By Dr. Steven Tsao, Phd
Even after treating anxiety disorders for over 20 years (which sounds unbelievable as I type that number), I still get the “warm fuzzies” getting to witness and collaborate in the journey of recovery with the clients that walk through my office door every day. I feel honored and grateful to have been trained in CBT for anxiety disorders and inspired to see the life-changing effects it can have in the lives of those who suffer. However, I am only one person, with limited time and chairs in my office, which means that there are waaaaay more people in need of help than I can see in a given week. As such, one part of the mission that my Co-Founder, Dr. David Yusko, and I made when we started Center for Anxiety & Behavior Therapy was to prioritize disseminating evidence-based treatments for anxiety, including bringing on trainee therapists to see clients at our practice. Since then, the most frequent question we hear from people considering working with a trainee is “Can I really get good therapy from someone just starting out?” After supervising trainee therapists for the last 15 years, here are some of the reasons I can honestly say “Yes!”
First, trainee therapists are often the most energetic, invested, and hard-working people you will find.
The life of a student or trainee is often singularly-focused on clinical psychology through coursework, research projects, and clinical rotations, which usually means they are the Energizer bunnies of therapists, willing to put in the time and effort it takes to do a great job. When I was a trainee, I definitely fit this mold and we at CABT have been lucky enough to bring on like-minded trainees over the years. While I wish it was not the case, there are unfortunately plenty of therapists that are several years or decades out of school who fall into cruise control and do not have the ability or time to put into their cases like trainees do. Trainees have also been learning the most up-to-date theories and research during their recent time in school, which makes them some of the most current thinkers about the best ways to deliver treatment.
Second, all unlicensed trainee therapists are given at least 2 hours of individual supervision with a licensed, expert-level psychologist every week where their individual cases are reviewed in detail.
This means that every trainee case has not one, but two highly-trained brains thinking about their care at all times. The old adage “Two is better than one” is just as true here as it is for all the other important things in life, like servings of ice cream. Having two smart, well-intentioned, and engaged therapists working on a single case makes the quality of that care exceptionally high.
Third, and especially true of following empirically-supported treatment protocols like CBT, the treatment delivered by a trainee therapist should look very similar to that of an experienced therapist.
If you were to be a fly on the wall of a session of Exposure and Response Prevention (ERP) for OCD in my office, then buzzed around to another session of ERP with a trainee, you would witness far more interventions and recommendations that looked very similar than the minor stylistic differences that arise between any therapists.
What does the research show?
Lastly, as a science-minded person and therapist, I’ll lean on a great research study to back up my aforementioned ideas. In 2003, Franklin and colleagues looked at how much therapist experience impacted treatment progress when delivering ERP for OCD. This study showed that well-trained, but inexperienced therapists (0-1 years of experience) that had regular high-quality expert supervision, helped their patients recover just as much as highly experienced therapists (9+ years of experience). For both of these groups, the average improvement in overall OCD severity fell in the subclinical range by the end of treatment, with over 85% of cases demonstrating “clinically significant improvement” for the inexperienced therapist group (the highly-experienced therapist group did only slightly better at 92%).
If you have made it this far in this post, I hope you feel a bit better about seeing a trainee therapist at CABT for your care. There are unfortunately too many barriers to accessing good mental health treatment these days, but my hope is that concerns about getting excellent treatment from a trainee therapist can be one less barrier to hurdle as you begin your road to recovery. Your best life is waiting for you, and one of our trainees is a great co-pilot to navigate you there. Read up on some of our wonderful trainees here. And if you are ready to take the next step in your mental health journey, check out our contact page!