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" Why is this? How can experience be so valuable in some professions but almost worthless in others? To see why, suppose that you are playing golf. You are out on the driving range, hitting balls toward a target. You are concentrating, and every time you fire the ball wide you adjust your technique in order to get it closer to where you want it to go. This is how practice happens in sport. It is a process of trial and error. But now suppose that instead of practicing in daylight, you practice at night—in the pitch-black. In these circumstances, you could practice for ten years or ten thousand years without improving at all. How could you progress if you don’t have a clue where the ball has landed? With each shot, it could have gone long, short, left, or right. Every shot has been swallowed by the night. You wouldn’t have any data to improve your accuracy. This metaphor solves the apparent mystery of expertise. Think about being a chess player. When you make a poor move, you are instantly punished by your opponent. Think of being a clinical nurse. When you make a mistaken diagnosis, you are rapidly alerted by the condition of the patient (and by later testing). The intuitions of nurses and chess players are constantly checked and challenged by their errors. They are forced to adapt, to improve, to restructure their judgments. This is a hallmark of what is called deliberate practice. For psychotherapists things are radically different. Their job is to improve the mental functioning of their patients. But how can they tell when their interventions are going wrong or, for that matter, right? Where is the feedback? Most psychotherapists gauge how their clients are responding to treatment not with objective data, but by observing them in clinic. But these data are highly unreliable. After all, patients might be inclined to exaggerate how well they are to please the therapist, a well-known issue in psychotherapy. But there is a deeper problem. Psychotherapists rarely track their clients after therapy has finished. This means that they do not get any feedback on the lasting impact of their interventions. They have no idea if their methods are working or failing—if the client’s long-term mental functioning is actually improving. And that is why the clinical judgments of many practitioners don’t improve over time. They are effectively playing golf in the dark.11 "
― Matthew Syed , Black Box Thinking: Why Some People Never Learn from Their Mistakes - But Some Do
