Trainee-therapists are not all equal: Examination of therapeutic efficiency, effectiveness and early client dropout after 12 months of clinical training

Banham, James A. & Schweitzer, Robert D. (2016) Trainee-therapists are not all equal: Examination of therapeutic efficiency, effectiveness and early client dropout after 12 months of clinical training. Psychology and Psychotherapy: Theory, Research and Practice, 89(2), pp. 148-162.

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  • Contemporary research demonstrates the feasibility of assessing therapeutic performance of trainee-therapists through the use of objective measures of client treatment outcome. Further, significant variation between individual therapists based on their client treatment outcomes has been demonstrated. This study sets out to determine whether a reliable composite measure of therapeutic efficiency, effectiveness and early dropout can be developed and used to objectively compare trainee-therapists against each other.

Design and methods

  • Treatment outcomes of 611 clients receiving treatment from 58 trainee-therapists enrolled in a professional training programme were tracked with the OQ-45.2 over a 6-year period to assess therapeutic efficiency, therapeutic effectiveness and early client dropout.


  • Significant variation between trainee-therapists was observed for each index. Findings of a moderately strong correlation between therapeutic efficiency and effectiveness enabled the ranking of trainee-therapists based upon a composite measure of these indexes. A non-significant correlation was found between early client dropout and measures of therapeutic effectiveness and efficiency.


  • The findings stress the importance of utilizing objective measures to track the treatment outcomes. Despite all trainee-therapists being enrolled in the same training programme, significant variation between trainee-therapists' therapeutic efficiency and effectiveness was found to exist.

Practitioner points

  • Developing of potential benchmarking tools that enable trainee-therapists, supervisors and educational institutions to quickly assess therapeutic performance can become part of a holistic assessment of a trainee-therapist's clinical development.

  • Despite an inherent optimistic belief that therapists do not cause harm, there appears to be a small and significant proportion of trainee-therapists who consistently evidence little therapeutic change.

  • Considerable variability in trainee-therapists' therapeutic efficiency and effectiveness can exist in the one training programme.

  • Early client dropout may not be associated with therapists' therapeutic effectiveness and efficiency.

Impact and interest:

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ID Code: 86132
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: trainee-therapists, therapeutic efficiency, therapeutic effectiveness, client dropout, OQ-45.2
DOI: 10.1111/papt.12071
ISSN: 2044-8341
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Psychology & Counselling
Copyright Owner: © 2015 The British Psychological Society.
Deposited On: 02 Aug 2015 23:19
Last Modified: 24 May 2016 01:02

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