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Competencies in Adult Clinical Psychology

  • Warren W. Tryon
Reference work entry

Abstract:

This chapter addressed the following background issues: evidence-based medicine, the empirically supported treatment debate, what constitutes evidence, and competency. The National Council of Schools and Programs in Professional Psychology (NCSPP) educational model was discussed including the following components: relationship, assessment, intervention, consultation and education, management and supervision plus research and evaluation. Six specific foundational competencies were considered including their essential components, behavioral anchors, and assessment methods that indicate readiness for practicum, internship, and practice. These foundational competencies include: reflective practice and self-assessment, scientific knowledge and methods, relationships, individual and cultural diversity, knowledge of ethical and legal standards and policies and interdisciplinary systems. The following six functional competencies were discussed: assessment-diagnosis-case conceptualization, intervention, consultation, research and evaluation, supervision and teaching, plus management and administration. Essential components with behavioral anchors and assessment methods that indicate readiness for practicum, internship, and practice were identified. What being expert entails was briefly discussed.

Keywords

Assessment Method Essential Feature Professional Practice Reflective Practice Professional Psychology 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. American Educational Research Association, American Psychological Association, & National Council on Measurement in Education. (1999). Standards for educational and psychological testing (2nd ed.). Washington, DC: American Educational Research Association.Google Scholar
  2. American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060–1073.Google Scholar
  3. American Psychological Association Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice. American Psychologist, 61, 271–285.Google Scholar
  4. Andrusyna, T. P., Tang, T. Z., DeRubeis, R. J., & Luborsky, L. (2001). The factor structure of the working alliance inventory in cognitive-behavioral therapy. Journal of Psychotherapy Practice and Research, 10, 173–178.PubMedGoogle Scholar
  5. Baker, J., Horton, S., Robertson-Wilson, Wall, M. (2003). Nurturing sport expertise: Factors influencing the development of elite athlete. Journal of Sports Science and Medicine, 2, 1–9. (http://www.jssm.org/vol2/n1/1/v2n1–1text.php)
  6. Barber, J. P., Sharpless, B. A., Klostermann, S., & McCarthy, K. S. (2007). Assessing intervention competence and its relation to therapy outcome: A selected review derived from the outcome literature. Professional Psychology, 38, 493–500.CrossRefGoogle Scholar
  7. Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison Wesley.Google Scholar
  8. Bent, R. J., & Cannon, W. G. (1987). Key functional skills of professional psychologists. In Bourg, E. T., Bent, R. J., Callan, J. E., Jones, N. F., McHolland, J., & Strieker, G. (Eds.), Standards and evaluation in the education and training of professional psychologists. Norman, OK: Transcript Press.Google Scholar
  9. Beutler, L. E. (2004). The empirically supported treatments movement: A scientist-practitioner’s response. Clinical Psychology: Science and Practice, 11, 225–229.CrossRefGoogle Scholar
  10. Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research and Practice, 16, 252–260.CrossRefGoogle Scholar
  11. Bourg, E. F., Bent, R. J., Callan, J. E., Jones, & N. F., McHolland, J., Stricker, G. (Eds.). (1987). Standards and evaluation in the education and training of professional psychologists: Knowledge, attitudes, and skills. Norman, OK: Transcript Press.Google Scholar
  12. Bourg, E. F., Bent, R. J., McHolland, J. D., & Stricker, G. (1989). Standards and evaluation in the education and training of professional psychologists: The National Council of Schools of Professional Psychology Mission Bay Conference. American Psychologist, 44, 66–72.CrossRefGoogle Scholar
  13. Brown, G. S., Lambert, M. J., Jones, E. R., & Minami, T. (2005). Identifying highly effective therapists in a managed care environment. American Journal of Managed Care, 11, 513–520.PubMedGoogle Scholar
  14. Cabana, M. D., Rand, C. S., Powe, N. R., Wu, A. W., Wilson, M. H., Abbound, P. A., et al. (1999). Why don’t physicians follow clinical practice guidelines? A framework for improvement. Journal of the American Medical Association, 282, 1458–1465.PubMedCrossRefGoogle Scholar
