Abstract
This chapter focuses on the remediation process for health service psychology (HSP) trainees who display problems of professional competence (PPC). To lay the groundwork, we provide an overview for the recent professional competency movement within HSP and discuss problems of professional competence within this larger competency framework. We then describe the qualities of optimal training environments for preventing and addressing PPC by encouraging both professional and personal growth and development. Subsequently, we focus on the remediation process, with specific attention paid to the purpose, a framework for guiding effective remediation efforts, and the nuts and bolts of implementing these efforts. We then highlight key challenges that may arise during the remediation process and how to effectively address these. Finally, we discuss areas for future research that may improve the remediation process for HSP programs and trainees with PPC.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002), Amended June 1, 2010 and January 1, 2017: Retrieved from http://www.apa.org/ethics/code/index.aspx.
Bamonti, P. M., Keelan, C. M., Larson, N., Mentrikoski, J. M., Randall, C. L., Sly, S. K., et al. (2014). Promoting ethical behavior by cultivating a culture of self-care during graduate training: A call to action. Training and Education in Professional Psychology, 8(4), 253–260. https://doi.org/10.1037/tep0000056
Barnett, J. E., Doll, B., Younggren, J. N., & Rubin, N. J. (2007). Clinical competence for practicing psychologists: Clearly a work in progress. Professional Psychology: Research and Practice, 38(5), 510–517. https://doi.org/10.1037/0735-7028.38.5.510
Bennion, L. D., Dunning, S. J., LaRochelle, J., Yoon, M., Schreiber-Gregory, D., Reamy, B. V., & Torre, D. (2018). Untying the Gordian knot: remediation problems in medical schools that need remediation. BMC Medical Education, 18, 120. https://doi.org/10.1186/s12909-018-1219-x
Bierer, S. B., Dannefer, E. F., & Tetzlaff, J. E. (2015). Time to loosen the apron strings: Cohort-based evaluation of a learner-driven remediation model at one medical scholl. Journal of General Internal Medicine, 30(9), 1339–1343. https://doi.org/10.1007/s11606-015-3343-1
Brown-Rice, K., & Furr, S. R. (2016). Counselor educators and students with problems of professional copmetence: A survey and discussion. The Professional Counselor, 6(2), 134–146. https://doi.org/10.15241/kbr.6.2.134
Buchanan, A. O., Stallworth, J., Christy, C., Garfunkel, L. C., & Hanson, J. L. (2012). Professionalism in practice: Strategies for assessment, remediation, and promotion. Pediatrics, 129, 407–409. https://doi.org/10.1542/peds.2011-3716
Callan, S., Schwartz, J., & Arputhan, A. (2021). Training future psychologists to be competent in self-care: A systematic review. Training and Education in Professional Psychology, 15(2), 117–125. https://doi.org/10.1037/tep0000345
Cleland, J., Cilliers, F., & van Schalkwyk, S. (2018). The learning environment in remediation: A review. The Clinical Teacher, 15(1), 13–18. https://doi.org/10.1111/tct.12739
DeDiego, A. C., & Burgin, E. C. (2016). The doctoral student as university supervisor: Challenges in fulfilling the gatekeeping role. Journal of Counselor Leadership and Advocacy, 3(2), 173–183. https://doi.org/10.1080/2326716X.2016.1187096
Domen, R. E. (2014). Resident remediation, probation, and dismissal: Basic considerations for program directors. American Journal of Clinical Pathology, 141(6), 784–790. https://doi.org/10.1309/AJCPSNPAP5R5NHUS
Elman, N. S., & Forrest, L. (2007). From trainee impairment to professional competence problems: Seeking new terminology that facilitate effective action. Professional Psychology: Research and Practice, 38(5), 501–509. https://doi.org/10.1037/0735-7028.38.5.501
Evans, T. M., Bira, L., Gastelum, J. B., Weiss, L. T., & Vanderford, N. L. (2018). Evidence for a mental health crisis in graduate education. Nature Biotechnology, 36(3), 282–284. https://doi.org/10.1038/nbt.4089
Falender, C. A., & Shafranske, E. P. (2017a). Competency-based clinical supervision: Status, opportunities, tensions, and the future. Australian Psychologist, 52(2), 86–93. https://doi.org/10.1111/ap.12265
Falender, C. A., & Shafranske, E. P. (2017b). Supervision essentials for the practice of competency-based supervision. American Psychological Association.
