How the field understands psychotherapy expertise is important. It affects how we practice and how we prepare others for practice. As in our other work, we argue that the most meaningful definition of expertise must involve steady improvement over time to achieve superior performance on some meaningful measure, which typically is client outcome. We also argue that the best means by which a therapist can achieve this is through ongoing deliberate practice. We contrast our position with not only Hill, Spiegel, Hoffman, Kivlighan, and Gelso’s preferred definition, in which they anchor expertise in therapist performance, but also with the various other possible definitions of expertise (e.g., therapist experience, therapist self-assessment of expertise) that they proffer as options.
AtirS.RosenzweigE.DunningD. (2015). When knowledge knows no bounds: Self-perceived expertise predicts claims of impossible knowledge. Psychological Science, 26, 1295-1303. doi:10.1177/0956797615588195
2.
BernardJ. M.GoodyearR. K. (2014). Fundamentals of clinical supervision (5th ed.). Boston, MA: Merrill.
3.
BoswellJ. F.GallagherM. W.Sauer-ZavalaS. E.BullisJ.GormanJ. M.ShearM. K.. . . BarlowD. H. (2013). Patient characteristics and variability in adherence and competence in cognitive-behavioral therapy for panic disorder. Journal of Consulting and Clinical Psychology, 81(3), 443-454. doi:10.1037/a0031437
4.
ChowD. L.MillerS. D.SeidelJ. A.KaneR. T.ThorntonJ. A.AndrewsW. P. (2015). The role of deliberate practice in the development of highly effective psychotherapists. Psychotherapy, 52, 337-345. doi:10.1037/pst0000015
5.
DarwinC. (1994). The correspondence of Charles Darwin (Vol. 9; BurkhardtF.BrowneJ.PorterD. M.RichmondM., Eds.). Cambridge, UK: Cambridge University Press.
6.
DawesR. M. (1995). House of cards: Psychology and psychotherapy built upon myth. New York, NY: Free Press.
7.
DuckworthA. L.KirbyT. A.TsukayamaE.BersteinH.EricssonK. A. (2011). Deliberate practice spells success: Why grittier competitors triumph at the national spelling bee. Social Psychological and Personality Science, 2, 174-181. doi:10.1177/1948550610385872
8.
DuncanB. L.ReeseR. J. (2015). The Partners for Change Outcome Management System (PCOMS) revisiting the client’s frame of reference. Psychotherapy, 52, 391-401.
9.
EricssonK. A. (2006). The influence of experience and deliberate practice on the development of superior expert performance. In <B>The Cambridge handbook of expertise and expert performance (pp. 683-703). Cambridge, UK: Cambridge University Press.
10.
GellerJ. D.NorcrossJ. C.OrlinskyD. E. (Eds.). (2005). The psychotherapist’s own psychotherapy: Patient and clinician perspectives. Oxford, UK: Oxford University Press.
11.
GoldbergS. B.Babins-WagnerR.RousmaniereT.BerzinsS.HoytW. T.WhippleJ. L. . . . WampoldB. E. (2016). Creating a climate for psychotherapist improvement: A case study of an agency focused on outcomes and deliberate practice. Psychotherapy, 53, 367-375. doi:10.1037/pst0000060
12.
GoldbergS. B.RousmaniereT.MillerS. D.WhippleJ.NielsenS. L.HoytW. T.WampoldB. E. (2016). Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting. Journal of Counseling Psychology, 63, 1-11. doi:10.1037/cou0000131
13.
HannanC.LambertM. J.HarmonC.NielsenS. L.SmartD.ShimokawaK. W.SuttonS. W. (2005). A lab test and algorithms for identifying clients at risk for treatment failure. Journal of Clinical Psychology: In Session, 61, 155-163. doi:10.1002/jclp.20108
14.
HatfieldD.McCulloughL.FrantzS. H.KriegerK. (2010). Do we know when our clients get worse? An investigation of therapists’ ability to detect negative client change. Clinical Psychology & Psychotherapy, 17, 25-32. doi:10.1002/cpp.656
15.
