Treating the client rather than the symptoms: Moving beyond manualised treatments in psychotherapy

There have been some challenges to the reliance upon data from randomised controlled clinical trials when identifying ‘evidence-based’ psychotherapy treatments. Similarly, data show that use of treatment manuals does not result in uniform and beneficial outcomes, that some evidence-based treatments are little better than non-specific counselling and that the search for those therapies or components that are effective has been largely fruitless. In an attempt to extend the debate about evidence-based treatments and drawing upon those aspects of cognitive and behavioural therapies that have been shown to be effective in most settings, this article describes valued outcomes analysis and therapy as a means of assisting clients to understand their own behaviour as (sometimes unwanted) adaptations to environmental demands and then to learn alternative ways of achieving the goals they pursue. A case illustration is provided.