Forrest, L., & Elman, N. S. (2014). Trainees with problems of professional competence. In W. B. Johnson & N. J. Kaslow (Eds.), The Oxford handbook of education and training in professional psychology (pp. 314–334). Oxford University Press.
Forrest, L., Shen-Miller, D. S., & Elman, N. (2008). Psychology trainees with competence problems: From individual to ecological conceptualizations. Training and Education in Professional Psychology, 2(4), 183–192. https://doi.org/10.1037/1931-3918.2.4.183
Forrest, L., Elman, N. S., Bodner, K. E., & Kaslow, N. J. (2021). Trainee confidentiality: Confusion, complexities, consequences, and possibilities. Training and Education in Professional Psychology. https://doi.org/10.1037/tep0000364
Fouad, N. A., Grus, C. L., Hatcher, R. L., Kaslow, N. J., Hutchings, P. S., Madson, M., et al. (2009). Competency benchmarks: A model for the understanding and measuring of competence in professional psychology across training levels. Training and Education in Professional Psychology, 3(4, Supplemental), S5–S26. https://doi.org/10.1037/a0015832
Freeman, J. C., & All, A. (2017). Academic support programs utilized for nursing students at risk of academic failure: A review of the literature. Nursing Education Perspectives, 38(2), 69–74. https://doi.org/10.1097/01.NEP.0000000000000089
Freeman, B., Woodliff, T., & Martinez, M. (2020). Teaching gatekeeping to doctoral students: A qualitative study of a developmental experiential approach. Professional Counselor, 10(4), 562–580. https://doi.org/10.15241/bf.10.4.562
Gilfoyle, N. (2008). The legal exosystem: Risk management in addressing student competence problems in professional psychology training. Training and Education in Professional Psychology, 2(4), 202–209. https://doi.org/10.1037/1931-3918.2.4.202
Gonsalvez, C. J., & Calvert, F. L. (2014). Competency-based models of supervision: Principles and applications, promises and challenges. Australian Psychologist, 49(4), 200–208. https://doi.org/10.1111/ap.12055
Gonsalvez, C. J., Bushnell, J., Blackman, R., Deane, F. P., Bliokas, V., Nicholson-Perry, K., et al. (2013). Assessment of psychology competencies in field placements: Standardized vignettes reduce rater bias. Training and Education in Professional Psychology, 7(2), 99–111. https://doi.org/10.1037/a0031617
Goodie, J. L., Bennion, L. D., Schvey, N. A., Riggs, D. S., Montgomery, M., & Dorsey, R. M. (2021). Development and implementation of an objective structured clinical examination for evaluating clinical psychology graduate students. Training and Education in Professional Psychology., 16, 287. https://doi.org/10.1037/tep0000356
Grus, C. L., Shen-Miller, D. S., Lease, S. H., Jacobs, S. C., Bodner, K. E., Van Sickle, K. S., et al. (2018). Professionalism: A competency cluster whose time has come. Ethics & Behavior, 28(6), 450–464. https://doi.org/10.1080/10508422.2017.1419133
Guerrasio, J., Garritty, M. J., & Aagaard, E. M. (2014). Learner deficits and academic outcomes of medical students, residents, fellows, and attending physicians referred to a remediation program, 2006-2012. Academic Medicine, 89, 352–358. https://doi.org/10.1097/ACM.0000000000000122
Guiney, M. C. (2018). Addressing problems of professional competence: Collaborating with university training programs to support struggling supervisees. Communiqué, 46(6), 6 –7.
Hatcher, R. L., Fouad, N. A., Grus, C. L., Campbell, L., McCutcheon, S. R., & Leahy, K. K. (2013). Competency benchmarks: Practical steps toward a culture of competence. Training and Education in Professional Psychology, 7(2), 84–91. https://doi.org/10.1037/a0029401
Henderson, K. L., & Dufrene, R. L. (2012). Student behaviors associated with remediation: A content analysis. Counseling Outcome Research and Evaluation, 3(1), 48–60. https://doi.org/10.1177/2150137812437364
Homrich, A. M., & Hernderson, K. L. (2018). Gatekeeping in the mental health professions. American Counseling Association.
