THE CLINICIAN ILLUSION AND THE PSYCHOTHERAPY PRACTICE - AN APPLICATION OF STOCHASTIC MODELING

The caseload of practicing clinicians tends to be unrepresentative of the population of psychotherapy patients. This results from the fact t hat, although the majority of patients use relatively few treatment se ssions, the majority of a clinician's time is spent with longer term c ases-a minority of patients consume the majority of services. Here, a stochastic model is used to describe the development of caseloads unde r 4 different treatment regimens. It is shown that a psychotherapy pra ctice will reach a steady state (a stable case mix) in relatively shor t time and at that this will limit the open appointment slots availabl e each week to serve new patients. Implications for training and clini c staffing are discussed.