Clinical Competency Interview

Southern Nazarene University

GRADUATE PROGRAMS

IN COUNSELING

CLINICAL COMPETENCY INTERVIEW

HANDBOOK

6729 NW 39th Expressway

Bethany, OK 73008

405-491-6360 CLINICAL COMPETENCY INTERVIEW

TABLE OF CONTENTS

OVERVIEW...... 3

CLINICAL COMPETENCY INTERVIEW EVALUATION...... 5

APPEALS PROCEDURE...... 6

APPENDIX A...... 7 EVALUATION FORM ...... 8

2 CLINICAL COMPETENCY INTERVIEW

CLINICAL COMPETENCY INTERVIEW

Overview

One of the major goals of the Graduate Programs in Counseling (GPC) is to provide a setting where students can acquire the skills and perspectives necessary to be a competent and effective counselor. In an effort to assist the student in this process, and insure the continued high quality of the Graduate Programs in Counseling, the student must demonstrate competency in their clinical skills prior to completion of the program. Clinical competency will be assessed through the documentation of various clinical enterprises, through work turned in during the program, and through the application of clinical knowledge to an extensive case study and will culminate in the Clinical Competency Interview (CCI).

The CCI is the culmination of the clinical training within the GPC. The purpose of the CCI is twofold: 1) To provide students with an opportunity to integrate and apply the knowledge they have acquired in the GPC to a case study and 2) To provide an opportunity for an exit interview from the GPC. The CCI will occur at the end of the Multicultural Treatment Planning module as an oral interview, within a small group setting, in conjunction with an extensive case study presented to the CCI faculty panel. Approximately 30 to 45 minutes of time will be allotted for each individual in the small group to present their case study and answer questions posed by the GPC faculty panel addressing eight clinical dimensions (these dimensions are outlined later in this document). A week in advance of the CCI, each student will turn in their written case study they will be presenting in the CCI. The CCI faculty panel will be made up of two GPC faculty members who will conduct the interviews, evaluate the students, and provide feedback to the students. Each student’s grade in the Multicultural Treatment Planning module will be tied to the completion of the paper and performance during the CCI. Completion of the CCI is required for graduation.

Each student will demonstrate competency in the following areas: diagnostic interviewing, assessment, diagnosing, report writing, treatment planning, implementation of counseling skills, and successful completion of a clinical internship. The student will be instructed on the tasks for each area of competence throughout the program. Following is a discussion of how each competency area will be assessed:

1. Diagnostic Interviewing: The student will learn to complete an initial interview during the Introduction to Counseling Techniques module. Students will gain exposure to DSM IV and criteria for diagnosis of the various types of psychopathology evident in adults during the Psychopathology module. Diagnostic criteria for geropsychiatric disorders will be surveyed during the Counseling the Elderly and criteria for disorders commonly found in children and adolescents will be covered during the Lifespan Development module as well as the Counseling Children and Adolescents module. During the Assessment module, students will explore use of mental status exams and other diagnostic interviewing techniques. The introduction to the Multicultural Treatment Planning course will provide an opportunity for students to practice diagnostic interviewing skills. Each student will be required to conduct a diagnostic interview on videotape. If this is done as a requirement of the Multicultural Treatment Planning module, a score of 80% or higher is required before your advisor will sign-off on the interview. If the interview is done outside of the Multicultural Treatment Planning module, the director of the GPC must evaluate and sign-off on the interview. This interview can also be listed as one of your intake reports. Exemplary diagnostic interviewing reports include a clear articulation of the nature and scope of the problem(s).

2. Assessment: The student will learn to administer, score, and interpret (at a rudimentary level) several psychological tests assessing personality, intellectual ability, and vocational interest(s). Students will gain exposure to the Minnesota Multiphasic Personality Inventory, 2nd Edition (MMPI-2), the Shipley Institute of Living Scale (SILS), Rotter’s Incomplete Sentence Blanks, Projective Drawings, Taylor-Johnson Temperment Analysis (T-JTA), and the Myers-Briggs Type Indicator (MBTI) in the Assessment module. Vocational and career measures will be the focus during the Career Assessment module. Administration (where necessary), interpretation, and reports following the format of the assessment class for the following tests must be completed satisfactorily for completion of the CCI. Assessments done as a class requirement will require a grade of at least an 80% to be considered satisfactorily completed. Where multiple uses of an assessment tool are required, one grade of a “C” will be accepted as long as it is not the most recent grade for that assessment tool. These assessments can then be signed-off by your class instructor or another GPC faculty member. All other assessments done outside of class must be evaluated and

3 CLINICAL COMPETENCY INTERVIEW signed-off on by a GPC faculty member. Provisions will be made, as needed, for substitution of assessment tools if the student’s clinical internship is with children. All tests must be accompanied by the date, test(s) name, and faculty member’s initials.