HillC. E.BaumannE.ShafranN.GuptaS.MorrisonA.RojasA. E. P. . . . GelsoC. J. (2015). Is training effective? A study of counseling psychology doctoral trainees in a psychodynamic/interpersonal training clinic. Journal of Counseling Psychology, 62, 184-201.
16.
HillC. E.SpiegelS. B.HoffmanM. A.KivlighanD. M.Jr.GelsoC. J. (2017). Therapist expertise in psychotherapy revisited. The Counseling Psychologist, 45, 7-53. doi:10.1177/0011000016641192
17.
LeeM. J. (2016). On patient safety: When are we too old to operate?Clinical Orthopaedics and Related Research, 474, 895-898.
18.
Malikiosi-LoizosM. (2013). Personal therapy for future therapists: Reflections on a still debated issue. European Journal of Counselling Psychology, 2, 33-50.
19.
MillerS. D.HubbleM. A.ChowD. L. (in press). Professional development: From oxymoron to reality. In RousmaniereT.GoodyearR. K.MillerS. D.WampoldB. E. (Eds.), The cycle of excellence: Using deliberate practice to improve supervision and training. New York, NY: John Wiley.
20.
NorcrossJ. C. (2011). Psychotherapy relationships that work: Evidence-based responsiveness. New York, NY: Oxford University Press.
21.
OwenJ.WampoldB. E.KoptaM.RousmaniereT.MillerS. D. (2016). As good as it gets? Therapy outcomes of trainees over time. Journal of Counseling Psychology, 63, 12-19.
22.
RønnestadM. H. (2016). Is expertise in psychotherapy a useful construct?Psychotherapy Bulletin, 51, 11-13.
23.
RousmaniereT.GoodyearR. K.MillerS. D.WampoldB. E. (Eds.). (in press). The cycle of excellence: Using deliberate practice to improve supervision and training. New York, NY: John Wiley.
24.
SamuelD. B. (2015). A review of the agreement between clinicians’ personality disorder diagnoses and those from other methods and sources. Clinical Psychology: Science and Practice, 22, 1-19.
25.
SearsE. S. (2015). Running through the ages (2nd ed.). Jefferson, NC: McFarland.
TraceyT. J. G.WampoldB. E.GoodyearR. K.LichtenbergJ. W. (2015). Improving expertise in psychotherapy. Psychotherapy Bulletin, 50, 7-13.
28.
TraceyT. J. G.WampoldB. E.LichtenbergJ. W.GoodyearR. K. (2014). Expertise in psychotherapy: An elusive goal?American Psychologist, 69, 218-229.
29.
WalfishS.McAlisterB.O’DonnellP.LambertM. J. (2012). An investigation of self-assessment bias in mental health providers. Psychological Reports, 110, 639-644. doi:10.2466/02.07.17.PR0.110.2.639-644
30.
WampoldB. E. (2015). Routine Outcome Monitoring: Coming of age—With the usual developmental challenges. Psychotherapy, 52, 458-462.
31.
WampoldB. E.ImelZ. E. (2015). The great psychotherapy debate: The research evidence for what works in psychotherapy (2nd ed.). New York, NY: Routledge
32.
WampoldB. E.LichtenbergJ. W.GoodyearR. K.TraceyT. J. G. (in press). Clinical expertise: A critical issue in the age of evidence-based practice. In DimidjianS. (Ed.), Evidence-based practice in action. New York, NY: Guilford.
33.
WatkinsD. (2011). Does psychotherapy supervision contribute to patient outcomes? Considering thirty years of research. Clinical Supervisor, 30, 235-256. doi:10.1080/07325223.2011.619417
34.
WebbC. A.DeRubeisR. J.BarberJ. P. (2010). Therapist adherence/competence and treatment outcome: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78, 200-211. doi:10.1037/a0018912
