Pericia, efectos del terapeuta y práctica deliberadaEl ciclo de la excelencia
- Javier Prado-Abril
- Alberto Gimeno-Peón
- Félix Inchausti
- Sergio Sánchez-Reales
ISSN: 0214-7823, 1886-1415
Year of publication: 2019
Issue Title: EVOLUCIÓN DEL CÓDIGO MEMÉTICO EN PSICOTERAPEUTASS
Volume: 40
Issue: 2
Pages: 89-100
Type: Article
More publications in: Papeles del psicólogo
Abstract
Evidence-based (clinical) practice is the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences. Similarly, the therapist factor is beginning to show its decisive influence on the outcome of psychological treatments. This paper emphasizes the therapist factor in the context of the PIR training program of Clinical Psychology specialists within our National Health System. Expertise and therapist effects are reviewed and deliberate practice is presented as a training system that can help clinical psychologists to improve their outcomes and treatments. Specific recommendations are made to improve the supervision model during PIR training and the implications and limitations of the topic are discussed.
Bibliographic References
- Alfonsson, S., Parling, T., Spännargård, Å., Andersson, G. y Lundgren, T. (2018). The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: A systematic review. Cognitive Behaviour Therapy, 47, 206228.
- Anderson, T., Crowley, M. E. J., Himawan, L., Holmberg, J. K. y Uhlin, B. D. (2016a). Therapist facilitative interpersonal skills and training status: A randomized clinical trial on alliance and outcome. Psychotherapy Research, 26, 511529.
- Anderson, T., McClintock, A. S., Himawan, L., Song, X. y Patterson, C. L. (2016b). A prospective study of therapist facilitative interpersonal skills as a predictor of treatment outcome. Journal of Consulting and Clinical Psychology, 84, 57-66.
- Anderson, T., Ogles, B. M., Patterson, C. L., Lambert, M. J., y Vermeersch, D. A. (2009). Therapist effects: Facilitative interpersonal skills as a predictor of therapist success. Journal of Clinical Psychology, 65, 755–768.
- American Psychological Association [APA] (2013). Recognition of psychotherapy effectiveness. Psychotherapy, 50, 102109.
- APA Presidential Task Force on Evidence-Based Practice (2006). Evidence-based practice in psychology. The American Psychologist, 61, 271-285.
- Baldwin, S. A. y Imel, Z. E. (2013). Therapist effects: Findings and methods. En M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (6th Ed., pp. 258–297). Hoboken, NJ: Wiley.
- Baldwin, S. A., Wampold, B. E. y Imel, Z. E. (2007). Untangling the alliance-outcome correlation: Exploring the relative importance of therapist and patient variability in the alliance. Journal of Consulting and Clinical Psychology, 75, 842852.
- Barkham, M., Lutz, W., Lambert, M. J. y Saxon, D. (2017). Therapist effects, effective therapists, and the law of variability. En L. G. Castonguay y C. E. Hill (Eds.), How and why are some therapists better than others? (pp. 13-36). Washington, DC: American Psychological Association.
- Barrett-Lennard, G. T. (1962). Dimensions of therapist response as causal factors in therapeutic change. Psychological Monographs: General and Applied, 76, 1-36.
- Beck, J. G., Castonguay, L. G., Chronis-Tuscano, A., Klonsky, E. D., McGinn, L. K. y Youngstrom, E. A. (2014). Principles for training in Evidence-Based Psychology: Recommendations for the Graduate Curricula in Clinical Psychology. Clinical Psychology Science and Practice, 21, 410-424.
- Bennett-Levy, J. (2019). Why therapists should walk the talk: The theoretical and empirical case for personal practice in therapist training and professional development. Journal of Behavior Therapy and Experimental Psychiatry, 62, 133145. https://doi.org/10.1016/j.jbtep.2018.08.004
- Beutler, L. E., Malik, M., Alimohamed, S., Harwood, T. M., Talebi, H., Noble, S. y Wong, E. (2004). Therapist variables. En M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (5th Ed., pp. 227306). Hoboken, NJ: John Wiley & Sons.
- Bohart, A. C. y Wade, A. G. (2013). The client in psychotherapy. En M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (6th Ed., pp. 219-257). Hoboken, NJ: Wiley.
- Brown, G. S., Lambert, M. J., Jones, E. R. y Minami, T. (2005). Identifying highly effective psychotherapists in a managed care environment. American Journal of Managed Care, 11, 513-520.
