Although positive findings have been replicated for several projective test scores, validity for most projective test scores is either unknown or poor. He notes that members of consensus panels and authors of literature reviews can be biased. Though it is important that we view guidelines with a critical eye, rather than abandon this approach, it would be better if we work to make the process more objective. Using this approach, one identifies patient qualities that will allow one to choose an effective treatment modality. Certainly there is a need for empirically based rules to help clinicians decide on a treatment.
Problems exist with the treatment decisions made by clinicians.
By using empirically based rules to decide on a treatment, the utility of treatments can be greatly improved. Graduate school curricula need to be revised so students are taught about empirically supported treatments and empirically validated assessment instruments. Students also need to be taught about the validity of clinical judgments, the promise of using computers to make judgments, and difficulties in learning from experience. Second, graduate school programs may need to change the way that students are selected for their programs. Unless changes occur in the type of students recruited to our field and in the work environment for graduates who become practicing clinicians, my sense is that all the efforts exerted in training programs, licensure, and continuing education will not accomplish any greater emphasis on the scientific principles underlying the helping process.