Cognitive Biases, Heuristics, and Logical Fallacies in Clinical Practice: A Brief Field Guide for Practicing Clinicians and Supervisors

Cognitive biases can permeate everyday clinical decision-making processes and adversely affect the accuracy of clinical judgments, even among the many practitioners who are capable, knowledgeable, and highly intelligent. Reviews summarizing the cognitive biases that affect clinical decision-making have largely targeted physicians rather than practicing psychologists. Further, much of the writing on this topic presumes a level of familiarity with technical aspects of the decision-making literature that may not be possessed by many practitioners. We present a contemporary and accessible introduction to the cognitive pitfalls that can adversely affect clinical decision-making for practicing psychologists, including clinical supervisors. We briefly review the dual-process model of cognition and describe biases, heuristics, and logical fallacies that are germane to a diverse range of clinical practices in psychology, along with clinically relevant examples. We conclude with a brief summary of the preliminary evidence for bias management strategies that may improve clinical accuracy. Owing in part to metabiases such as bias blind spot, practicing clinicians and supervisors should strive to acquire insight into their decision-making processes and learn how they can go awry. Public Significance Statement Research suggests that cognitive biases are pervasive in mental health professionals' decision-making and can diminish the accuracy of clinical judgments, even among skilled practitioners. This user-friendly introduction reviews biases, heuristics, and logical fallacies that are particularly relevant to psychological practice and supervision. Decreasing reliance on working memory and bolstering psychoeducation may alleviate the effects of bias on clinical decision-making.