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Evaluation of psychotherapists has always been challenging. By its very nature, psychotherapy is a treatment that requires privacy. As noted in Chapter 10 (“Use of Supervision”), the introduction of recording devices or a third-party observer alters the fundamental setting in such a way that both therapist and patient may behave differently than they do in private. Similarly, when one relies on notes to convey what happens in a psychotherapy session, the therapist may construct a version of the hour that has fictional elements, many of which may shed more favorable light on the therapist.
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