UM/Sheppard Pratt Psychiatry Residency Program

Psychotherapy Competencies

Psychotherapy Competency Evaluation Form
General Competencies	Skill Not Apparent	Skill Emerging	Skill Apparent	Skill Highly Developed	Not Applicable
Boundaries:
Ability to establish and maintain a treatment frame (e.g., time, space, outside agencies/relationships, setting schedules and sticking to times)
Ability to establish and maintain a professional relationship.
Ability to understand and protect the patient from unnecessary intrusions into privacy and confidentiality.
Ability to handle financial arrangements with patient in a manner appropriate to the treatment context.
Therapeutic Alliance:
Ability to establish rapport.
Ability to understand and develop a therapeutic alliance with the patient.
Ability to recognize a variety of forms of therapeutic alliances including negativistic ones.
Ability to enable the patient to actively participate in the treatment.
Ability to recognize and attempt to repair disturbances in the alliance.
Ability to establish a treatment focus.
Ability to provide a holding environment.
Listening:
Ability to listen non-judgementally and with openness.
Ability to facilitate the patient talking openly and freely.
Emotions:
Ability to recognize and specifically describe affects.
Ability to tolerate direct expressions of hostility, affection, sexuality and other powerful emotions.
Ability to recognize and describe (to the supervisor) one's own affective response to the patient.
Ability to recognize and tolerate one's uncertainties as a trainee in psychotherapy.
Understanding:
Ability to empathize with the patient's feeling states.
Ability to convey empathic understanding.
Use of Supervision
Ability to establish an educational alliance with the supervisor.
Ability to incorporate material discussed in supervision into the psychotherapy.
Resistances/Defenses:
Ability to identify problems in collaborating with the treatment/therapist.
Ability to recognize defenses in clinical phenomena.
Ability to recognize obstacles to change and an understanding of possible ways to address them.
Techniques of Intervention:
Ability to maintain focus in treatment when appropriate.
Ability to confront
Ability to assess readiness for and manage termination from treatment.
Ability to assess the patient's readiness for certain interventions.
Ability to assess the patient's response to certain interventions.
Competencies for Psychodynamic Psychotherapy:
Ability to identify and effectively begin treatment with a suitable patient for psychodynamic psychotherapy.
Ability to identify aspects of an of an ongoing case in terms of theories of drive and defense, internalized object relationships, and consideration of the patient's self experience.
Ability to link present to past as demonstrated by understanding the patient's present pattern of thought, feeling, action and relationship in terms of his or her past personal experience.
Ability to identify and respond appropriately and flexibly to a variety of defenses in the clinical setting.
Ability to effectively confront, clarify and interpret previously preconscious and unconscious material in the therapeutic setting.
Ability to facilitate discovery of latent meaning of clinical material (e.g. dreams, associations, transference material. etc.)
Ability to recognize and make therapeutic use of transference.
Ability to recognize, contain and make therapeutic use of countertransference
Ability to maintain a therapeutic alliance in the face of transference distortions, using concepts of neutrality, abstinence, empathy and support in an appropriate manner.
Ability to manage termination issues within the context of a psychodynamic psychotherapy.
Competencies for Brief and Crisis Intervention
Ability to rapidly establish a therapeutic alliance with the patient
Ability to identify the precipitating event (stressor) and the patient's reactions to it
Ability to identify a history of the patient's usual coping mechanisms
Ability to facilitate the patient's expression of emotions
Ability to normalize the patient's emotional reactions to the event in the setting of crisis, when appropriate.
Ability to focus the therapy on the precipitating crisis
Ability to provide support to the patient
Ability to actively listen to the patient to enhance understanding
Ability to provide psychoeducation about the crisis.
Ability to help the patient develop adaptive coping mechanisms and identify additional sources of support
Ability to establish achievable therapeutic goals with the patient
Ability to rapidly obtain collateral information where appropriate.
Knowledge of community resources and ability to make timely and safe dispositions.
Competencies for Combined Psychopharmacology and Psychotherapy:
Ability to integrate biological and psychological aspects of a patient's history.
Ability to provide psychoeducation about psychiatric illness and the risks/benefits of commonly prescribed psychotropics.
Ability to understand how the meaning of a medication to a patient can significantly impact on its efficacy and learn how to explore what medications mean to a patient.
Ability to use the placebo effect to more successfully prescribe medications.
Ability to demonstrate a basic understanding of diagnosis-specific psychotherapy and medication management.
Have a basic understanding of medico-legal and psychotherapeutic issues in the context of one person prescribing medication and another person providing psychotherapy: confidentiality, informed consent and collaboration.
Ability to use the concepts of transference and counter-transference in prescribing medications in a therapeutic manner.
Recognize the ways prescribing medication can enhance or hinder psychotherapy and ways that psychotherapy can enhance or hinder medication management.
Identify psychological aspects of non-adherence.
Competencies for Cognitive/Behavioral Psychotherapy:
Ability to state cognitive model.
Ability to socialize patient into cognitive model.
Ability to use structured cognitive behavioral model including mood check, bridging to prior session, agenda setting, and review of homework, capsule summaries and patient feedback.
Ability to identify and elicit automatic thoughts.
Ability to state and employ knowledge of cognitive triad of depression.
Ability to use Dysfunctional Thought Records as a tool in therapy
Ability to use Activity Scheduling as a tool in therapy.
Ability to identify common cognitive errors in thinking.
Ability to use behavioral techniques as a tool in therapy.
Ability to plan booster sessions, follow-up and self help sessions appropriately with patients when terminating active therapy.
Competencies in Supportive Psychotherapy:
Ability to assess regressive and adaptive shifts in ego functioning
Ability to make interventions specifically in support of a patient's ego functions, including defensive operations.
Ability to deliberately take a non-interpretative stance in relation to a defensive operation in a patient.
Ability to recognize internal conflict and help a patient contain it without an emphasis on interpretation.
Ability to be directive: give advice, set limits and educate when appropriate with a patient.
Ability to make appropriate manipulations of the environment or take action on behalf of a patient.

This page was last updated on: December 5, 2007.

For more information, call the University Physicians Consultation and Referral Service at 1-800-492-5538 (patients) or 1-800-373-4111 (physicians).