Critical dimensions in the choice and maintenance of successful treatments: Strength, integrity, and effectiveness.

TLDR

Successful clinical practice demands good judgment in choosing optimal treatments, yet the criteria guiding these choices are often implicit. The article argues that clinicians can improve judgment by explicitly attending to treatment strength, integrity, and effectiveness. The authors draw on psychological and evaluation literature to illustrate practical considerations and problems of this approach. Monitoring strength, integrity, and effectiveness during treatment enables mid‑course adjustments and clarifies their interrelationships.

Abstract

Successful clinical practice demands that we use good judgment in choosing optimal treatments for the conditions in question. However, the criteria on which we base our choice are often implicit. In this article, it is argued that practicing clinicians can enhance the quality of these judgments by attending more explicitly to the strength and integrity of treatment as well as to specific standards of treatment effectiveness. Numerous examples from the psychological and evaluation literature are utilized to portray the practical considerations and problems inherent to this approach. By monitoring strength, integrity, and effectiveness for the duration of treatment, we can make appropriate mid-course corrections and determine the relationship among these three critical dimensions of treatment.