Why should treatment guidelines be used? First, no matter how skillful or artful any of us may be, there are frequent occasions when we feel the need for expert guidance and external validation of our clinical experience. Second, our field is becoming standardized at an ever more rapid pace. The only question is who will be setting the standards? We believe that practice guidelines should be based on the very best in clinical and research opinion. Otherwise, they will be dominated by other less clinical and less scientific goals (e.g., pure cost reduction, bureaucratic simplicity). Third, it should be of some comfort to anyone concerned about losing clinical art under the avalanche of guidelines that the complex specificity of clinical practice will always require close attention to the individual clinical situation. Guidelines can provide useful information but are never a substitute for good clinical judgment and common sense.

Our guidelines are already being used throughout the country and seem to be helpful not only to clinicians but also to policy makers, administrators, case managers, mental health educations, patient advocates, and clinical and health services researchers. Ultimately, of course, the purpose of this whole enterprise is to do whatever we can to improve the lives of our patients. It is our hope that the expert advice provided in these guidelines will make our treatments ever more specific and effective.



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