Becoming a competent clinician: basic competencies in intervention

This article summarizes the results from the Intervention Work Group of the Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology. The generic charge presented to the Intervention Work Group was "to address issues related to interventions." The Intervention Work Group identified four competency components of knowledge, skills, and abilities: (a). foundational competencies; (b). intervention planning; (c). intervention implementation; and (d). intervention evaluation competencies. A fifth component that included "practice management" was labeled as "others." Each component is discussed, including competencies that were deemed an essential knowledge, skill, and/or value. A discussion of training for intervention competence and assessing that intervention competence is included. Future directions for the science and practice of psychology in the intervention arena are summarized. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist.     

Competencies conference: future directions in education and credentialing in professional psychology

The Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology was organized around eight competency-focused work groups, as well as work groups on specialties and the assessment of competence. A diverse group of psychologists participated in this multisponsored conference. After describing the background and structure of the conference, this article reviews the common themes that surfaced across work groups, with attention paid to the identification, training, and assessment of competencies and competence. Recommendations to advance competency-based education, training, and credentialing in professional psychology are discussed. This is one of a series of articles published together in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist.     

Achieving competency in psychological assessment: directions for education and training

This article provides an overview of issues related to the development and evaluation of competency in psychological assessment. Specifically, we delineate the goals, ideas, and directions identified by the psychological assessment work group in the Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist. The psychological assessment group was charged with the tasks of: (a). identifying the core components of psychological assessment competency; (b). determining the central educational and training experiences that will aid competency development; (c). explicating strategies for evaluating competence; and (d). establishing future directions for furthering the identification, training, and evaluation of competence in psychological assessment. We present a set of eight core competencies that we deemed important for achieving psychological assessment competency and discuss four guidelines for training in the domain of psychological assessment. A variety of methods for evaluating competencies in this domain are suggested, with emphasis on using a collaborative model of evaluation. Recommendations for future directions include strengthening the academic prerequisites for graduate school training; increasing training in culturally sensitive measures; incorporating innovative assessment-related technologies into training; and addressing discontinuities between academic training, internship, and practice environments.     

Unified professional psychology: implications for the Combined-Integrated model of doctoral training

The authors outline a new identity for the professional psychologist termed Unified Professional Psychology (UPP). UPP combines recent movements toward a unified psychological science, an independent professional psychology, and Combined-Integrated (C-I) doctoral training programs in psychology. The value in the synthesis of these ideas is that they (a) provide a comprehensive system of thought that defines the science and practice of psychology in a commensurable manner, (b) offer a clear identity for the professional psychologist, and (c) set the stage for a training model that develops competencies that will prepare graduates to serve as leaders and advocates in a wide array of health settings. Issues pertaining to why a new view is needed and how UPP specifies the science-practice relationship are addressed in detail.     

Consultation and interprofessional collaboration: modeling for the future

Consultation and interprofessional collaboration by psychologists occur with individuals, groups, programs, and organizations. The practice of consultation and interprofessional collaboration involves interdisciplinary relationships, preparation, and advanced skill development within specialty areas of psychology (e.g., clinical, counseling, industrial-organizational, and school). The Workgroup on Consultation and Interdisciplinary Relationships engaged in a planning process at the Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology to address fundamental issues regarding consultation and interprofessional collaboration in professional psychology. The Workgroup articulated working definitions, consensus points about psychologists as consultants and interprofessional collaborators, a consulting and interprofessional competency blueprint for preparation and assessment strategies, and future directions. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist.     

The Consensus Conference and Combined-Integrated model of doctoral training in professional psychology--overview of part 1: nature and scope of the Combined-Integrated model

This special series of articles on the Consensus Conference and Combined-Integrated (C-I) model of doctoral training in professional psychology consists of 13 articles in two successive volumes of the Journal of Clinical Psychology. Six articles are presented in Part 1 (Vol. 60, Issue 9), which collectively describe the "nature and scope" of the C-I model (e.g., historic and definitional issues; the potential advantages of this model; implications for the profession). In Part 2 of this special series (Vol. 60, Issue 10), articles 7 through 12 address the broader implications and potential applications of the C-I model within a range of professional and societal contexts (e.g., for interprofessional collaboration; the health care field; development of a global curriculum; the unified psychology movement; issues of assessment and professional identity; and higher education); article 13 provides a summary of the series as well as a discussion of future directions. As an overview, this paper provides the abstract for each of the articles in Part 1, and describes the various topics of the articles in Part 2. Taken together, the articles in this special series are designed to provide a coherent account of how and why the C-I model is timely and relevant, and therefore warrants serious consideration by the larger education and training community in professional psychology.     

