You state that adaptive interventions are protocolized, but then you stated that clinical judgment can be part of an adaptive intervention. How can this be?


Yes, we agree with both statements. It is a common misconception that clinical judgment is at odds with a protocolized/manualized intervention, but this is not true.

In many settings, there is no evidence to suggest that one intervention is better or worse than another; here, clinical judgment must be used to make a decision about which treatment to offer. In fact, most real-world biobehavioral or educational interventions utilize some form of clinical judgment. The ultimate goal of an adaptive intervention is to guide the most critical decisions, not replace clinical judgment. Further, an adaptive intervention can also be designed to help guide when clinical judgment is most necessary.



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