Agreed that is not a role of the training program, at least at present. I guess the university gives the degree based on achievement of certain requirements and after that, the state gives the license based on some combination of coursework, a licensing exam, and a certain number of hours of supervised experience with supervisors who are trained in supervision. There is no official "aftersight" after the person is licensed, unless they commit some ethical violation or are grossly negligent and it can be documented. After being licensed, the T stays in business based at least in part (I hope) on his results and competence. If a T is not effective, clients will not stick with him/her, not recommend to friends and colleagues, etc. So this kind of T might be marked by a pattern of having clients only for a few sessions or months. It's kind of an informal way--a marketplace way--of weeding out those who are incompetent (they won't be able to make a living, so they get out of the profession). At least in theory.... And the insurance companies may look at a pattern like this--clients routinely "complete" therapy after only 6 sessions!--and say, "hey, this T is highly efficient, we definitely want him as part of our preferred provider network."

I wonder if that is how it was for my first therapist? I found her through my EAP, and not knowing anything about therapists, I assumed she was fine. But now that I have had a good therapist, I understand she was very ineffective. In fact, I believe most of her business was in providing acupuncture services. (Perhaps I was her only psychotherapy client?) Surely she did not intend to be an acupuncturist when she got her MSW, so perhaps she was such an ineffective therapist she had to learn a new skill--acupuncture--to support herself? Or she ended up hating being a therapist so she branched out?