Clinical Supervision of Psychotherapy: Essential Ethics Issues for Supervisors and Supervisees

Clinical supervision is an essential aspect of every mental health professional's training. The importance of ensuring that supervision is provided competently, ethically, and legally is explained. The elements of the ethical practice of supervision are described and explained. Specific issues addressed include informed consent and the supervision contract, supervisor and supervisee competence, attention to issues of diversity and multicultural competence, boundaries and multiple relationships in the supervision relationship, documentation and record keeping by both supervisor and supervisee, evaluation and feedback, self‐care and the ongoing promotion of wellness, emergency coverage, and the ending of the supervision relationship. Additionally, the role of clinical supervisor as mentor, professional role model, and gatekeeper for the profession are discussed. Specific recommendations are provided for ethically and effectively conducting the supervision relationship and for addressing commonly arising dilemmas that supervisors and supervisees may confront.     

Society of pediatric psychology task force report: recommendations for the training of pediatric psychologists

OBJECTIVE: To provide an overview of the types of training experiences considered most important to the development of competency in pediatric psychology. METHODS: This is the work of a task force commissioned by the Society of Pediatric Psychology, Division 54 of the American Psychological Association. RESULTS: Twelve topic areas, adapted from Roberts et al. (1998), deemed important for obtaining knowledge and expertise in pediatric psychology, were identified. These topics include life span developmental psychology; life span developmental psychopathology; child, adolescent, and family assessment; intervention strategies; research methods and systems evaluation; professional, ethical, and legal issues pertaining to children, adolescents, and families; issues of diversity; the role of multiple disciplines in service-delivering systems; prevention, family support, and health promotion; social issues affecting children, adolescents, and families; consultant and liaison roles; and disease process and medical management. Each area is briefly described and recommendations for obtaining training in these areas are offered. CONCLUSIONS: The Society of Pediatric Psychology offers this document as a comprehensive review of the ideal types of training experiences most important to developing competencies in pediatric psychology. These recommendations can be used by graduate students and graduate programs in shaping a training plan for students interested in pediatric psychology training.     

Feminism found: An examination of gender consciousness in community psychology

Articles about women's issues published in the American Journal of Community Psychology and Journal of Community Psychology, from their inception in 1973 through 2000 were examined for feminist content. Feminism was defined as including consciousness of gender issues, gender‐stratified power imbalances, and contextual analyses of gender. We identified 89 articles with feminist content. All 89 feminist articles were examined to identify themes of gender consciousness and intersecting identities. Within the theme of gender consciousness, we identified articles that addressed power asymmetries, the link between individuals and environments, contextual analyses, and a focus on competencies. Within the theme of intersecting identities, we identified articles that addressed race, class, sexual orientation, and disabilities. We discuss the trend toward more feminist research and explore ways create a feminist subdiscipline within the field of community psychology. Finally, we discuss recommendations for future feminist scholarship in the field. © 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 189–209, 2003.     

Individual and cultural-diversity competency: focus on the therapist

The Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology was held in Arizona in November 2002. One of the workshops, Individual and Cultural Differences (ICD), focused on racism, homophobia, and ageism. The consensus was that self-awareness and knowledge about the three "isms" are critical components in the education and training of psychologists. This article, authored by four of the workshop attendees, is a review of the current research and theoretical literature. Implications that address both content and context in graduate programs and training sites are presented. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist.     

Self-reported competency ratings of graduates of a problem-based medical curriculum.

PURPOSE: To study the self-reports of professional competencies by graduates of a problem-based medical curriculum. METHOD: All graduates from a medical school and a faculty of health sciences with a problem-based curriculum were sent a questionnaire asking them to compare their own performances in 19 domains with those of colleagues trained at schools with conventional curricula. RESULTS: Overall, alumni of the medical school rated themselves as better than colleagues who were trained at schools with conventional curricula for cooperation skills, problem-solving skills, skills relevant to running meetings, and the ability to work independently. There was no difference for possession of general academic knowledge and writing reports or articles. The self-reported ratings of better competencies were maintained after correcting the data for self-overestimation. CONCLUSION: The problem-based medical curriculum appears to contribute to the development of professional competencies. Further study is needed, however, to control for the effect of selection bias and respondents' emotional commitment to their alma mater.     

