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The Condensed MFT Core Competencies: A Streamlined Approach for Measuring Student and Supervisee Learning Using the MFT Core Competencies
Abstract
In this article, the authors present a condensed version of the Marriage and Family Therapy Core Competencies (MFT‐CC), collapsing the original 128 MFT‐CC to 16 using a qualitative research method. Educators, supervisors, and researchers can more easily and efficiently use the condensed MFT‐CC to measure student and supervisee learning for accreditation and training. The 16 Condensed MFT‐CC are mapped to the original MFT‐CC, COAMFTE's Version 12 Foundational Curriculum Areas and the Association for Marital and Family Therapy Regulatory Boards 6 domains upon which the national exam is predicated.
... MFT Condensed Core Competencies. The MFT Condensed Core Competencies were created by collapsing the original 128 MFT-CCs into 16 distinct categories with the intent to make the Core Competencies easier to use by researchers, supervisors, and trainees without substantially changing the essence of any of the competencies (Northey & Gehart, 2019). The 16 categories include the following: 1) MFT Theories (application of systems concepts, theories, and techniques; 2) Human and Family Development (understanding of principles related to areas such as human development, family development, human sexuality, gender development, and trauma and their implications on treatment); 3) Cultural and Contextual Awareness (ability to assess and provide services with awareness of contextual dynamics such as gender, age, socioeconomic status, race/ethnicity, culture, sexual orientation, larger systems, etc.); 4) Selecting Treatment Models (ability to recognize the strengths and limitations of various MFT models and adapt/integrate models to fit client needs); 5) Therapeutic Relationship (ability to establish and maintain effective therapeutic alliances with clients and recognizing when to involve outside individuals or systems); 6) Diagnosis (ability to assess and diagnose behavioral and relational health concerns utilizing current models); 7) Relational Assessment (ability to assess interpersonal patterns, family history, social positions using tools such as a genogram, systemic interviewing techniques, etc to provide systematic treatment and develop relational hypotheses); 8) Treatment Planning (ability to develop measurable outcomes, treatment goals/plans, and to provide appropriate plans and aftercare); 9) Treatment, Intervention, and Practice, (ability to provide systemic interventions consistent with therapeutic model, evidence based, contextual dynamics, setting, and treatment plan); 10) Safety Planning (ability to assess for and develop safety plans related to substance abuse, maltreatment of child-ren/vulnerable adults, violence, suicidal ideation, and potential danger to self or others); 11) Collaboration (ability to work with stakeholders such as family members, significant persons, and other professionals to empower clients to navigate systems of care); 12) Law and Ethics (ability to practice within ethical standards and laws/regulations); 13) Supervision and Consultation (ability to contribute to supervision and consultation); 14) Self-of-Therapist (ability to monitor personal reactions and their impact on clinical outcomes); 15) Measure Effectiveness (ability to measure the effectiveness of one's clinician practice using outcomes measures and client feedback); and 16) Research (ability to use current research to inform clinical practice) (Northey & Gehart, 2019). ...
