A Competency Based Approach to Supervision: Basic Skills

Transcription

1 A Competency Based Approach to Supervision: Basic Skills Supervisor Tool Kit Presenter Assoc Prof Craig Gonsalvez

2 Supervisor Toolkit Contents Competency Measures Practice Theory Attachments Page C1a_Competency benchmarks, brief 3 C2_CB competencies 5 C3_CTS revised, brief 8 C4_ Wayne State Uni Psychodynamic scale 10 C5_CB Therapist performance scale 11 C7Sr_Generic supervisor competencies 12 P1Sr_Supervision Plans evaluation criteria 13 P3_Supervision plans trainee preparation 14 Best Practice Guidelines for CDP 16 Competency Grids 18 Designing Supervision Plans: Flowchart 19 T1_Developmental Stages (T) 20 T2_Developmental Stages (Sr) 22 T3_Competency cube 23 Attachments compiled by Craig Gonsalvez, June 2013

3 Training and Education in Professional Psychology 2009 American Psychological Association 2009, Vol. 3, No. 4(Suppl.), S5 S /09/$12.00 DOI: /a Competency Benchmarks: A Model for Understanding and Measuring Competence in Professional Psychology Across Training Levels Nadya A. Fouad University of Wisconsin Milwaukee Robert L. Hatcher University of Michigan Philinda Smith Hutchings Midwestern University Frank L. Collins, Jr. University of North Texas Catherine L. Grus American Psychological Association Nadine J. Kaslow Emory University Michael B. Madson University of Southern Mississippi Raymond E. Crossman Adler School of Professional Psychology The Competency Benchmarks document outlines core foundational and functional competencies in professional psychology across three levels of professional development: readiness for practicum, readiness for internship, and readiness for entry to practice. Within each level, the document lists the essential components that comprise the core competencies and behavioral indicators that provide operational descriptions of the essential elements. This document builds on previous initiatives within professional psychology related to defining and assessing competence. It is intended as a resource for those charged with training and assessing for competence. Keywords: competency models, professional psychology education and training, benchmarks, professional development NADYA A. FOUAD, PhD, received her doctorate from the University of Minnesota in Counseling Psychology. She is professor and training director of the Counseling Psychology program at the University of Wisconsin- Milwaukee. She is editor of The Counseling Psychologist. She has published articles and chapters on cross-cultural vocational assessment, career development of women and racial/ethnic minorities, interest measurement, cross-cultural counseling and race and ethnicity. CATHERINE L. GRUS, PhD, received her doctorate in clinical psychology from Nova University. She is the Associate Executive Director for Professional Education and Training at the American Psychological Association (APA). At APA, Dr. Grus works to advance policies and practices that promote quality education and training in professional psychology. ROBERT L. HATCHER, PhD, received his doctorate in Clinical Psychology from the University of Michigan, where he is currently the director of the Psychological Clinic. He is president emeritus of the Association of Directors of Psychology Training Clinics. His research interests include the alliance in therapy, interpersonal measurement, and professional competencies. NADINE J. KASLOW, PhD, earned her doctorate in clinical psychology from the University of Houston. She is Professor and Chief Psychologist at Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences at Grady Hospital and Special Assistant to the Provost. Currently, she is President of Division 29 and of the American Board of Clinical Psychology. Her research and clinical practice focus on competency-based education, training, and supervision of interns and postdoctoral fellows; family violence; suicidal behavior across the life-span; and family systems medicine. PHILINDA SMITH HUTCHINGS, PhD, earned her doctorate in psychology at the University of Kansas. She is professor and program director of clinical psychology at Midwestern University, Glendale, Arizona. Her scholarly interests include treatment of sexual trauma and professional training issues, such as competency development and assessment. MICHAEL B. MADSON, PhD, earned his doctorate in counseling psychology from Marquette University. He is an Assistant Professor in the Psychology Department at the University of Southern Mississippi. His research interests include professional training and supervision, motivational interviewing, and brief alcohol screening and interventions for college students. FRANK L. COLLINS, JR., PhD, is currently the Director of Clinical Training for the Clinical Health Psychology Program at the University of North Texas. Dr. Collins served on the Steering Committee for the 2002 Competency Conference, as Chair of the Council of University Directors of Clinical Psychology (CUDCP), and a member of the APA Committee on Accreditation. He is a Fellow in APAs Division 12 and on the Editorial Board for Training and Education in Professional Psychology and the Journal of Clinical Psychology. RAYMOND E. CROSSMAN, PhD, is President at the Adler School of Professional Psychology, a graduate school preparing social justice practitioners with campuses in Chicago and Vancouver. He completed his doctorate in clinical psychology at Temple University. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Nadya A. Fouad, University Distinguished Professor, Department of Educational Psychology, PO 413, University of Wisconsin-Milwaukee, Milwaukee, WI [email protected] S5 Source: Fouad et al. (2009) Competency Benchmarks; A Model for Understanding and Measuring Competence in Professional Psychology. Training and Education in Professional Psychology, 3 (4), S5-S26. 3 of 23

