Expertise in psychotherapy: Inherent liabilities of becoming experienced.

Abstract

The properties of problem representation among experts working in well-structured problem spaces are distinguished from those working in the poorly structured and more complex domain of psychotherapy. The implications of forward and backward causal reasoning, the absence of a consensually sanctioned, canonical domain knowledge, and the reigning confusion about what constitutes a relevant clinical database in a psychotherapeutic relationship are drawn out. A number of normative characteristics of expert performance are examined in view of the manner in which they constitute liabilities for those working in fuzzy problem spaces."An expert," said Frank Lloyd Wright, "is one who does not have to think. He knows." Herein lies a problem. One may suspect that Wright was not referring solely to architects. Whether or not psychotherapists and counselors, most of whom in the course of their careers become highly experienced if not expert, escape the implications of that maxim remains to be seen. In any event, evidence exists (Chi, Glaser & Farr, 1988) that the characteristics of expert systems are similar across disciplines. That means that expertise in psychotherapy may share, in varying degrees, properties that inhere in other skill domains.

Making Sense of Client Data: Clinical Experience and Confirmationism Revisited

“…e.g., Dawes, 1994;Dumont, 1991;Garb, 1989Garb, , 1998Spengler & Strohmer, 1994;Peterson, 1995). Although studies in expert systems provide ample evidence that process in clinical medical disciplines can be profoundly affected by level of expertise (e.g., Azevedo, Lajoie, & Fleiszer, 1996;Chi, Glaser, & Farr, 1989;Johnson et al, 1981), such experience has not been related to many characteristics of information processing in psychotherapy.…”

“…These findings have yet to be satisfactorily addressed. If "practice makes perfect," one may ask why this principle is not more evident in the mental health professions (Dumont, 1991).…”

Zoektocht van een psychotherapeut in opleiding

“…Zij plaatst soortgelijke vraagtekens en vraagt zich af of traditionele therapieopleidingen wel voldoende aandacht hebben voor essentiële persoonlijke kwaliteiten van therapeuten in opleiding, of nog scherper: of deze opleidingen mogelijk zelfs een remmende en ontmoedigende werking hebben op een reeds bestaande of natuurlijke wijze van optreden van beginnende therapeuten. Zij haalt hierbij onderzoeken aan (Hattie, Sharpley & Rogers, 1984;Dumont, 1991) waaruit naar voren komt dat onervaren of niet-professionele hulpverleners even goede en soms zelfs betere resultaten behalen dan ervaren en geschoolde therapeuten. Leijssen acht persoonlijke eigenschappen van therapeuten van groter belang dan geleerde methodieken.…”

Echtheid in cliëntgerichte therapie

“…Bevestigt deze casus de onderzoeksbevindingen (Hattie, Scharpley & Rogers, 1984;Dumont, 1991) die voor velen onthutsend waren, namelijk dat onervaren hulpverleners even goede en soms betere resultaten behalen dan ervaren en geschoolde therapeuten? Ja en nee.…”