Feature

When W. Brad Johnson, PhD, was undergoing radiation therapy, he wasn't worried about whether his medical crisis was affecting his performance as a psychology professor in the department of leadership, ethics and law at the U.S. Naval Academy. But he should have been.

"I had an inflated sense of how well I was doing," says Johnson, describing how concerns about his health blinded him to the fact that he wasn't doing his job as well as before. "Things were slipping through the cracks."

That's when Johnson's closest friends in psychology stepped in to urge him to reduce his teaching load and other responsibilities. The experience underlined for him the importance of psychologists not just assessing themselves but also of being ready to intervene when a colleague is too impaired to function effectively.

During graduate education, students have people keeping an eye on them, gauging their competence and identifying areas in need of improvement. That stops the moment you become a practitioner, says Nadine J. Kaslow, PhD, a professor of psychiatry and behavioral sciences at Emory University School of Medicine who has championed the competency-based approach to psychology training. "You have to assess yourself," she says.

Fortunately, there are tools and strategies that can help practitioners ensure they are practicing competently, including the College of Psychologists of Ontario Self-Assessment Guide and Professional Development Plan, APA's Competency Benchmarks for Professional Practice, 360-degree evaluations or some combination of these. And APA's Advisory Committee on Colleague Assistance has suggestions for what to do when it's a fellow practitioner who is falling short.

Self-assessment strategies

For Kaslow, self-assessment is something she typically does during a quiet period of self-­reflection at year's end. Often working with a colleague from what she calls her "inner core" to help ensure an accurate analysis, Kaslow takes stock of where she is, where her skills have grown rusty and what she needs to work on. She then sets goals for the coming year, outlines a plan for achieving them and reviews her progress each quarter. But there are other, more structured methods of self-­assessment psychologists can use, including:

The College of Psychologists of Ontario Self-Assessment Guide and Professional Development Plan. The college, a regulatory body that ensures competent, ethical psychological services, launched its self-assessment program in 1999 "to help members undertake an honest, personal assessment of strengths, weaknesses and any gaps in their current level of knowledge and skill," says Rick Morris, PhD, the college's registrar and executive director. While the self-assessment program is designed for use by the college's members, anyone can download the forms and go through the process themselves (see "Resources").

The first part of the Self-Assessment Guide asks users about their familiarity with legislation, standards, codes and guidelines. The second asks them to assess their competence in such areas as service to clients, supervision, teaching and research and then come up with a professional development plan. Members must complete the self-assessment every other year.

The finished self-assessment is strictly for members' own use as a self-improvement tool, but the college does want to make sure people actually go through the process. That's why members are required to send back a form attesting that they have completed the self-assessment, even though they don't have to submit the finished product to the college. "We know from consultations we've done and just common sense that when people are filling out evaluations of themselves and sending them to a regulatory body, they may not be as frank with themselves or the college as they might be," says Morris, adding that the college expects 100 percent compliance. If members fail to submit the attestation form after several reminders, the college requires them to send in their completed plans so that the college's Quality Assurance Committee can review them and provide feedback; the college also randomly selects members to undergo "peer-­assisted reviews" in which two peers review the member's practice and progress on his or her professional development plan.

Competency Benchmarks. APA's Competency Benchmarks lay out the core competencies students need to tackle before they are ready to enter practice. While the benchmarks aren't in widespread use as a self-assessment tool for those already in practice, they could be a helpful resource for that group, too, says Rebecca Schwartz-Mette, PhD, an assistant professor of psychology at the University of Maine in Orono. "It makes sense," she says. "If this is what we expect of entry-level practitioners, it could also be used as a benchmark for maintaining competence across the spectrum."

360-degree evaluations. While assessing yourself is important, it's not enough, says psychologist Jac J. W. Andrews, PhD, who has researched 360-degree evaluations—also known as multi-source feedback—and called for psychologists to make this strategy's use as common as it is with other health-care professionals. "We know that self-reflection isn't always consistent with reality," says Andrews, who chairs the school and applied child psychology department at the University of Calgary.

Self-assessment involves self-reflection and evaluation of professional strengths and limitations in functional and foundational domains and decisions about how to address developmental needs, Andrews points out. But, he says, "a major problem with self-assessment as an approach for evaluating competence is that very few self-assessment measures have established adequate psychometric properties, and they tend not to correlate well with ratings by peers or supervisors or with measures of performance."

