The Evolution of Psychotherapy:The Evolution of Psychotherapy:Training
Scott D. Miller, Ph.D.International Center for Clinical Excellence
http://twitter.com/scott_dm http://www.linkedin.com/in/scottdmphd
www.centerforclinicalexcellence.com
The Evolution of Psychotherapy:The Evolution of Psychotherapy:
Time:
•M.S., MSW, 2-3 years;
•Psy.D. or Ph.D., 5-7 years.
Training
•Psy.D. or Ph.D., 5-7 years.
Money:
•Public, $60,000/year;
•Private, $75,000/year.
Cherry, K. (2013). How long does it take to get a Ph.D. in psychology.
http://psychology.about.com/od/education/a/phd-psychology-time.htm. Retrieved
December 1, 2013.
Cherry, K. (2013). Psychologist salaries.
http://psychology.about.com/od/careersinpsychology/a/psychologist-salaries.htm.
Retrieved December 1, 2013.
The Evolution of Psychotherapy:The Evolution of Psychotherapy:Training
Profession Starting
Salary
Median
(2010)
Psychologist 34-55K 68,500
Bureau of Labor Statistics. http://www.bls.gov. Retrieved December 1, 2013.
Time, F. (2013). Entry level salary of a clinical psychologist.
http://everydaylife.globalpost.com/entry-level-salary-clinical-psychologist-26345.html.
Retrieved December 1, 2013.
Psychologist 34-55K 68,500
Social Worker 23-40K 55,000
MFT 23-40K 45,720
Mental Health Coun 23.5-35K 38,150
•Studies to date show little or no
evidence:
•Traditional professional training leads to
better outcomes:
•No difference between professionals,
The Evolution of Psychotherapy:The Evolution of Psychotherapy:Training
Atkins, D.C., & Christensen, A. (2001). Is professional training worth the bother? A review of the impact of psychotherapy training on client
outcome. Australian Psychologist, 36, 122-130.
Nyman, S. et al. (2010). Client outcomes across counselor training level within multitiered supervision model. Journa of Counseling and
Development, 88, 204-209.
Malouff, J. (2012). The need for empirically supported psychology training standards. Psychotherapy in Australia, 18(3), 28-32.
Miller, S.D., & Hubble, M.A. (2011). The road to mastery. The Psychotherapy Networker, 35(2), 22-31, 60.
Neimeyer, G. et al. (2010). Continuing education in psychology. Professional Psychology: Research and Practice, 41(5), 435-441.
•No difference between professionals,
students and paraprofessionals.
•Supervision enhances effectiveness;
•Experience leads to better outcomes (may
actually worsen);
•Participation in continuing education
improves effectiveness.
The Evolution of Psychotherapy:The Evolution of Psychotherapy:From Training to Professional Development
•Some therapists achieve consistently better
results than others;
•Differences between therapists consistently
accounts for 5-9% of variability in treatment
outcome;outcome;
•Differences persist when therapist competence
is held constant and treatments are manualized;
•Difference is unrelated to age, gender, caseload,
theoretical orientation, social skills, professional
degree, years of experience, and time spent
conducting therapy.
Miller, S., Hubble, M., & Duncan, B. (2007). Supershrinks: Learning from the field’s most
effective practitioners. Psychotherapy Networker, 31(6), 26-35, 56
Chow, D., Miller, S. D., Kane, R., & Thornton, J. (n.d.). The study of supershrinks:
Development and deliberate practices of highly effective psychotherapists. Manuscript in
preparation.
The Evolution of Expertise:The Evolution of Expertise:How Top Therapists Improve?How Top Therapists Improve?
Hours per week
spent alone seriously
De·lib·er·atediˈlibərit/
Adjective
Done consciously and intentionally spent alone seriously
engaging in activities
related to improving
therapy skills
Done consciously and intentionally
Prac·ticeˈpraktəs/
Noun
To carry out a particular activity regularly
Chow, D., Miller, S. D., Kane, R., & Thornton, J. (n.d.). The study of supershrinks: Development and
deliberate practices of highly effective psychotherapists. Manuscript in preparation.
Miller, S., Hubble, M., & Duncan, B. (2007). Supershrinks: Learning from the field’s most effective
practitioners. Psychotherapy Networker, 31(6), 26-35, 56
The Evolution of Expertise:The Evolution of Expertise:How Top Therapists Improve?How Top Therapists Improve?
Hours per week
spent alone seriously 6
8
Hours/Week
spent alone seriously
engaging in activities
related to improving
therapy skills0
2
4
6
Top 3rd 2nd 1st
Hours
Chow, D., Miller, S. D., Kane, R., & Thornton, J. (n.d.). The study of supershrinks: Development and
deliberate practices of highly effective psychotherapists. Manuscript in preparation.
Miller, S., Hubble, M., & Duncan, B. (2007). Supershrinks: Learning from the field’s most effective
practitioners. Psychotherapy Networker, 31(6), 26-35, 56
• Thinking, planning,
executing, reflecting;
The Evolution of Expertise:The Evolution of Expertise:How Top Therapists Improve?How Top Therapists Improve?
• Practicing at the
“edge” of the “realm
of reliable
performance.”
The Evolution of Psychotherapy:The Evolution of Psychotherapy:From Training to Professional Development
•Adopting an “apprenticeship”
model with structures and
practices that support continuous
development
practices that support continuous
development:
•Ongoing measurement;
•Identification of practitioner specific
errors and learning objectives;
•Time for practice outside of practice;
•Access to coaching and practitioner-
specific training;
•Connection with learning community.
Miller, S., Hubble, M., & Duncan, B. (2007). Supershrinks: Learning from the field’s
most effective practitioners. Psychotherapy Networker, 31(6), 26-35, 56
Miller, S.D., & Hubble, M.A. (2011). The road to mastery. The Psychotherapy
Networker, 35(2), 22-31, 60.