4 S18 FOUAD ET AL. Table 1 (continued) Behavioral Anchor: Behavioral Anchor: Behavioral Anchor: Identifies DSM criteria Articulates relevant developmental features and clinical symptoms as applied to presenting question Treatment plans incorporate relevant developmental features and clinical symptoms as applied to presenting Describes normal development consistent with broad area of training Demonstrates ability to identify problem areas and to use concepts of differential diagnosis problem Demonstrates awareness DSM and relation to ICD codes Regularly and independently identifies problem areas and makes a diagnosis E. Conceptualization and Recommendations Readiness for Practicum Readiness for Internship Readiness for Entry to Practice Essential Component: Essential Component: Essential Component: Basic knowledge of formulating diagnosis and case conceptualization Utilizes systematic approaches of gathering data to inform clinical decision-making Independently and accurately conceptualizes the multiple dimensions of the case based on the results of assessment Behavioral Anchor: Behavioral Anchor: Behavioral Anchor: Demonstrates the ability to discuss diagnostic formulation and case conceptualization Presents cases and reports demonstrating how diagnosis is based on case material Independently prepares reports based on Prepares basic reports which articulate theoretical material Administers, scores and interprets test results Formulates case conceptualizations incorporating theory and case material F. Communication of Findings Readiness for Practicum Readiness for Internship Readiness for Entry to Practice Essential Component: Essential Component: Essential Component: Awareness of models of report writing and progress notes Writes assessment reports and progress notes Communication of results in written and verbal form clearly, constructively, and accurately in a conceptually appropriate manner Behavioral Anchor: Behavioral Anchor: Behavioral Anchor: Demonstrates this knowledge including content and organization of test reports, mental status Writes a basic psychological report Writes an effective comprehensive report examinations, interviews Demonstrates ability to communicate basic Effectively communicates results findings verbally Reports reflect data that has been collected via interview verbally Reports reflect data that has been collected via interview and its limitations Intervention Interventions designed to alleviate suffering and to promote health and well-being of individuals, groups, and/or organizations. Developmental Level A. Knowledge of Interventions Readiness for Practicum Readiness for Internship Readiness for Entry to Practice Essential Component: Essential Component: Essential Component: Basic knowledge of scientific, theoretical, and contextual bases of intervention and basic knowledge of the value of evidence-based practice and its role in scientific psychology Knowledge of scientific, theoretical, empirical and contextual bases of intervention, including theory, research, and practice Applies knowledge of evidence-based practice, including empirical bases of intervention strategies, clinical expertise, and client preferences Behavioral anchor: Behavioral Anchor: Behavioral Anchor: Articulates the relationship of EBP to the science of psychology Demonstrates knowledge of interventions and explanations for their use based on EBP Writes a case summary incorporating elements of evidence-based practice Identifies basic strengths and weaknesses of intervention approaches for different problems and populations Demonstrates the ability to select interventions for different problems and populations related to the practice setting Presents rationale for intervention strategy that includes empirical support Investigates existing literature related to problems and client issues Writes a statement of one s own theoretical perspective regarding intervention strategies (table continues) Source: Fouad et al. (2009) Competency Benchmarks; A Model for Understanding and Measuring Competence in Professional Psychology. Training and Education in Professional Psychology, 3 (4), S5-S26. 4 of 23

