Toward Transdisciplinary Quality Measures of Competence in Psychotherapy: Measures to Identify "Good Enough"...

Mental health providers who profess competence in psychotherapy include people with M.D.s, Ph.D.s, and Psy.D.s; an assortment of master's-level providers; and advanced practice registered nurses (APRNs). Training requirements and individual training experiences in psychotherapy vary widely across and within these specialties. In this article, the author aims to identify practical approaches that employers and patients can use to identify competent practitioners and weed out those who are ineffective or dangerous.

To supplement clinical observations, a narrative review was conducted that examined systematic and scoping reviews and other articles that have addressed the assessment of competence and quality in psychotherapy practice.

Existing measures of competence and quality in psychotherapy practice have largely been developed within, rather than across, mental health disciplines. Psychiatrists have been less involved in these efforts in the 21st century than in prior years, and few studies have explicitly involved APRNs. Most published measures have been based on assorted logs, self-reports, and observations of simulated or actual therapy sessions. After initial development, few have been deployed as ongoing measures for the purpose of screening applicants for psychotherapy positions or quality assurance. All have significant limitations.

No available measure of psychotherapy competence has achieved gold-standard status. Several published measures could contribute to quality-assurance efforts. Practically speaking, to assess therapist competence, employers and patients must still largely rely on an assortment of certifications, personal references, and patients' accounts of experiences with their therapists. All these sources are increasingly accessible, thanks to web-based technologies.