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APA Psychotherapy Training Videos are intended solely for educational purposes for mental health professionals. Viewers are expected to treat confidential material found herein according to strict professional guidelines. Unauthorized viewing is prohibited.
Systematic Treatment Selection (STS) is not simply a psychotherapy system. Most directly it is a method of planning and delivering optimal treatments in a way that is consistent with established scientific literature and that cuts across different theoretical approaches. STS is a tracking and treatment system that involves applying contemporary research findings to clinical problems in an integrated and cross-cutting way. It provides the clinician with principles and strategies for addressing a wide range of patient problems, more than with specific techniques or theoretical constructs about the nature of the psychopathology or treatment process. The STS approach seeks to establish an optimal and maximally beneficial fit between patient and problem characteristics, on one hand, and therapist and treatment characteristics, on the other. Six patient and problem characteristics (e.g., functional impairment, social support, complexity, coping style, resistance traits, and distress), along with a similar number of treatment, therapist, and relationship characteristics, provide the basic data from which optimal treatment is planned in STS. The treatment planning dimensions were extracted from comprehensive literature reviews. These reviews identified variables that have been reliably associated with change, either because (1) they predict treatment outcomes directly, or (2) their presence has been systematically observed to moderate the impact of treatments. To aid the translation of research into practice, "Research-Informed Relationships" among patient, alliance, clinician, and treatment qualities are articulated as guiding principles. Each of the patient, therapist, treatment, and relationship dimensions have been identified through systematic research as being valid contributors to improving efficacy or effectiveness, and each is a differential indicator of some aspect of treatment. The value of the dimensions that are central to the STS system is determined by the degree to which each dimension is predictive, within scientific research literature, of treatment benefit. Thus, the dimensions are not dependent on the validity of a theory of psychopathology or change, but on the leverage that is gained when a body of research is expressed and used as a principle of change that is available to guide the application of treatment. Because it is not bound to a finite set of principles or to a particular theory of psychopathology and change, STS has the flexibility to blend the best of scientific research with clinical theory and practice. The dimensions forming the current basis of STS were designed as a starting place from which other principles and dimensions could be added as research identifies them. Eighteen research-based principles were originally derived from research on therapeutic outcomes (Beutler, Clarkin, & Bongar, 2000), but this list has subsequently been expanded by the work of the American Psychological Association's Division 12 (Society of Clinical Psychology) joint Task Force (Castonguay & Beutler, 2006) and now includes specific principles that are applied for different kinds of problems. Both common (those that cut across disorders) and specific (those that are unique to particular problems) principles have been applied to the treatment of mass trauma victims (Housley & Beutler, in press). Moreover, a subset of the original set of 18 principles have also been applied to the specific case of using individual psychotherapy for the treatment of those with depression and chemical abuse disorders (Beutler & Harwood, 2000). Thus, the principles that have been developed to date can assist the clinician in selecting and using the methods that are most likely to succeed, regardless of the theoretical framework from which these methods originated or the modality and format through which treatment is applied. A strength of the STS system is that it does not specify a "typical" patient. It is designed to allow each client to receive a treatment that is tailored to their particular needs and characteristics. The system is specifically designed to vary as a function of the many qualities that characterize patients who seek mental health intervention. It is easier to specify the limits of the STS applications as reflected in the paucity of research among certain groups. For example, the current literature from which patient, treatment, and matching variables were defined does not translate readily to children or to severely disorganized populations. It is anticipated that different dimensions and algorithms of treatment matching will be called for in applying STS to these populations. The various rules or algorithms of application do include all or most of those identified by different gender, ethnic, and age demographics. Download a step-by-step presentation about the STS system (PDF format, 741KB). |
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