The effect of trainee experience in psychotherapy on client treatment outcome

Driscoll, Kimberly A.; Cukrowicz, Kelly C.; Reitzel, Lorraine R.; Hernandez, Annya; Petty, Scharles; Joiner, Thomas E.

doi:10.1016/s0005-7894(03)80011-4

Cited by 23 publications

(25 citation statements)

References 12 publications

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“…The data from the CAS and the OQ-45 indicated that clients who obtained services from a training center using a multitiered counselor supervision model experienced moderate symptom relief over the course of six sessions regardless of whether they were seen by a licensed doctoral-level counselor, a predoctoral intern, or a practicum student. This finding appears to contradict some previous research that suggested trends favoring positive client outcomes achieved by experienced counselors (Callahan & Hynan, 2005;Driscoll et al, 2003;Roth, 2003). Although this finding also appears to contradict the basic assumption that experienced professionals should be more adept than supervised trainees at facilitating client improvement, there is increasing evidence that this assumption is unfounded (Lambert, 2005).…”

Section: Discussioncontrasting

confidence: 88%

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Client Outcomes Across Counselor Training Level Within a Multitiered Supervision Model

Nyman

Nafziger

Smith

2010

Jour of Counseling & Develop

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The authors examined client outcome data to evaluate treatment effectiveness across counselor training level. They used a multitiered supervision model consisting of professional staff, interns, and practicum students. Clients (N = 264) demonstrated significant improvement with no significant outcome differences between professional staff and supervised trainees. Limitations and future directions are discussed.

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Section: Discussioncontrasting

confidence: 88%

“…circumstances, counselor experience level (Roth, 2003) and degree of trainee experience (Driscoll et al, 2003) can be significant predictors of client improvement. However, the overall magnitude of the differences between counselors and trainees in terms of client outcomes has not been established in the literature (Lambert, 2005).…”

mentioning

confidence: 99%

Client Outcomes Across Counselor Training Level Within a Multitiered Supervision Model

Nyman

Nafziger

Smith

2010

Jour of Counseling & Develop

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“…Fine-grained measures of therapist experience are positively correlated with outcomes in CT (Driscoll et al, 2003), despite the fact that educational credentials are largely unrelated to therapist success (Christensen & Jacobson, 1994). In our study, trainee therapists were in their third year of clinical training but their first year of learning to practice CT in particular, and they had low caseloads (typically two clients at a time, seldom with the same disorder and therefore the same applicable treatment manual).…”

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confidence: 67%

Sudden gains versus gradual gains in a psychotherapy training clinic

2010

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Sudden gains are abrupt and substantial improvements in symptoms. This study used the Outcome Questionnaire-45 (OQ-45; Lambert et al., 1996) to characterize sudden gains occurring in a cognitive-behavioral therapy training clinic. Also, gradual gainers were identified and used as a comparison group. Sudden gains were identified in 23% of patients and in 29% of those who entered treatment in the clinical range on the OQ, within the range of prevalence established by previous sudden gain studies in the context of randomized controlled trials (RCT's). As in earlier research, sudden gains tended to occur early in therapy. However, sudden gains were more likely to be reversed than in RCT's. Gradual gains occurred for 54% of nonsudden gainers; they were of similar magnitude to sudden gains but occurred later in therapy. Sudden gainers showed significantly better outcomes at the end of treatment than did gradual gainers. Sudden gains have clear prognostic significance, but more research is needed to determine why they may be more transient in naturalistic studies or studies involving less experienced therapists than they are in RCT's.

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“…In addition, we do not know much about differences between training clinics and nontraining clinics, and whether the findings from training clinics can be applied to non-training settings. The studies in this review that compared trainee psychotherapists to registered psychotherapists found that while trainees improved in effectiveness over the course of their training (Driscoll et al, 2003;Hill et al, 2015;Powell, Hunter, Beasley, & Vernberg, 2010;Reese, Usher et al, 2009), they can still be as effective as registered psychotherapists (Nyman et al, 2010). The preliminary findings are therefore promising that training clinic research can be applied outside of the training environment, but it is premature to apply these findings yet, without more understanding of how psychotherapist competence changes over the course of their training, and how other dimensions of training, such as increased supervision or reduced caseload, might also influence psychotherapy process and outcome.…”

Section: Discussionmentioning

confidence: 97%

A systematic review of research in psychology training clinics: How far have we come?

Dyason¹,

Shanley²,

Hawkins³

et al. 2019

Training and Education in Professional Psychology

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Psychology training clinics provide evidence-based, cost-effective psychological services to the general public, while at the same time providing a training ground for future psychotherapists. Research in training clinics can advance the clinical literature, train psychotherapists in evidence-based practice and improve outcomes for clients. However, since the last published review of research published in psychology training clinics (Todd, Kurcias, & Gloster, 1994), it is unclear how much the training clinic literature has advanced in the last two decades or if findings can be synthesized across sites. A systematic, quantitative literature review with strict inclusion and exclusion criteria described 257 empirical studies conducted in training clinics since the previous review (1993-2015). Studies were coded and categorized into themes by three independent raters. Studies explored the nature and organization of training clinics, client characteristics, assessment, intervention, staff and clinical training, as well as research and research training. Across themes, it appeared that the literature has broadened extensively, highlighting that researchers have embraced training clinics as a sample source. While there was a great breadth of topics researched, there remains insufficient depth in the majority of areas, and a need for multi-site collaborations with a shared research agenda across training clinics. The review highlighted the extent to which training clinics are valuable research locations, although more research is needed to compare different training clinics and between training clinics versus non-training clinics.

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The effect of trainee experience in psychotherapy on client treatment outcome

Cited by 23 publications

References 12 publications

Client Outcomes Across Counselor Training Level Within a Multitiered Supervision Model

Client Outcomes Across Counselor Training Level Within a Multitiered Supervision Model

Sudden gains versus gradual gains in a psychotherapy training clinic

A systematic review of research in psychology training clinics: How far have we come?

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