What makes a good therapist? A miniseries

Does the gender, age, or experience of your therapist matter? Not really!

Research runs the gamut on successful therapist variables including both observed traits and states. Firstly, it is both relieving and logical that a therapist's sex, age, and race are all poor indicators of treatment outcomes. There is research out there suggesting that gender matching (female-female, male-male) could be beneficial for particular clients, such as those with a sexual abuse history. However generally speaking, matching issues rarely make waves. Even when clients initially feel reticent to work with a therapist of particular gender, race, or age, those issues can typically be resolved with an understanding and relatable therapist.

Secondly, therapist's observable traits include the amount and type of professional training. Landmark studies in this area include the meta-analsyis (combination of many studies) by Smith and Glass (1980) that found slightly favorable outcomes for psychologists over psychiatrists. As well the Seligman (1995) consumer reports study that showed positive results for all disciplines although social workers got slightly more positive results than psychologists and psychiatrists and all three were more highly rated than marriage and family therapists.

If there is any difference in outcomes for observable states of therapists, experience level of therapist would be it. There is moderate support for a positive relationship between years of experience and successful outcomes (Blatt et al., 1996; Propst et al., 1994; Luborsky et al., 1997) although effect sizes from the three studies varied from minor to strong.

An interesting quote I recently heard from a psychologist about experience vs. up-to-date/cutting edge therapists was an analogy comparing recent graduates of a top school vs. oldest expert in the field. If the technique is about a science (e.g. lasik surgery) then you would likely select the top graduate. If the technique is more about art (e.g. painting a picture) you likely select the old expert (maybe van gogh?). But when the question of therapy comes up, the selection might be less clear cut. Therapy is both an art and a science and thus experience as well as cutting edge techniques typically prove to be the best remedy. More on the cutting edge techniques to follow in the next few weeks.