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.

We investigated counseling psychologists' (N= 165) vocational diagnostic and treatment decisions when vocational and personal problems are presented concurrently. Participants assessed the same vocational problem either alone or in conjunction with a personal problem of one-half, equal, or double the severity of the vocational problem. Without consideration for counselors' problem preference, ratings of the vocational problem were equivalent across the three personal problem severity levels. However, with preferences considered, counseling psychologists who reported greater preference for working with personal problems, in comparison to vocational problems, were less likely to assess, diagnose, and treat the vocational problem than were counseling psychologists who reported equivalent or reversed problem preferences. This biasing effect occurred when the personal problem was of equal or double the severity of the vocational problem.

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 study found that counselor individual differences in cognitive complexity, but not preferences for client problems, moderate the cognitive processes that lead to bias in clinical judgment. A particularly robust and unambiguous clinical bias, known as diagnostic overshadowing (S. Reiss,

Sexual minority (SM) individuals live in a heterosexist society that denigrates their sexual orientation identity. The stigma and prejudice they regularly encounter is hypothesized to lead to their significantly increased risk for developing mental health disorders. Because of these factors, therapists should be diligent to create an affirming and supportive therapeutic environment but this is often not the case. SM clients frequently report experiencing sexual orientation microaggressions in therapy, such as heteronormative statements, a disregard for their sexual orientation identity, and an assumption that their presenting issues are rooted in their sexual orientation identity. These microaggressions should be viewed as bias manifested as clinical errors because of how they weaken therapeutic alliance, decrease the effectiveness of treatment, decrease utilization intent, and cultivate feelings of shame, anger, and misunderstanding. This article provides empirically supported findings regarding common SM clinical errors and microaggressions, a clinical example of such biases with corrective examples along with the author's personal reactions, and more general strategies for avoiding microaggressive errors with SM clients. Implications for practice, training, and research are discussed. (PsycINFO Database Record