Linda Forrest

Trainee Impairment A Review of Identification, Remediation, Dismissal, and Legal Issues

This article reviews the professional literature on the topic of evaluating the competence of trainees in professional psychology training programs including program policies, procedures, and actual practice for identifying, remediating, and, in extreme cases, dismissing trainees who are judged unable to provide competent, professional care. This review covers the literature on the following major issues related to trainee performance: (a) problems with definitions of impairment, (b) established professional standards for supervision and evaluation of trainees based on accreditation guidelines and ethical standards, (c) methodological critiques of empirical studies on trainee impairment, (d) issues related to evaluation and identification of trainees who are making inadequate progress toward professional competence, (e) issues related to remediation, (f) dismissal and due process, and (g) relevant legal cases and considerations. The review of these topics provides the platform for an extensive list of recommendations directed toward faculty and supervisors responsible for professional psychology training programs and internships.

Recognizing, assessing, and intervening with problems of professional competence.

THIS ARTICLE WAS AUTHORED by members of a workgroup on students with competence problems associated with the Council of Chairs of Training Councils, which is affiliated with the Education Directorate of the American Psychological Association. Nadine J. Kaslow and Nancy J. Rubin took primary responsibility for crafting this manuscript. Nadine J. Kaslow is the workgroup chair. To the extent possible, the remaining authors are listed in the order of their contributions: Nadine J. Kaslow, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine; Nancy J. Rubin, Department of Psychiatry and Behavioral Medicine, University of Alabama School of Medicine—Tuscaloosa Campus; Linda Forrest, Counseling Psychology and Human Services, University of Oregon; Nancy S. Elman, Psychology in Education, University of Pittsburgh; Barbara A. Van Horne, Department of Psychology, University of Wisconsin-Madison; Sue C. Jacobs, Applied Health and Educational Psychology, Oklahoma State University; Stephen K. Huprich, Department of Psychology, Eastern Michigan University; Sherry A. Benton, Counseling Services, Kansas State University; Victor F. Pantesco, Department of Clinical Psychology, Antioch University New England; Stephen J. Dollinger, Department of Psychology, Southern Illinois University; Catherine L. Grus, Education Directorate, American Psychological Services; Stephen H. Behnke, Ethics Office, American Psychological Association; David S. Shen Miller, Counseling Psychology and Human Services, University of Oregon; Craig N. Shealy, Department of Graduate Psychology, James Madison University; Laurie B. Mintz, Educational, School, and Counseling Psychology, University of Missouri-Columbia; Rebecca Schwartz-Mette, Department of Psychology, University of Missouri-Columbia; Kristi Van Sickle, Department of Psychology, James A. Haley VA Hospital in Tampa; Beverly E. Thorn, Department of Psychology, University of Alabama. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Nadine J. Kaslow, Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Grady Hospital, 80 Jesse Hill Jr. Drive, Atlanta, GA 30303. E-mail: nkaslow@emory.edu Professional Psychology: Research and Practice Copyright 2007 by the American Psychological Association 2007, Vol. 38, No. 5, 479–492 0735-7028/07/

Psychotherapy in the Remediation of Psychology Trainees: Exploratory Interviews With Training Directors.

12.00 DOI: 10.1037/0735-7028.38.5.479

Impulsiveness and compulsiveness in alcoholics and nonalcoholics

Practicing psychotherapists and trainers of psychology doctoral students are often concerned about the role of personal psychotherapy for trainees, particularly when intended for remediation. The training directors for 14doctoral programs were interviewed regarding the use of personal psychotherapy for remediation. The major theme in a qualitative analysis of these exploratory interviews was the challenge of balancing confidentiality of the trainees personal therapy with training program accountability and quality assurance to protect the public. Program practices ranged from hands-off to active program involvement in aspects of the trainees personal therapy. Recommendations for program decision making about psychotherapy as remediation for trainees are suggested.

A review of the feminist pedagogy literature: The neglected child of feminist psychology

Impulsiveness and compulsiveness questionnaires were completed by recovering alcoholics (n = 54) and by a community sample (n = 351). No relationship was found, indicating these traits are independent, distinct constructs. Alcoholics scored significantly higher on impulsiveness than nonalcoholics, and impulsiveness was negatively associated with age for both groups. Interestingly, the significant difference between the two groups on impulsiveness was maintained across age groups. Alcoholic and nonalcoholic compulsiveness scores showed no difference; however, compulsiveness was negatively related to age in nonalcoholics, but not alcoholics.