... The MFT Condensed Core Competencies were created by collapsing the original 128 MFT-CCs into 16 distinct categories with the intent to make the Core Competencies easier to use by researchers, supervisors, and trainees without substantially changing the essence of any of the competencies (Northey & Gehart, 2019). The 16 categories include the following: 1) MFT Theories (application of systems concepts, theories, and techniques; 2) Human and Family Development (understanding of principles related to areas such as human development, family development, human sexuality, gender development, and trauma and their implications on treatment); 3) Cultural and Contextual Awareness (ability to assess and provide services with awareness of contextual dynamics such as gender, age, socioeconomic status, race/ethnicity, culture, sexual orientation, larger systems, etc.); 4) Selecting Treatment Models (ability to recognize the strengths and limitations of various MFT models and adapt/integrate models to fit client needs); 5) Therapeutic Relationship (ability to establish and maintain effective therapeutic alliances with clients and recognizing when to involve outside individuals or systems); 6) Diagnosis (ability to assess and diagnose behavioral and relational health concerns utilizing current models); 7) Relational Assessment (ability to assess interpersonal patterns, family history, social positions using tools such as a genogram, systemic interviewing techniques, etc to provide systematic treatment and develop relational hypotheses); 8) Treatment Planning (ability to develop measurable outcomes, treatment goals/plans, and to provide appropriate plans and aftercare); 9) Treatment, Intervention, and Practice, (ability to provide systemic interventions consistent with therapeutic model, evidence based, contextual dynamics, setting, and treatment plan); 10) Safety Planning (ability to assess for and develop safety plans related to substance abuse, maltreatment of child-ren/vulnerable adults, violence, suicidal ideation, and potential danger to self or others); 11) Collaboration (ability to work with stakeholders such as family members, significant persons, and other professionals to empower clients to navigate systems of care); 12) Law and Ethics (ability to practice within ethical standards and laws/regulations); 13) Supervision and Consultation (ability to contribute to supervision and consultation); 14) Self-of-Therapist (ability to monitor personal reactions and their impact on clinical outcomes); 15) Measure Effectiveness (ability to measure the effectiveness of one's clinician practice using outcomes measures and client feedback); and 16) Research (ability to use current research to inform clinical practice) (Northey & Gehart, 2019). The condensed core competencies were used as the coding framework for this study. ...
... Overall, the participants reported that they had a positive experience in Campus Connections and their participation contributed to their professional development in unique and meaningful ways. Interviews were coded both based on the MFT Condensed Core Competencies (Northey & Gehart, 2019) and for new codes which emerged throughout the coding process. ...
... The resulting list included 128 competencies with which C/MFT education and programs worked to align their curriculum to ensure those skills were included in some aspect of the C/MFT training. This list was later distilled into 16 categories that reflect the content of the original 128, yet are better organized to fit the paperwork for COAMFTE-accredited programs, training, and professional regulation (Northey & Gehart, 2020). ...
... Theoretical discussions and forages into research are taking place, yet individual C/MFT training programs have been granted flexibility in determining which, if any, of the core competencies to adopt. As can also be expected, the limitations of incorporating telebehavioral health competencies into the C/MFT core competencies are impacted by the fluid nature of competencies in education (Northey & Gehart, 2020). Serious decisions lie ahead. ...
... The integration of these competencies is a relatively easy way for COAMFTE training programs to move toward the demonstration of telebehavioral health competence without reinventing the wheel or introducing drastic changes to their programs. Fortunately, telebehavioral health competencies already align with C/MFT core competencies (Nelson et al., 2007;Northey & Gehart, 2020) as well as with the basic skills (Nelson & Johnson, 1999). Especially in light of COVID-19, readers are encouraged to participate in the development of more evidence-based, competency-based protocols for C/MFT telehealth. ...
During the coronavirus pandemic, many behavioral health professionals providing psychotherapeutic services, including couple/marriage and family therapists (C/MFTs), quickly changed from providing in-person services to telebehavioral health (TBH) services, with specific reliance on teleconferencing. Many therapists were thrust into telehealth with minimal or no prior telebehavioral health experience, education, or training. Although TBH services have been shown to be effective and efficient with mental health and substance abuse problems, the teaching and learning of telebehavioral competencies have generally not been included in the formal education and training received by C/MFTs. This article presents an existing interprofessional telebehavioral health competencies framework not before published in C/MFT journals. This article will also demonstrate how those competencies are applicable to the education, training, and practice of telebehavioral health by C/MFTs. Implications for educational, service, and regulatory organizations are presented.
... The AAMFT supported the development of an extensive set of core competencies (CC) for the practice of marriage and family therapy (MFT; AAMFT, 2004;Nelson et al., 2007;Northey & Gehart, 2019;Appendix B). Although the list is a daunting number of competencies, it is organized by domains such as "admission to treatment," and subdomains such as "conceptual," "perceptual," and "executive" skills. ...
