Assessing Competencies in Couples and Family Therapy/counseling: A Call to the Profession
Perosa, Linda M., Perosa, Sandra L., Journal of Marital and Family Therapy
Psychometrically sound measures of family therapy competencies are necessary to assess the effectiveness of training on student performance. This article critiques the self-report and observer rating measures developed to date to assess the clinical skills of trainees in the individual and in the family therapy fields. Suggestions are made to foster future instrument development specifically designed for the field of couples and family therapy/counseling.
The recent formulation and adoption of core competencies (CC) by the American Association for Marriage and Family Therapy (AAMFT) and the resulting paradigm shift from input-oriented to outcome-based education (OBE) requires trainers and researchers to develop measures to assess the attitudes, knowledge, and clinical skills of students during and at the completion of training. This challenge for the field of couples and family therapy mirrors the process already begun in the individual counseling field with the early adoption of competencies by the American Counseling Association (ACA) and the American Psychological Association (APA). Measures developed by Counselor Educators and Psychologists have centered on supervisor ratings of student skills displayed during training. Other measures have been created to assess student beliefs about their clinical competence using individual and group counseling skills. In comparison, measures to assess student clinical competence with couples and families are only beginning to be formulated and empirically tested by family therapy educators. An important next step is for MFT researchers to draw upon the developments made in all of these related clinical fields and adopt, adapt, and revise some of these instruments in the pursuit of creating a viable MFT clinical competencies evaluation system.
The purpose of this article is to describe and critique the trainee self-report and supervisor observer rating scales of clinical competence that have been developed both in the individual and systems counseling fields in order to spur research and highlight future instrument development designed specifically for couples and family therapy. Measures of individual counseling skills are included because we believe that some individual counseling skills also are used by marriage and family therapists when working with individuals and form the basis of some couples and family therapy techniques that build upon individual skills. We acknowledge that not all family therapists agree with our assumptions, but our goal is to provide a comprehensive overview of important instruments in the hope that individuals can select questionnaires that are most relevant to their unique interests and needs. Measures of ratings by supervisors/trainers of counselor/therapist competence performing skills as well as trainee self-report evaluations of their use of skills effectively are included because of the close ties between the CC and OBE.
THE AAMFT CORE COMPETENCIES
The AAMFT (2004) has adopted 128 CC to be demonstrated by family therapists at the licensure stage of training. They have been defined as "a collection of the basic or minimum skills that each practitioner should possess in order to provide safe and effective care" (Graves, 2005, p. 15). The CC cover six areas: (a) admission to treatment; (b) clinical assessment and diagnosis; (c) treatment planning and case management; (d) therapeutic interventions; (e) legal issues, ethics, and standards; and (f) research and program evaluation. Between 9 and 25 more detailed competencies have been specified under each area. The CC also are categorized as demonstrating conceptual, perceptual, executive, professional, or evaluative skills. Conceptual skills reflect knowledge and understanding of course content taught in classes related to the above six areas; conceptual skills begin with the word understand (e.g., theories and techniques). Perceptual skills emphasize thought processes related to formulating hypotheses, integrating information about clients from a variety of sources, and distinguishing between content and process; perceptual competencies stress the words recognize, consider, or distinguishes between (e. …