A Systems Perspective on Trainee Impairment Continuing the Dialogue

Abstract Feminist psychologists have introduced feminist values, critiques, and methods into the science and practice of psychology. On the topic of teaching, feminist psychologists have done a thorough job of addressing curricula issues, but they have been involved marginally in developing the literature on feminist pedagogy. A comprehensive review of the feminist pedagogy literature was compiled based on a review of 60 articles, 25 chapters from books, 10 books, and 4 bibliographies. The review covers major aspects of the legacy of patriarchy in schools as well as feminist transformations of traditional educational practice. Explanations are posed for the minimal involvement of feminist psychologists in the development of the feminist pedagogy literature. Reciprocal benefits are identified for both the field of psychology and the feminist pedagogy scholars if more bridges are built between the two.

Working With Adult Clients Who May Have Experienced Childhood Abuse: Recommendations for Assessment and Practice

The three reactions written in response to our review article (Forrest, Elman, Gizara, & Vacha-Haase, 1999 [this issue]) are gratifying on a number of levels. First, we are pleased and appreciative of the thorough feedback we received from these three eminent psychologists whose work has informed our thinking on trainee impairment. As the lead author on early and seminal works on trainee impairment (Lamb, Cochran, & Jackson, 1991; Lamb et al., 1987), Douglas Lamb’s (1999 [this issue]) comments clarify several points in our review, and the new work he presents extends the dialogue about this complex topic in exciting new directions. In “Practicing What We Preach,” Gary Schoener (1999 [this issue]) brings to his reactions an extensive background and well-developed expertise in treating distressed and impaired practicing psychologists, as well as his long-time involvement with state and national professional associations. Melba Vasquez’s (1999 [this issue]) mul ticultural, feminist perspective combines with her many years of experience as training director of an American Psychological Association (APA) accred ited internship and as an author of a popular ethics textbook (Pope & Vasquez, 1991) to provide unique perspectives on trainee impairment. Second and more important, we believe that Lamb (1999), Schoener (1999), and Vasquez (1999) have extended the conversation that we hoped to facilitate about the extent of the unfinished work on the subject of impaired and incompetent trainees. Each of the reactants thoughtfully steps into the dialogue, extending our review by articulating new insights and proposing future directions for consideration. Together, the reactants’ comments push our understanding of trainee impairment from an individual level focused on the trainee to a complex

Linking International Psychology, Professional Competence, and Leadership: Counseling Psychologists as Learning Partners

The delayed memory debate has generated many questions about therapeutic practices that are likely to be beneficial and detrimental to clients. This article proposes components of optimal practice for working with adult clients who may have been abused as children. The recommendations are organized around the following themes: (a) competence, (b) assessment and treatment planning, (c) psychotherapy process and technique, (d) memory issues, (e) and ethics. The authors emphasize the importance of a collaborative therapeutic relationship and urge clinicians to proceed cautiously when encountering treatment issues for which scientific knowledge and consensus are still evolving.

Training Directors' Conceptualizations of the Intersections of Diversity and Trainee Competence Problems A Preliminary Analysis

In this presidential address, I want to push beyond what we accomplished at the 2008 International Counseling Psychology Conference (ICPC) by linking together three big ideas: first, the movement to internationalize psychology; second, the movement to identify and codify standards of professional competence; and third, the dispositions of successful 21st-century leaders. The first two trends are occurring at the same time in psychology and, for that matter, in the larger world. The connection between these two forces in psychology may not be immediately obvious; yet, their interconnection has captured my attention. For the past several years, I have been involved actively in the efforts toward both greater internationalization of counseling psychology and the competency movement, yet these efforts have been living in separate parts of my being. The focus of my presidential address has been to integrate these worlds within myself and, from this place of greater integration, share my perspectives and concerns. If the internationalization and delineation of professional competence are not better integrated, I fear that U.S.-based psychology will become more isolated from psychology around the world, as psychology around the world becomes more connected— concern that has been voiced by others writing about international issues in psychology (Arnett, 2008; Cole, 2006).

Current Practices of Counseling Psychology Faculty in K-12 Schools A National Survey

Counseling psychology has demonstrated leadership on multicultural issues through serious and committed attention to diversity in scholarship, conferences, and training and recruitment. Yet a survey of the literature on trainees with competence problems resulted in limited references to race/ethnicity and/or gender (REG). Using transcripts of phone interviews, we examined the degree to which Training Directors from 14 counseling psychology doctoral programs included REG in their conceptualizations of trainee remediation. REG conceptualizations differed in terms of (a) definitional clarity and conceptual sophistication about RE, (b) differential integration of approaches to diversity and remediation, and (c) strong emotions associated with race/ethnicity in trainee remediation. Implications for training and research are discussed.