Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting.

Goldberg, Simon B.; Rousmaniere, Tony; Miller, Scott D.; Whipple, Jason L.; Nielsen, Stevan L.; Hoyt, William T.; Wampold, Bruce E.

doi:10.1037/cou0000131

Cited by 242 publications

(241 citation statements)

References 55 publications

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“…A recent study investigating characteristics of highly effective psychotherapists found that the amount of time spent on improving therapeutic skills (i.e., deliberate practice) predicted positive client outcomes (Chow et al, ). A case study focusing on an agency that implemented deliberate practice and routine outcome monitoring also indicated that therapists improved their outcomes over time (Goldberg et al, ), in contrast to other studies (e.g., Goldberg, Babins‐Wagner, et al, ). This may suggest that devoting time to improving therapeutic skills may be of importance to patient outcome.…”

Section: Discussionmentioning

confidence: 98%

Do clinical experience, formal cognitive behavioural therapy training, adherence, and competence predict outcome in cognitive behavioural therapy for anxiety disorders in youth?

Bjaastad

Wergeland

Haugland

et al. 2018

Clin Psychology and Psychoth

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Section: Discussionmentioning

confidence: 98%

Do clinical experience, formal cognitive behavioural therapy training, adherence, and competence predict outcome in cognitive behavioural therapy for anxiety disorders in youth?

Bjaastad

Wergeland

Haugland

et al. 2018

Clin Psychology and Psychoth

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“…the same reductions in PTSS as dyads whose treatment could focus immediately on symptom reduction. Although some meta-analyses indicate larger treatment effects on child symptoms with a higher level of provider training (see Sandler et al, 2014 for a review), a number of crosssectional studies have failed to find differences in treatment outcomes resulting from level of training or experience (for a review, see Goldberg et al, 2016). In the current study, parental PTSS decreased more when the dyad was treated by a licensed clinical staff member rather than a therapist-in-training, but child improvement did not differ in this manner.…”

Section: Discussionmentioning

confidence: 99%

Parent and Child Trauma Symptoms During Child–Parent Psychotherapy: A Prospective Cohort Study of Dyadic Change

Hagan

Browne

Sulik

et al. 2017

Journal of Traumatic Stress

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Five randomized controlled trials have shown that child-parent psychotherapy (CPP) improves trauma symptoms in children. Less is known about parent symptoms or moderators of symptom change. In a sample of 199 parent (81% biological mother; 54% Latina/o) and child (aged 2 to 6 years; 52% male; 49% Latina/o) dyads who participated in an open treatment study of CPP, this study investigated whether parent and child symptoms similarly decreased during treatment and whether improvement was moderated by parent, child, and treatment characteristics. Parents completed baseline and posttreatment interviews regarding exposure to traumatic events, posttraumatic stress symptomatology (PTSS), and other mental health indices. Latent difference score analysis showed that PTSS significantly decreased by more than 0.5 SD for parents and children. The PTSS improvement in parents was associated with reductions in child avoidance, r = .19, p = .040, and hyperarousal, r = .33, p < .001. Girls showed a greater reduction than boys in reexperiencing, β = -.13, p = .018, and hyperarousal, β = -.20, p = .001. Contrary to expectations, parent and child improvement in PTSS was greater for those with fewer parental lifetime stressors, β = .15 to .33, and for those who participated in fewer treatment sessions, β = .15 to .21. The extent of improvement in parent PTSS varied based on clinician expertise, β = -.20, p = .009. Significant reductions in parent and child PTSS were observed during community-based treatment, with CPP and symptom improvement varying according to child, parent, and treatment characteristics.

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“…As for therapist experience, although common sense suggests that it should improve the effectiveness of therapy, the first longitudinal study that addresses this question, with data from 170 psychotherapists and 6,591 patients (Goldberg et al, 2016), did not endorse this. In our opinion, the highly structured intervention program and the wealth of resources and material available to the therapist minimize the possible impact of their inexperience.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Psychological Intervention for Patients with Chronic Pain in Primary Care

et al. 2017

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According to evidence from recent decades, multicomponent programs of psychological intervention in people with chronic pain have reached the highest levels of efficacy. However, there are still many questions left to answer since efficacy has mainly been shown among upper-middle class patients in English-speaking countries and in controlled studies, with expert professionals guiding the intervention and with a limited number of domains of painful experience evaluated. For this study, a program of multicomponent psychological intervention was implemented: (a) based on techniques with empirical evidence, but developed in Spain; (b) at a public primary care center; (c) among patients with limited financial resources and lower education; (d) by a novice psychologist; and (e) evaluating all domains of painful experience using the instruments recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). The aim of this study was to evaluate this program. We selected a consecutive sample of 40 patients treated for chronic non-cancer pain at a primary care center in Utrera (Seville, Spain), adults who were not in any employment dispute, not suffering from psychopathology, and not receiving psychological treatment. The patients participated in 10 psychological intervention sessions, one per week, in groups of 13–14 people, which addressed psychoeducation for pain; breathing and relaxation; attention management; cognitive restructuring; problem-solving; emotional management; social skills; life values and goal setting; time organization and behavioral activation; physical exercise promotion; postural and sleep hygiene; and relapse prevention. In addition to the initial assessment, measures were taken after the intervention and at a 6-month follow-up. We assessed the program throughout the process: before, during and after the implementation. Results were analyzed statistically (significance and effect size) and from a clinical perspective (clinical significance according to IMMPACT standards). According to this analysis, the intervention was successful, although improvement tended to decline at follow-up, and the detailed design gave the program assessment a high degree of standardization and specification. Finally, suggestions for improvement are presented for upcoming applications of the program.

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Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting.

Abstract: Implications of these findings for the development of expertise in psychotherapy are explored. (PsycINFO Database Record

Cited by 242 publications

References 55 publications

Do clinical experience, formal cognitive behavioural therapy training, adherence, and competence predict outcome in cognitive behavioural therapy for anxiety disorders in youth?

Do clinical experience, formal cognitive behavioural therapy training, adherence, and competence predict outcome in cognitive behavioural therapy for anxiety disorders in youth?

Parent and Child Trauma Symptoms During Child–Parent Psychotherapy: A Prospective Cohort Study of Dyadic Change

Evaluation of a Psychological Intervention for Patients with Chronic Pain in Primary Care

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