Barber, Sharpless Competence Professional Psych 2007-1

Barber, Sharpless Competence Professional Psych 2007-1 -...

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Assessing Intervention Competence and Its Relation to Therapy Outcome: A Selected Review Derived From the Outcome Literature Jacques P. Barber, Brian A. Sharpless, Susan Klostermann, and Kevin S. McCarthy University of Pennsylvania School of Medicine The assessment of intervention competence possesses an obvious relevance for practitioners and clinical scientists alike. It is often assessed as part of the evaluation of treatment integrity in clinical research in general, and in randomized clinical trials (RCTs) in particular. The authors first attempt to add clarity to the concept and better differentiate intervention competence from closely related constructs. Next, the authors review and evaluate the main measures of therapist competence used in RCTs, relying on this conceptual foundation to provide suggestions for future measures. The empirical literature on the relation between therapist competence and clinical outcome is then reviewed. The relation, while positive, is weaker than expected, and factors having a potential bearing on this are discussed. The authors then recommend that new measures be created and that the assessment of limited-domain competence be supplemented by explorations of global competence. Due to the potential ramifications for the field, the authors also recommend that caution be exercised in the task of operationally defining competence. Keywords: therapist competence, competency, therapy outcome, treatment integrity, process of change Competencies of various kinds have permeated our lives and have garnered popular and professional attention. This is likely due to factors such as the increased degree of specialization in various disciplines in conjunction with societal demands for accountabil- ity. In professional psychology in particular, we have witnessed a burgeoning interest in competency-based education and practice termed the competencies-based movement (Kaslow, 2004). Kaslow (2004) described eight domains of psychologist compe- tencies (e.g., ethical, assessment) warranting attention. This paper will focus on one of them, namely intervention competencies, and what we have learned about competence assessment from random- ized clinical trials (RCTs). Despite the narrow focus on RCTs, we will address four questions holding practical implications for pro- fessional psychologists. First, what is intervention competence, and can conceptual clarity be added to this concept? Second, how is intervention competence typically measured in RCTs, and can improvements be made in its measurement? Third, what is the relation between competence and therapy outcome? And finally, what are the implications of this current state of knowledge for our field? Before addressing these issues, however, some contextual discussion of intervention competency is warranted. Intervention competence has a number of ethical and practical
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Barber, Sharpless Competence Professional Psych 2007-1 -...

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