Clinical predictions made by mental health practitioners are compared with those using statistical approaches. Sixty-seven studies were identified from a comprehensive search of 56 years of research; 92 effect sizes were derived from these studies. The overall effect of clinical versus statistical prediction showed a somewhat greater accuracy for statistical methods. The most stringent sample of studies, from which 48 effect sizes were extracted, indicated a 13% increase in accuracy using statistical versus clinical methods. Several variables influenced this overall effect. Clinical and statistical prediction accuracy varied by type of prediction, the setting in which predictor data were gathered, the type of statistical formula used, and the amount of information available to the clinicians and the formulas. Recommendations are provided about when and under what conditions counseling psychologists might use statistical formulas as well as when they can rely on clinical methods. Implications for clinical judgment research and training are discussed.

Clinical and educational experience is one of the most commonly studied variables in clinical judgment research. Contrary to clinicians' perceptions, clinical judgment researchers have generally concluded that accuracy does not improve with increased education, training, or clinical experience. In this meta-analysis, the authors synthesized results from 75 clinical judgment studies where the experience of 4,607 clinicians was assessed in relation to the accuracy of their judgments about mental health (e.g., diagnosis, prognosis, treatment) and psychological issues (e.g., vocational, personality). The authors found a small but reliable effect, d = .12, showing that experience, whether educational or clinical, is positively associated with judgment accuracy. This small effect was robust across several tested moderator models, indicating experienced counselors and clinicians acquire, in general, almost a 13% increase in their decision-making accuracy, regardless of other factors. Results are discussed in light of their implications for clinical judgment research and for counseling psychology training and practice.

This clinical judgment study found an overshadowing bias that existed in the treatment of major depression in AIDS patients. Two clinician individual differences-cognitive complexity about AIDS issues and attitudes toward AIDS victims-were investigated for possible moderating effects of the treatment overshadowing bias. Cognitive complexity about AIDS issues had a significant moderating effect, as more complex clinical and counseling psychologists were more likely to recommend antidepressant medication. Attitudes toward AIDS victims, measured by the Attitudes Towards AIDS Victims scale (Larsen, Serra, & Long, 1990), did not moderate clinician's treatment judgments. Results from a second set of exploratory analyses suggest that the diagnostic overshadowing occurred, but as a function of the presence of a terminal illness (AIDS or cancer) and not as a bias unique to AIDS issues. Implications for research and practice are discussed.

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