Evaluating competence in psychotherapy.
BACKGROUND
The Residency Review Committee (RRC) for Psychiatry has recently charged psychiatry training programs with developing methods to demonstrate competence of trainees in five areas of psychotherapy. Each program must decide what specific skills are essential for competence in each of the five listed psychotherapies. This requires determining whether those skills that are necessary are also sufficient for effective psychotherapy and whether additional specific skills are required for each one.


METHODS
Two lists of general skills for psychotherapy are compared, one from the perspective of specific "schools" of psychotherapy and one from a more eclectic "integrative" approach. The issue of measuring competence is addressed by placing ratings of "competent" midway on a continuum from "novice" to "expert." Thirteen methods for measuring competence from the Accreditation Council for Graduate medical Education (ACGME) "tool-box" are described and reviewed with respect to applicability to psychotherapy. Examples of toolbox implementation are described based on a functioning psychotherapy evaluation program at the University of Missouri.


CONCLUSIONS
The authors found both theoretical as well as practical problems in measuring competence in psychotherapy. We propose that global rather than highly specific assessment methods may be more practical in these early stages of development, and we offer specific suggestions for assessment components that can currently be implemented.
Manring
John
J
Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA. manringj@upstate.edu
Beitman
Bernard D
BD
Dewan
Mantosh J
MJ
D000068:Accreditation; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement; D006801:Humans; D011361:Professional Competence; D015397:Program Evaluation; D011613:Psychotherapy / Q000592:standards*