5 Source: Roth, A. D., & Pilling, S. (2008). Using an Evidence-Based Methodology to Identify the Competences Required to Deliver Effective Cognitive and Behavioural... 5 of 23

6 Source: Roth, A. D., & Pilling, S. (2008). Using an Evidence-Based Methodology to Identify the Competences Required to Deliver Effective Cognitive and Behavioural... 6 of 23

7 Source: Roth, A. D., & Pilling, S. (2008). Using an Evidence-Based Methodology to Identify the Competences Required to Deliver Effective Cognitive and Behavioural... 7 of 23

8 Manual of the Revised Cognitive Therapy Scale (CTS-R) Introduction This is a scale for measuring therapist competence in Cognitive Therapy and is based on the original Cognitive Therapy Scales (CTS, Young & Beck, 1980, 1988). The CTS-R was developed jointly by clinicians and researchers at the Newcastle Cognitive and Behavioural Therapies Centre and the University of Newcastle upon Tyne, UK. The CTS-R contains 12 items, in contrast to earlier versions of the CTS which contained either 13 (Young & Beck, 1980) or 11 (Young & Beck, 1988). The development of the revised scale, together with the psychometric properties, is described in the appendices. Table 1: The CTS-R Items General items Item 1: Agenda Setting & Adherence* Item 2: Feedback Item 3: Collaboration Item 4: Pacing and Efficient Use of Time Item 5: Interpersonal Effectiveness Cognitive therapy specific items Item 1: Agenda Setting & Adherence* Item 6: Eliciting Appropriate Emotional Expression ** Item 7: Eliciting Key Cognitions Item 8: Eliciting Behaviours** Item 9: Guided Discovery Item 10: Conceptual Integration Item 11: Application of Change Methods Item 12: Homework Setting Item 9 - Guided Discovery Introduction Guided discovery is a form of presentation and questioning which assists the patient to gain new perspectives for himself/herself without the use of debate or lecturing. It is used throughout the sessions in order to help promote the patient to gain understanding. It is based on the principles of socratic dialogue, whereby a questioning style is used to promote discovery, to explore concepts, synthesise ideas and develop hypotheses regarding the patient s problems and experiences. The key features of Guided Discovery is outlined in the CTS-R Rating Scale as follows: Key features: The patient should be helped to develop hypotheses regarding his/her current situation and to generate potential solutions for him/herself. The patient is helped to develop a range of perspectives regarding his/her experience. Effective guided discovery will create doubt where previously there was certainty, thus providing the opportunity for re-evaluation and new learning to occur. Two elements need to be considered: (i) the style of the therapist - this should be open and inquisitive; (ii) the effective use of questioning techniques (e.g. Socratic questions) should encourage the patient to discover useful information that can be used to help him/her to gain a better level of understanding. It has been observed that patients are more likely to adopt new perspectives, if they perceive they have been able to come to such views and conclusions for themselves. Hence, rather than adopting a debating stance, the therapist should use a questioning style to engage the patient in a problem solving process. Cognitive Therapy Rating Scale (Sample item) 8 of 23

