The Evolution of Psychotherapy:The Evolution of Psychotherapy:Research

Scott D. Miller, Ph.D.International Center for Clinical Excellence

The Evolution of Psychotherapy:The Evolution of Psychotherapy:Research

•In 1952, Eysenck publishes a

review of 24 studies of

psychotherapy and

concludes:

Eysenck, H. (1952). The effects of psychotherapy: An evaluation. Journal of consulting Psychology, 16,

319-324.

Miller, S.D., Hubble, M.A., Chow, D.L., & Seidel, J.A. (2013). The outcome of psychotherapy:

Yesterday, Today, and Tomorrow. Psychotherapy, 50(1), 88-97.

psychotherapy and

concludes:

•“The results…fail to support

the hypothesis that

psychotherapy facilitates

recovery.”

Hans Eysenck, Ph.D.

The Evolution of Psychotherapy:The Evolution of Psychotherapy:Research

•Sixty years and 1000’s of

studies later:

•“The best research evidence

conclusively shows that individual,

American Psychological Association. (2012). Recognition of psychotherapy effectiveness.

http://www.apa.org/about/policy/resolution-psychotherapy.aspx Retrieved December 1,

2013.

Miller, S.D., Hubble, M.A., Chow, D.L., & Seidel, J.A. (2013). The outcome of psychotherapy:

Yesterday, Today, and Tomorrow. Psychotherapy, 50(1), 88-97.

conclusively shows that individual,

group and couple/family

psychotherapy are effective for a

broad range of disorders,

symptoms and problems with

children, adolescents, adults, and

older adults.”

The Evolution of Psychotherapy:The Evolution of Psychotherapy:Research

•Sixty years and 1000’s of

studies later:

•“The best research evidence

conclusively shows that individual,

•Sixty years and 1000’s of

studies later:•“(1) Psychotherapies are roughly

equivalent in effectiveness; and (2)

American Psychological Association. (2012). Recognition of psychotherapy effectiveness.

http://www.apa.org/about/policy/resolution-psychotherapy.aspx Retrieved December 1,

2013.

Miller, S.D., Hubble, M.A., Chow, D.L., & Seidel, J.A. (2013). The outcome of psychotherapy:

Yesterday, Today, and Tomorrow. Psychotherapy, 50(1), 88-97.

conclusively shows that individual,

group and couple/family

psychotherapy are effective for a

broad range of disorders,

symptoms and problems with

children, adolescents, adults, and

older adults.”

equivalent in effectiveness; and (2)

patient and therapist

characteristics, which are not

usually captured by a patient's

diagnosis or by the therapist's use

of a specific psychotherapy, affect

the results.”

The Evolution of The Evolution of Psychotherapy:Psychotherapy:How can Therapists Improve?

CT

Method Diagnosis

CT

Therapy

BEFORE AFTER

AS WELL AS…

PIANO

CHESS

SURGERY

The Evolution of ExpertiseThe Evolution of Expertise::Research

SURGERY

RADIOGRAPHY

TEACHING

PROGRAMMING

SOCCER

TENNIS

SINGING…

Charness, N., Krampe. R., & Mayu, U. (1996). The role of practice and coaching in entreprenurial skill domains. In K.A. Ericsson (ed.). The road to

excellence: The acquisition of expert performance in the arts and sciences, sports, and games (pp. 51-80). Hillsdale, NJ: LEA.

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.

Edge of AbilityEdge of Ability

Deliberate PracticeZone of “Proximal Development”:

•Reliable performance inconsistent

•Identification of errors, misperceptions

•Setting small process and outcome objectives

•Involves planning, rehearsal, reflection

Too DifficultToo DifficultToo EasyToo EasyRealm of “Reliable” Performance:

•Processes executed quickly, automatically

•Involves recognition, retrieval, execution

Ambit of Admiration:

•Abilities of others appear flawless, magical, dramatic

•Effort and attention focused on easily recognized, but

non-causal factors and/or processes (superstition)

•Risk of failure and injury high

•On average, the best

therapists:

•Achieve 50% better outcomes;

The Evolution of ExpertiseThe Evolution of Expertise::ResultsResults

•Achieve 50% better outcomes;

•Experience 50% fewer drop outs,

and 33% less deterioration;

•Provide more value per dollar

spent.

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.D. (2013). Psychometrics of the ORS and SRS. Results from RCT’s and meta-analyses of routine

outcome monitoring and feedback: The available evidence.

http://www.slideshare.net/scottdmiller/measures-and-feedback-2013-compatibility-mod. Retrieved

December 4, 2013.