2016, APA has developed three clinical practice guidelines on the topics of treatment of posttraumatic stress disorder, depression, and child overweight and obesity. Now, APA is seeking psychologists’ help in updating the PTSD guideline.

According to best practices, clinical practice guidelines should be updated every five years or sooner if it is determined that an update is warranted due to new scientific findings that could impact the recommendations.

The PTSD clinical practice guideline was approved in 2017 and will be the first APA guideline to be updated. APA has announced a call for nominations to the panel responsible for doing this work. Psychologists are encouraged to nominate themselves.

In addition to this significant update, APA continues to work on new guidelines for psychologists to use in practice. Here’s the latest news on APA’s guideline development and how you can get involved with the process.

The new clinical practice guideline panel on the treatment of chronic musculoskeletal pain in adults began meeting in the spring of 2020 and is determining the precise scope for a new chronic pain guideline. The panel is following the scoping framework of “PICOTS”—identifying populations, interventions, comparators, timing, and settings. The panel will solicit public feedback at key points in the development process.

This new guideline and APA’s other clinical practice guidelines are developed by independent panels appointed by the APA Board of Directors following procedures adopted internationally by guideline development groups. The websites for APA’s approved clinical practice guidelines contain resources for clinicians, patients, and families such as treatment information, assessment instruments, case examples, and more.

A work group of the clinical practice guideline Advisory Steering Committee is finalizing a written report that examines how different types of evidence could be rigorously evaluated by a guideline development panel. The group is also looking at how psychotherapy change processes might be included in a guideline on interventions of a transdiagnostic nature, as opposed to a conventional diagnosis. This work group was formed in 2019 to evaluate the value and feasibility of developing such a guideline.

Two new professional practice guidelines on evidence-based practice and treating individuals who have experienced trauma are currently in development under the purview of the Committee on Professional Practice and Standards, which reports to the Board of Professional Affairs.

Professional practice guidelines are designed to inform psychologists in practice about professional roles, populations, or settings, and do not focus on specific disorders or treatments. They are generally based on a consensus review of the literature (rather than on systematic reviews, as clinical practice guidelines are). Examples of professional practice guidelines include the record keeping guidelines, telepsychology guidelines, and guidelines developed in coordination with other governance groups such as the comprehensive multicultural guidelines and guidelines on older adults and LGBTQ populations.

The draft professional practice guideline on evidence-based practice in health care has undergone public comment and is being revised by developers. The guideline on treating individuals who have experienced trauma—intended to complement APA’s clinical practice guideline on PTSD—is expected to go out for public comment in late 2020. Both professional practice guidelines will ultimately go to the Council of Representatives for review and approval.

The APA and APA Services Advisory Work Group on the Implementation of Evidence-Based Practice in Health Service Psychology is currently evaluating APA policies, programs, and activities related to APA’s 2005 Policy Statement on Evidence-Based Practice in Psychology and identifying areas or directions in which proposals for new or updated policies, programs, or activities could or should be pursued.

The group’s scope of work is limited to health-care-related practice and does not include other areas of practice or general applied psychology. Included in the group’s review are APA’s extensive professional practice and clinical practice guidelines. The group will solicit input from members as part of its process.

There are various ways for APA members to get involved with guideline development:

• Apply to serve on a clinical practice guideline development panel, the Advisory Steering Committee for clinical practice guidelines, a professional practice guideline group, the Committee on Professional Practice and Standards, and more.
• Respond to calls for public comments for any of the APA guidelines as well as for outside entities such as the United States Preventive Services Task Forceopens in new window and the Agency for Healthcare Research and Qualityopens in new window when they have relevant documents on mental and behavioral health topics. You not only can submit comments on your own but also send your comments to APA staff for potential inclusion in the association’s comments.

Be on the lookout for announcements about these opportunities on APA and division listservs, newsletters, and social media.

You can also email APA’s Practice Directorate at any time with questions or comments about any aspect of APA’s work on evidence-based practice and guidelines in the health care domain.