Does practice really make perfect for therapists?
The impact of therapist experience on client outcomes
Summary
- The study investigated the relationship between therapist experience and therapy outcome.
- Longitudinal data from a large German university psychotherapy outpatient clinic was used to assess the effect of therapist experience on client outcomes.
- Results suggest no association between therapist experience and therapy outcome across all operationalisations of experience and outcome criteria.
- Although findings indicate that experience can lead to faster change.
The belief that “practice makes perfect” is common in many professions, including psychotherapy. However, empirical evidence suggests that this may not be the case when it comes to therapist experience and therapy outcome. While some studies have supported the hypothesis that therapist experience improves therapy outcome, other studies have failed to detect better results for therapies carried out by more experienced therapists compared to less experienced therapists or therapists in training.
This study aimed to replicate a longitudinal study from the US in the German healthcare system. The study used routine evaluation data of a large German university psychotherapy outpatient clinic to assess the effect of 241 therapists’ experience on the outcomes of their 3,432 clients longitudinally using linear and logistic multilevel modelling. Experience was operationalised using the number of days since the first client of a therapist as well as the number of clients treated beforehand. Outcome criteria were defined as change in general psychopathology as well as response, remission, and early termination. The study found no association between therapists’ experience and therapy outcome across all operationalisations of experience and therapy outcome. Preliminary evidence suggests that therapists need fewer sessions to achieve the same outcomes when they gain more experience. However, therapeutic experience seems to be unrelated to clients’ change in outcome.
The lack of findings in this study is important for improving postgraduate training and the quality of psychotherapy in general. The study suggests that psychotherapists’ experience is largely not associated with the amount of improvement their patients achieve throughout therapy.
So, while the belief that “practice makes perfect” may hold true in many professions, this study suggests that the same may not be the case when it comes to psychotherapy. While therapists may require fewer sessions to achieve the same outcomes as they gain more experience, therapeutic experience seems to be unrelated to client change in outcome.
This is good news for trainee therapists and psychologists, who are learning a new approach. Trainees often feel very anxious at the beginning and worry they are not being as effective as they could for their clients. However most trainees especially diligent at the start in applying the models that are learning. This coupled with good engagement skills as likely leading to the good outcome seen in the study.
Reference:
Germer, S., Weyrich, V., Bräscher, A.-K., Mütze, K., & Witthöft, M. (2022). Does practice really make perfect? A longitudinal analysis of the relationship between therapist experience and therapy outcome: A replication of Goldberg, Rousmaniere, et al. (2016). Journal of Counseling Psychology, 69, 745–754.