Sunday, April 29, 2018

Clinical experience is positively associated with increased confidence & perceived mastery in clinical ability, increased flexibility in professional identity & therapeutic orientation, reduced stress & anxiety in clinical practice, & improvements in clinical judgment & decision-making, but not to ability to increase quality

Years of Clinical Experience and Therapist Professional Development: A Literature Review. Glen C. Dawson. Journal of Contemporary Psychotherapy, June 2018, Volume 48, Issue 2, pp 89–97. https://link.springer.com/article/10.1007%2Fs10879-017-9373-8

Abstract: The purpose of this article is to review the effect of years of clinical experience on aspects of therapist professional development. Themes within this specific literature were determined inductively as part of an all-inclusive review. Years of clinical experience were found to be positively associated with increased confidence and perceived mastery in clinical ability, increased flexibility in professional identity and therapeutic orientation, reduced stress and anxiety in clinical practice, and improvements in clinical judgment and decision-making. Although years of experience were found to relate to increased therapist focus on the therapeutic relationship, evidence does not suggest that it is associated with improved ability to increase its quality. It is unclear how years of clinical experience affect therapist usage of and attitude towards evidence supported treatments and evidence based practice given the interference of age cohort effects. This literature is limited by overly-proportionate psychodynamic samples and the use of primarily cross-sectional designs.

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Patient outcome's variability is weakly or not related to competence, training nor adherence of therapists:

Common versus specific factors in psychotherapy: opening the black box. RogerMulder, Greg Murray, Julia Rucklidge. The Lancet Psychiatry, Volume 4, Issue 12, December 2017, Pages 953-962. https://www.bipartisanalliance.com/2017/11/patient-outcomes-variability-is-weakly.html

Psychotherapy was a marvellous invention, but initial enthusiasm regarding its efficacy has now been obfuscated due to scientific biases that systematically inflate estimates:

Raising awareness for the replication crisis in clinical psychology by focusing on inconsistencies in psychotherapy research: how much can we rely on published findings from efficacy trials? Michael P. Hengartner. Front. Psychol. | doi: 10.3389/fpsyg.2018.00256, https://www.bipartisanalliance.com/2018/02/psychotherapy-was-marvellous-invention.html

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