Manualized Treatment Programs for FSD: Research Challenges and Recommendations

INTRODUCTION: The use of manualized treatment programs offers a useful research framework for assessing psychotherapeutic interventions for female sexual dysfunctions (FSDs), but it does not address all issues related to methodological rigor and replication, and raises new research issues in need of discussion. AIMS: The goals of this manuscript are to review the literature on treatment trials utilizing manualized psychotherapy treatments for FSD and to explore the benefits and research issues associated with the flexible use of treatment manuals. METHODS: The method used was the review of the relevant literature. RESULTS: While the use of manualized treatments for FSDs can address certain methodological issues inherent in psychotherapy research, flexibility in manual administration is necessary in order to allow tailoring for individual needs that can be beneficial to both the participant and the research. The flexible use of manuals, as opposed to strict manual adherence, may also be more relevant for clinical utility. CONCLUSIONS: In order to administer manualized treatments for FSDs with appropriate flexibility, while also maximizing internal validity and replicability, the authors recommend that predetermined decision rules be utilized to guide individual tailoring, that potential gaps in the manual be identified and addressed, and that differing levels of motivation and readiness for treatment be taken into consideration in the treatment protocol.