... Although the list is a daunting number of competencies, it is organized by domains such as "admission to treatment," and subdomains such as "conceptual," "perceptual," and "executive" skills. Northey and Gehart (2019) have condensed the MFT Core Competencies into a more manageable list while preserving their essence and intent. The competencies serve as a guide for graduate training and for postgraduate supervision with the aim of mastery of each competency by the time a trainee is ready to be licensed for independent practice. ...
... Consider the process of answering this question: applicability over time and across contexts, these competencies do not name specifics, such as essential theories or areas of research. Similarly, the condensed version of these competencies proposed by Northey and Gehart (2019) does not list specific theories or areas of knowledge to increase its applicability. Similarly, the MFT accreditation standards (COAMFTE, 2023, Version 12.5) summarizes the required curriculum in nine broad areas of knowledge that does not define specific theories, practices, research, or areas of knowledge. ...
This article describes the findings of a study that explored potential factors that influence the pass rate for those taking marriage and family therapy (MFT) licensing exams, both the national and California exams. An online, national survey was conducted to determine factors associated with passing the MFT licensing exams. The survey included measures of test anxiety, coping strategies, perceived stress, and experience of discrimination. The demographic results included patterns of racial and age disparities similar to those reported by the Association of Social Work Boards (2022), especially for Black respondents. Specific and readily implemented recommendations for making the current exams more equitable include (a) changing the phrasing of questions, (b) clarifying and reducing the scope of the content, (c) reducing the number of questions during the 4-hour period, and (d) ensuring adequate accommodations for disabilities.
... Family therapists have training and experience in the systemic conceptualization of individual complaints as well as systemic and relational interventions (Section 5.F.8-12;CACREP, 2024;Northey & Gehart, 2020). This training and skills have increased support for including MFTs in schools (American Association for Marriage and Family Therapy, 2022) and even to create a school certification for MFT students (Laundy et al., 2011) or specialization in school-based family therapy (Kern et al., 2022). ...
Family therapy in schools is gaining increasing focus in both education and counseling fields. To explore existing literature on family therapy in schools, this scoping review examines and synthesizes key concepts of peer-reviewed literature on family therapy or family-focused interventions. Empirical and conceptual articles were included if the article included behavioral or discipline-related concerns and involved family therapy or family-focused interventions within the context of K-12 education provided by clinical mental health counselors (CMHC) or marriage and family therapists (MFT). This PRISMA scoping review synthesizes themes including the school and behavioral contexts, the target population and sample characteristics, the interventions provided, and the outcomes assessed. Implications for this review include serving as a foundation for future research, such as a systematic review, informing family therapy program development within schools, and informing training objectives for counselor educators.
... The need for this kind of cultural understanding extends to an awareness and ability to work with the impact of marginalization for CD couples (de Brito Silva et al., 2021). Various professional organizations have documented cultural competencies or how to attend to culture in counseling work (e.g., Northey & Gehart, 2019;Ratts et al., 2016). Furthermore, it is an ethical imperative that therapists be culturally aware and competent (Seedall et al., 2014). ...
Emotionally Focused Therapy (EFT) is an evidence-based approach to working with couple distress. Similar to much of the research about the efficacy and effectiveness of couple therapy approaches, EFT research samples consist of white, heterosexual couples or research studies do not report further identifying information. In this paper, we report on 23 interviews of minimally trained EFT therapists to explore more in-depth experiences with cultural adaptations. Following a thematic analysis of the interviews, we identified five themes that include: therapist factors that contribute to work with diverse populations; model factors that provide a mechanism to engage across cultures; specific strategies therapists have used; training experiences; and challenges that research participants reported.
... Overall, faculty and students have responded positively to the core competencies and believe that gains are made both in program, and post-graduation as a practitioner. Faculty and students perceive the competencies as effective, and believe they adequately promote skill development, increase confidence, and lay a foundation of knowledge that will support post-degree work (Northey & Gehart, 2020). Future research should focus on other factors that may influence perceived competency such as personality, work setting and job satisfaction, general life experience, or family and/or social support. ...
