Graduate training in psychotherapy: Are therapy outcomes enhanced?

Abstract

Several sources of indirect evidence supporting the value of graduate training in psychotherapy are reviewed here. Training protocols that are known to enhance trainees' skills are briefly discussed, as are conclusions of meta-analytic reviews examining relationships between therapist experience and training, and therapy outcome. An updated meta-analysis of therapy outcome studies involving within-study comparisons of psychotherapists of different levels of training and experience is summarized. It is concluded that a variety of outcome sources are associated with modest effect sizes favoring more trained therapists. In many outpatient settings, therapists with more training tend to suffer fewer therapy dropouts than less trained therapists. Shortcomings of available research and speculations about possible variables influencing outcomes are discussed.

Science at the Heart of Psychotherapy: A Review of Three Evidence-Based Treatments

“…Some research on psychotherapy outcomes suggests that the specific techniques used in psychotherapy account for less of the outcome than common factors such as the therapeutic alliance (Lambert and Barley, 2002). Other factors such as therapist professionalism and level of training have also been associated with treatment outcome and patient dropout rates (Stein and Lambert, 1995). A review of the psychotherapy outcome literature by Lambert and Barley (2002) produced the following conclusions: psychotherapy is successful for many people; many comparative studies find that various types of psychotherapy are relatively equivalent in producing change; the therapeutic relationship accounts for more of the outcome than do specific therapy techniques; and certain therapist characteristics such as warmth and empathy are associated with positive therapy outcomes.…”

Ten Research Questions for Family Therapy

“…The following therapist characteristics have been found to be associated with a good outcome in individual therapy: personal adjustment, therapeutic competence, therapist training and supervision, matching therapeutic style to clients' needs, credibility, and problem-solving creativity (Beutler et al 2004;Lambert & Ogles, 1997;Stein & Lambert, 1995). Research which assesses the correlation between these types of client and therapist characteristics and outcome in marital and family therapy is required.…”

A Novel Group Therapeutic Format in Cognitive Behavioral Treatment for Clients with Social Phobia in a Training Setting: A Case Study of One Treatment Group with Nine Clients

“…In part, the positive results achieved by inexperienced student therapists might be explained by the fact that, relatively, they have few clients and a good deal of time for them, both for offering further sessions and for reflecting on their cases. One of the reasons for findings that experienced therapists don't always achieve better results than inexperienced therapists (e.g., Christensen & Jacobson, 1994;Stein & Lambert, 1995) might be the higher caseload among the former (Stein & Lambert, 1995). At least one study found higher caseload of clients among therapists to predict lower outcomes (Vocisano et al, 2004).…”