The Promise and Challenge (and Reality) of Defining Therapist Expertise

This article is a commentary on Hill, Spiegel, Hoffman, Kivlighan, and Gelso’s interesting and thought-provoking article focused on defining psychotherapy expertise. I address Hill et al.’s inclusion of other criteria to evaluate expertise that counters Tracey, Wampold, Goodyear, and Lichtenberg’s conclusion that treatment outcome is the only criterion supported by the research to determine expertise. I also address Hill et al.’s discussion on the development of expertise with a focus on monitoring treatment outcome to promote therapist improvement. In sum, Hill et al. provide a way forward for psychotherapy researchers to address proposed dimensions of expertise that currently are based more on our clinical wisdom than empirical evidence and, in doing so, offer the promise of better understanding what makes an excellent psychotherapist.