Clinical Competency Examination Handbook, Exercises of Clinical Psychology

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Clinical Psy.D. Program

Antioch University Seattle

Clinical Competency Examination

Student and Faculty Handbook

Effective Fall, 2019

Last Revised 10.03.19 clh

Table of Contents

Part 1: Overview of the Clinical Competency Examination

1.1 Introduction and Purpose

The Psy.D. Program’s Clinical Competency Examination (CCE), formerly the Clinical Oral Examination, is modeled after the American Board of Clinical Psychology (ABCP) Specialty Board Examination of the American Board of Professional Psychology (ABPP). It is intended to certify that the successful clinical internship candidate possesses the knowledge, skills, and attitudes necessary to provide quality entry-level services as a clinical psychology intern. It is a competency-based examination and to maintain congruence within the profession, the contents of this handbook have been heavily borrowed or adapted from the most recent Examination Manual for Board Certification in Clinical Psychology (American Board of Professional Psychology, 2019). The CCE will be useful for students in a number of ways. First, the goal is for the exam to provide the opportunity and motivation for students to integrate their academic, research, and clinical training. Second, the exam process will provide another level of quality assurance for students to meet basic standards for scholarship and clinical skills. In addition, participating in the exam process can help prepare students for internship interviews, licensing exams, and Board Certification examinations. Many doctoral programs utilize a comprehensive exam and find the exam process useful in monitoring, helping students in their clinical development, and providing student feedback. The exam provides a comprehensive learning experience in helping students consolidate academic, clinical, and research training in a meaningful, coherent manner. The CCE will assess the student’s competency mastery level and indicate areas for improvement. The Practice Samples are required for all candidates, and provide foundation for assessing the candidate’s attainment of competencies necessary for clinical psychology internship readiness. More specifically, the CCE is designed to provide a multi-method competency-based assessment by examining Practice Samples consisting of a variety of performance indicators including the candidate’s written work, self-reflection, ethical vignette, oral presentation, and videod treatment session.

Aside from the ethical vignettes used during the Oral Examination, which are provided to the examination teams by the CCE Coordinator, this handbook includes all information, forms, and rubrics for the Clinical Competency Examination. Components of this handbook may be posted individually (e.g., forms or evaluation rubrics posted on Sakai), but this handbook (plus any subsequent revisions or updates) should be considered the final source for the Psy.D. Program’s Clinical Competency Examination.

1.2 Scope and Content

Clinical Psychology is both a general practice and health service provider specialty in professional psychology. Clinical Psychologists provide professional services relating to the diagnosis, assessment, evaluation, treatment, and prevention of psychological, emotional, psychophysiological and behavioral disorders in individuals across the lifespan. These services include procedures for understanding, predicting, and alleviating cognitive, emotional, physical, psychological, social and behavioral maladjustment, and mental illness, as well as other forms of discomfort. In addition, it includes services for the enhancement of functioning in all of these areas (ABCP, 2019) with the goal of psychological resilience and well-being. The services provided by Clinical Psychology Interns and licensed independent practitioners alike include the ability to conduct clinically-relevant research, assessment (evaluation, diagnosis, and formal psychological testing), and to engage in psychological intervention (treatment and prevention, consultation, and supervision). In addition, these functions should be carried out with consultation with other professionals in diverse settings, demonstrate sensitivity to, and skills in dealing with, multicultural diverse populations. In this handbook, the terms “multicultural” and “individual cultural diversity” are used interchangeably. Individual and cultural diversity recognizes the broad scope of such factors as race, ethnicity, sexual orientation, gender, age, disability, class status, education, religion/spiritual orientation, and other cultural dimensions (ABPP, 2019).

