Clinical Psychology and Psychotherapy
Clin. Psychol. Psychother. 12, 417–426 (2005)
Copyright © 2005 John Wiley & Sons, Ltd.
Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/cpp.473
The Effect of Therapist Experience
on Psychotherapy Outcomes
Scott C. Leon,
1
* Zoran Martinovich,
2
* Wolfgang Lutz
3
and John S. Lyons
2
1
Department of Psychology, Loyola University Chicago, IL, USA
2
Department of Psychiatry, Division of Psychology, Northwestern University
Medical School Chicago, IL, USA
3
Department of Psychology, University of Berne, Switzerland
The present study investigates the impact of therapist experience
treating clients on outcomes for future clients with similar demo-
graphic and clinical characteristics. Prior research has consistently
failed to demonstrate that therapists with more experience (i.e. years
of experience working with patients) are more effective than thera-
pists with less experience. However, the literature is often criticized
for failing to control for variables such as the amount and type of
patients treated across therapist comparisons. The samples for the
current study are taken from a larger national sample of 2366 outpa-
tients receiving psychotherapy from across 92 therapists. The overall
sample includes 83 matched pairs of patients across 83 of the 92 orig-
inal therapists. Results indicate that therapists may be able to use
prior experience with a patient to enhance future outcomes as long as
latter patients are clinically and demographically similar and enter
treatment shortly after the initial patient. Implications for how ther-
apists are trained and use experience are discussed. Copyright © 2005
John Wiley & Sons, Ltd.
* Correspondence to: Scott C. Leon, Loyola University
Chicago, Department of Psychology, 6525 North Sheridan,
Chicago, IL 60626, USA.
E-mail: sleon@luc.edu
As part of the classic meta-analysis by Smith and
Glass (1977) demonstrating the overall effective-
ness of psychotherapy, these researchers examined
whether years of experience as a therapist corre-
lated with outcome. The authors found that years
of experience correlated -0.01 with effect size
(Smith & Glass, 1977). In their 1980 meta-analysis
of 485 studies, the correlation was again zero
(Smith, Glass, & Miller, 1980). Shapiro and
Shapiro (1982) conducted another meta-analysis
in response to the criticisms made of the meta-
analyses of Smith et al. Sample therapists had an
average of three years of experience. Despite
improvements in their meta-analysis, these
researchers again failed to find a correlation
between years of experience and effect size.
After multiple studies suggesting that experience
plays a minimal to non-existent role in psy-
chotherapy outcome and the inability to effectively
criticize this literature (Nietzel & Fisher, 1981),
A fair amount of research has now accumulated
demonstrating that the therapist variable plays a
role in psychotherapy outcome (Luborsky et al.,
1986; Crits-Christoph & Mintz, 1991; Crits-
Christoph et al., 1991). Specific variables such as
therapist age, sex, race, therapeutic alliance, direc-
tiveness, locus of control, dominance and coping
style have all been examined and shown to have
variable relationships with outcome (Beutler et al.,
1997). One frequently provocative area in the
history of this research involves the effect of ther-
apist experience (i.e. years in practice) on psy-
chotherapy outcomes.