  15. Callan, J. E., Peterson, D. R., & Stricker, G. (Eds.). (1986). Quality in professional psychology training: A national conference and self-study. Norman, OK: Transcript Press.Google Scholar
  16. Chapman, L. J. (1967). Illusory correlation in observational report. Journal of Verbal Learning and Verbal Behavior, 6, 151–155.CrossRefGoogle Scholar
  17. Chapman, L. J., & Chapman, J. P. (1967). Genesis of popular but erroneous psychodiagnostic observations. Journal of Abnormal Psychology, 72, 193–204.PubMedCrossRefGoogle Scholar
  18. Drake, R., E., Dixon, L., Burns, B. J., Flynn, L., Rush, A. J., Clark, R. E., et al. (2001). Implementing evidence-based practices for persons with severe mental illnesses. Psychiatric Services, 52, 45–50.PubMedCrossRefGoogle Scholar
  19. Dreyfus, H. L., & Dreyfus, S. E. (1986). Mind over machine: The power of human intuition and expertise in the era of the computer. New York: The Free Press.Google Scholar
  20. Eagle, K. A., Montoye, C. K., Riba, A. L., DeFranco, A. C., Parrish, R., Skorcz, S., et al. (2005). Guideline-based standardized care is associated with substantially lower mortality in medicare patients with acute myocardial infarction. Journal of the American College of Cardiology, 46, 1242–1248.PubMedCrossRefGoogle Scholar
  21. Eddy, D. M. (1990). Practice policies: Where do they come from? Journal of the American Medical Association, 263, 1265, 1269, 1272, 1275.PubMedCrossRefGoogle Scholar
  22. Eddy, D. M. (2005). Evidence-based medicine: A unified approach. Health Affairs, 24, 9–17.PubMedCrossRefGoogle Scholar
  23. Elman, N. S., & Forrest, L. (2007). From trainee impairment to professional competence problems: Seeking new terminology that facilitates effective action. Professional Psychology, 38, 501–509.CrossRefGoogle Scholar
  24. Epstein, R. M., & Hundert, E. M. (2002). Defining and assessing professional competence. Journal of the American Medical Association, 287, 226–235.PubMedCrossRefGoogle Scholar
  25. Eysenck, H. J. (1952). The effects of psychotherapy: An evaluation. Journal of Consulting Psychology, 16, 319–324.PubMedCrossRefGoogle Scholar
  26. Fisher, C. B. (2003). Decoding the ethics code: A practical guide for psychologists. Thousand Oaks, CA: Sage.Google Scholar
  27. Greenhalgh, T. (2002). Intuition and evidence – uneasy bedfellows? British Journal of General Practice, 52, 395–400.PubMedGoogle Scholar
  28. Guyatt, G. H., & Rennie, D. (1993). Users’ guides to the medical literature. Journal of the American Medical Association, 270, 2096–2097.PubMedCrossRefGoogle Scholar
  29. Guyatt, G. H., Haynes, R. B., Jaeschke, R. Z., Cook, D. J., Green, L., Naylor, C. D., et al. (2000). Users’ guides to the medical literature: XXV. Evidence-Based Medicine: Principles for Applying the Users’ Guides to Patient Care. Journal of the American Medical Association, 284, 1290–1296.PubMedCrossRefGoogle Scholar
  30. Hatcher, R. L., & Lassiter, K. D. (2007). Initial training in professional psychology: The practicum competencies outline. Training and Education in Professional Psychology, 1, 49–63.CrossRefGoogle Scholar
  31. Herbert, J. D. (2003). The science and practice of empirically supported treatments. Behavior Modification, 27, 412–430.PubMedCrossRefGoogle Scholar
  32. Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the working alliance inventory. Journal of Counseling Psychology, 36, 223–233.CrossRefGoogle Scholar
  33. Horvath, A. O., & Symonds, B. D. (1991). Relation bet-ween working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology, 38, 139–149.CrossRefGoogle Scholar
  34. Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., et al. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64, 295–304.PubMedCrossRefGoogle Scholar
  35. Kaslow, N. J. (2004). Competencies in professional psychology. American Psychologist, 59, 774–781.PubMedCrossRefGoogle Scholar
  36. Kaslow, N. J., Rubin, N. J., Bebeau, M. J., Leigh, I. W., Lichtenberg, J. W., Nelson, P. D., et al. (2007). Guiding principles and recommendations for the assessment of competence. Professional Psychology, 38, 441–451.CrossRefGoogle Scholar
  37. Kaslow, N. J., Rubin, N. J., Forrest, L., Elman, N. S., Van Horne, B. A., Jacobs, S. C., et al. (2007). Recognizing, assessing, and intervening with problems of professional competence. Professional Psychology, 38, 479–492.CrossRefGoogle Scholar
  38. Kettlewell, P. W. (2004). Development, dissemination, and implementation of evidence-based treatments: Commentary. Clinical Psychology: Science and Practice, 11, 190–195.CrossRefGoogle Scholar