1.4 Clinical Competency Examination Process

1. Student submits Form A: Candidate Registration and Approval to the CCE Coordinator at least TWO (2) MONTHS prior to the Tuesday of Oral Examination week. This is the Tuesday of Week 4. The form must be signed by the student’s advisor indicating that the student meets all prerequisites listed on the form prior to submitting.
2. The CCE Coordinator will review and approve the student to move forward, indicating that the student is now a CCE candidate.
3. Candidate emails the CCE Written Examination (often referred to as the CCE package) to the CCE Coordinator, in a single document at least ONE (1) MONTH prior to the Tuesday of Oral Exam Week. This occurs on the Tuesday of Week 8. The CCE Package must include the following: a. Updated Curriculum Vitae. b. Professional Statement (See Required Components of CCE Exam section below). c. Assessment Practice Sample (See Required Components of CCE Exam section below). d. Intervention Practice Sample with transcription (See Required Components of CCE Exam section below).
4. The CCE Coordinator reviews all submissions for completeness and then sends each candidate’s CCE package to their assigned committee. At this point, the candidate will be notified of their committee makeup and any communication regarding the actual exam will include the candidate and the committee members.
5. Each CCE committee member will complete Form B: Examiner Ratings - Written and submit to the CCE Coordinator at least TWO (2) weeks prior to the first Tuesday of Oral Exam week. Candidates are expected to respond quickly to any committee questions or requests during this time. Based on the results of the written evaluation: a. Candidates who pass the Written Examination will be notified that they have been approved to sit for the Oral Component of the CCE.

b. Candidates who do not pass the Written Examination will be notified of this and provided next steps. They will not be permitted to continue to the Oral Examination but will likely be asked to attend the scheduled Oral Examination meeting time with their committee to discuss issues of concern and to develop a collaborative plan for remediation.

6. Candidates who pass the written component and are approved to move forward will present their oral defense of the clinical skills and readiness for internship during a three hour Oral Examination with their committee at either 9am or 1pm on either Tuesday or Thursday of Oral Exam Week. It is important that the candidate arrive for their oral exam early in order to set things up for the exam and to be ready to begin at their assigned time. More details about this component can be found in chapter 2.
7. Committee members will each complete Form C: Examiner Ratings - Oral and will together complete Form D: Committee Ratings and will submit these to the CCE Coordinator by the Tuesday following Oral Exam Week.
8. Students are asked to complete Form E: Candidate Feedback and submit to the CCE Coordinator by the Tuesday following Oral Exam Week. This form is not required, but it is highly encouraged from each candidate.
9. The CCE Coordinator will email Form F: Final Candidate Evaluation to each candidate, notifying them of their final status for the Clinical Competency Exam within one week after the Tuesday following Oral Exam Week. This is the Tuesday of Week 1 of the following quarter. If a candidate does not pass the CCE, they will be instructed on next steps. See Appendix A for a calendar view of the CCE submission requirements.

1.5 Examining Committee Composition

1. The examination team consists of two faculty members (full-time or part-time; core, teaching, clinical, and/or affiliate), both of whom must be licensed as psychologists during the course of the Examination.
2. CCE committee members are selected by the CCE Coordinator with consideration of the theoretical orientation, knowledge base, professional interest and experience

9. Provide information sessions to students.
10. Oversee continuous quality improvement of the CCE through data analysis, candidate and committee feedback, and changes within the profession. Annual CCE Evaluation Every year at the time of the Annual Psy.D. Program Evaluation meeting in the Fall quarter, the Psy.D. faculty will conduct a review of the CCE, led by the Psy.D. CCE Coordinator. The review will consist of pass/fail rates and identification of any trends indicating program areas potentially in need of improvement. For training and standardization purposes, the Psy.D. faculty will examine the scoring of at least one randomly selected written case formulation and one intervention implementation component of the CCE in order to monitor and improve reliability. Annual Psy.D. Program Summary Every year at the time of the Annual Psy.D. Program Evaluation meeting in the Fall quarter, the Psy.D. Chair will provide a report that summarizes overall program status and outcome updates including the results from the Annual CCE Evaluation. The Annual Psy.D. Program Summary will be posted publicly at the Sakai Antioch Seattle Psy.D. Community Site/Resources/Annual Psy.D. Program Summary minus any confidential information. Committee Training and Expectations The high-quality, collegiality, relevance, and standardization of the CCE process are maximized by a clear and explicit CCE Handbook, and through careful training of examiners. For these reasons:
11. All new examiners are expected to review this handbook in detail prior to reviewing and evaluating Written Examinations and conducting Oral Examinations. In addition, all faculty members are required to review all handbook revisions.

2. All new examiners are assigned to a committee with a senior examination member, often referred to as the committee chair, who is responsible for orienting the new member to the examination process and educating him/her on the expectations of an examiner along with other responsibilities.
3. Committee members will discuss the process and provide feedback to each other and to the CCE Coordinator aimed at continually improving the CCE process.
4. In addition to the above, the Annual Psy.D. Program Review Meeting is conducted in order to continually improve the quality and standardization of the CCE process.

