Core Competencies Clinical Psychology A Guide
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1 Committee for Scrutiny of Individual Clinical Qualifications Core Competencies Clinical Psychology A Guide Please read this booklet in conjunction with other booklets and forms in the application package November 2006
2 Contents 1 Introduction Required learning outcomes Core Competencies Transferable skills Psychological assessment Psychological formulation Psychological intervention Evaluation Research Personal and professional skills Communication and teaching Service delivery Clients, services and modes of work Clients, services and modes of work Clients Service delivery systems Modes and types of work...6
3 1. Introduction All applicants for Registration as a Chartered Clinical Psychologist via the British Psychological Society s Statement of Equivalence in Clinical Psychology must read this booklet BEFORE attempting to complete the enclosed Application Form. To be recognised as a qualified clinical psychologist you must have successfully undertaken a programme of training, including academic study, supervised clinical practice and research, that enables you to demonstrate the learning outcomes. The key learning outcomes are described in Section 2 with adequate experience of the range of clients, service settings and modes of work as specified in Sections 3 and 4. The exact requirements for each individual will be set by the Committee for the Scrutiny of Individual Clinical Qualifications (CSICQ). The following information has been extracted from the Society s Regulations for the Statement of Equivalence in Clinical Psychology. 1
4 2. Required learning outcomes Qualified clinical psychologists should understand and embrace the core purpose and philosophy of the profession as described in the document prepared by the Division of Clinical Psychology. 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. Thus qualified clinical psychologists will have: The skills, knowledge and values to develop working alliances with clients, including individuals, carers and/or services, in order to carry out: 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, orally, electronically and in writing. 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 health care. 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 self-care, 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 psychologists will have achieved the following learning outcomes: Knowledge and understanding of psychological theory and evidence, encompassing specialist client group knowledge across the profession of Clinical Psychology and the knowledge required to underpin clinical and research practice. A professional and ethical value base, including that set out in the British Psychological Society s Code of Conduct, the Division of Clinical Psychology (DCP) statement of the Core Purpose and Philosophy of the Profession, and the DCP Professional Practice Guidelines. Clinical and research skills that demonstrate work with clients and systems based on a scientistpractitioner and reflective-practitioner model that incorporates a cycle 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. 2
5 3. Core competencies The following statements are intended as broad, high-level summaries of the required objectives that demonstrate competence in clinical psychology and clinical settings. 3.1 Transferable skills Deciding, using a broad evidence and knowledge base, how to assess, formulate and intervene psychologically, from 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. Ability to think critically, reflectively and evaluatively. 3.2 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 or gathering information from others). Conducting appropriate risk assessment and using this to guide practice. 3.3 Psychological formulation 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. 3
6 3.4 Psychological Intervention 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. 3.5 Evaluation 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. 3.6 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. 3.7 Personal and professional skills Understanding of 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. 4
7 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. 3.8 Communication and teaching Communicating effectively clinical and non-clinical information from a psychological perspective in a style appropriate to a variety of different audiences (e.g. 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 (e.g. by appropriate adaptations to methods and content). Understanding of the supervision process for both supervisee and supervisor roles. 3.9 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. 5
8 4. Clients, services and modes of work The parameters described below aim to provide the framework for pathways through training, delineating client populations, clinical contexts and learning outcomes which contribute to a generic training in clinical psychology. It is important to recognise that the scope of clinical psychology is so great that initial training provides a foundation for the range of skills and knowledge demonstrated by the profession. Further skills and knowledge will need to be acquired through continuing professional development appropriate to the specific employment pathways taken by newly-qualified psychologists. Clinical experience will be gained in service delivery systems that offer a coherent clinical context. This will usually be in a setting oriented towards a population defined by age (e.g. child, adult, older people) by special needs (e.g. learning disabilities, serious mental health problems, health-related problems, substance abuse) or by a service delivery focus (e.g. psychological therapy). In addition, clinical experience will be gained in a range of service contexts (primary, secondary and tertiary care, inpatient, outpatient, community) with service delivery models ranging from independently organised work through to integrated inter-professional working. 4.1 Clients, services and modes of work The learning objectives described in Section 2 need to be demonstrated with a range of clients and across a range of settings. These are not defined prescriptively and there are multiple pathways that are possible ways of achieving the required goals. The range of clients and settings includes: Clients A fundamental principal is that candidates must work with clients across the lifespan, such that they see a range of clients whose difficulties are representative of problems across all stages of development. In this context candidates must have experience of undertaking substantial clinical work with: A wide breadth of presentations from acute to enduring and mild to severe. Problems ranging from those with mainly biological causation to those emanating mainly from psychosocial factors. Problems of coping/adaptation to adverse circumstances that are not themselves reversible by psychological intervention (e.g. physical disability, physical illness, bereavement). Clients from a range of backgrounds reflecting the demographic characteristics of the population. It is also essential that candidates work with: Clients with significant levels of challenging behaviour. Clients across a range of levels of intellectual functioning over a range of ages. Clients whose disability makes it difficult for them to communicate. Carers and families. 6
9 4.1.2 Service delivery systems Candidates must undertake substantial pieces of clinical work over a substantial period of time in each of the range of settings, including: Inpatient or other residential facilities for individuals with high dependency needs, both acute and long term. Secondary health care. Community and primary care Modes and types of work Direct work. Indirect through staff and/or carers. Work within multi-disciplinary teams and specialist service systems including some observation or other experience of change and planning in service systems. Working in more than one recognised model of formal psychological therapy. The total supervised clinical experience must be of at least 340 days duration, made up of supervised placements in a range of service settings that meet the requirement specified in Section and allow the opportunity to work with the range of clients specified in Section Only placements that last for at least four months and include at least 45 days clinical work will be counted towards the requirements set out above. Experience gained in other placements will not count towards the requirements set out in Section
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