Hook, J. N., Davis, D. E., Owen, J., Worthington, J. E. L., & Utsey, S. O. (2013). Cultural humility: Measuring openness to culturally diverse clients. Journal of Counseling Psychology, 60(3), 353–366. https://doi.org/10.1037/a0032595
Hook, J. N., Watkins, C. E., Davis, D. E., Owen, J., Van Tongeren, D. R., & Ramos, M. J. (2016). Cultural humility in psychotherapy supervision. American Journal of Psychotherapy, 70(2), 149–166. https://doi.org/10.1176/appi.psychotherapy.2016.70.2.149
Horn, J., DeMers, S. T., Lightfoot, S., & Webb, C. (2019). Using continuing professional development to improve maintenance of professional competence: A call for change in licensure renewal requirements. Professional Psychology: Research and Practice, 50(2), 120–128. https://doi.org/10.1037/pro0000233
Jacobs, S. C., Huprich, S. K., Grus, C. L., Cage, E. A., Elman, N. S., Forrest, L., et al. (2011). Trainees with professional competency problems: Preparing trainers for difficult but necessary conversations. Training and Education in Professional Psychology, 5(3), 175–184. https://doi.org/10.1037/a0024656
Johnson, W. B., Barnett, J. E., Elman, N. S., Forrest, L., & Kaslow, N. J. (2012). The competent community: Toward a vital reformulation of professional ethics. American Psychologist, 67(7), 557–569. https://doi.org/10.1037/a0027206
Johnson, W. B., Barnett, J. E., Elman, N. S., Forrest, L., Schwartz-Mette, R., & Kaslow, N. J. (2014). Preparing trainees for lifelong competence: Creating a communitarian training culture. Training and Education in Professional Psychology, 8(4), 211–220. https://doi.org/10.1037/tep0000048
Kalet, A., Guerrasio, J., & Chou, C. L. (2016). Twelve tips for developing and maintaining a remediation program in medical education. Medical Teacher, 38(8), 787–792. https://doi.org/10.3109/0142159X.2016.1150983
Kalet, A., Chou, C. L., & Ellaway, R. H. (2017). To fail is human: Remediating remediation in medical education. Perspectives in Medical Education, 6, 418–424. https://doi.org/10.1007/s40037-017-0385-6
Kallaugher, J., & Mollen, D. (2017). Student experiences of remediation in their graduate psychology programs. Training and Education in Professional Psychology, 11(4), 276–282. https://doi.org/10.1037/tep0000175
Kaslow, N. J. (2004). Competencies in professional psychology. American Psychologist, 59(8), 774–781. https://doi.org/10.1037/0003-066X.59.8.774
Kaslow, N. J., Rubin, N. J., Bebeau, M., Leigh, I. W., Lichtenberg, J., Nelson, P. D., et al. (2007a). Guiding principles and recommendations for the assessment of competence. Professional Psychology: Research and Practice, 38(5), 441–451. https://doi.org/10.1037/0735-7028.38.5.441
Kaslow, N. J., Rubin, N. J., Forrest, L., Elman, N. S., Van Horne, B. A., Jacobs, S. C., et al. (2007b). Recognizing, assessing, and intervening with problems of professional competence. Professional Psychology: Research and Practice, 38(5), 479–492. https://doi.org/10.1037/0735-7028.38.5.479
Kaslow, N. J., Grus, C. L., Campbell, L. F., Fouad, N. A., Hatcher, R. L., & Rodolfa, E. R. (2009). Competency assessment toolkit for professional Psychology. Training and Education in Professional Psychology, 3(4, Supplement), S27–S45. https://doi.org/10.1037/a0015833
Kaslow, N. J., Graves, C. C., & Smith, C. O. (2012). Specialization in psychology and health care reform. Journal of Clinical Psychology in Medical Settings, 19, 12–21. https://doi.org/10.10007/s10880-011-9273-0
Kaslow, N. J., Grus, C. L., Allbaugh, L. J., Shen-Miller, D. S., Bodner, K. E., Veilleux, J. C., & Van Sickle, K. (2018). Trainees with competence problems in the professionalism domain. Ethics & Behavior, 28(6), 429–449. https://doi.org/10.1080/10508422.2018.1438897
