Does Practice Always Make Perfect? A Study of Whether Psychotherapists Treating Older Adults Become More Efficient as They Gain More Experience

The current longitudinal study investigates the effects of practice on the outcome of psychotherapy for elderly persons. It follows 4 psychologists for the first 143 clients of their professional lives to explore whether increased practice leads to better outcomes for their clients. The participating psychologists routinely monitor the effect of their work with different psychometric outcome measures and receive weekly supervision. The clients consist of 267 primarily elderly persons above the age of 65, who receive psychotherapy to improve their overall well-being. Well-being is measured with the WHO-5 Well-being Index. Regression analyses, with outcome improvement functioning as the dependent variable, were calculated as pre-treatment scores subtracted from post-treatment scores. There was no significant effect of the chronological rank of clients on the overall effect of treatment. Hence, no practice effects were found in terms of increased well-being. Variations in effect did not change either. However, the psychologists used significantly fewer sessions to achieve the same effect as time went on, as there was a significant effect of the chronological rank of clients on the number of sessions. Though significant, the size of this effect was small. Results are discussed in the light of the literature on expertise and expert performance, and possible ways to increase the effect in psychotherapy with elderly persons are suggested.