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Do Therapists Get Better With Time? A Closer Look at What the Research Says

At Garden Refuge, we often hear thoughtful questions from clients and community partners about our intern training model. One of the most common concerns sounds like this: "Aren't more experienced therapists better? Why would I see someone who is just starting out?"

It's a reasonable question. We all tend to assume that the longer someone does something, the better they get at it. But when it comes to psychotherapy, the research paints a much more nuanced—and in some cases surprising—picture.

In this article, we'll take a closer look at what decades of scientific research reveal about therapist effectiveness over time. Do clinicians become more effective as they gain experience? Are newer therapists truly less effective? And what does this mean for clients working with interns or newly licensed counselors?

The Assumption: More Years = Better Therapy?

In most fields, experience is a proxy for expertise. We expect a master carpenter to cut cleaner joints than an apprentice, or a seasoned lawyer to argue more effectively than a recent law school grad. Psychotherapy, though, may not follow the same curve.

The assumption that therapists improve over time makes intuitive sense, but multiple studies show that therapist effectiveness tends to plateau early in a career—and sometimes even declines slightly with time. Let’s walk through what the research actually says.

What the Data Tells Us

Goldberg et al. (2016): Therapists Don't Get Better—They Might Even Get Worse

In one of the most widely cited studies on this topic, Goldberg and colleagues tracked 170 therapists and over 6,500 clients across multiple years. They wanted to know: do psychotherapists improve with time and experience?

The surprising answer: no. In fact, the data showed that therapist effectiveness slightly declined over time.

"On the whole, therapists’ patient outcomes tended to diminish as experience (time or cases) increased."— Goldberg et al., 2016

Clients didn’t get worse—but they didn’t improve more, either. The more sessions therapists delivered, the more their effectiveness leveled off or dropped. The only bright spot: therapists with more experience had lower client dropout rates, meaning clients stuck with therapy longer. But symptom reduction (like anxiety or depression scores) didn’t improve.

Citation: Goldberg, S. B., Rousmaniere, T., Miller, S. D., et al. (2016). Do psychotherapists improve with time and experience? Journal of Counseling Psychology, 63(1), 1–11. https://doi.org/10.1037/cou0000131

Germer et al. (2022): A Global Replication Confirms the Same

A German research team led by Germer (2022) attempted to replicate Goldberg’s findings in a separate health system. They analyzed data from 241 therapists and over 3,400 clients. Again, they found no improvement in therapist outcomes with additional experience. Experienced therapists were no more effective than early-career clinicians.

“Therapeutic experience seems to be unrelated to patients’ change in psychopathology.”— Germer et al., 2022

Citation: Germer, S., Weyrich, V., Bräscher, A.-K., et al. (2022). Does practice really make perfect? Journal of Counseling Psychology, 69(5), 745–754. https://doi.org/10.1037/cou0000604

Wampold & Brown (2005): Experience Doesn’t Explain Outcome Differences

In an earlier study, Wampold and Brown examined data from over 6,000 clients treated by 581 therapists in a managed care network. They found that:

• Only about 5% of client outcome differences were due to which therapist they saw.

• Years of experience didn’t significantly predict outcomes.

In other words, some therapists were better than others—but that difference wasn’t explained by how long they had been practicing.

Citation: Wampold, B. E., & Brown, G. S. (2005). Estimating variability in outcomes attributable to therapists. Journal of Consulting and Clinical Psychology, 73(5), 914–923.

Meta-Analysis: A Small Effect for Some Disorders, but Not All

To round out the picture, a 2019 meta-analysis by Walsh and colleagues looked at 22 studies and 208 effect sizes. They found that experience had a small but statistically significant effect—mostly for clients dealing with depression, but not for anxiety or when therapy followed a strict treatment manual.

"Therapist experience may matter for internalizing clients under certain circumstances, but this relationship is modest."

Citation: Walsh, L. M., Jensen-Doss, A., et al. (2019). A meta-analysis of the effect of therapist experience on outcomes for internalizing disorders. Psychotherapy Research, 29(7), 783–798. https://doi.org/10.1080/10503307.2018.1447700

Why Doesn’t Experience Automatically Make Us Better?

If experience alone doesn’t improve outcomes, why not?

Experts believe it comes down to one thing: intentional learning.

Miller, Hubble, and Chow (2018) argue that most therapists plateau after a few years because they stop engaging in deliberate practice. They aren’t getting regular, structured feedback, and they aren’t reviewing outcome data to improve. Without those ingredients, experience just reinforces what someone already does—even if that approach is only moderately effective.

"Therapists do not automatically improve simply by logging more sessions. Deliberate practice and feedback are essential."

Citation: Miller, S. D., Hubble, M., & Chow, D. (2018). The question of expertise in psychotherapy. Journal of Expertise, 1(2), 121–129.

What This Means for Clients Working With Interns

So what does all this mean for a client considering therapy with an intern or newly licensed counselor?

It means you aren’t taking a risk—you might actually be getting the best of all worlds:

• Interns are closely supervised. At Garden Refuge, every intern is supervised weekly by a licensed, experienced clinician who reviews their work, helps them sharpen their skills, and ensures clients are getting safe, ethical care.

• Interns are more up-to-date. Many of our interns come into the field with certifications in evidence-based treatments like the Gottman Method for couples counseling. They’re trained in the latest science and best practices.

• Interns bring energy and empathy. Our interns often connect quickly with teens and young adults. They’re attuned to today’s stressors around identity, anxiety, and family dynamics.

• Interns are part of a team. Every intern at Garden Refuge is part of a supportive, collaborative care model. They work with supervisors and peers to ensure clients receive thoughtful, holistic support.

  
  

Choosing to work with an intern doesn’t mean you’re settling. It means you’re participating in a research-aligned model of care—one that supports training, expands access, and still provides meaningful results.

The Takeaway

Experience does matter—but it isn’t everything. The most effective therapists are not always the ones with the most years under their belt. They’re the ones who never stop learning. They're the ones who are humble enough to ask how you think therapy is going. That’s why we believe so strongly in what we do at Garden Refuge. We support our interns through rich supervision, client feedback, and ongoing reflection. We train therapists to stay flexible, humble, and connected to the people they serve.

And as the research shows: that mindset matters more than mileage.

By Araxie Jensen