Supporting Trainees With Competence Problems

Trainees with competence problems are common in professional psychology training programs. This comprehensive resource guides trainers and administrators as they navigate the challenges involved in supporting these trainees.

Trainees with problems of professional competence (TPPC) have difficulty acquiring and/or maintaining developmentally appropriate levels of functional or foundational competence, with deficits in skills, functioning, attitudes, ethical practice, and/or interpersonal behaviors.

These situations can be stressful for all involved, from trainees facing difficult feedback and remediation, to trainers navigating their responsibility to both educate and gatekeep, to administrators and other stakeholders who uphold academic standards and assist trainees in their educational experience.

Problems of professional competence are complex, often involving assessment, evaluation, relational, ethical, and even legal challenges. Although excellent resources exist to guide trainees, trainers, and training programs through these challenging situations, no centralized, comprehensive source of information has been available until now.

The editors and chapter authors bring together incredible depth and breadth of knowledge, experiences, and practical guidance in this volume.

Introduction: Building a Supportive Culture for Trainees Managing Competence Issues
Rebecca Schwartz-Mette, Evelyn Hunter, and Nadine Kaslow

• Chapter 1: Creating a Communitarian, Multiculturally-Sensitive, and Socially Just Training Culture
  Mary Mendoza-Newman and Jennifer A. Erickson Cornish
• Chapter 2: Competencies in Health Service Psychology
  Lydia McGaffee, Cassandra Rasmussen, and Emil Rodolfa
• Chapter 3: Problems of Professional Competence
  Suzanne H. Lease and Catherine L. Grus
• Chapter 4: Systemic Perspectives on Trainees with Problems of Professional Competence
  Debra Mollen and Marlene Williams
• Chapter 5: Identification and Assessment of Problems of Professional Competence
  Salina Renninger and Consuelo Cavalieri
• Chapter 6: Remediation, Counseling Out, and Dismissal
  Rebecca Schwartz-Mette
• Chapter 7: Trainee Confidentiality: The Hidden Challenge of Competence Problems
  Linda Forrest and Nancy S. Elman
• Chapter 8: Ethical Issues in Working with Trainees with Problems of Professional Competence (TPPC)
  Jeffrey E. Barnett and W. Brad Johnson
• Chapter 9: Legal Issues in Working with TPPC
  Sanjay Shah and Sarah Fishel
• Chapter 10: Building Program Policies in a Communitarian and Multiculturally-Sensitive Training Culture
  Jennifer C. Veilleux and Meredith Scafe
• Chapter 11: Troubleshooting Common Pitfalls
  Evelyn Hunter and Rebecca Schwartz-Mette

Appendix A: Key Terms
Appendix B: Cube Model for Competency Development
Appendix C: Competency Remediation Plan
Appendix D: Additional Resources for Readers

Rebecca Schwartz-Mette, PhD, is nationally recognized for her contributions to scholarship in the areas of ethics and training, as well as NIMH-funded research on adolescent peer relationships and psychopathology. She is a licensed psychologist and an associate professor at the University of Maine, where she trains and supervises doctoral students in ethics, research, and clinical practice. Her research on professional practice focuses on ethics and competency in psychologists, with a particular focus on working with trainees with competence problems.

Dr. Schwartz-Mette is a member of the APA's Board of Educational Affairs' Workgroup on Trainees with Problems of Professional Competence, past cochair of the APA Advisory Committee on Colleague Assistance (ACCA), and the current chair of the APA Ethics Committee.

She regularly provides APA-sponsored training workshops on the topic of trainees with competence problems. 

Evelyn Hunter, PhD, is a licensed psychologist and associate professor at Auburn University. Her research investigates the pathways by which multicultural and diversity characteristics intersect with mental health, behavioral, and training constructs. This work has followed two directions: 1) the development of psychology trainee competencies and 2) disparities in mental health and physical health correlates (e.g. multiple sclerosis).

She is engaged in the development and training of doctoral level supervises in an APA-accredited counseling psychology program, with a particular focus on ethics and professional issues training. She is a member of the APA Board of Educational Affairs' Workgroup on Trainees with Problems of Professional Competence, the current chair of the Early Career Psychologists Committee for the Society of Counseling Psychology, and appointed to the Special Task Group for the development of the Social Justice Advocacy Training Model for Counseling Psychology.

Nadine J. Kaslow, PhD, ABPP, is a professor and vice chair for faculty development, diversity, equity, and inclusion, Emory University School of Medicine Department of Psychiatry and Behavioral Sciences; chief psychologist, Grady Health System; and director of postdoctoral residency training, Emory University School of Medicine. A licensed psychologist, she is board certified through the American Board of Professional Psychology.

The 2014 president of APA, she is past president/chair of four APA divisions, American Board of Professional Psychology (ABPP), and the Association of Psychology Postdoctoral and Internship Centers (APPIC). She has received numerous national awards for her roles as educator, supervisor, and mentor. The recipient of multiple federal and foundation grants, she has published over 300 articles and four books including the Oxford Handbook of Education and Training in Professional Psychology.

The chair of the APA Board of Educational Affairs' Workgroup on Trainees with Problems of Professional Competence, she is one of the authors of APA's Guidelines for Clinical Supervision in Health Service Psychology (2015). She has given countless local, regional, national, and international workshops on psychology education, training, and supervision with a multicultural and communitarian focus.

This book is a masterful combination of theoretical and empirical literature, professional standards, and best practices, with a much-needed inclusive, supportive, and socially just approach to understanding and addressing problems of professional competence. Educators, supervisors, administrators, and policymakers will all find thought-provoking material and practical advice to guide effective and humane work.
—Debora J. Bell, PhD, professor and chair of psychological sciences, University of Missouri, Columbia, MO, United States; APA fellow

It is easy to tell trainees in our programs that they should feel welcome and that we care. The distinguished authors in this volume explore the much harder task of creating a culture that actualizes our commitment to all trainees, including those who struggle. The practical, ethical, legal, contextual, systemic, and theoretical considerations in this volume will be immensely useful to trainees and trainers at every level.
—Mitchell M. Handelsman, PhD, professor and CU president’s teaching scholar, University of Colorado Denver, Denver, CO, United States

In this book, recognized experts provide an excellent and comprehensive overview of the state of the field related to trainees with competence problems. However, what is truly groundbreaking is their explicit incorporation of communitarian and multicultural perspectives that provide an enhanced and compassionate context for the critical task of training future psychologists for lifelong professional competence and resilience.
—Erica H. Wise, PhD, clinical professor emerita and adjunct professor, Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States