The concept of best treatment practice is a response to the growing diversity of therapeutic
experience and to the frequently inadequacy of service reality and guidelines. Ideally,
best practice guidelines are based on the available research evidence about effi cacy and
effectiveness of therapeutic approaches. But limitations of outcome research must be
taken into consideration as well as limitations of guideline applicability. Circumstantial
factors are also relevant for treatment outcomes, and clinicians are expected to adapt
evidence-based recommendations to such factors in their daily practice with individual
patients. In addition, availability and access to recommended treatments are in the responsibility
of service planners and providers, thereby facilitating the implementation of
best practices. We understand best practice not as treatment provided in some centres
of excellence, but as a system providing all those in need of treatment in the best possible
way. Finally, major changes are expected for the future, redirecting the focus from a
traditional evaluation of clinical usefulness for populations to an assessment of individually
optimised interventions (personalised medicine: 'treating the patient, not the disease')