9 Skilfully phrased questions, which are presented in a clear manner, can help to highlight either links or discrepancies in the patient's thinking. In order to accommodate the new information or learning, new insight is often achieved. Padesky (1993) emphasises that the aim of questioning is not to 'change minds' through logic, but to engage the patient in a socratic dialogue. Within this dialogue the patient can arrive at new perspectives and solutions for themselves. The therapist's questioning technique should reveal a constant flow of inquiry from concrete and specific ("Does your mood drop every time you argue with your mother?") to abstract ("Do you always feel this way when someone is shouting at you?") and back again ("What thoughts were going through your head when it was your mother shouting?"). Good questions are those asked in the spirit of inquiry, while bad ones are those which lead the patient to a predetermined conclusion. The techniques may also permit the patient to make both lateral and vertical linkages. The lateral links are those day to day features of the patient's life which produce and maintain his/her difficulties (i.e. the NATs, dysfunctional behaviours, moods and physical sensations). The vertical links are the historical patterns and cycles, which manifestly relate to the patient's current problems (i.e. childhood issues, parenting, relationship difficulties, work issues, etc.). The questions posed should not be way-beyond the patient's current level of understanding, as this is unlikely to promote effective change. Rather they should be phrased within, or just outside, the patient's current understanding in order that he/she can make realistic attempts to answer them. The product of attempting to deal with such intelligently phrased question is likely to be new discoveries. The therapists should appear both inquisitive and sensitive without coming across as patronising. CHECKLIST: QUESTIONS FOR RATERS TO ASK THEMSELVES: 1. Has the therapist used appropriate questions? 2. Does the manner in which the questions are asked facilitate the patient's understanding? 3. Did the questions lead to or promote change? 4. Did you hear any of the following: I wonder whether there are any other times in your life when you felt the same way? You have this dreadful image when you're with both John and Paul, but you never have it with Peter. Can you think of a reason for this? If you were not depressed, how might you think differently about this situation? How does this relate to what you told me earlier - that you never get anything right? What is the common link between X and Y? Key references: Blackburn, I.-M., James, I. A., Milne, D. L., Baker, C., Standart, S. H., Garland, A. and Reichelt, F. K. (2001). The Revised Cognitive Therapy Scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, James, I. A., Blackburn, I.-M., Milne, D. L. and Reichelt, F. K. (2001). Manual of the Revised Cognitive Therapy Scale. Unpublished manuscript, Newcastle Cognitive and Behavioural Therapies Centre, Newcastle, UK. Cognitive Therapy Rating Scale (Sample item) 9 of 23

10 WAYNE STATE UNIVERSITY DEPARTMENT OF PSYCHIATRY & BEHAVIORAL NEUROSCIENCES PSYCHODYNAMIC PSYCHOTHERAPY COMPETENCY EVALUATION Resident: Beginning Date: Pt. Initials (if applicable): - Termination Date: KNOWLEDGE COMPETENCIES Resident demonstrates understanding of the indications for psychodynamic psychotherapy. Resident understands and is able to evaluate patient s suitability for psychodynamic psychotherapy. Resident demonstrates an understanding of the influence of development through the life cycle on thoughts, feelings, and behavior. SKILLS COMPETENCIES Resident is able to establish treatment goals and frame with the patient. Skill Not Apparent Skill Not Apparent Skill Emerging Skill Emerging Skill Apparent Skill Apparent Skill Well Developed Skill Well Developed Not Applicable Not Applicable Resident is able to engage patient in exploring his/her past experiences. Resident is able to effectively listen to the patient (direct and indirect communication). Resident is able to utilize clarification, confrontation, and interpretation of previously unconscious material in therapy. Resident is able to recognize and make therapeutic use of central psychodynamic concepts such as resistance, transference, and countertransference. Resident is able to utilize selfreflection and interpretation to manage disruptive transference and countertransference. Resident is able to effectively utilize central dynamic issues (e.g., transference) in therapy. Source: Wayne State University, Department of Psychiatry & Behavioral Neurosciences 10 of 23

11 THERAPIST PERFORMANCE SCALE V3 COMPETENCE AS A COGNITIVE BEHAVIOURAL THERAPIST VIDEO ID: Name of Rater:.. Therapist Rater: Self / Peer / Expert Therapist Performance Rating Scale V2.3 (Cognitive Behavioural Therapy) ITEMS Rating A. Structure and direction of therapy B. Eliciting, identifying and verbalizing automatic thoughts C. Use of the socratic dialogue interviewing style D. Therapist s knowledge, professionalism, and competence. E1. Socratic dialogue: Preparation for guided discovery. E2. Socratic dialogue: Consolidation of guided discovery. F. Choice of methods to foster evaluation of belief structures. G. Cognitive restructuring: Choice of beliefs to evaluate H. Therapist caring and support I. Use of Psychoeducation NA J. Resistance to interventions NA K. Use of Home tasks NA L. Rapport and engagement M. Positive feedback, positive affect and empowerment. N. Other behavioural techniques NA GLOBAL RATINGS I. Overall choice and implementation of NA cognitive strategies II. Overall choice and implementation NA of behavioural strategies III. Overall rating of general counseling skills IV. Overall therapy effectiveness In general, numbers 1=unskilled, 2=Novice, 3=Advanced beginner, 4=Competent, 5=Proficient; 6=Expert Subscale 1: Counselling skills. Means of items D,H,L Subscale 2: CBT skills. Means of items A,B,C,E,F,G,J For item descriptions, [email protected] Dr. Craig Gonsalvez School of Psychology, University of Wollongong 11 of 23

