Breathing life into a manual: Flexibility and creativity with manual- based treatments

Manuals (a) provide an overall framework that outlines treatment and session goals, (b) supply strategies that aid the therapist in achieving the goals, and (c) guide the therapist as he or she navigates each challenge that arises over the course of treatment. Following a brief description of our model of treatment, treatment strategies are described and illustrated. Specifically, the discussion and illustrations focus on somatic cues, relaxation, self-talk, the FEAR plan, exposure tasks, and the closing video (commercial). The examples demonstrate how to individualize treatment, and the discussion includes the perspectives of two visiting scholars and considers the merits of flexible and creative use of manual-based treatments. This article addresses the use of a manual as a guide for the treatment of children, particularly children with anxiety disorders.