Graduate level marriage and family therapy programs prepare practitioners to provide family therapy. Research is lacking on the role program leadership plays in student professional development. This pilot study explored differences in program leadership styles and student perceptions of competency. It used survey data from the Perception of Competency Scale (PCS), a self-rating competency assessment, and the Vannsimpco Leadership Survey (VLS), which determines leadership styles among nine modes of practice. Results determined that students had varying perceptions of leadership style, preferred transformational leaders, and that they perceived themselves as having adequate knowledge and skill to practice.
... However, emergence is the outcome of lower-order CAS states, that are transformed into higher-order irreducible CAS states (Turner & Baker, 2019 West et al., 2013). As such, the present study contributed to Northey and Gehart's (2020) research suggesting the development of "usable" education and research competencies that align the "practice within state, federal, and provincial laws/regulations and professional ethical standards" (p. 56). ...
Abstract
A trend exists among marriage and family therapy pre-clinical fellows to complete their supervised clinical experience in independent practice rather than in a community agency. However, once in independent practice, it is unclear if marriage and family therapists have the business knowledge and skills necessary to manage the business of clinical practice. This descriptive comparative study with quantitative methods addressed the following research problem: Business knowledge and skills acquisition are not required parts of marriage and family therapy training; thus, marriage and family therapists may not be prepared to manage the business aspect of independent practice. The purpose of this study was to examine and compare the differences in perceptions of preparedness between marriage and family therapy pre- and clinical fellows, at the time of graduation and survey, to manage the business of independent practice. The study’s conceptual framework, complex adaptive systems, was used to manage the complexity of the study’s problem. A 33-item online measure was field tested and disseminated to 562 Washington State marriage and family therapists licensed between 2007–2019. The final sample consisted of 93 participants (76 Licensed Marriage and Family Therapy Clinical Fellows and 17 Licensed Marriage and Family Therapy Pre-Clinical Fellows). Descriptive and inferential statistics were used to analyze the data, and analysis of covariance was conducted to partial out the effects of the covariate (self-efficacy beliefs) on the dependent variable (perceptions of clinical business preparedness). The research findings revealed no statistically significant differences between the two levels of the independent variable (marriage and family therapy experience). Thus, the results of the analysis failed to reject the null hypothesis.
Recommendations for practice included utilization by marriage and family therapist pre- and clinical fellows of the study’s survey scales as a framework for the development of business
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competencies. Recommendations for future research included replication of the study with a cohort (time-series) design; examination of marriage and family therapists’ perceptions of clinical business preparedness and the actual survival rates of the therapists’ respective clinical practices; and utilization of mediation analysis to explain how business knowledge acquisition and skills development in marriage and family therapy education are mediated by self-efficacy beliefs.
This study contributed to existing marriage and family therapy theory, education, supervisor training and clinical practice, and established a starting point for further research into the need for business core competencies in marriage and family therapy education.
This qualitative study explored couple/marriage and family therapists’ experiences following ethnic-racial socialization conversations with Latino families in therapy. Semi-structured interviews with therapists (n = 20) were conducted. A rigorous thematic analysis revealed how multifaceted contextual influences shaped participants’ ongoing professional development, emphasizing growth from experiences and advocacy for justice. The results provide recommendations for enhancing inclusive practices among therapists working with Latino families, leveraging awareness of exposures and interactions across contexts.
This article describes the findings of a study that explored potential factors that influence the pass rate for those taking marriage and family therapy (MFT) licensing exams, both the national and California exams. An online, national survey was conducted to determine factors associated with passing the MFT licensing exams. The survey included measures of test anxiety, coping strategies, perceived stress, and experience of discrimination. The demographic results included patterns of racial and age disparities similar to those reported by the Association of Social Work Boards (2022), especially for Black respondents. Specific and readily implemented recommendations for making the current exams more equitable include (a) changing the phrasing of questions, (b) clarifying and reducing the scope of the content, (c) reducing the number of questions during the 4-hour period, and (d) ensuring adequate accommodations for disabilities.
