Practice. Practice. Practice. & It's Impact on Effective Therapy: Research Brief

The Role of Deliberate Practice in the Development of Highly Effective Psychotherapists

Psychotherapy, 2015, 52(2) 2015 337-345

Therapists vary significantly in performance and skill. Some therapists consistently have better results for their patients than others. For consumers of psychotherapy, assessing or predicting who is an effective therapist is a challenging task. 


While use of empirically supported treatment accounts for some of the successful outcomes in psychotherapy, it has been well documented that the clinician themselves account for a greater percentage of effectiveness than the psychotherapy treatment modality.  


This study sought to assess whether factors such as: years of experience, treatment modality, age, gender, level of education qualification, professional discipline, theoretical approach, integration of different approaches, size of caseload and the amount of time therapists spent in deliberate practice impact psychotherapists’ effectiveness. 


The results of this study show the main factor determining psychotherapists’ effectiveness is their time spent in systematic incremental improvement through practice with a peer/supervisor who provides feedback and allows for successive refinement of skills. Experience, professional degrees and discipline do not predict effectiveness. 



Highlights from the Study


“Therapist variables (age, gender, qualifications, professional discipline, years of experience)” as well as “theoretical approach” and “integration” “failed to predict client outcomes”. 


“Deliberate practice was significantly related to outcomes, this finding is consistent with results from numerous studies in different professional domains including sports, chess, business, computer programming, teaching, and medicine and surgery .” P.341


The average amount of time spent in deliberate practice was found to be the strongest predictor of therapists effectiveness. ”The estimated cumulative time spent by the top quartile (most effective therapists) was on average 2.8 times more hours per week engaged in deliberate practice” as compared with the lower quartiles  P. 342




Difference in Client Outcomes with Deliberate Practice 


Deliberate practice consists of individualized training activities designed to improve specific aspects of the therapist’s performance through successive refinement of skill, with targets just beyond the therapist’s current abilities. It is not only crucial for developing skills, but also for maintenance of skills. 


At Feeling Good Institute, we know that experience alone is not enough to improve effectiveness. Our therapists engage in weekly deliberate practice sessions of advanced therapy skills and Cognitive Behavior Therapy (CBT). 

Learn about the essential skills for effective cognitive behavior therapy and how we set therapists up for success.

Citation: Chow, D. L., Miller, S. D., Seidel, J. A., Kane, R. T., Thornton, J. A., & Andrews, W. P. (2015). The role of deliberate practice in the development of highly effective psychotherapists. Psychotherapy, 52(3), 337–345.

Feeling Good Tips In Your Inbox

High-quality content. Zero spam.

When was the last time you felt your best

Find A Therapist

Get matched with a therapist proven and vetted to help you feel better faster