An Investigation of Self-Assessment Bias in Mental Health Providers

Abstract

Previous research has consistently found self-assessment bias (an overly positive assessment of personal performance) to be present in a wide variety of work situations. The present investigation extended this area of research with a multi-disciplinary sample of mental health professionals. Respondents were asked to: (a) compare their own overall clinical skills and performance to others in their profession, and (b) indicate the percentage of their clients who improved, remained the same, or deteriorated as a result of treatment with them. Results indicated that 25% of mental health professionals viewed their skill to be at the 90th percentile when compared to their peers, and none viewed themselves as below average. Further, when compared to the published literature, clinicians tended to overestimate their rates of client improvement and underestimate their rates of client deterioration. The implications of this self-assessment bias for improvement of psychotherapy outcomes are discussed.

Factors related to psychotherapists' self-assessment when treating anxiety and other disorders

“…Such an assumption would mean that clinicians would perceive little reason to focus on monitoring, maintaining, and improving their skills and outcomes. Walfish, McAlister, O'Donnel, and Lambert (2012) found evidence to support this hypothesis. In a cohort of psychological therapists, the mean self-rated skill level relative to colleagues was high, with the mean rating being at the 80 th centile (rather than the 50 th , as should be the case).…”

“…This overestimation of ability is found in a range of skills, such as driving and job performance (e.g., Anderson, Warner, & Spencer, 1984;Meyer, 1990), and is known as 'self-assessment bias'. Furthermore, when asking these clinicians about how many of their patients recovered or improved, Walfish et al (2012) found that clinicians believe that most of their clients recover after therapy. In a similar vein, Brosan, Reynolds, and Moore (2008) found that, overall, therapists' self-ratings have no more than moderate agreement with independent ratings of their competence.…”

“…The first aim of this study is to replicate the work of Walfish et al (2012), assessing at what relative level clinicians perceive their own abilities and those of their colleagues, and their judgements of how effective is the therapy that they deliver. This replication will be Self-assessment bias 6 carried out in the UK, rather than in the US (Walfish et al, 2012).…”

“…This replication will be Self-assessment bias 6 carried out in the UK, rather than in the US (Walfish et al, 2012). The second aim is to extend that work by determining factors that might influence this self-assessment bias, focusing on clinicians' personality traits and other clinical and demographic factors (e.g., age, supervision).…”

Do mental health patients learn what their cognitive-behaviour therapists think they do? A short report on qualitative interviews comparing perspectives

“…Accordingly, we focused not only on depression (Barnes et al, 2013; French et al, 2017; Hundt et al, 2013) but included different diagnoses, which also implied heterogeneity. Study limitations refer to the small accidental sample size, reactivity due to an awareness of being interviewed, self-assessment bias (Walfish, McAlister, O’Donnell, & Lambert, 2012), patient selection by therapists (which is why it remains unclear whether prototypical or especially cooperative patients were included), of therapies mainly in the early stages, and the restriction to a university treatment setting. In future studies, learning and skills use could be addressed routinely and repeatedly as a complete survey within a certain time period, both to reduce bias, and to underscore the importance of skills use.…”