- Budge, S. L., Owen, J. J., Kopta, S. M., Minami, T., Hanson, M. R. y Hirsch, G. (2013). Differences among trainees in client outcomes associated with the phase model of change. Psychotherapy, 50, 150-157.
- Castonguay, L. G., Boswell, J. F., Constantino, M. J., Goldfried, M. R. y Hill, C. E. (2010). Training implications of harmful effects of psychological treatments. American Psychologist, 65, 34-49. https://doi.org/10.1016/j.jbtep.2018.08.004
- Castonguay, L.G. y Hill, C.E. (Eds.) (2017). How and why are some therapists better than others? Washington, DC: American Psychological Association.
- Chow, D. (2014). The study of supershrinks: Development and deliberate practices of highly effective psychotherapists (Tesis Doctoral). Curtin University, Australia. Recuperado de: https://espace.curtin.edu.au/handle/20.500.11937/45
- Chow, D., y Miller, S. D. (2015). Taxonomy of deliberate practice activities worksheets. Chicago, IL: International Center for Clinical Excellence.
- Chow, D., Miller, S. D., Seidel, J. A., Kane, R. T., Thornton, J. y Andrews, W. P. (2015). The role of deliberate practice in the development of highly effective psychotherapists. Psychotherapy, 52, 337–345.
- Del Re, A. C., Flückiger, C., Horvath, A. O., Symonds, D. y Wampold, B. E. (2012). Therapist effects in the therapeutic alliance–outcome relationship: A restricted-maximum likelihood meta-analysis. Clinical Psychology Review, 32, 642– 649.
- Ericsson, K. A. (2006). The influence of experience and deliberate practice on the development of superior expert performance. En K. A. Ericcson, N. Charness, P. J. Feltovich y R. R. Hoffman (Eds.), The Cambridge handbook of expertise and expert performance (pp. 685-705). New York, NY: Cambridge University Press.
- Ericsson, K. A., Charness, N., Feltovich, P. J. y Hoffman, R. R. (Eds.) (2006). The Cambridge handbook of expertise and expert performance. New York, NY: Cambridge University Press.
- Ericsson, K. A., Krampe, R. T. y Tesch-Römer, C. (1993). The role of deliberate practice in the acquisition of expert performance. Psychological Review, 100, 363-403.
- Flückiger, C., Del Re, A. C., Wampold, B. E. y Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analyt ic synthesis. Psychotherapy, 55, 316-340. http://dx.doi.org/10.1037/pst0000172
- Gimeno-Peón, A., Barrio-Nespereira, A. y Álvarez-Casariego, M. T. (2018a). Psicoterapia: Marca registrada [Psychotherapy: Trademark]. Revista de la Asociación Española de Neuropsiquiatría, 38, 131-144.
- Gimeno-Peón, A., Barrio-Nespereira, A. y Prado-Abril, J. (2018b). Monitorización sistemática y feedback en psicoterapia [Routine outcome monitoring and feedback in psychotherapy]. Papeles del Psicólogo, 39, 174-182. doi: 10.23923/pap.psicol2018.2872
- Goldberg, S. B., Babins-Wagner, R., Rousmaniere, T., Berzins, S., Hoyt, W. T., Whipple, J. L., ... y Wampold, B. E. (2016a). Creating a climate for therapist improvement: A case study of an agency focused on outcomes and deliberate practice. Psychotherapy, 53, 367-375.
- Goldberg, S., Rousmaniere, T. G., Miller, S. D., Whipple, J., Nielsen, S. L., Hoyt, W. y Wampold, B. E. (2016b). Do psychotherapists improve with time and experience? A longitudinal analysis of real world outcome data. Journal of Counseling Psychology, 63, 1–11.
- Goodyear, R. K. y Rousmaniere, T. (2017). Helping therapists to each day become a little better than they were the day before. En T. Rousmaniere, R. K. Goodyear, S. D. Miller y B. E. Wampold (Eds.), The cycle of excellence: Using deliberate practice to improve supervision and training (pp. 67-95). Hoboken, NJ: John Wiley & Sons.
- Goodyear, R. K., Wampold, B. E., Tracey, T. J. y Lichtenberg, J. W. (2017). Psychotherapy expertise should mean superior outcomes and demonstrable improvement over time. The Counseling Psychologist, 45, 54-65.
- Hannan, C., Lambert, M. J., Harmon, C., Nielsen, S. L., Smart, D. W., Shimokawa, K. y Sutton, S. W. (2005). A lab test and algorithms for identifying clients at risk for treatment failure. Journal of Clinical Psychology, 61, 155-163.
