Seventy-one doctoral programs in professional psychology were surveyed with respect to the incidence of students' professional deficiencies and related procedures. Professional deficiencies, particularly limited clinical skills and personality/emotional problems, were reported by 89% of the respondents, twice the number that have official policies for dealing with such problems. Incidence of limited clinical skills was related positively to interviewing applicants and use of practicum grades for evaluation and related negatively to using recommendation letters and reliance on clinical supervisor's assessment. Responses to deficiencies reflected appropriate due process concepts and were most likely to include terminating students and psychotherapy referral. Recommendations are made for definitions of professional competencies, development of policies, and research on the reliability and validity of screening and evaluation mechanisms.
The goal of graduate training in professionally oriented psychology programs is the development of competent professionals. Professional competence is a complex, multidimensional construct that includes both applied skills and psychological fitness. Deficiencies in these areas have proven difficult both to identify and to ameliorate. Shaw and Dobson (1988), for example, have identified four skill areas that are characteristic of competent therapists: use of a theoretical framework to guide interactions, clinical memory, skillful use of interventions, and knowledge of when to employ these interventions. Even if one were to accept these criteria, evaluating relevant skills might prove to be highly subjective. There also is disagreement as to whether competence is a trait or state variable, which is reflected in different approaches to evaluation. The trait approach involves one-time procedures for evaluating competence. Examples include course examinations, licensing procedures, and the diplomate procedure of the American Board of Professional Psychology. When competence is viewed as a state variable, it is posited that skill may vary with type of case, course of treatment, and other factors. The continuing education approach to evaluation is most compatible with the state conception of competence.
In addition to skills, professional competence includes the equally important construct of psychological fitness. Included in this area are the ethics, professional values, and psychological health of the student (Bourg, 1986). After a review of the literature, Beutler, Crago, and Arizmendi (1986) concluded that "the therapist's emotional wellbeing at least modestly facilitates both effective treatment process and outcomes" (pp. 272-273). While this nonacademic area is particularly crucial to competence, it is especially difficult to evaluate. In his study of the evaluation procedures of schools of professional psychology, Bourg (1986) found that discussion of the areas of professional attitudes and psychological fitness was neglected. The 24 programs that responded to his survey