York Hagmayer, University of Göttingen, Germany

Causal reasoning in clinical decision making - when does it make sense?

Proponents of clinical case formulations claim that analyzing the factors and mechanisms causing and maintaining a client’s problem is useful for deciding on a treatment. But respective evidence is scarce and the studies yielded mixed findings. At present, it is unclear whether and under which conditions a causal analysis leads to better outcomes. In the talk I will present a summary of theoretical arguments why causal considerations should improve decisions on treatments and show that findings from experimental research on causal decision making provide supportive evidence. Then I will review studies investigating the treatment utility of causal knowledge and reasoning. Finally, I will propose the causal explanation based decision making framework, a structured decision making process describing how causal knowledge and reasoning should be involved in treatment choice. This framework may guide future research on the role of causal considerations in treatment choice and may help us to better understand when a causal analysis will result in better outcomes for patients.