The Assessment of Marriage, Couples, and Family Counseling Competencies (AMCFCC) is an evaluation tool designed to measure marriage, couples, and family counseling trainees’ (MCF-CIT) learning outcomes in essential counseling and specialized competencies. The AMCFCC was developed to align with the Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards, as well as the American Association for Marriage and Family Therapy Marriage and Family Therapy Core Competencies (MFT-CC). In this manuscript, we (a) present the need for the development of an AMCFCC; (b) introduce the AMCFCC; and (c) offer implications for preparation programs using the AMCFCC and areas for future research.
Licensed Clinical Social Workers (LCSWs) have been integrating technology into psychotherapy practice for at least two decades, but the COVID-19 pandemic dramatically shifted the primary method of service delivery for diagnostic assessment and therapy to telebehavioral health. By developing telebehavioral health competencies, the 250,000 + LCSWs in the US can ensure and enhance the quality of care both during and after the COVID public health emergency (PHE). This article applies an evidence- and consensus-based, interprofessional telebehavioral health (TBH) competency framework to the field of social work. This framework was developed by the Coalition for Technology in Behavioral Science (CTiBS), initially published in 2017. It has seven competency domains: (1) clinical evaluation and care; (2) virtual environment and telepresence; (3) technology; (4) legal and regulatory issues; (5) evidence-based and ethical practice (comprised of Standards and Guidelines and Social Media); (6) mobile health and apps; and (7) telepractice development. The framework outlines three competency levels (novice, proficient, and authority) covering 49 specific objectives and 146 measurable competencies or practices. The TBH competencies support existing in-person clinical practices and are intended for trainees and practitioners who are implementing TBH in practice. This competency framework can also be used to integrate clinical social work professional development, research, and training. Additionally, considerations for other behavioral health professions regarding licensure, certification, and policy may apply to clinical social work. Future research is needed on implementation and evaluation of the competencies.
The turn of the century saw a shift from input-based to outcome-based education in Marriage and Family Therapy (MFT) training. An attempt was also made to establish core competencies that practitioners of MFT should attain to provide effective client care. These developments had a significant impact on version 11.0 and 12.0 of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) Accreditation Standards. Since then, MFT educators have used these standards and guidelines to transition their programs from input-based to competency-based education. The MFT program at a West Coast University was the first COAMFTE accredited program to propose an alternative competency model requiring the completion of 300 direct client contact hours instead of 500 h for all students in the program, when it went through the process of reaccreditation in 2019. The program was granted renewal of accreditation in May 2020. Since then, version 12.5 of the COAMFTE Accreditation Standards have been released and this University’s competency model is aligned with these new standards. This article provides an overview of the competency model used by the MFT program at this University which can serve as an example for other MFT programs. Trends and future directions in competency-based MFT education are also discussed.
This paper describes the development of a scale for measuring systemic supervision which is called the Systemic Supervision Rating Scale (the 3D‐SSRS). This scale was developed through a thematic synthesis of the systemic supervision literature, which included 137 papers on the subject. The scale was then subjected to a face validity investigation via a series of qualitative focus groups. These groups included both supervisors of supervision and students on an AFT Accredited Supervision training. Focus groups were held at the beginning and at the end of the course to understand how useful the 3D‐SSRS was to supervision practice. The 3D‐SSRS uses a seven‐point scale to rate supervision practice and prioritises qualitative comments in 11 dimensions, including the supervisory relationship, context of supervision, developmental stage of supervisee, development of systemic skills and thinking, and attention to power and difference.
Practitioner points
• Systemic supervision draws on knowledges and skills unique to systemic practice within specific contexts.
• A new Systemic Supervision Rating Scale (the 3D‐SSRS) has been developed for use in clinical and training contexts of supervision.
• Initial investigations into the usefulness and face validity of the scale find it able to capture many of the unique aspects of systemic supervisory practice.
• More research is needed into what makes for effective live supervision, perhaps unique to systemic supervisory practice, and supervision provided to groups.
Supervision has long been considered essential to developing effective mental health practice, especially among COAMFTE accredited training programs. But with telemental health rapidly being accepted as a standard treatment medium for couple and family therapy, there is little guidance about how to supervise clinicians who are engaged in telemental health practice. This paper presents an important step toward increasing the effectiveness of the supervision of therapists who are delivering relational therapies online through the identification of relational competencies unique to this delivery medium. These competencies have been adopted and integrated into a COAMFTE accredited master's degree program that has been providing training in telemental health since 2008. The competencies are described, and supervision strategies that can be utilized and developmentally assessed throughout the program will be detailed.
