A summary of the findings from research on psychotherapy presented on a panel discussion with David Barlow and Steven Hayes at the 2013 Evolution of Psychotherapy conference in Anaheim, California

1. The Evolution of Psychotherapy:
Research
Scott D. Miller, Ph.D.
International Center for Clinical Excellence

2. The Evolution of Psychotherapy:
Research
•In 1952, Eysenck publishes a
review of 24 studies of
psychotherapy and
concludes:
•“The results…fail to support
the hypothesis that
psychotherapy facilitates
recovery.”
Hans Eysenck, Ph.D.
Eysenck, H. (1952). The effects of psychotherapy: An evaluation. Journal of consulting Psychology, 16,
319-324.
Miller, S.D., Hubble, M.A., Chow, D.L., & Seidel, J.A. (2013). The outcome of psychotherapy:
Yesterday, Today, and Tomorrow. Psychotherapy, 50(1), 88-97.

3. The Evolution of Psychotherapy:
Research
•Sixty years and 1000’s of
studies later:
•“The best research evidence
conclusively shows that individual,
group and couple/family
psychotherapy are effective for a
broad range of disorders,
symptoms and problems with
children, adolescents, adults, and
older adults.”
American Psychological Association. (2012). Recognition of psychotherapy effectiveness.
http://www.apa.org/about/policy/resolution-psychotherapy.aspx Retrieved December 1,
2013.
Miller, S.D., Hubble, M.A., Chow, D.L., & Seidel, J.A. (2013). The outcome of psychotherapy:
Yesterday, Today, and Tomorrow. Psychotherapy, 50(1), 88-97.

4. The Evolution of Psychotherapy:
Research
•Sixty years and 1000’s of
studies later:
•“(1) Psychotherapies are roughly
equivalent in effectiveness; and (2)
patient and therapist
characteristics, which are not
usually captured by a patient's
diagnosis or by the therapist's use
of a specific psychotherapy, affect
the results.”
•Sixty years and 1000’s of
studies later:
•“The best research evidence
conclusively shows that individual,
group and couple/family
psychotherapy are effective for a
broad range of disorders,
symptoms and problems with
children, adolescents, adults, and
older adults.”
American Psychological Association. (2012). Recognition of psychotherapy effectiveness.
http://www.apa.org/about/policy/resolution-psychotherapy.aspx Retrieved December 1,
2013.
Miller, S.D., Hubble, M.A., Chow, D.L., & Seidel, J.A. (2013). The outcome of psychotherapy:
Yesterday, Today, and Tomorrow. Psychotherapy, 50(1), 88-97.

5. The Evolution of Psychotherapy:
How can Therapists Improve?
Method
Diagnosis
T
C
BEFORE
Therapy
AFTER

6. The Evolution of Expertise:
Expertise:
Research
AS WELL AS…
PIANO
CHESS
SURGERY
RADIOGRAPHY
TEACHING
PROGRAMMING
SOCCER
TENNIS
SINGING…
Charness, N., Krampe. R., & Mayu, U. (1996). The role J. (n.d.). The study of supershrinks: Development and deliberate practices of road to
Chow, D., Miller, S. D., Kane, R., & Thornton, of practice and coaching in entreprenurial skill domains. In K.A. Ericsson (ed.). The
excellence: The acquisition of expert performance in thein preparation. sports, and games (pp. 51-80). Hillsdale, NJ: LEA.
highly effective psychotherapists. Manuscript arts and sciences,

7. Deliberate Practice
Zone of “Proximal Development”:
•Reliable performance inconsistent
•Identification of errors, misperceptions
•Setting small process and outcome objectives
•Involves planning, rehearsal, reflection
Edge of Ability
Too Easy
Realm of “Reliable” Performance:
•Processes executed quickly, automatically
•Involves recognition, retrieval, execution
Too Difficult
Ambit of Admiration:
•Abilities of others appear flawless, magical, dramatic
•Effort and attention focused on easily recognized, but
non-causal factors and/or processes (superstition)
•Risk of failure and injury high

8. The Evolution of Expertise:
Expertise:
Results
•On average, the best
therapists:
•Achieve 50% better outcomes;
•Experience 50% fewer drop outs,
and 33% less deterioration;
•Provide more value per dollar
spent.
Chow, D., Miller, S. D., Kane, R., & Thornton, J. (n.d.). The study of supershrinks: Development and
deliberate practices of highly effective psychotherapists. Manuscript in preparation.
Miller, S.D. (2013). Psychometrics of the ORS and SRS. Results from RCT’s and meta-analyses of routine
outcome monitoring and feedback: The available evidence.
http://www.slideshare.net/scottdmiller/measures-and-feedback-2013-compatibility-mod. Retrieved
December 4, 2013.