Clinical training: Competencies

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In the UK there has been a clear move to competency based training:

So what are the competencies that a newly qualified psychologist should have attained?

This list follows the competencies considered by the BPS when they evaluate courses in the UK

Trainees should be able to work as clinical psychologists with the range of clients and services in a range of settings.
Newly qualified clinical psychologists should understand and embrace the core purpose and philosophy of the profession.
They should be committed to reducing psychological distress and enhancing and promoting psychological well-being through the systematic application of knowledge derived from psychological theory and evidence.
Their work will be based on the fundamental acknowledgement that all people have the same human value and the right to be treated as unique individuals.

By the end of their training, they will have:

The skills, knowledge and values to develop working alliances with clients, including individuals, carers and/or services, in order to:
- conduct psychological assessment,
- develop a formulation based on psychological theories and knowledge,
- carry out psychological interventions,
- evaluate their work and communicate effectively with clients, referrers and others,
The skills knowledge and values to work effectively with clients from a diverse range of backgrounds, understanding and respecting the impact of difference and diversity upon their lives;
The skills, knowledge and values to work effectively with systems relevant to clients, including for example statutory and voluntary services, self-help and advocacy groups, user-led systems and other elements of the wider community;
The skills, knowledge and values to work in a range of indirect ways to improve psychological aspects of health and healthcare
The skills, knowledge and values to conduct research that enables the profession to develop its knowledge base and to monitor and improve the effectiveness of its work
High level skills in managing a personal learning agenda and selfcare, and in critical reflection and self-awareness that enable transfer of knowledge and skills to new settings and problems.

In order to achieve these goals trainees should demonstrate:

Knowledge and understanding of psychological theory and evidence, encompassing specialist client group knowledge across the profession of Clinical Psychology
Knowledge required to underpin clinical and research practice.
A professional and ethical value base, being aware of all relevant ethical and practice guidelines.
Clinical and research skills that demonstrate work with clients and systems based on both a scientist-practitioner and reflective-practitioner model including cycles of assessment, formulation, intervention and evaluation.
Professional competence relating to personal and professional development and awareness of the clinical, professional and social context within which the work is undertaken.

More specifically trainees should be able to demonstrate the following:

Transferable skills
- Deciding, using a broad evidence and knowledge base, how to assess, formulate and intervene psychologically, using a range of possible models and modes of intervention with clients, carers and service systems
- Generalising and synthesising prior knowledge and experience in order to apply them in different settings and novel situations
- Demonstrating self-awareness and working as a reflective practitioner with an aAbility to think critically, reflectively and evaluatively

Ability to conduct psychological assessment
- Developing and maintaining effective working alliances with clients, including individuals, carers and services.
- Ability to choose, use and interpret a broad range of assessment methods appropriate:
  - to the client and service delivery system in which the assessment takes place
  - to the type of intervention which is likely to be required
- Assessment procedures in which competence is demonstrated will include
  - formal procedures (use of standardised instruments)
  - systematic interviewing procedures
  - other structured methods of assessment (e.g. observation)
- Conducting appropriate risk assessment and using this to guide practice

Develop psychological formulations
- Developing formulations of presenting problems or situations which integrate information from assessments within a coherent framework that draws upon psychological theory and evidence and which incorporates interpersonal, societal, cultural and biological factors
- Using formulations with clients to facilitate their understanding of their experience
- Using formulations to plan appropriate interventions that take the client's perspective into account
- Using formulations to assist multi-professional communication, and the understanding of clients and their care
- Revising formulations in the light of ongoing intervention and when necessary re-formulating the problem.

Deliver psychological interventions
- On the basis of a formulation, implementing psychological therapy or other interventions appropriate to the presenting problem and to the psychological and social circumstances of the client(s), and to do this in a collaborative manner with:
  - individuals
  - couples, families or groups
  - services/organisations
- Implementing interventions through and with other professions and/or with individuals who are formal (professional) carers for a client, or who care for a client by virtue of family or partnership arrangements
  - Recognising when (further) intervention is inappropriate, or unlikely to be helpful, and communicating this sensitively to clients and carers.
Conducting evaluations
- Selecting and implementing appropriate methods to evaluate the effectiveness, acceptability and broader impact of interventions (both individual and organisational), and using this information to inform and shape practice. Where appropriate this will also involve devising innovative procedures.
- Auditing clinical effectiveness

Conduct research
- Identifying and critically appraising research evidence relevant to practice Conducting service evaluation and small N research Conducting collaborative research.
- Planning and conducting independent research i.e. identifying research questions, demonstrating an understanding of ethical issues, choosing appropriate research methods and analysis, reporting outcomes and identifying appropriate pathways for dissemination

Demonstrate personal and professional skills
- Understand ethical issues and applying these in complex clinical contexts, ensuring that informed consent underpins all contact with clients and research participants
- Appreciating the inherent power imbalance between practitioners and clients and how abuse of this can be minimised.
- Understanding the impact of difference and diversity on people's lives, and its implications for working practices
- Working effectively at an appropriate level of autonomy, with awareness of the limits of own competence, and accepting accountability to relevant professional and service managers
- Managing own personal learning needs and developing strategies for meeting these
- Using supervision to reflect on practice, and making appropriate use of feedback received
- Developing strategies to handle the emotional and physical impact of own practice and seeking appropriate support when necessary, with good awareness of boundary issues.
- Working collaboratively and constructively with fellow psychologists and other colleagues and users of services, respecting diverse viewpoints

Communicate and Teach
- Communicating effectively clinical and non-clinical information from a psychological perspective in a style appropriate to a variety of different audiences (eg to professional colleagues, and to users and their carers)
- Adapting style of communication to people with a wide range of levels of cognitive ability, sensory acuity and modes of communication
- Preparing and delivering teaching and training which takes into account the needs and goals of the participants (for example by appropriate adaptations to methods and content)
- Understanding of the supervision process for both supervisee and supervisor roles

Adapt service delivery
- Adapting practice to a range of organisational contexts, on the basis of an understanding of pertinent organisational and cultural issues
- Understanding of consultancy models and the contribution of consultancy to practice
- Awareness of the legislative and national planning context of service delivery and clinical practice
- Working with users and carers to facilitate their involvement in service planning and delivery
- Working effectively in multi-disciplinary teams
- Understanding of change processes in service delivery systems

References[]

(2002) Criteria for the Accreditation of Postgraduate Training Programmes in Clinical Psychology.
Thomas, J.C., Hersen, M. (2009). Handbook of Clinical Psychology Competencies.Springer-Verlag New York Inc.ISBN: 9780387097565

Clinical training: Competencies

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