Therapists do not improve with experience: on average they become less effective, and their clients drop out more the longer they have practised.

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  Psychotherapy follows a dose-response curve: it takes more than 20 sessions before half of patients meaningfully improve, and more than 40 before three quarters do.

  Shedler says therapy follows a dose-response curve, with more than twenty sessions before half of patients meaningfully improve. Miller says therapists on average get LESS effective the longer they have practised. More of the treatment helps and more practice at giving it does not, which is a strange pair to hold at once and both men have the trials.

Shared subject first, then similar wording. They may agree or disagree.

• "Evidence-based therapy" is a branding term rather than a scientific one, and in practice it is a code word for "not psychodynamic". JSJonathan Shedler2 Oct 2013Psychotherapy
• A couples therapist starts by validating where people are, not by asking them to be vulnerable. SJSue Johnson15 May 2023Psychotherapy
• A diagnosis does not tell a therapist what to do. SHSteven C. Hayes22 Sept 2025Psychotherapy
• A prescriber cannot outsource containment to the therapy hour: the emotional and relational dynamics are part of prescribing, not an intrusion on it. AAAwais Aftab5 Jul 2026Psychotherapy
• A therapy is only shown to be more effective if it is compared against another treatment intended to help, not against a control nobody expected to work. SMScott D. Miller11 Sept 2024Psychotherapy

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