In response to COVID‐19, a couple and family therapy (CFT) graduate training program integrated a teaming therapy model with virtual technology using mixed‐reality simulation software. By utilizing teaming therapy‐‐a model with strong roots in systemic theory and practice‐‐ combined with cutting‐edge simulation technology, this distance learning modality provides distinctly relational therapy supervision and training for students at a time when their internships sites are struggling to offer remote clinical services due to the pandemic. This integrative framework offers a high degree of both realism and safety, allowing experiential learning to be appropriately scaffolded for optimum creativity and engagement in an online setting. This paper describes the conceptual, systemic basis for the learning modality, steps for implementation, benefits of the model, and the authors plan for further evaluation.
Objective:
Asynchronous technologies such as mobile health, e-mail, e-consult, and social media are being added to in-person and synchronous service delivery. To ensure quality care, clinicians need skills, knowledge, and attitudes related to technology that can be measured. This study sought out competencies for asynchronous technologies and/or an approach to define them.
Methods:
This 6-stage scoping review of Pubmed/Medline, APA PsycNET, PsycINFO and other databases was based on a broad research question, "What skills are needed for clinicians and trainees to provide quality care using asynchronous technologies for children and adolescents, and how can they be made measurable to implement, teach and evaluate?" The search focused on key words in 4 concept areas: (a) competencies; (b) asynchronous technology; (c) synchronous telepsychiatry, telebehavioral or telemental health; and (d) clinical. The screeners reviewed the full-text articles based on inclusion (mesh of the key words) and exclusion criteria.
Results:
From a total of 5,877 potential references, 2 authors found 509 eligible for full text review and found 110 articles directly relevant to the concepts. Clinical studies discuss clinical, technical and administrative workflow rather than competencies, though behavioral health professions' position statements advise on adapting care and training. Existing technology competencies for video, social media, mobile health, and other asynchronous technologies were used to build a framework. Training, faculty development, and organizational suggestions are suggested.
Conclusions:
Research is needed on how to implement and evaluate asynchronous competencies to ensure quality clinical care and training, which is a paradigm shift for participants. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Online telesupervision (OTS) is synchronous (real-time) audio and video interactions between a supervisor and a clinician who are not in the same physical location. The COVID-19 pandemic created an abrupt pivot to OTS, requiring systemic supervisors and clinicians to adopt and utilize technologies which were unfamiliar to many. To facilitate the effective adoption and implementation of OTS we draw attention to three distinct competencies critical to the effective use of OTS: technological, contextual, and relational. These competencies are in no way exhaustive but lay the ground work for systemic supervisors to engage and connect with supervisees using video conferencing technology. In addition to the competencies, specific techniques and strategies are suggested to assist supervisors hone their skills in OTS and subsequently improve the quality and effectiveness of supervision in a virtual environment.
Purpose:
There have been critiques that competency training, which defines the roles of a physician by simple, discrete tasks or measurable competencies, can cause students to compartmentalize and focus mainly on being assessed without understanding how the interconnected competencies help shape their role as future physicians. Losing the meaning and interaction of competencies can result in a focus on "doing the work of a physician" rather than identity formation and "being a physician." This study aims to understand how competency-based education impacts the development of a medical student's identity.
Methods:
Three ceramic models representing three core competencies Medical Knowledge, Patient Care, and Professionalism were used as sensitizing objects, while medical students reflected on the impact of competency-based education on identity formation. Qualitative analysis was used to identify common themes.
Results:
Students across all four years of medical school related to the 'Professionalism' competency domain (50%). They reflected that 'being an empathetic physician' was the most important competency. Overall, students agreed that competency-based education played a significant role in the formation of their identity. Some students reflected on having difficulty in visualizing the interconnectedness between competencies, while others did not. Students reported that the assessment structure deemphasized Professionalism as a competency.
