Expertise in psychotherapy: An elusive goal?

Terence Tracey, Bruce E. Wampold, James W. Lichtenberg, Rodney K. Goodyear

Research output: Contribution to journalArticle

133 Scopus citations


It has been argued that psychotherapy is a profession without any expertise (Shanteau, 1992). We examine the validity of this claim, reviewing the literature on expertise, clinical decision making, and psychotherapeutic outcome assessment, and find it a reasonable assessment. There is no demonstration of accuracy and skill that is associated with experience as a therapist. We posit that this absence of an expertise-experience relation is attributable to therapists' lack of access to quality outcome information regarding their interventions and an overreliance on fallible information-processing strategies even when such outcome information is available. The research on providing outcome feedback is reviewed, and although it does relate to client improvement, it has not been shown to be associated with any gains in therapist skill or expertise. We propose a model of outcome information usage and specific a priori hypothesis testing as a means of developing expertise.

Original languageEnglish (US)
Pages (from-to)218-229
Number of pages12
JournalAmerican Psychologist
Issue number3
StatePublished - Apr 2014


  • Clinical decision making
  • Clinical feedback
  • Expertise

ASJC Scopus subject areas

  • Psychology(all)

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    Tracey, T., Wampold, B. E., Lichtenberg, J. W., & Goodyear, R. K. (2014). Expertise in psychotherapy: An elusive goal? American Psychologist, 69(3), 218-229.