3. Diagnosis: During the Psychopathology and Multicultural Treatment Planning modules the student will focus on the criteria necessary for the diagnosis of various adult mental disorders. In addition, the student will discern differential diagnostic issues for disorders of childhood and adolescence during the Lifespan Development module and the Counseling Children and Adolescents. Disorders found more commonly in elderly adults are reviewed and evaluated during the Counseling the Elderly module. Each student will be required to successfully diagnose 3 cases with an appropriate understanding of the potential differential diagnoses, as well as provide an appropriate treatment plan. Treatment plans must include at least 4 references from the clinical literature supporting the treatment plan. The focus of these treatment plans should be on synthesizing the various details of the case and organizing those details to lead to a logical diagnosis. The diagnosis should include not only a logical DSM-IV diagnosis, but should also reflect an appropriate understanding of the role of potential developmental issues, defense mechanisms, and internal psychodynamics. Previous diagnostic reports and vignettes from the Psychopathology and/or Multicultural Treatment Planning modules are acceptable to build a treatment plan upon. GPC faculty members will evaluate and sign-off on these cases.

4. Report Writing: This competence will be demonstrated by the student’s extensive case study presented for the CCI. The requirements for this report will be established in the Assessment and Multicultural Treatment Planning module. The focus of the report writing should be on the integration of the various data gathered from the clinical interview and assessment into a clear and consistent articulation of the diagnosis and treatment plan.

5. Treatment Planning: An important competency for students working in a managed care environment is the ability to develop appropriate treatment plans based on an understanding of professional clinical literature. The case presented for the CCI must have a review of clinical literature supporting the treatment plan recommended. Treatment plans are expected to utilize the “top-down” approach taught in Multicultural Treatment Planning. A minimum of four articles or chapters supporting the treatment plan recommended for the CCI case study must be submitted with the case study. Each student will be required to successfully diagnose 3 cases, one of which will be the case developed for the CCI, with an appropriate understanding of the potential differential diagnoses, as well as provide an appropriate treatment plan. Treatment plans must include at least 4 references from the clinical literature supporting the treatment plan. Previous diagnostic reports and vignettes from the Psychopathology and/or Multicultural Treatment Planning modules are acceptable to build a treatment plan upon. GPC faculty members will evaluate and sign-off on these cases.

6. Counseling Skills: Throughout the GPC, the student is encouraged to develop their counseling skills. During the first module, Introduction to Counseling Techniques, the student learns basic helping skills such as empathy, respect, genuineness, and reflective listening. Throughout the balance of the program, the student will learn various techniques to use in counseling sessions. In each of the counseling courses, the student will be practicing techniques and learning appropriate settings for their application. The student will submit three counseling sessions that are videotaped for evaluation by a GPC faculty member. Each tape will be transcribed and the student will indicate various places in the session where they applied techniques from a particular theoretical perspective. Even though a student may use a variety of techniques and develop an eclectic approach to counseling, it is expected that each student will know when and how they are utilizing various techniques to facilitate achieving goals mutually agreed upon by the counselor and the client. The counselor must be able to articulate when they were using techniques, how well the technique was utilized in the session and indicate how it helped the client move forward in their treatment. The technique must fit with the goals of the client, the skill of the counselor and be appropriate with the diagnosis of the client. Each session, the student must have a theoretical orientation within which they operate throughout the session. The student in the CCI will be expected to conceptualize their case from a specific theoretical perspective, using appropriate theoretical constructs to describe their case (i.e. etiology, dynamics, interventions, etc.).

7. Professional and Ethical Issues: Professional and ethical issues, including Oklahoma laws related to the practice of counseling, are evaluated in the CCI. Students will be able to demonstrate an understanding of confidentiality, duty to warn, suicide and homicide risk, Oklahoma laws related to treatment of minors, and laws related to involuntary hospitalization of clients.

8. Internship Evaluation and Summary: Each student will successfully complete a clinical internship, or have the majority of a clinical internship completed, prior to sitting for the CCI. The student’s internship evaluation will serve as documentation for this dimension.

Clinical Competency Interview Evaluation

The following five point Likert scale will be used to evaluate each student across each of the eight clinical skill dimensions.

Inadequate Below Meets Exceeds Exceptional Information Deficient Expectation Expectation Expectation Skills

0 1 2 3 4 5

Each student will be evaluated across several dimensions of skills necessary for competency as a clinician. The evaluation of the student will take into account their developmental level as a clinician. The following eight clinical dimensions (with expected skill level) will be assessed as part of the Clinical Competency Interview:

1. Diagnosis – The trainee demonstrates the ability to diagnose clients appropriately according to the DSM- IV, as well as an appropriate diagnostic understanding of the role of potential developmental issues, defense mechanisms, and internal psychodynamics within psychopathology. The student is able to make the diagnosis based on information gathered from interviews, family histories, suicide/depression interviews or inventories, discussion of SES, employment, school, and developmental stages, and psychological testing results.

2. Theory – The student is able to articulate theory as it is applied in practice, utilizes concepts appropriately, and describes interventions that fit with the theory and hypotheses. The student demonstrates the ability to describe the etiology of the diagnosis from a theoretical viewpoint.

