A conceptual and empirical review of the meaning, measurement, development, and teaching of intervention competence in clinical psychology
Section snippets
Why should we assess intervention competence?
We begin by asking two fundamental questions: should we assess intervention competence, and if so, why? The answers to these seemingly obvious questions are, in fact, quite complex. A simple-minded, yet nonetheless accurate response to these questions would be that the APA Ethics Guide (2002) says that we should. These guidelines clearly indicate that a therapist's competence is an ethical issue that we as psychologists are bound not only to consider and evaluate, but also to increase and
What is intervention competence, and what is not intervention competence?
Before we explore specific aspects of intervention competence, it is necessary to possess both positive and negative definitions of the term (viz., what it is, and what it is not). However, a plurality of definitions currently exists, and none is self-evident. Dictionary definitions provide some conceptual guidance, but lack specificity. For instance, competence can be defined as: (1) the state or quality of being adequately or well-qualified, (2) demonstrating ability, or (3) it can have a
How might intervention competence develop?
Another fundamental question about intervention competence concerns the nature of its development. Most would agree that it is a dimensional construct (although qualitative disjunctures in competence may exist) and that the development of competence “is an ongoing process within an individual that is, ideally, in a state of constant flux and renewal (Nagy, 2005, pg. 29).” Thus, development of competence is not an absolute and static notion possessing a fixed endpoint, but more a lifelong
Assessing patient outcome
Measuring intervention competence through assessment of patient outcome has been discussed in the literature. It makes intuitive sense that psychologists with high levels of competence should evidence better patient outcomes than less competent psychologists. Though not a prevalent approach, examples in the literature do exist (Brown et al., 2005, Okiishi et al., 2006) and a more widespread application could be easily accomplished through the use of pre- and post-therapy assessments conducted
Recommendations for engendering intervention competence in future psychologists
Providing suggestions for training future psychotherapists is a difficult venture, especially when data are lacking. There currently exists a plurality of program types and methods already slated with this task and, given the limited knowledge of how best to cultivate competence (if there is an objectively “best way”), this is probably a reasonable state of affairs. However, there may be pedagogical deductions from the reviews above that are applicable to future therapists. From a developmental
Conclusion
We have explored the concept of intervention competence, further differentiated it from adherence, and clinically elaborated upon an existing framework for its development. We hope that our psychotherapeutic adaptation of Dreyfus and Dreyfus's (1986) model and its progressive stages (namely the movement from a caricatured “adherence” to nuanced contextual judgment and increased levels of accountability and immersion) may prove useful in formulating competence benchmarks. Additionally, we
Acknowledgment
The authors would like to thank Shabad-Ratan Khalsa and Taylor DiGravina for their assistance in preparing this manuscript. This article was supported in part by NIMH R01-070664.
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