Being bolder with the Boulder model: the challenge of education and training in empirically supported treatments.

A number of factors interfere with the realization of the scientist-practitioner model of training in applied psychology. Resistance to empirically supported treatments (ESTs) may arise from both academic faculty and internship supervisors who have an investment in approaches of longer standing but with less empirical justification. A possible problem with ESTs, however, is that they typically derive from studies that use treatment manuals, which, originally developed to define the independent variables in psychotherapy research, have become central in graduate training. Because manuals can constrain clinician behavior and because they are almost always associated with categorically defined diagnostic categories, one can lose sight of the idiographic analysis of single cases. Reliance on manualized treatment can discourage functional analysis of the complexities of individual cases. Achieving some synthesis of this dialectic poses a significant challenge to the continuing development of the science and profession of applied psychology.