- Hill y Knox (2013) Training and supervision in psychotherapy. En M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (6th Ed., pp. 775– 811). Hoboken, NJ: Wiley.
- Hill, C. E., Spiegel, S. B., Hoffman, M. A., Kivlighan Jr, D. M., y Gelso, C. J. (2017). Therapist expertise in psychotherapy revisited. The Counseling Psychologist, 45, 7-53.
- Horvath, A. O., Del Re, A. C., Flückiger, C. y Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48, 9–16.
- Imel, Z. E., Sheng, E., Baldwin, S. A., y Atkins, D. C. (2015). Removing very low-performing therapists: A simulation of performance-based retention in psychotherapy. Psychotherapy, 52, 329-336.
- Inchausti, F., Prado-Abril, J., Sánchez-Reales, S., Vilagrà-Ruiz, R. y Fonseca-Pedrero, E. (2018). El trastorno de personalidad por evitación: Una propuesta de tratamiento especializado en la sanidad pública española [The avoidant personality disorder: A proposal for specialized treatment in the Spanish National Health System]. Ansiedad y Estrés, 24, 144-153. doi: 10.1016/j.anyes.2018.05.002
- Kraus, D. R., Bentley, J. H., Alexander, P. C., Boswell, J. F., Constantino, M. J., Baxter, E. E. y Castonguay, L. G. (2016). Predicting therapist effectiveness from their own practice-based evidence. Journal of Consulting and Clinical Psychology, 84, 473-483.
- Lambert, M. J. (2013). The efficacy and effectiveness of psychotherapy. En M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (6th Ed., pp. 169-218). Hoboken, NJ: Wiley.
- Malikiosi-Loizos, M. (2013). Personal therapy for future therapists: Reflections on a still debated issue. European Journal of Counselling Psychology, 2, 33-50.
- Miller, S. D., Hubble, M. A., y Chow, D. (2017). Professional Development. En T. Rousmaniere, R. K. Goodyear, S. D. Miller y B. E. Wampold (Eds.), The cycle of excellence: Using deliberate practice to improve supervision and training (pp. 23-47). Hoboken, NJ: John Wiley & Sons.
- Miller, S. D., Hubble, M. A. y Chow, D. (2018). The question of expertise in psychotherapy. Journal of Expertise, 1, 121-129.
- Miller, S. D., Hubble, M. A, Chow, D., y Seidel, J. A. (2013). The outcome of psychotherapy: Yesterday, today, and tomorrow. Psychotherapy, 50, 88-97.
- Miller, S. D., Hubble, M. A. y Duncan, B. L. (2007). Supershrinks: Learning from the field’s most effective practitioners. Psychotherapy Networker, 31, 26-35.
- Miller, W. R., y Rollnick, S. (2015). La entrevista motivacional: Ayudar a las personas a cambiar (3ª Ed.). Barcelona: Paidós.
- Nissen-Lie, H. A., Monsen, J. T., Ulleberg, P. y Rønnestad, M. H. (2013). Psychotherapists’ self-reports of their interpersonal functioning and difficulties in practice as predictors of patient outcome. Psychotherapy Research, 23, 86-104.
- Nissen-Lie, H. A., Rønnestad, M. H., Høglend, P. A., Havik, O. E., Solbakken, O. A., Stiles, T. C. y Monsen, J. T. (2017). Love yourself as a person, doubt yourself as a therapist? Clinical Psychology & Psychotherapy, 24, 48-60. http://dx.doi.org/10.1002/cpp.1977
- Norcross, J. C. y Wampold, B. E. (2011). Evidence-based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 48, 98-102.
- Norcross, J. C. y Wampold, B. E. (2018). A new therapy for each patient: Evidence-based relationships and responsiveness. Journal of Clinical Psychology, 74, 1889-1906. https://doi.org/10.1002/jclp.22678
- Okiishi, J. C., Lambert, M. J., Eggett, D., Nielsen, L., Dayton, D. D. y Vermeersch, D. A. (2006). An analysis of therapist treatment effects: Toward providing feedback to individual therapists on their clients’ psychotherapy outcome. Journal of Clinical Psychology, 62, 1157-1172.
- Okiishi, J. C., Lambert, M. J., Nielsen, L. y Ogles, B. M. (2003). Waiting for supershrink: An empirical analysis of therapist effects. Clinical Psychology & Psychotherapy, 10, 361-373.