Conclusion:
Students perceive Professionalism as a competency that impacts their identity formation in the social role of "being a doctor," albeit a competency they are less likely to be assessed on. High-stakes exams, including the USMLE Clinical Skills Exam, promote this perception.
Education and training in many professions, including clinical psychology, has shifted toward emphasis on demonstrations of competency in particular areas of knowledge, skill, and attitudes. In this regard, incorporation of standardized patients (SPs) into training and assessment provides unique advantages and challenges. This article describes a newly developed 3-phase evaluation of clinical competency, the Comprehensive Clinical Competency Examination (CCCE), that employs an SP and takes place across a 6-week period in the students’ 3rd year of doctoral training. In Phase I, graduate student examinees view a video recording of an intake interview with the SP and then develop an applied clinical diagnosis, working patient conceptualization, and assessment/treatment plan for the SP while documenting their use of accepted principles of evidence-based practice. In Phase II, the examinees conduct a simulated 5th therapy session, with the same SP from Phase I, that must demonstrate consistency with their diagnosis and treatment plan from Phase I. The session is video recorded for later faculty evaluation. Phase III requires the students to defend the work they did in Phases I and II before a faculty committee. Faculty have generally been impressed with student performance, perhaps surprisingly so, and successful students have experienced increased confidence and self-efficacy regarding their clinical skills.
Competency-based education (CBE) is a model that guides the educational process toward acquisition of the knowledge, skills, and attitudes needed for effective professional practice in service of the public. Increasingly adopted by medicine and other professions, the CBE model involves establishing competency goals, developing curricula and other experiences designed to help students reach these goals, integrating instruction in the full range of competencies throughout the educational sequence, guiding and evaluating student learning through ongoing assessment of competence, and revising courses and activities in light of student competence outcomes. Included in a full CBE model are attention to unintended learning outcomes (the “hidden curriculum”) and to areas not covered (the “null curriculum”), and efforts to promote education based on individual student learning trajectories as opposed to set courses or number of hours. Within professional psychology, we suggest that APA accreditation is aligned with a version of the CBE model; and significant progress has been made in identifying and measuring professional competencies. However, these are merely tools that can help training programs implement a broader CBE educational model that we contend has not been widely realized in professional psychology. This article reviews CBE and its application in medicine, discusses the benefits and criticisms of CBE, and considers what a fuller realization of CBE would look like in professional psychology training programs, including graduate programs, practicum, internships, and postdoctoral settings.
The Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) requires that accredited programs evaluate trainees' clinical skills at various times during trainees' programs. The Commission does not attempt, however, to describe for programs either the nature of the skills nor how they are to be evaluated, leaving this to the programs to create. This paper describes the development and uses of the Basic Skills Evaluation Device (BSED). Using a published list of skills (Figley & Nelson, 1989), data from the literature, and data collected from COAMFTE accredited and candidacy programs, the authors and their colleagues developed a device for supervisors to use in evaluating beginning family therapists. Data regarding the reliability of the device are presented, along with limitations and suggestions for various ways of using the device.
Competency-based training approaches are being used more in healthcare to guide curriculum content and ensure accountability and outcomes in the educational process. This article provides an overview of the state of competency development in the field of behavioral health. Specifically, it identifies the groups and organizations that have conducted and supported this work, summarizes their progress in defining and assessing competencies, and discusses both the obstacles and future directions for such initiatives. A major purpose of this article is to provide a compendium of current competency efforts so that these might inform and enhance ongoing competency development in the varied behavioral health disciplines and specialties. These varied resources may also be useful in identifying the core competencies that are common to the multiple disciplines and specialties.
In response to a series of national policy reports regarding what has been termed the "quality chasm" in health and mental health care in the United States, in January 2003, the American Association for Marriage and Family Therapy convened a task force to develop core competencies (CC) for the practice of marriage and family therapy (MFT). The task force also was responding to a call for outcome-based education and for the need to answer questions about what marriage and family therapists do. Development of the CC moves the field of MFT into a leading-edge position in mental health. This article describes the development of the CC, outcomes of the development process for the competencies, and recommendations for their continued development and implementation.