Katz, E. D., Dahms, R., Sadosty, A. T., Stahmer, S. A., & Goyal, D. (2010). Guiding principles for resident remediation: Recommendations of the CORD remediation task force. Academic Emergency Medicine, 17(Supplement 2), S95–103. https://doi.org/10.1111/j.1553-2712.2010.00881.x
Knapp, S., Gottlieb, M. C., & Handelsman, M. M. (2017). Enhancing professionalism through self-reflection. Profesional Psychology: Research and Practice, 48(3), 167–174. https://doi.org/10.1037/pro0000135
Lucey, C. R., & Souba, W. (2010). The problem with the problem of professionalism. Academic Medicine, 85(6), 1018–1024. https://doi.org/10.1097/ACM.0b013e3181dbe51f
Maize, D. F., Fuller, S. H., Hritcko, P. M., Matsumoto, R. R., Soltis, D. A., Taheri, R. R., & Duncan, W. (2010). A review of remediation programs in pharmacy and other health professions. American Journal of Pharmaceutical Education, 74(2), 25. https://doi.org/10.5688/aj740225
Perry, K. N., Donovan, M. I., Knight, R., & Shires, A. (2017). Addressing professional competency problems in clinical psychology trainees. Australian Psychologist, 52(2), 121–129. https://doi.org/10.1111/ap.12268
Ponce, A. N., Aosved, A. C., & Hill, K. (2021). Facilitation of consultation and communication between psychology doctoral programs and internships. Training and Education in Professional Psychology, 15(3), 189–194. https://doi.org/10.1037/tep0000313
Prescott-Clements, L., Voller, V., Bell, M. D., Nestors, N., & van der Vieuten, C. P. M. (2017). Rethinking remediation: A model to support the detailed diagnosis of clinicians' performance problems and the development of effective remediation plans. Journal of Continuing Education in the Health Professions, 37, 245–254. https://doi.org/10.1097/CEH.0000000000000173
Price, S. D., Callahan, J. L., & Cox, R. J. (2017). Psychometric invesigation of competency benchmarks. Training and Education in Professional Psychology, 11(3), 128–139. https://doi.org/10.1037/tep0000133
Roberts, M. C., Borden, K. A., Christiansen, M. D., & Lopez, S. J. (2005). Fostering a culture shift: Assessment of competence in the education and careers of professional psychologists. Professional Psychology: Research and Practice, 36(4), 355–361. https://doi.org/10.1037/0735-7028.36.4.355
Rodolfa, E. R., & Schaffer, J. (2019). Challenges to psychology education and training in the culture of competence. American Psychologist, 74(9), 1118–1128. https://doi.org/10.1037/amp0000513
Rodolfa, E. R., Bent, R. J., Eisman, E., Nelson, P. D., Rehm, L., & Ritchie, P. (2005). A cube model for competency development: Implications for psychology educators and regulators. Professional Psychology: Research and Practice, 36(4), 347–354. https://doi.org/10.1037/0735-7028.36.4.347
Rodolfa, E. R., Greenberg, S., Hunsley, J., Smith-Zoeller, M., Cox, D., Sammons, M. T., et al. (2013). A competency model for the practice of psychology. Training and Education in Professional Psychology, 7(2), 71–83. https://doi.org/10.1037/a0032415
Rummell, C. M. (2015). An exploratory study of psychology graduate student workload, health, and program satisfaction. Professional Psychology: Research and Practice, 46(6), 391–399. https://doi.org/10.1037/pro0000056
Rust, J. P., Raskin, J. D., & Hill, M. S. (2013). Problems of professional competence among counselor trainees: Programmatic issues and guidelines. Counselor Education and Supervision, 52, 30–42. https://doi.org/10.1002/j.1556-6978.2013.00026.x
Schaffer, J. B., Rodolfa, E. R., Hatcher, R. L., & Fouad, N. A. (2013). Professional psychology competency initiatives: Reflections, contrasts, and recommendations for the next steps. Training and Education in Professional Psychology, 7(2), 92–98. https://doi.org/10.1037/a0032038
Schwartz-Mette, R. A. (2011). Out with impairment, in with professional competence problems: Response to commentary by Collins, Falender, and Shafranske. Ethics & Behavior, 21, 5. https://doi.org/10.1080/10508422.2011.604551
