Comparative effectiveness of paraprofessional and professional helpers

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The outcome and adequacy of design in 42 studies comparing the effectiveness of professional and paraprofessional helpers are reviewed. Although studies have been limited to examining helpers functioning in narrowly defined clinical roles with specific client populations, it is argued that the findings are consistent and provocative. Paraprofessionals achieve clinical outcomes equal to or significantly better than those obtained by professionals. In terms of measureable outcome, professionals may not possess demonstrably superior clinical skills when compared with paraprofessionals. Moreover, professional mental health education, training, and experience do not appear to be necessary prerequisites for an effective helping person. The strongest support for paraprofessionals has come from programs directed at the modification of college students' and adults' specific target problems and, to a lesser extent, from group and individual therapy programs for non-middle-class adults. Future studies need to define, isolate, and evaluate the primary treatment ingredients of paraprofessional helping programs to determine the nature of the paraprofessional's therapeutic influence. (62 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved)

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