Family therapy is moving increasingly toward evidence-based practice and competency-based training. This article explores what might seem to be an unlikely link between social constructionist supervision, which is based on dialogic and fluid processes of meaning-making, and the increasing reliance on discrete core competencies in the education and training of family therapists. We propose an alternate approach to competencies for supervision with therapists in training that, among other things, invites accountability and provides evaluative props. The approach we propose is based on a set of orientations that we hope reflect the dialogic and contextual nature of social constructionist practice and supervision. These orientations consist of reflexivity and attention to power, fostering polyphony and generativity, collaborative stance, and focus on client resourcefulness. Ideas and questions for supervisors and therapists in training to address the orientations are articulated.
In an attempt to identify needed mental health skills, many professional organizations have or are in the process of establishing core competency standards for their professions. The AAMFT identified 128 core competencies for the independent practice of MFT. The aim of this study was to learn the opinions of AAMFT Approved Supervisors as to how well prepared postgraduate trainees are when compared to the core competencies. One hundred thirty-five AAMFT Approved Supervisors provided their perspectives on (a) which competencies are most commonly learned in MFT graduate programs, (b) how well the graduates have mastered these competencies, and (c) the level to which the supervisors need the competencies to be mastered prior to entering advanced training. Results suggest that a gap exists between the level of mastery that the postgraduate trainees exhibit and the level desired by supervisors. Implications are suggested for closing this gap.
The MFT core competencies and latest COAMFTE accreditation standards usher in a new paradigm for MFT education. This transition necessitates not only measuring student mastery of competencies but also, more importantly, adopting a contemporary pedagogical model. This article provides an overview of the changes, a review of parallel trends in other health professions, definitions of learning-centered and outcome-based pedagogy, and a detailed description of a systematic approach for developing a competency-based curriculum, including a list of educator competencies necessary for successful implementation.
The field of marriage and family therapy (MFT) has recently engaged in the process of defining core competencies for the profession. Many MFT training programs are adapting their curriculum to develop more competency-based training strategies. The Objective Structured Clinical Examination (OSCE) is widely used in the medical profession to assess clinical competence. These examinations involve using simulated clinical situations as a tool in conducting summative evaluations of trainee competence. This article describes an adaptation of the OSCE procedures for competency-based training of MFT students. Instead of using the procedures as a summative examination as is typical in medical education, this article proposes how to use them as formative exercises in the development of student competence. The development of the OSCE is discussed, including "blueprinting," focused competencies, procedures, and feedback protocols. The article concludes with suggestions of how to continue the development of the OSCE for evaluation in MFT education.
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.
There is a growing movement to define competency within the field of marriage and family therapy (MFT), particularly with respect to the training of practitioners and the evaluation of clinical practice. Efforts to define competency, however, transcend the practice of MFT and much can be learned from the experiences of other disciplines. Professions such as education, law, and medicine have made strides toward addressing the complex issue of competency standards in their respective fields. This article describes some ways in which the issue of competency has been approached in other professions, as well as some common dilemmas posed by adopting a competency-based orientation, to shed light on the process of defining competency in MFT. Moreover, this article identifies some of the more useful conceptualizations, modes of pedagogy, and evaluative practices found in other professions.
The popularity of the co-dependency concept has grown rapidly in the alcoholism treatment field. At the same time, empirical findings gained through scientific research have raised questions concerning the validity of the concept. This paper discusses some of the problems that are created by the disease model of co-dependency and highlights some alternative views that may be more appropriate. It is argued that the field's understanding of the alcoholic/spouse relationship and its ability to help the spouse are limited unless other conceptualizations are seriously considered.
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CFT faculty speak: The MFT Core Competency and Outcome based education six years later. Poster presented at te 69th Annual Conference of the American Association for Marriage and Family Therapy
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Teaching Competencies Track: Developing and Implementing Supervision Assessment Devices. Workshop presented at the 64th Annual Conference of the American Association for Marriage and Family Therapy
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