Trainee‐therapists are not all equal: Examination of therapeutic efficiency, effectiveness and early client dropout after 12 months of clinical training

Abstract

Developing of potential benchmarking tools that enable trainee-therapists, supervisors and educational institutions to quickly assess therapeutic performance can become part of a holistic assessment of a trainee-therapist's clinical development. Despite an inherent optimistic belief that therapists do not cause harm, there appears to be a small and significant proportion of trainee-therapists who consistently evidence little therapeutic change. Considerable variability in trainee-therapists' therapeutic efficiency and effectiveness can exist in the one training programme. Early client dropout may not be associated with therapists' therapeutic effectiveness and efficiency.

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

“…One possible way to assess the performance of mental health counselors in the integrated care teams is to use methods similar to those used in nonintegrated systems. The outcome variables used to evaluate mental health providers in those studies usually include effectiveness, efficiency, and rates of early client dropout (see Banham & Schweitzer, 2016; Okiishi et al, 2003). Effectiveness is defined as the amount of a client's improvement in response to a counselor's or therapist's intervention and is assessed by comparing the initial and final psychosocial measure of functioning (Banham & Schweitzer, 2016; Okiishi et al, 2003).…”

“…The outcome variables used to evaluate mental health providers in those studies usually include effectiveness, efficiency, and rates of early client dropout (see Banham & Schweitzer, 2016; Okiishi et al, 2003). Effectiveness is defined as the amount of a client's improvement in response to a counselor's or therapist's intervention and is assessed by comparing the initial and final psychosocial measure of functioning (Banham & Schweitzer, 2016; Okiishi et al, 2003). An evaluation of the effectiveness of nonintegrated systems showed varying levels of effectiveness (Banham & Schweitzer, 2016; Dinger et al, 2008; Kraus et al, 2011; Okiishi et al, 2003, 2006).…”

“…Therapeutic efficiency , defined as the amount of time and resources spent to achieve a clinically significant improvement, also has been measured to evaluate the performance of mental health providers (Banham & Schweitzer, 2016; Okiishi et al, 2003, 2006). Efficient counseling helps clients achieve their therapeutic goals in a shorter period of time and a cost‐effective fashion.…”

“…Efficient counseling helps clients achieve their therapeutic goals in a shorter period of time and a cost‐effective fashion. Growth curve modeling (Banham & Schweitzer, 2016; Okiishi et al, 2003, 2006)—a method commonly used to compare efficiency in implementing and reaching clients' treatment goals—demonstrates wide variability in mental health professionals' therapeutic efficiency.…”

Therapeutic conversations: Therapists’ use of observational language contributes to optimal therapeutic outcomes

“…Current literature suggests that some specific therapeutic practices predict negative client outcomes (Castonguay, ). Research indicates that some therapists achieve consistently better outcomes than other therapists (Banham & Schweitzer, ; Okiishi, Lambert, Nielsen, & Ogles, ; Okiishi et al ., ). This variation between therapists may be disorder specific (Kraus, Castonguay, Boswell, Nordberg, & Hayes, ).…”