- Pérez-Álvarez, M. (2019). La psicoterapia como ciencia humana, más que tecnológica [Psychotherapy as a human science, more than technological one]. Papeles del Psicólogo, doi: 10.23923/pap.psicol2019.2877
- Prado-Abril, J., García-Campayo, J. y Sánchez-Reales, S. (2013). Funcionamiento de la terapia cognitivo-interpersonal en los trastornos de la personalidad: Estudio de dos casos [Eff icacy of interpersonal-cognit ive therapy in personality disorders: Two cases]. Revista de Psicopatología y Psicología Clínica, 18, 139-149. doi: 10.5944/rppc.vol.18.num.2.2013.12770
- Prado-Abril, J., Sánchez-Reales, S. y Aldaz-Armendáriz, J. A. (2014). Psicología Sanitaria: En busca de identidad [Health Psychology: In search of identi ty]. Behavioral Psychology/Psicología Conductual, 22, 153-160.
- Prado-Abril, J., Sánchez-Reales, S. y García-Campayo, J. (2016). Dificultades en el manejo cognitivo-interpersonal del trastorno narcisista de la personalidad: Estudio de caso [Difficulties in interpersonal-cognitive management of narcissistic personality disorder: A case study]. Revista Argentina de Clínica Psicológica, 25, 317-325.
- Prado-Abril, J., Sánchez-Reales, S. y Inchausti, F. (2017). En busca de nuestra mejor versión: Pericia y excelencia en Psicología Clínica [Searching for our best version: Expertise and excellence in Clinical Psychology]. Ansiedad y Estrés, 23, 110-117. doi: 10.1016/j.anyes.2017.06.001
- Rousmaniere, T. (2016). Deliberate practice for psychotherapists: A guide to improving clinical effectiveness. New York, NY: Routledge.
- Rousmaniere, T., Goodyear, R. K., Miller, S. D. y Wampold, B. E. (Eds.). (2017). The cycle of excellence: Using deliberate practice to improve supervision and training. Hoboken, NJ: John Wiley & Sons.
- Rousmaniere, T. G., Swift, J. K., Babins-Wagner, R., Whipple, J. L. y Berzins, S. (2014). Supervisor variance in psychotherapy outcome in routine practice. Psychotherapy Research, 26, 196-205.
- Saxon, D. y Barkham, M. (2012). Patterns of therapist variability: Therapist effects and the contribution of patient severity and risk. Journal of Consulting and Clinical Psychology, 80, 535-546.
- Schauenburg, H., Buchheim, A., Beckh, K., Nolte, T., BrenkFranz, K., Leichsenring, F.,... y Dinger, U. (2010). The influence of psychodynamically oriented therapists’ attachment representations on outcome and alliance in inpatient psychotherapy. Psychotherapy Research, 20, 193-202.
- Schöttke, H., Flückiger, C., Goldberg, S. B., Eversmann, J. y Lange, J. (2017). Predicting psychotherapy outcome based on therapist interpersonal skills: A five-year longitudinal study of a therapist assessment protocol. Psychotherapy Research, 27, 642-652.
- Tracey, T. J., Wampold, B. E., Lichtenberg, J. W. y Goodyear, R. K. (2014). Expertise in psychotherapy: An elusive goal? American Psychologist, 69, 218-229.
- Walfish, S., McAlister, B., O’Donnell, P. y Lambert, M. J. (2012). An investigation of self-assessment bias in mental health providers. Psychological Reports, 110, 639-644.
- Wampold, B. E. y Brown, J. (2005). Estimating variability in outcomes attributable to therapists: A naturalistic study of outcomes in managed care. Journal of Consulting and Clinical Psychology, 73, 914-923.
- Wampold, B. E., Baldwin, S. A., Grosse-Holtforth y Imel, Z. E. (2017). What characterizes effective therapists? En L. G. Castonguay y C. E. Hill (Eds.), How and why are some therapists better than others? (pp. 37-54). Washington, DC: American Psychological Association.
- Wampold, B. E. y Imel, Z. E. (2015). The great psychotherapy debate: The research evidence for what works in psychotherapy (2nd Ed.). New York, NY: Routledge.
- Watkins, C. E. (2011). Does psychotherapy supervision contribute to patient outcomes? Considering thirty years of research. Clinical Supervisor, 30, 235–56.
- Webb, C. A., DeRubeis, R. J. y Barber, J. P. (2010). Therapist adherence/competence and treatment outcome: A metaanalytic review. Journal of Consulting and Clinical Psychology, 78, 200-211.