  39. Koocher, G. P., & Keith-Spiegel, P. (2008). Ethics in psychology: Professional standards and cases (3rd ed.). New York: Oxford University Press.Google Scholar
  40. Kunda, Z. (1990). The case for motivated reasoning. Psychological Bulletin, 108, 480–498.PubMedCrossRefGoogle Scholar
  41. Lambert, M. J., & Bergin, A. E. (1994). The effectiveness of psychotherapy. In Bergin, A. E., & Garfield, S. L. Handbook of psychotherapy and behavior change (pp. 143–189). New York: Wiley.Google Scholar
  42. Lambert, M. J., Shapiro, D. A., & Bergin, A. E. (1986). The effectiveness of psychotherapy. In Garfield, S. L. & Bergin, A. E. Handbook of psychotherapy and behavior change (3rd ed., pp. 157–212). New York: Wiley.Google Scholar
  43. Leigh, I. W., Smith, I. L., Bebeau, M. J., Lichtenberg, J. W., Nelson, P. D., Portnoy, S., et al. (2007). Competency assessment models. Professional Psychology, 38, 463–473.CrossRefGoogle Scholar
  44. Lichtenberg, J. W., Portnoy, S. M., Bebeau, M. J., Leigh, I. W., Nelson, P. D., Rubin, N. J., et al. (2007). Challenges to the assessment of competence and competencies. Professional Psychology, 38, 474–478.CrossRefGoogle Scholar
  45. Lilienfeld, S. O., Lynn, S. J., & Lohr, J. M. (2003). Science and pseudoscience in clinical psychology. NewYork: Guilford.Google Scholar
  46. Manring, J., Beitman, B. D., & Dewan, M. J. (2003). Evaluating competence in psychotherapy. Academic Psychiatry, 27, 136–144.PubMedCrossRefGoogle Scholar
  47. Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–450.PubMedCrossRefGoogle Scholar
  48. Mays, D. T., & Franks, C. M. (Eds.). (1985). Negative outcome in psychotherapy and what to do about it. New York: Springer.Google Scholar
  49. McFall, R. M. (1996). Manifesto for a science of clinical psychology. The Clinical Psychologist, 44, 75–88.Google Scholar
  50. Meehl, P. E. (1954). Clinical versus statistical prediction. Minneapolis: University of Minnesota Press.CrossRefGoogle Scholar
  51. Meehl, P. E. (1997). Credentialed persons, credentialed knowledge. Clinical Psychology: Science and Practice, 4, 91–98.CrossRefGoogle Scholar
  52. Meehl, P. E., & Rosen, A. (1955). Antecedent probability and the efficiency of psychometric signs, patterns, or cutting scores. Psychological Bulletin, 52, 194–216.PubMedCrossRefGoogle Scholar
  53. Nathan, P. E., & Gorman, J. M. (2002). A guide to treatments that work (2nd ed.). New York: Oxford University Press.Google Scholar
  54. Nathan, P. E., & Gorman, J. M. (2002). Efficacy, effectiveness, and the clinical utility of psychotherapy research. In Nathan, P. E., & Gorman, J. M. (Eds.), A guide to treatments that work (2nd ed., pp. 643–654). New York: Oxford University Press.Google Scholar
  55. Nelson, P. D. (2007). Striving for competence in the as-sessment of competence: Psychology’s professional education and credentialing journey of public accountability. Training and Education in Professional Psychology, 1, 3–12.CrossRefGoogle Scholar
  56. Newell, A., & Rosenbloom, P. S. (1981). Mechanisms of skill acquisition and the law of practice. In Anderson, J. R. (Ed.), Cognitive skills and their acquisition (pp. 1–55). Hillsdale, NJ: Erlbaum.Google Scholar
  57. Overholser, J. C., & Fine, M. A. (1990). Defining the boundaries of professional competence: Managing the subtle cases of clinical incompetence. Professional Psychology: Research and Practice, 21, 462–469.CrossRefGoogle Scholar
  58. Peterson, R. L. (1991). The social, relational, and intellectual context of the core curriculum and the San Antonio conference. In Peterson, R. L., McHolland, J. D., Bent, R. J., Davis-Russell, E., Edwall, G. E., Polite, K., et al. (Eds.) The core curriculum in professional psychology (pp. 3–12). Washington, DC: American Psychological Association.Google Scholar
  59. Peterson, R. L., McHolland, J. D., Bent, R. J., Davis-Russell, E., Edwall, G. E., Polite, K. et al. (Eds.) (1991). The core curriculum in professional psychology. Washington, DC: American Psychological Association. (Individual chapters or the entire book can be obtained electronically from http://www.ncspp.info/core.htm)
  60. Peterson, R. L., Peterson, D. R., Abrams, J. C., & Stricker, G. (1997). The National Council of Schools and Programs of Professional Psychology educational model. Professional Psychology: Research and Practice, 28, 373–386.CrossRefGoogle Scholar