Using well-constructed instruments, multi-source assessment incorporates self-­assessment along with assessments from peers, co-workers and clients or patients, who provide information about such areas as clinical competence, professionalism, case management, interpersonal relations and communication. What's most useful about 360-degree evaluations is the chance to compare feedback from different sources, says Andrews, explaining that psychologists should analyze where there's agreement and disagreement among reviewers and between others' perceptions and their own.

This approach offers a chance to identify psychologists' strengths and weaknesses in core competencies and provide useful feedback for professional development and enrichment, says Andrews. It could also increase psychology's accountability to the public, he adds. Consumers would see that psychologists are keeping up with their competencies and being judged by themselves and others as being competent, he says. National, provincial and state psychology associations as well as provincial and statewide psychology regulatory boards could even use information from multi-source feedback for oversight and governance of ­professional psychology, he points out.

Enlisting your colleagues

Another problem with self-assessment is that the psychologists who need it the most may be the ones least likely to do it. That's why you need a group of close colleagues who can monitor you, says Johnson. "A competence constellation is a deliberately created network of colleagues whom we stay in very close connection with," says Johnson, who laid out the idea of a communitarian approach to training in a 2014 paper with Kaslow, Schwartz-Mette and others in Training and Education in Professional Psychology. "They're the very first folks to recognize when we're getting into trouble or having a hard time."

How can practitioners invite what Johnson calls "intrusive collegiality" into their professional lives? For a solo practitioner, Johnson says, the people keeping an eye on you could consist of a personal psychotherapist, a consultation group or a close group of colleagues—anyone you've got a close enough relationship with that they're willing to give you difficult feedback if necessary. Johnson, for example, breakfasts regularly with a colleague who monitors whether Johnson is indulging in his bad habit of taking on too much.

You can and should consider intervening by sharing your observations and concerns, even if you're not especially close to a fellow practitioner, says Erica H. Wise, PhD, a past chair of APA's Advisory Committee on Colleague Assistance. Such conversations can be awkward, especially if you're not sure a colleague is engaging in professional behavior that falls below standards of competence, says Wise, who directs the psychology clinic at the University of North Carolina at Chapel Hill.

Situations can be ambiguous, Wise says, and APA's Ethics Code gives little guidance if a situation doesn't involve an actual ethical violation. For example, while the Ethics Code calls for refraining from activities when personal problems prevent a psychologist from providing services competently, says Wise, it can be hard to know where the cutoff is for yourself and even more so for others.

That said, there's plenty practitioners can do when they're concerned about a colleague, says Wise. Practitioners should think carefully about what their concern is and what they actually know, then find a time to talk to the person. "Use ‘I' statements: Say ‘This is what I'm noticing, why it concerns me and what I think we need to do about it,'" says Wise, adding that some state psychological associations have colleague assistance programs that can help. "It should be presented as concern, not ‘I think you're not OK,'" she says.

Of course, she adds, when a psychologist is aware that a colleague has engaged in behavior that is clearly unethical or harmful, the best approach is to consult with the state psychology board about making a report.

Wise and others believe that this communitarian approach to competence should be ingrained in the Ethics Code, which will undergo revision in 2017. In the meantime, says Schwartz-Mette, it's important to remember that self-assessment is meant to help practitioners improve, not to be punitive.

"We don't want to stigmatize individuals who are struggling," says Schwartz-Mette, noting that there will always be times in your career when you fall short. "There are always ways to seek and get support to improve functioning if need be."

APA's Advisory Committee on Colleague Assistance has developed several resources on psychologist wellness. Access them at www.apa.org/practice/resources/assistance/index.aspx.

Resources

Assessing Psychologists in Practice: Lessons From the Health Professions Using Multisource Feedback
Andrews, J.W., et al. Professional Psychology: Research and Practice, 2013

College of Psychologists of Ontario Self-Assessment Guide and Professional Development Plan
www.cpo.on.ca/Self-Assessment_and_Professional_Development_Plan.aspx

APA's Benchmark Evaluation System
www.apa.org/ed/graduate/benchmarks-evaluation-system.aspx