Implicit and untested assumptions about the role of psychotherapy treatment manuals in evidence-based mental health practice

We consider Carroll and Nuro's (this issue) model of treatment manual development in the broader context of attempts to bring accountability and evidence-based practice to clinical services. The current zeitgeist surrounding treatment manual dissemination is guided by several implicit and largely untested assumptions. We describe each assumption, consider how it guides current thinking about dissemination of empirically supported treatments, and briefly summarize relevant research. We conclude that treatment manual development and dissemination, while clearly a worthwhile pursuit, is only one way to merge science and practice.