2.1.1 Research

While research related skills are evaluated in more depth during the dissertation process, they are important to every aspect of clinical competency, especially in the era of evidence-based practice. A successful internship candidate demonstrates increasing knowledge of core science/research from subfields of psychology including theoretical and philosophical psychology. For example, candidates should be able to apply scientific methods and knowledge to clinical and academic professional practice. In addition, potential clinical internship candidates should demonstrate knowledge, understanding, application, and critical analysis of the concept of evidence-based practice (EBP). For example, candidates should know how and when to apply EBP in clinical work and use data to guide mid-course corrections to interventions and research. APA includes the following elements of the research competency. Unless otherwise noted, these standards will be evaluated as part of the CCE. APA Standard: Demonstrate the substantially independent ability to formulate research or other scholarly activities (e.g., critical literature reviews, dissertation, efficacy studies, clinical case studies, theoretical papers, program evaluation projects, program development projects) that are of sufficient quality and rigor to have the potential to contribute to the scientific, psychological, or professional knowledge base. (ASSESSED AS IT RELATES TO PROFESSIONAL PRACTICE ONLY) APA Standard: Conduct research or other scholarly activities. (NOT ASSESSED ON THE CCE) APA Standard: Critically evaluate and disseminate research or other scholarly activity via professional publication and presentation at the local (including the host institution), regional, or national level. (NOT ASSESSED ON THE CCE)

2.1.2 Ethical and legal standards

A successful clinical psychology intern candidate demonstrates intermediate to advanced level of knowledge and understanding of the most recent APA Ethical Principles and Code

of Conduct and other relevant ethical/professional codes, standards and guidelines; laws, statutes, rules, and regulations. The intern candidate demonstrates knowledge and ability to apply an ethical decision-making model and is able to apply relevant elements of ethical decision making to a dilemma. APA Standard: Be knowledgeable of and act in accordance with each of the following: ● The current version of the APA Ethical Principles of Psychologists and Code of Conduct; ● Relevant laws, regulations, rules, and policies governing health service psychology at the organizational, local, state, regional, and federal levels; and ● Relevant professional standards and guidelines. APA Standard: Recognize ethical dilemmas as they arise, and apply ethical decision-making processes in order to resolve the dilemmas. APA Standard: Conduct self in an ethical manner in all professional activities. Ethical competencies are demonstrated in the following CCE components: Written Examination: Written professional Statement, Assessment Practice Summary, Intervention Practice Summary Oral Examination: Candidate Presentation and Interview, Assessment Case Presentation, Assessment Case Discussion, Intervention Case Presentation, Intervention Case Discussion, Ethical Vignette

2.1.3 Individual and cultural diversity

A successful clinical psychology intern candidate demonstrates the ability to observe and apply social privilege and system of oppression in assessment, treatment, and consultation. For example, an internship candidate should critically evaluate feedback and initiate supervision regularly about power and privilege issues; actively and critically examine one’s own cultural and political prejudgments; identifies and articulates one’s own privilege;

2.1.4 Professional values, attitudes, and behaviors

A successful clinical psychology intern candidate demonstrates professional values in behavior, communication, and presentation across different settings. For example, brings accountability to all situations including coursework, clinical work, and professional interactions; accepts responsibility for actions and acknowledges errors. Consistently acts to understand and safeguard the welfare of others; recognizes situations that challenge adherence to professional values; consults; behaves according to professional values and principles. The intern candidate displays professionally appropriate communication and physical conduct, including attire, across different settings. For example, candidates show awareness of power differentials in relationships with professors, colleagues and clients and demonstrate emerging professional identity and utilize opportunities for professional development through attendance at colloquia, workshops, conferences. APA Standard: Behave in ways that reflect the values and attitudes of psychology, including integrity, deportment, professional identity, accountability, lifelong learning, and concern for the welfare of others. APA Standard: Engage in self-reflection regarding one’s personal and professional functioning; engage in activities to maintain and improve performance, well-being, and professional effectiveness. APA Standard: Actively seek and demonstrate openness and responsiveness to feedback and supervision. APA Standard: Respond professionally in increasingly complex situations with a greater degree of independence as they progress across levels of training. Professional competencies are demonstrated in the following CCE components: Written Examination: Curriculum Vitae, Written professional Statement, Assessment Practice Summary, Assessment Practice Sample, Intervention Practice Summary, Intervention Practice Sample