Sharpless, B. A., & Barber, J. P. (2009). The Examination for Professional Practice in Psychology (EPPP) in the era of evidence-based practice. Professional Psychology: Research and Practice, 40(4), 333–340. https://doi.org/10.1037/a0013983
Shearer, C., Bosma, M., Bergin, F., Sargeant, J., & Warren, A. (2019). Remediation in Canadian medical residency programs: Established and emerging best practices. Medical Teacher, 41(1), 28–35. https://doi.org/10.1080/0142159X.2018.1436164
Shen-Miller, D. S., Forrest, L., & Elman, N. (2009). Training directors' conceptualizations of the intersection of diversity and trainee competence problems: A preliminary analysis. The Counseling Psychologist, 37(4), 482–518. https://doi.org/10.1177/0011000008316656
Shen-Miller, D. S., Grus, C. L., Van Sickle, K. S., Schwartz-Mette, R., Cage, E. A., Elman, N. S., et al. (2011). Trainees' experiences with peers having competence problems: A national survey. Training and Education in Professional Psychology, 5(2), 112–121. https://doi.org/10.1037/a0023824
Shen-Miller, D. S., Forrest, L., & Burt, M. (2012). Contextual influences on faculty diversity conceptualizations when working with trainee competence problems. The Counseling Psychologist, 40(8), 1181–1219. https://doi.org/10.1177/0011000011431832
Vacha-Hasse, T., Elman, N. S., Forrest, L., Kallaugher, J., Lease, S. H., Veilleux, J. C., & Kaslow, N. J. (2019). Remediation plans for trainees with problems of professional competence. Training and Education in Professional Psychology, 13(4), 239–246. https://doi.org/10.1037/tep0000221
Veilleux, J. C., January, A. M., VanderVeen, J. W., Reddy, L. F., & Klonoff, E. A. (2012). Differentiating amongst characteristics associated with problems of professional competence: Perceptions of graduate student peers. Training and Education in Professional Psychology, 6(2), 113–121. https://doi.org/10.1037/a0028337
Warlick, C. A., Van Gorp, A., Farmer, N. M., Patterson, T., & Armstrong, A. (2021). Comparing burnout between graduate-level and professional clinicians. Training and Education in Professional Psychology, 15(2), 150–158. https://doi.org/10.1037/tep0000328
Wise, E. H., Hersh, M. A., & Gibson, C. M. (2012). Ethics, self-care and well-being for psychologists: Reenvisioning the stress-distress continuum. Profesional Psychology: Research and Practice, 43(5), 487–494. https://doi.org/10.1037/a0029446
Ziede, J. S., & Norcross, J. C. (2020). Personal therapy and self-care in the making of psychologists. The Journal of Psychology, 154, 585–618. https://doi.org/10.1080/00223980.2020.1757596
Ziomek-Daigle, J., & Christensen, T. M. (2010). An emergent theory of gatekeeping practices in counselor education. Journal of Counseling & Development, 88(4), 407–415. https://doi.org/10.1002/j.1556-6678.2010.tb00040.x
Ziring, D., Danoff, D., Grosseman, S., Langer, D., Esposito, A., Jan, M. K., et al. (2015). How do medical schools identify and remediate professionalism lapses in medical students: A study of U.S. and Canadian medical schools. Academic Medicine, 90(7), 913–920. https://doi.org/10.1097/ACM.0000000000000737
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Freitag, S.L., Marshall-Lee, E.D., Zhang, S., Seitz, S.R., Kaslow, N.J. (2023). Remediation Processes for Health Service Psychology Trainees with Problems of Professional Competence. In: Terjesen, M.D., Del Vecchio, T. (eds) Handbook of Training and Supervision in Cognitive Behavioral Therapy. Springer, Cham. https://doi.org/10.1007/978-3-031-33735-2_16
Download citation
DOI: https://doi.org/10.1007/978-3-031-33735-2_16
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-33734-5
Online ISBN: 978-3-031-33735-2
eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)