12 C7Sr Generic supervision competencies /- Not applicable 1. Structure supervisory sessions 2. Form and maintain supervisory alliances 3. Adapt supervision to different contexts 4. Work with difference 5. Apply ethical principles 6. Apply educational principles 7. Reflect and act on their limitations 8. Gauge the competence of supervisees 9. Offer accurate and constructive feedback 10. Help supervisees reflect on their clinical work 11. Help supervisees present their clinical work 12. Help supervisees practice clinical skills Source: Bagnall et al., Generic supervision competencies for psychological therapies. Mental health practice 14, of 23

13 P1Sr OBJECTIVES BASED APPROACH TO CLINICAL SUPERVISION BEST PRACTICE GUIDELINES: SUPERVISION PLANS ITEMS 1. Learning objectives (overall rating) 1.1. Do they fulfill the SMART criteria? Are they Specific? Are they Measureable? Are they Appropriate(developmentally Appropriate)? Are they Recommended by accrediting/ professional bodies? Are they Time-wise (realistic, achievable)? 2. Are they comprehensive and balanced? (overall) 2.1. Do they cover knowledge, skills, attitude-value and relationship competencies? 2.2. Do they cover important domains (e.g., assessment, intervention, professional aspects) 2.3. Do they cover metacompetencies 3. Supervision methods/techniques (overall rating) 3.1. Consistent with types of learning objectives 3.2. Wide repertoire 4. Plan management and coordination (overall) 4.1. Capitalises on supervisor strengths 4.2. Capitalises on trainee strengths 4.3. Effective use of available staff (multidisciplinary) and other learning activities (e.g., ward rounds) 4.4. Creative and effective use of other materials/resources (e.g., diversity of clientele, client records) 4.5. Organisation and time-management 4.6. Effective management of barriers and constraints 5. Assessment (overall rating) 5.1. Consistent with the type of learning objectives 5.2. Multifaceted, by multiple assessors, if feasible 5.3. Ecological valid (as close to actual practice) OVERALL: Nature of the outcome achieved given opportunities and constraints /- Not applicable 6. Process (overall rating) 6.1. Collaborative and constructive 6.2. Effective use of the activity and process to foster and enhance supervision alliance 6.3. Effective use of the process to foster and enhance reflective skills Source: C.Gonsalvez School of Psychology, Uni. Of Wollongong 13 of 23

14 P3 COMPETENCY BASED CLINICAL SUPERVISION ESTABLISHING SUPERVISION PLANS: TRAINEE S PREPARATION Supervisee s name. Date:... This brief questionnaire seeks to enhance your awareness of what your preferences are with regard to supervision objectives and methods. This exercise is important because it facilitates planning and coordination of supervision to increase the chances that the targeted competencies are attained. If your supervision is going to be part of your psychologist registration, tertiary course or other official requirement, you must become familiar with the relevant guidelines before you complete this form. 1. Intended placement period (start and stop date): 2. Highest qualification already awarded Current degree enrolled in (if applicable).. 4. Years of experience as a psychologist until now (if applicable) Place a tick in the cell that best describes your experience in terms of placement hours and supervision completed. Placement hours Individual supervision hours Group Less than 100 Less than 20 Less than Is the supervision going to be part of PBA requirements/university Course/APS or ACPA/other agency to whom monitoring and reporting have to be sent? 7. Time per week you have available for readings or other placement related clinical work outside actual placement hours? 8. Your access to resources associated with professional training (e.g., professional libraries, Psychinfo search options, audio/videotape equipment, computer skills and so forth)? Source: C.Gonsalvez School of Psychology, Uni. Of Wollongong 14 of 23