The scientifically-minded psychologist: science as a core competency

At the Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology, the Scientific Foundations and Research Competencies Work Group focused on identifying how psychologists practice scientifically. This article presents the subcomponents associated with the core competency of scientific practice. The subcomponents include: 1). access and apply current scientific knowledge habitually and appropriately; 2). contribute to knowledge; 3). critically evaluate interventions and their outcomes; 4). practice vigilance about how sociocultural variables influence scientific practice; and 5). routinely subject work to the scrutiny of colleagues, stakeholders, and the public. In addition, the article briefly discusses how the depth of training for and assessment of each subcomponent will vary by training model. Implications and future directions for individual psychologists, training programs, and the profession are discussed. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist.     

Responding to graduate students' professional deficiencies: A national survey

Seventy-one doctoral programs in professional psychology were surveyed with respect to the incidence of studentS' professional deficiencies and related procedures. Professional deficiencies, particularly limited clinical skills and personality/emotional problems, were reported by 89% of the respondents, twice the number that have official policies for dealing with such problems. Incidence of limited clinical skills was related positively to interviewing applicants and use of practicum grades for evaluation and related negatively to using recommendation letters and reliance on clinical supervisor's assessment. Responses to deficiencies reflected appropriate due process concepts and were most likely to include terminating students and psychotherapy referral. Recommendations are made for definitions of professional competencies, development of policies, and research on the reliability and validity of screening and evaluation mechanisms.     

A model and method for "making" a Combined-Integrated psychologist: equilintegration (EI) theory and the beliefs, events, and values inventory (BEVI)

Although the Consensus Conference on Combined and Integrated Doctoral Training in Psychology (e.g., Bailey, 2003) generated much content of relevance to the structure and commitments of Combined-Integrated (C-I) programs, faculty, and students-and Competencies 2002: Future Directions in Education and Credentialing in Professional Psychology (www.appic.org) developed language and guidelines regarding the knowledge areas, skills, and values that students in professional psychology programs should acquire and demonstrate-specific models and methods are necessary to translate these professional guidelines and aspirations into reality. This article offers one such model, Equilintegration (EI) Theory, and method, the Beliefs, Events, and Values Inventory (BEVI), that can be used by faculty, training staff, supervisors, and students in C-I programs to operationalize, assess, and cultivate basic values of education and training from a C-I perspective (e.g., self-awareness, self-assessment, and self-reflection). In addition to this model and method, relevant background information, theory, and research are presented along with attendant implications, hypotheses, and principles.     

Competency in surgical residency training: defining and raising the bar.

Competency-based surgical residency training is rapidly becoming the norm across surgical specialties. Ensuring that graduating surgeons are competent to deliver the necessary services and skills to their patients remains a seminal objective of training programs. Defining surgical competence, the measures used to assess and quantify that competence, and the criteria used to judge whether it has been achieved are critical issues. The bar that surgical residency programs have established is, and must continue to be, set very high. Definitions of competency differ across disciplines. In education, two approaches are recognized. According to the behaviorist approach, competence is assessed by precise measures of performance, generally documented by checklists. The integrated (holistic) approach defines competence as a complex combination of personal attributes. Assessments of competence also fall under two categories: the traditional scientific paradigm, emphasizing objectivity and reproducibility, and the judgment paradigm, reflecting the need to assess clinical competence in the final stages of medical training. In surgery, competence is the ability to successfully apply professional knowledge, skills, and attitudes to new situations as well as to familiar tasks. A critical step in assessing surgical competency is developing methodology for competency evaluation and certification. Matching different aspects of surgical competency with the appropriate assessment instruments is the theme of the contemporary evaluation process, with emphasis on a whole-task approach and the assessment of professional judgment. An effective assessment program will incorporate several competency elements, using multiple sources of information to assess competencies on multiple occasions, at various levels, and in different settings.     

