Critical dimensions in the choice and maintenance of successful treatments: Strength, integrity, and effectiveness.

Successful clinical practice demands that we use good judgment in choosing optimal treatments for the conditions in question. However, the criteria on which we base our choice are often implicit. In this article, it is argued that practicing clinicians can enhance the quality of these judgments by attending more explicitly to the strength and integrity of treatment as well as to specific standards of treatment effectiveness. Numerous examples from the psychological and evaluation literature are utilized to portray the practical considerations and problems inherent to this approach. By monitoring strength, integrity, and effectiveness for the duration of treatment, we can make appropriate mid-course corrections and determine the relationship among these three critical dimensions of treatment.