  61. Rello, J., Lorente, C., Bodf, M., Diaz, E., Ricart, M., & Kollef, M. H. (2002). Why do physicians not follow evidence-based guidelines for preventing ventilator-associated pneumonia? A survey based on the opinions of an international panel of intensivists. Chest, 122, 656–661.PubMedCrossRefGoogle Scholar
  62. Rodolfa, E. R., Bent, R. J., Eisman, E., Nelson, P. D., Rehm, L., & Ritchie, P. (2005). A cube model for competency development: Implications for psychology educators and regulators. Professional Psychology: Research and Practice, 36, 347–354.CrossRefGoogle Scholar
  63. Rogers, C. R. (1942). Counseling and psychotherapy. Boston: Houghton Mifflin Co.Google Scholar
  64. Rogers, C. R. (1951). Client-centered therapy. Boston: Houghton Mifflin Co.Google Scholar
  65. Rosen, G. M., & Davison, G. C. (2003). Psychology should list empirically supported principles of change (ESPs) and not credential trademarked therapies or other treatment packages. Behavior Modification, 27, 300–312.PubMedCrossRefGoogle Scholar
  66. Ross, P. E. (2006, August). The expert mind. Scientific American, 295, 64–71.PubMedCrossRefGoogle Scholar
  67. Rubin, N. J., Bebeau, M., Leigh, I. W., Lichtenberg, J. W., Nelson, P. D., Portnoy, S., et al. (2007). The competency movement within psychology: An historical perspective. Professional Psychology, 38, 452–562.CrossRefGoogle Scholar
  68. Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1999). Evidence based medicine: what it is and what it isn’t: It’s about integrating individual clinical expertise and the best external evidence. British Medical Journal, 312, 71–72.CrossRefGoogle Scholar
  69. Simon, H. A., & Chase, W. G. (1973). Skill in chess. American Scientist, 61, 394–403.Google Scholar
  70. Stricker, G., Davis-Russell, E., Bourg, E., Duran, E., Hammond, W. R., McHolland, J., et al. (Eds.). (1990). Toward ethnic diversification in psychology education and training. Washington, DC: American Psychological Association.Google Scholar
  71. Tichenor, V., & Hill, C. E. (1989). A comparison of six measures of working alliance. Psychotherapy, 26, 195–199.CrossRefGoogle Scholar
  72. Tracey, T. J., & Kokotovic, A. M. (1989). Factor structure of the working alliance inventory. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1, 207–210.CrossRefGoogle Scholar
  73. Tryon, W. W. (2005). Possible mechanisms for why desensitization and exposure therapy work. Clinical Psychology Review, 25, 67–95.PubMedCrossRefGoogle Scholar
  74. Tryon W. W. (2008a). History and theoretical foundations. In Hersen, M., & Gross, A. M. Handbook of clinical psychology: Vol. 1. Adults. New York: Wiley.Google Scholar
  75. Tryon, W. W. (2008b). Whatever happened to symptom substitution? Clinical Psychology Review, 28, 963–968.PubMedCrossRefGoogle Scholar
  76. Tryon, W. W., & Misurell, J. R. (2008). Dissonance induction and reduction: A possible principle and connectionist mechanism for why therapies are effective. Clinical Psychology Review, 28, 1297–1309. (http://dx.doi.org/10.1016/j.cpr.2008.06.003)
  77. Tversky, A., & Kahneman, D. (1971). Belief in the law of small numbers. Psychological Bulletin, 76, 105–110.CrossRefGoogle Scholar
  78. Tversky, A., & Kahneman, D. (1983). Extensional versus intuitive reasoning: The conjunction fallacy in probability judgment. Psychological Review, 90, 293–315.CrossRefGoogle Scholar
  79. Wampold, B. E., Mondin, G. W., Moody, M., Stich, F., Benson, K., & Ahn, H. (1997). A meta-analysis of outcome studies comparing bonafide psychotherapies: Empirically, “All must have prizes.” Psychological Bulletin, 122, 203–215.CrossRefGoogle Scholar
  80. Webbe, F. M., Farber, P. D., Edwall, G. E., & Edwards, K, J. (1990). Academic-scientific core curriculum. In Peterson, R. L. McHolland, J. D., Bent, R. J., Davis-Russell, E., Edwall, G. E., Polite, K. et al. (Eds.), The core curriculum in professional psychology (pp. 37–42). Washington, DC: American Psycholog-ical Association.Google Scholar
  81. Weiss, B. J. (1991). Toward a competency-based core curriculum in professional psychology: A critical history. In Peterson, R. L., McHolland, J. D., Bent, R. J., Davis-Russell, E., Edwall, G. E., Polite, K., D. L., et al. (Eds.), The core curriculum in professional psychology (pp. 13–22). Washington, DC: American Psychological Association.Google Scholar
  82. Wennberg, J. E., & Gittelsohn, A. (1973). Small area variations in health care delivery. Science, 117, 1102–1108.CrossRefGoogle Scholar

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© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • Warren W. Tryon
    • 1
  1. 1.Fordham UniversityBronxUSA

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