Yes, I agree: probably much of the therapy given is not given according to the protocol and that means the average effectiveness is likely lower than the numbers in the studies indicate. In many cases, I think this might not be due to the psychotherapists or therapists themselves but the organization which they work in, e.g. crowded outpatient clinics where the policy is to meet each client in every 3 weeks or in order to not to make the queues to treatment appear so long.
I think think there might be potential for big impact for somebody with clinical background who is willing to advocate long-term for systemic change within mental health care and psychotherapy: optimal treatment protocols (best value per therapy-hour or so), triage, adherance to protocols etc.
Yes, I agree: probably much of the therapy given is not given according to the protocol and that means the average effectiveness is likely lower than the numbers in the studies indicate. In many cases, I think this might not be due to the psychotherapists or therapists themselves but the organization which they work in, e.g. crowded outpatient clinics where the policy is to meet each client in every 3 weeks or in order to not to make the queues to treatment appear so long.
I think think there might be potential for big impact for somebody with clinical background who is willing to advocate long-term for systemic change within mental health care and psychotherapy: optimal treatment protocols (best value per therapy-hour or so), triage, adherance to protocols etc.