15 P3 9. What if any is your preferred approach to therapy, how strongly committed are you to this approach, and in what approach do you want training (Circle one). If you use multiple approaches, identify the dominant approach. Use eclectic only when you use an eclectic approach for most clients. BT ACT Psychodynamic Eclectic CBT Family- systems Humanisticexistential Other: mention Comments: 10. Will you be receiving supervision from any another professional during the period? If yes, details: 11. Any intended absences/commitments that will affect availability/work load during your placement? If yes, details: 12. In an overall sense and across supervisors, what was the approximate percentage of supervision time your past supervisor(s) allocated to the following supervision methods? Enter this in Column A. In Column B, record how supervision time should be allocated to best help you attain the learning outcomes you want to achieve from supervision. Percentage values in Columns A and B must total to 100. Supervision methods a) Live supervision (e.g., demonstrations of therapy, co-therapy, one-way mirror, and other live-supervision methods) b) Observation with delayed feedback (E.g., feedback using audio/videotapes of your therapy) c) Role play & feedback: Supervisor involved you in a role-play exercise to demonstrate clinical skills before discussion & feedback. d) Case presentation & Discussion: Includes advice, suggestions, discussion of case-problems and other professional issues. e) Any other method not included above (mention) A: Supervision received (mention %) B: Effective supervision (mention %) 13. Other agency specific information required: Source: C.Gonsalvez School of Psychology, Uni. Of Wollongong 15 of 23

16 Table 1. Overarching considerations for CDPs: Best practice guidelines: 1. Acquire a good working knowledge of competency frameworks from key accreditation bodies and professional societies. 2. If the supervisee is a student, obtain competency lists from the supervisee s training institution along with input requirements concerning caseload, case type, and supervision. 3. If applicable, obtain competency lists and requirements/recommendations about the practicum from the service agency at which the placement will be conducted. 4. Obtain relevant information to help you assess the supervisee s developmental stage (e.g., previous supervisor s report; inventory to assess development). Have the supervisee submit representative samples of performance (e.g., recording of therapy session) if this is warranted. 5. Become aware, acknowledge, and build the programme around your strengths and values. 6. Cultivate an awareness of how you are faring yourself, personally and professionally, on the burnout-thrive continuum and the effect of this on your supervision. 7. Become aware and acknowledge gaps within the supervision programme and explore options to bridge these gaps. 8. Design a list of peer expertise and learning activities (e.g., ward and grand rounds) that will build on and enrich learning outcomes from the primary supervisor s input. 9. When supervising an individual from a different cultural background, gain an understanding of cultural factors affecting supervisory processes through education or supervision. Craig Gonsalvez: Competency-based clinical supervision 16 of 23

17 Table 2. Assisting supervisees formulate a personalised list of competencies: Best practice guidelines 1. Ensure the supervisee understands the importance of formulating a personalised list of competencies that the supervisee would like to attain during the placement. Insist on a written draft. 2. Commence the process of goal setting and reflection two or more weeks before supervision commences. Assist them in this process by providing them with relevant resources (information about the placement, information about how to formulate SMART competencies, and guidelines you have drawn up, or examples of adequate and inadequately formulated competencies). 3. Offer additional support and scaffolding if the initial effort by the supervisee is unsatisfactory. This can be achieved by providing supervisees with a template or matrix with common domains, offering examples of different types of competencies including knowledge, skills, attitude, and relationship, providing them with a program of competencies designed for a peer at the same developmental stage, or providing different sets of competencies that span developmental levels just below and just above the supervisee s current developmental stage. 4. Following submission of an initial draft of competencies, have supervisees identify the overlap and areas of mismatch between their personal list and the competencies recommended by relevant professional stakeholders. Supervisees may then progress to revise and prioritise their list of competencies. 5. Match the level of assistance you provide to the supervisee s developmental level. 6. Have the supervisee identify a profile of perceived strengths and needs that will help inform and customise planned learning outcomes. Craig Gonsalvez: Competency-based clinical supervision 17 of 23