3. Treatment Plan – The student exhibits the ability to formulate multiple hypotheses about a case based on articulated principles of a theory of change. She or he can develop treatment plans, which include a rationale for intervention based on hypotheses and current research literature on treatment. The student is able to utilize a “top- down” approach to treatment planning.

4. Ethical/Legal Issues – The student knows and observes the code of ethics of ACA, AAMFT, and/or APA, and is familiar with the laws of Oklahoma regarding privileged communication, mandatory reporting, and duty-to-warn issues. The student appropriately uses supervision and consultation regarding ethical issues. The student avoids potentially exploitative relationships with clients and other students. The student deals appropriately with his or her own issues as they affect therapy and is willing to take responsibility for her or his own actions.

5. Psychological Testing – The student demonstrates a basic ability to recognize when psychological testing is necessary and warranted. He or she can suggest appropriate psychological tests for the client and can interpret the results at a basic level. The student is able to integrate assessment results into a clear understanding of the client.

6. Report Writing – The student demonstrates an ability to write psychological reports in a clear and concise manner. The reports reflect a consistency between diagnosis and symptomatology, a clear theoretical conceptualization, an empirically supported and sensible treatment plan, and a development of a cohesive understanding of the client.

7. Integration of Faith and Psychology – The student demonstrates an ability to recognize and respond to religious issues in therapy in an ethical and responsible manner. The student can articulate how his or her own faith impacts their biases, counter transference issues, and worldview.

8. Multicultural Issues – The student is sensitive to gender, race, and cultural issues. He or she can articulate and provide flexible interventions based on gender, race, and cultural issues.

The student may pass the CCI with no qualifications or pass with qualifications. In the case of the student who passes with qualifications, additional work to enhance deficient areas may be required. One of three levels of remediation may be prescribed. First, the CCI faculty panel may prescribe specific readings for the student that addresses the deficient clinical skill dimensions of the student. The student would successfully complete this remedial step by reporting to the director of the GPC that the readings had been completed. Second, the CCI faculty panel may prescribe specific readings addressing the deficient clinical skill dimensions and require an oral report over those readings to ensure comprehension of the material. The student would successfully complete this remedial step by displaying comprehension of the material orally before the prescribing CCI faculty panel. Third, the CCI faculty panel may prescribe that the student presents another written case study, or a revision of the initial CCI case study, which addresses those areas that were deficient. The student would successfully complete this remedial step by presenting a written case study, as well as an oral presentation, to the prescribing CCI faculty panel, which must display satisfactory competence in the lacking areas

Appeals Procedure A decision by the CCI faculty panel may be appealed by the student. The process for appealing a CCI faculty panel decision is as follows:

1. Seek resolution with the appropriate CCI faculty panel members within a week after the CCI.

2. If not resolved with the CCI faculty panel members, the student should discuss the situation with the GPC Director. The student will present a written explanation of why the decision is being appealed. The CCI faculty panel will present a written explanation outlining their decision. The Program Director will then decide to either a) uphold the decision of the CCI faculty panel or b) convene a new CCI faculty panel. If a new CCI faculty panel is convened, those new faculty members will rate the student according to their written case study and performance during the prior CCI. The new CCI faculty panel will rate the student as either passing or passing with qualifications per the above outlined parameters.

*Note: In the event that the Program Director is on the CCI faculty panel whose decision is being appealed, a committee of two GPC faculty members will decide to either a) uphold the prior decision or b) reconvene a new CCI faculty panel.

3. In the event that the first two steps do not bring about resolution, appeals will then follow the “appeals step” process noted in the Student Handbook.

APPENDIX A

CCI EVALUATION FORM

Clinical Skill Inadequate Below Meets Exceeds Exceptional Information Deficient Expectation Expectation Expectation Skills 0 1 2 3 4 5 Presenting Complaint Succinct Comprehensive Comments:

Assessment Coherent Accounts for all data (e.g. psych testing) Appropriate interpretation of Testing Comprehensive Reconciles contradictions Comments:

Diagnostic Formulation Appropriate diagnoses Differential diagnoses considered Rationale for diagnoses clear Comments:

Theoretical Formulation Use of theory’s language Accurate application of theory Accounts for all major issues of client Appropriate citations Comments:

Treatment Plan Aim Consistent with diagnosis & problems Consistent with theory identified Goals Will work toward Aim Can be empirically measured Addresses diagnoses & problems Strategies Not contradictory with each other Tactics Specific Consistent with strategies Addresses diagnoses & problems Supported empirically and cited Comments:

Clinical Skill Inadequate Below Meets Exceeds Exceptional Information Deficient Expectation Expectation Expectation Skills 0 1 2 3 4 5 Legal and Ethical Multicultural issues addressed approp. Risky behavior identified Risky behavior intervened w/ approp. Reporting requirements addressed Comments:

Integration Issues Addressed Comments:

Writing Clarity Coherence Flow Comprehensive Style Comments:

______Pass

______Pass with Qualifications

______Not Pass

Remediation: 1. Reading 2. Oral 3. Written

Areas of Remediation:

Prescribed Readings:

Rationale:

GPC Faculty Member Date