Clinical practice guidelines for posttraumatic stress disorder: Are they still clinical?

This article traces the evolution of clinical practice guidelines (CPGs) for the treatment of Posttraumatic Stress Disorder (PTSD) to illustrate how their construction and use have become intertwined and often conflated with other pressing clinical and scientific controversies. This review locates critical analysis of key documents regarding PTSD CPG construction within the context of longstanding tensions and frank competition about the relative value of science and clinical experience in the effort to establish best practices. As is true of so many dichotomies, the competition between science and clinical practice is more apparent than real. The growing tendency of developers to exclude common clinical practices in the construction of (and within the discussion sections of) CPGs for PTSD imposes a false sense of precision and predictability on clinical practice, which is anything but precise or predictable. As such, it raises the question as to whether these CPGs are still clinical at all. It also distracts from critically important opportunities to harness the tension between competing perspectives and domains to significantly advance the care of patients. (PsycINFO Database Record (c) 2019 APA, all rights reserved)