Deliberate practice is now recognized as possibly the most relevant variable for the development of "expertise" or superior performance in any area of work. Its importance has already been demonstrated in areas as diverse as sport, medicine, music, chess and, more recently, psychotherapeutic practice. Its central assumption is that superior performance, or "expertise," is acquired gradually by investing in training tasks that the individual can master sequentially. Generally, planning and evaluating these tasks is done with the support of a teacher or coach. [1]
Figure 1. Four pilars of deliberate practice (Rousmaniere et al., 2017) [14] |
Traditionally, several teaching systems have focused almost exclusively on accumulating knowledge, for example through reading, often leaving students with the task of applying that knowledge for themselves. However, Norcross et al. stress that knowing about psychotherapy is very different from knowing how to do psychotherapy. According to these authors, it is possible to be an "expert" on psychotherapy without this meaning that one is an effective therapist, since theoretical knowledge and practical application are two very distinct, although complementary, activities. [2] Unlike more traditional teaching, deliberate practice focuses on the performance of the practitioner and ways to reliably improve it. For this purpose, tasks are created which are meant to gradually refine their performance through repetition, feedback and continuous monitoring. These tasks are highly individualized, created specifically for the professional and focused on their competencies yet to be developed. [3, 1]
Perhaps controversially, research in psychotherapy has repeatedly shown that there is no significant correlation between years of therapeutic experience and obtained outcomes. [4, 5, 6] Although a large proportion of therapists believe to be improving their performance over time, this self-assessment is often skewed or even incorrect. [7, 8, 9] Indeed, simply working longer hours is not enough to explain better professional performances. |
On the other hand, it is necessary to distinguish the concept of "expertise" or superior performance from that of competence, since the expertise to administer specific factors in psychotherapy - as techniques associated with specific models - seems not to be related to outcomes. Thus, "expertise" in psychotherapy is defined not by mastery of these specific ingredients but by consistently superior measurable clinical outcomes. [10, 11, 12]
Figure 2. The cycle of deliberate practice (Rousmaniere et al., 2017) [14]
Here is a list of key features of deliberate practice (PD). [3, 15]
Learn more about deliberate practice research and how to start establishing a routine:
[1] Ericsson, K. A. (2006). The influence of experience and deliberate practice on the development of superior expert performance. In K. A. Ericsson, N. Charness, P. J. Feltovich, & R. R. Hoffman (Eds.), The Cambridge handbook of expertise and expert performance (p. 683–703). Cambridge, UK: Cambridge University Press.
[2] Norcross, J. C., & Karpiak, C. P. (2017). Our best selves: Defining and actualizing expertise in psychotherapy. The Counseling Psychologist, 45(1), 66-75.
[3] Ericsson, K. A., Krampe, R. T., & Tesch-Römer, C. (1993). The role of deliberate practice in the acquisition of expert performance. Psychological review, 100(3), 363.
[4] Goldberg, S. B., Rousmaniere, T., Miller, S. D., Whipple, J., Nielsen, S. L., Hoyt, W. T., & Wampold, B. E. (2016). Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting. Journal of Counseling Psychology, 63(1), 1.
[5] Wampold, B. E., & Brown, G. S. J. (2005). Estimating variability in outcomes attributable to therapists: a naturalistic study of outcomes in managed care. Journal of consulting and clinical psychology, 73(5), 914.
[6] Stein, D. M., & Lambert, M. J. (1984). On the relationship between therapist experience and psychotherapy outcome. Clinical Psychology Review, 4(2), 127-142.
[7] Walfish, S., McAlister, B., O'donnell, P., & Lambert, M. J. (2012). An investigation of self-assessment bias in mental health providers. Psychological Reports, 110(2), 639-644.
[8] Hatfield, D., McCullough, L., Frantz, S. H., & Krieger, K. (2010). Do we know when our clients get worse? An investigation of therapists' ability to detect negative client change. Clinical Psychology & Psychotherapy, 17(1), 25-32.
[9] Hartmann, A., Joos, A., Orlinsky, D. E., & Zeeck, A. (2015). Accuracy of therapist perceptions of patients' alliance: Exploring the divergence. Psychotherapy Research, 25(4), 408-419.
[10] Ahn, H., & Wampold, B. E. (2001). Where oh where are the specific ingredients? A meta-analysis of component studies in counseling and psycotherapy. Journal of Counseling Psychology, 48(3), 251–257.
[11] Messer, S. B., & Wampold, B. E. (2002). Let's face facts: Common factors are more potent than specific therapy ingredients. Clinical Psychology: Science and Practice, 9(1), 21-25.
[12] Goodyear, R. K., Wampold, B. E., Tracey, T. J., & Lichtenberg, J. W. (2017). Psychotherapy expertise should mean superior outcomes and demonstrable improvement over time. The Counseling Psychologist, 45(1), 54-65.
[13] Tracey, T. J., Wampold, B. E., Lichtenberg, J. W., & Goodyear, R. K. (2014). Expertise in psychotherapy: An elusive goal?. American Psychologist, 69(3), 218.
[14] Rousmaniere, T., Goodyear, R. K., Miller, S. D., & Wampold, B. E. (Eds.). (2017). The cycle of excellence: Using deliberate practice to improve supervision and training. John Wiley & Sons.
[15] Ericsson, A., & Pool, R. (2016). Peak: Secrets from the new science of expertise. Houghton Mifflin Harcourt.
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