18 Grid: Competency Types Knowledge & Knowapplication (WHAT) Skills (HOW) Relationship Attitude-value Competency Domains Professional Intervention Assessment Disorders: Population: Child/adult Psychometry Reporting Documentation Disorders Child/adult Reporting Documentation Ethical legal Communication skills Intra and inter disciplinary aspects Socio-cultural aspect Professional identity Diagnositc issues Accurate diagnoses Case conceptualisation Knowledge about indications/contraindications of interventions Procedural knowledge Rationale for choice of interventions Models of psychopathology Knowledge about ethical issues. Competencies to make ethical judgments when given case-scenarios Ability to conduct assessments in a competent fashion (includes elements of fluency, time-efficiency, pace, and communication style) Ability to conduct interventions in a competent fashion (includes elements of fluency, time-efficiency, pace, and communication style) Oral and written communication skills with other professionals T-Ct relationship while conducting assessments. Ability to engage difficult clients, enhance alliance whilst doing assessments Therapist-client relationship and interactions while conducting interventions CBT: key cognitions about client and self Psychodynamic: Transference and CT Sr-therapist relationship Relationship with other psychologists and health professionals Attitudes towards profession and key professional roles including assessment, intervention, professional development Self: (e.g., self doubt, anxiety/confidence) Clients: (positive regard/, caring, cynical, pessimistic) Other professionals Work: (e.g., conscientious, overly responsible, tardy) Authority including supervisors: (e.g., open and responsive vs. defensive) Ability to think and act ethically demonstrated in ethical conduct Burn out vs. thriving Professional development Scientist-practitioner mindset (Respect for empirical evidence, scientific method, objectivity) Meta-Cs Reflective practice capabilities Unconditional positive regard Craig Gonsalvez: Competency-based clinical supervision 18 of 23

19 19 of 23

20 Source: Falender, C. A., & Shafranske, E. P. (2004). Clinical Supervision: a competency-based approach. 20 of 23

21 Source: Falender, C. A., & Shafranske, E. P. (2004). Clinical Supervision: a competency-based approach. 21 of 23

22 Source: Falender, C. A., & Shafranske, E. P. (2004). Clinical Supervision: a competency-based approach. 22 of 23

23 COMPETENCY BENCHMARKS S7 Figure 1. Cube model (Rodolfa et al., 2005). assessment of competence (Kaslow et al., 2007a; Collectively, these developments provide evidence of what has been referred to as a shift to a culture of competence (Roberts et al., 2005) in professional psychology. The urgency of shifting to a culture of competence assessment in psychology was heightened also in 2006 by the APA Council of Representatives adoption of the following policy guidance related to licensure eligibility in psychology that encouraged entry to practice at the end of the doctorate. Specifically, the Council of Representatives passed the following resolution: Applicants should be considered for admission to licensure upon completing a sequential, organized, supervised professional experience equivalent to two years of full-time training that can be completed prior or subsequent to the granting of the doctoral degree (APA, 2006). One of the two years is to be a predoctoral internship for those preparing for practice as health service providers. There is a need for a better, competency-based definition, of readiness for entry to practice. For many years, the doctoral degree has been linked with the vaguely defined construct of entry level to practice. Entry level to practice generally has been defined by documentation of completion of required coursework, including a requisite number of hours of supervised training. These criteria are likely a poor proxy for actual evaluation of competence, and the relationship between these criteria and actual competence as a professional psychologist is tenuous at best. In addition, external groups such as the United States Department of Education, regional accrediting bodies, and other regulatory bodies are considering incorporating rules and regulations that would measure education and training outcomes in terms of specific competencies that trainees acquire. Benchmarks Work Group A recent step in the competency movement was the creation of the Assessment of Competency Benchmarks Work Group (hereafter referred to as the Workgroup). This group was the outcome of a proposal from the CCTC to the APA Board of Educational Affairs (BEA), which authorized the project in The group met for two days in September 2006 to identify levels of competence appropriate for different stages of professional education and training in psychology. The document developed by this group identifies benchmarks for 15 core competency areas at three developmental levels of education and training. The Workgroup operated on several guiding principles. First, the focus of the meeting, while broad, was not intended to address the full developmental continuum for learning in professional psychology. Specifically, it was acknowledged that there are competencies necessary for entry to graduate school as well as competencies that reflect a lifelong commitment to learning. The group was not able to address these two levels but recognized their importance. Second, the Workgroup began with the Cube model of core competencies (see Figure 1) in professional psychology as the basis for their work (Rodolfa et al., 2005). This decision was based on recognition that the group could easily spend all of its time trying to develop consensus on what competencies to address and not have time to complete its more central purpose of defining benchmarks. Source: Fouad et al. (2009) Competency Benchmarks; A Model for Understanding and Measuring Competence in Professional Psychology. Training and Education in Professional Psychology, 3 (4), S5-S of 23