Why residents should teach: a literature review

Resident doctors contribute significantly to the quality of undergraduate medical training and it is assumed that by participating in the process, they also improve their own professional competency. We decided to investigate whether there is evidence to support this assumption. Our hypothesis, the physician-as-teacher rule, stated that "A skilled teacher has an increased likelihood of becoming a competent clinician, than a skilled clinician has of becoming a competent teacher". We conducted a literature review to search for evidence to confirm or refute this assumption. Twenty-four articles written after 1990 were identified as relevant from 132 references we generated by searching Medline. The identified articles were qualitatively reviewed to identify key research conclusions and/or main discussion points. The findings from the review were collated and discussed. None of the studies showed specific evidence of how teaching results in improved professional competence. However, there was evidence that teaching ability correlated positively with the perception of clinical competency. There was also need for improved supervision and training programmes for residents in teaching skills. The review provided evidence that teaching influenced the perceived professional competency of physicians positively. Physicians who were perceived as competent were those who taught effectively, and who had a basic understanding of teaching and learning. The review shows that training in teaching is essential for physicians, and that further research is still needed to demonstrate the effect of good teaching on professional competency.     

The Hierarchical Clustering of Clinical Psychology Practicum Competencies: A Multisite Study of Supervisor Ratings

Competency evaluation rating forms are widely used to assess a range of global and specific psychology practitioner competencies during and at the end of clinical placements. Surprisingly, there is little research examining the dimensional structure or the hierarchical clustering of items on these ratings. The current, multisite study examined supervisor ratings of clinical psychology trainees (N = 204) on the Clinical Psychology Practicum Competencies Rating Scale (CΨPRS). Based on the proximity criterion chosen, hierarchical clustering yielded either nine clusters or four super clusters: Good Practitioner Attributes and Conduct, Scientist Practitioner and Professional Management, Assessment and Intervention, and Psychological Testing. The study also tracked the developmental trajectory of competency attainment. CΨPRS ratings differentiated groups between early but not between later stages of training. Measurement issues and implications for training and practice are discussed.     

一年制心理危机干预热线咨询员培训过程

介绍北京回龙观医院一年制心理危机干预热线咨询员培训过程与特色。北京回龙观医院北京心理危机干预热线咨询员培训时间为一年制,分3个阶段完成:2个月的理论与技能培训阶段、4个月的上线实践阶段及6个月独立接线试用阶段。提出建议要培训合格的危机干预热线咨询员需编制系统、严谨的培训教材;制订完善的培训计划;配备资深的教师队伍;建立严格的督导机制;制订科学有效的热线质量评估标准;并注重咨询员的专业成长与心理维护以防止心理枯竭。     

Health Psychology 2000:The Development of Professional Health Psychology: European Federation of Professional Psychologists' Associations (EFPPA) Task Force on Health Psychology Final Report

This Final Report of the European Federation of Professional Psychologists' Associations (EFPPA) Task Force on Health Psychology defines the nature and scope of health psychology and its possible future development to the year 2000 and beyond. Training needs and objectives are specified for professional health psychologists working in Europe. Practical and policy implications of medical progress and societal changes are discussed. The future development of health psychology as a profession depends on putting theory and policy into practice through the implementation of high quality training. Currently there are relatively few European countries where this has yet happened. Training programmes need to be introduced in all European countries within the framework of each member- country's national laws, regulations and practices.     

How can the postgraduate training program in pathology departments in India be improved?

There exists a wide variation in the competence of the postgraduate residents trained in pathology in different institutions across India. This results in strong disparities in the clinical diagnostic skills, teaching skills, research capabilities and the managerial skills of the graduates. The end users of this training, namely the community, clinicians and health care institutions would benefit from a more uniform and better trained pathologist. The article reviews the reasons for the variation in the quality of the training programs. The main deficiencies include, lack of well-defined criteria for recruitment of residents, training facilities, faculty resources, curriculum with well-defined learning objectives and competencies, hands-on experiences in diagnostic and research activities, diagnostic specimens and medical autopsies, exposure to molecular pathology, pathology informatics, electron microscopy, research experiences, communication skills, professional behavior and bioethics, business practices in pathology and quality assurance. There is also a lack of defined career tracks in various disciplines in laboratory medicine, standard protocols for evaluation and regional and national oversight of the programs. The steps for rectification should include defining the competencies and learning objectives, development of the curriculum including teaching methods, facilities and evaluation strategies, communication skills, professional behavior skills, teaching skills, legal aspects of practicing pathology and the various career pathways to subspecialties in pathology. The training should include defined exposure to molecular pathology, electron microscopy, quality control and assurance, laboratory accreditation, business aspects of pathology practice, review of literature, evidence-based medicine, medical autopsy and medical informatics. Efforts should be made to share human and laboratory resources between regional cooperation. The oversight and accreditation policies should be evolved and well-documented. Web-based platforms need to be developed for easy interaction among residents, faculty and administrators on a national level.