Stanley B. Messer, PhD


Medscape General Medicine. 2002;4(4) 

In This Article


With the exception of the controversy over prescription privileges for psychologists, there is probably no issue currently as contentious in the field of mental health treatment as that of the advocacy and use of manual-guided, empirically supported treatments (ESTs). I shall say at the outset that I believe there is value in knowing and practicing ESTs. I must quickly add, however, that there are many reasons for us not to be sinking all our mental health capital into ESTs alone, especially if it means the exclusion of other therapies and modes of practice. My object in this paper is to raise questions about the value of manual-guided therapies, or ESTs, especially compared with non-EST therapies, and to present the case for the equal or greater importance of the therapy-patient relationship in determining therapy outcome.