Treating the Client Rather Than the Symptoms: Moving Beyond Manualised Treatments in Psychotherapy.

here have been some challenges to the reliance upon data from randomised con- trolled 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 cogni- tive 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 behav- iour as (sometimes unwanted) adaptations to environmental demands and then to learn alternative ways of achieving the goals they pursue. A case illustration is provided.