Tailor-made and standardized therapy: complementary tasks in behavior therapy. A contrarian view.

In medicine, decisions about treatment selection are mainly based on clinical diagnoses, whereas behavior therapists have typically assumed that it is necessary to tailor treatments based on individual problem analyses. However, various studies (including our own using patients with phobic anxieties) have failed to demonstrate an advantage for this procedure. At least for some disorders, clinical diagnosis appears to be a relevant and sufficient criterion for treatment selection. A process model is presented that views treatment individualization and standardization as complementary strategies. Although the application of techniques should be standardized as much as possible, translating general method rules into a concrete intervention for a particular person will remain a task of individualization. Individualization will also remain necessary for the other primary task of the therapist: promoting basic patient behavior that is conducive to treatment and a precondition for the successful application of interventions.