Oral Examination: Candidate Presentation and Interview, Assessment Case Presentation, Assessment Case Discussion, Intervention Case Presentation, Intervention Case Discussion, Ethical Vignette

2.1.5 Communication and interpersonal skills

A successful clinical psychology intern candidate demonstrates they can form and maintain productive and respectful relationships with clients, peers/colleagues, supervisors, and professionals from other disciplines. For example, candidates demonstrate an ability to establish effective working alliance with clients. Successful intern candidates negotiate differences and resolve conflict satisfactorily. For example, they provide effective feedback to others and receive feedback non-defensively; and demonstrate active problem solving and acknowledge one’s own role in difficult interactions. APA Standards: Develop and maintain effective relationships with a wide range of individuals, including colleagues, communities, organizations, supervisors, supervisees, and those receiving professional services. APA Standard: Produce and comprehend oral, nonverbal, and written communications that are informative and well-integrated; demonstrate a thorough grasp of professional language and concepts. APA Standard: Demonstrate effective interpersonal skills and the ability to manage difficult communication well. Communication competencies are demonstrated in the following CCE components: Written Examination: Written professional Statement, Assessment Practice Summary, Assessment Practice Sample, Intervention Practice Summary, Intervention Practice Sample Oral Examination: Candidate Presentation and Interview, Assessment Case Presentation, Assessment Case Discussion, Intervention Case Presentation, Intervention Case Discussion, Ethical Vignette

Oral Examination: Assessment Case Presentation, Assessment Case Discussion, Ethical Vignette

2.1.7 Intervention

A successful internship candidate demonstrates the ability to formulate and conceptualize clinical cases and plans interventions utilizing at least one theoretical orientation. For example, interns formulate diagnoses; select appropriate interventions for different problems and populations; write case conceptualizations and treatment plans based on EBP; expand confidence in interventions as rules become guidelines; and broaden selection of interventions and their planning. The intern candidate develops sound approaches to intervention. For example, they develop therapeutic relationship with clients to serve as a base from which to implement interventions; implement EBP interventions that take into account empirical support, clinical judgment, and client diversity; evaluate treatment progress and modify treatment planning as indicated, utilizing established outcome measures; and make mid-course corrections of interventions when necessary. APA Standard: Establish and maintain effective relationships with the recipients of psychological services. APA Standard: Develop evidence-based intervention plans specific to the service delivery goals. APA Standard: Implement interventions informed by the current scientific literature, assessment findings, diversity characteristics, and contextual variables. APA Standard: Demonstrate the ability to apply the relevant research literature to clinical decision making. APA Standard: Modify and adapt evidence-based approaches effectively when a clear evidence-base is lacking. APA Standard: Evaluate intervention effectiveness, and adapt intervention goals and methods consistent with ongoing evaluation.

Intervention competencies are demonstrated in the following CCE components: Written Examination: Curriculum Vitae, Intervention Practice Summary, Intervention Practice Sample Oral Examination: Intervention Case Presentation, Intervention Case Discussion, Ethical Vignette

2.1.8 Supervision

A successful internship candidate can identify the responsibilities of the supervisor and supervisee and can discuss the importance of supervision in the clinical training process. Candidates should demonstrate how they have used supervision to improve their knowledge, skills, and attitudes related to their professional practice and how they will utilize supervision in their internship to work toward readiness for independent practice. APA Standard: Demonstrate knowledge of supervision models and practices. (NOT ASSESSED IN THE CCE, BUT CANDIDATES WILL BE ASKED ABOUT THE ROLE OF SUPERVISION IN THEIR PROFESSIONAL DEVELOPMENT) Supervision competencies are demonstrated in the following CCE components: Written Examination: Written professional Statement, Assessment Practice Summary, Intervention Practice Summary Oral Examination: Candidate Presentation and Interview, Assessment Case Presentation, Assessment Case Discussion, Intervention Case Presentation, Intervention Case Discussion

2.1.9 Consultation and interprofessional/interdisciplinary skills

Health Service Psychology as a profession is becoming more integrated in health care and, as such, psychologists are tasked more and more with communicating across disciplines and professions. The ability to provide consultation to others and request and incorporate