Clinical Competency Evaluation in LIEIPD Training

Competencies

The Living Institute Existential-Integrative Psychotherapy Diploma (LIEIPD) program is structured so that it leads to development of the competencies required for clinical practice as defined by College of Registered Psychotherapists of Ontario in their Entry-to-Practice Competency Profile for Registered Psychotherapists. ‘Competencies’ have been defined by the transitional Council of the CRPO, in brief, as the ability to achieve a specified level of proficiency in a practice activity, and results from specific skills, knowledge and judgement. The CRPO has developed a list of specific competencies that applicants for registration as psychotherapists are required to have developed. The CRPO clinically oriented entrance exam is based on these competencies. A list of these competencies is given on the CRPO website. We have also developed a list of competencies as interpreted within the specific depth psychotherapy modalities that we teach. These are the humanistic, psychodynamic, existential, phenomenological, archetypal, transpersonal and somatic traditions. An outline of the LIEIPD approach to modality based competency development and assessment is given on our website (see http://livinginstitute.org/lieipd-tradition-based-practitioner-competencies). We have a particular concern for the Safe and Effective Use of Self (SEUS) competencies, which we have integrated into our Self Development Program. For an outline of this go to our Program Handbook, p 14-16. See also our Self Development Program checklist to be used by therapist/counsellors and the Clinical Director in monitoring student self development progress.

In a paper on student competency assessment in psychology training programs, published by the American Psychological Association in 2009 (provide to us by David Lukoff, PhD, in response to our request for assistance in developing our student assessment model), competency is defined as "the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice ... consisting of cognitive, integrative, relational, affective/moral and habits of mind dimensions" that are "developmental and context dependent". The APA paper defines the essence of competency as "knowledge, skills, attitudes and their integration", which may be considered as complementary to the CRPO definition given above (Competency Assessment Toolkit for Professional Psychology, Training and Education in Psychology, 2009, Vol. 3, No.4 [Suppl.]. S27 – S45. N. J. Kaslow, L. F. Campbell, R. L. Hatcher, C. L. Grus, N. A.Fouad, E. R. Rodolfa, S28, S34). Knowledge is self-explanatory, as is skills. Attitudes refers to the way you think about something in an emotional, reflective, valuing and ethical sense. Integration is self-explanatory. The LIEIPD draws on both the CRPO and APA overall definitions of competency in designing our program toward clinical practice ,as well as drawing on the specific modalities that we teach in the program.

Competencies Assessment

Assessment of competency development in a psychotherapy training program is a complex and multifaceted endeavor. In developing and refining our student assessment model and methods in the LIEIPD, we have particularly drawn on the APA Competency Assessment Toolkit paper. The Living Institute has created a user friendly edit of this document for our own purposes and we have shared this with our Alliance of Psychotherapy Training Institutes (APTI) fellow training programs.

Specific Assessment Tools

We have incorporated the following assessment tools from the APA Competency Assessment Toolkit:

  • Portfolios (p3, Living Institute Edit ) - In the LIEIPD, implemented as academic assignments, case reports, learning reports, exit paper, workshop report, typology and intake assignments, Clinical Skills report, group observation and facilitation reports;
  • 360-Degree Evaluations (p5, Living Institute Edit) - In the LIEIPD, implemented by reviewing reports from classroom faculty, psychotherapist, supervisor, core faculty, fellow students, program director, clinical director;
  • Annual/Rotation Performance Reviews (p6, Living Institute Edit) - In the LIEIPD, implemented as a year-end review of all current assessments;
  • Live or Recorded Performance Ratings (p8 Living Institute Edit) - In the LIEIPD, implemented as Clinical Skills Reflecting Team class where students volunteer to be client and therapist, session is then reviewed as a reflecting team, sometimes utilizing video recording;
  • Simulations/Role Plays (p9, Living Institute Edit) - In the LIEIPD, implemented as intake class where students role play doing intakes on each other, experiential learning (e.g. Expressive Arts, Basic Therapy Skills, bioenergetics, gestalt) where students practice tradition specific methods on each other;
  • Competency Evaluation Rating Forms (CERF) (p10, Living Institute Edit) - In the LIEIPD, implemented as competency review checklist, e.g. Self Development Review check list;
  • Record Reviews (p11, Living Institute Edit) In the LIEIPD, implemented through supervisor reviewing intern case notes;
  • Case Presentation Reviews (p12, Living Institute Edit) - In the LIEIPD, implemented through each intern making Case Presentations to their fellow interns and other students;
  • Client/Patient Process and Outcome Data (p13, Living Institute Edit) - In the LIEIPD, implemented as periodic client/intern process review dialogue, progress notes, progress reviews with supervisor;
  • Self-Assessment (p14, Living Institute Edit) - In the LIEIPD, implemented as part of self development, VCS performance review, typology & intake reports.

We use both formative and summative evaluations in the program. Formative evaluations assess competence and provide ongoing corrective, developmentally informed feedback to the individual to foster growth throughout the program. Summative evaluations measure outcomes at the end-point of a developmental process for purposes of gatekeeping regarding progression to the next training stage and prior to graduation.

For an outline of progress reviews throughout the program go to Program Handbook, p19 http://www.livinginstitute.org/program-handbook