Some Deliberations on Deliberate Practice in Psychotherapy: A Commentary

In this commentary on the issue of the Journal of Clinical Psychology: In Session dedicated to Deliberate Practice (DP), we highlight commonalities between DP supervision as illustrated in the target papers and Alliance-Focused Training (AFT) and applaud the shift towards more experiential learning. We also note one major difference, namely the absence of Behavioral Rehearsal (BR) in AFT in spite of this being a key element of DP as conceptualised in the Sentio Supervision Model and in the target papers. We then offer some critique of DP as modelled in this issue. We suggest that empirical evidence on what constitutes therapeutic expertise is undeveloped. Consequently, there is a risk of building a super-structure of DP on foundations that still await solid empirical support. We note how DP might be tailored more closely to what is known about therapeutic effectiveness, drawing on process research and Task Analysis. We then suggest that DP may have failed to sufficiently conceptualise the relational nature of therapeutic expertise-different in character to skill training in fields where DP was originally formulated and developed. We argue that processes of interpersonal attunement offer a frame in which parenting skills, developmental psychopathology, the earning of secure attachment both in and outside of therapy, and the safe base of supervision can all be gathered into a unifying paradigm. We end by arguing that the ability to be mindfully present in relationship underpins the experiential depth and skilful responsiveness at the heart of both attachment and successful psychotherapy.