This chapter offers for clinicians, supervisors, and supervisees an opportunity to review the level of competence in clinical practice. The cognitive behaviour therapy (CBT) model is a structured model that can be applied with idiosyncratic flexibility. The CBT skills are divided into eight categories: assessment; interviewing; structuring; change directed interventions; overcoming resistance; evaluation; self-reflection; intervention planning. A pass for the assessment component is defined as: competent use of existing assessment tools and monitoring forms, designing idiosyncratic ones for specific situations, combined with the ability to translate historical and assessment data in a cognitive behavioural framework leading to a case formulation. For a client entering therapy with a complaint of depression, the therapist should use tools to measure frequency, intensity, and duration of the depressive symptoms. Competence …

Interpreted in historical context, Kubie's 1948 proposal to move the professional aspects of clinical psychology training and the awarding of the doctorate into the medical-school environment was an attempt to remedy a critical shortage of psychotherapists while maintaining medical control over the professional practice of psychology. The proposal failed, in part, because medicine had no legitimate claim to either training or regulating clinical psychologists. A parallel was drawn between that post-war situation and the current one in which many psychological practitioners are pressing for prescribing privileges in regard to psychoactive drugs, and similarities and important differences are noted between the two conditions. The requirement that medicine be involved importantly in the psychopharmacologic training of psychologists poses an acute problem concerning the maintenance of professional independence.

With the diagnosis schizophrenia used as an example throughout, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders's (American Psychiatric Association, 1994) approach to psychopathologic taxonomy is subjected to critical analysis as representing a fundamentally Aristotelian conception of the phenomena of mental disorders. This approach is contrasted, in the manner suggested by Kurt Lewin's early writing on the subject, with the Galileian mode of thought, emphasizing the dynamic causal matrix in which behavior occurs. Some of the positive implications of an altered view of the problem of taxonomy within the latter perspective are drawn out, and brief suggestions are made as to directions for the future.

A significant but often overlooked aspect of the circumplex structure of the domain of interpersonal functioning is its systematically continuous ordering of the quality of the behavioral variations addressed. It is a domain, in other words, explicitly lacking in categorical boundaries wherein a given behavior can be sharply discriminated from others proximal to it within a shared circumplex space; any identified border is at best a "fuzzy" one characterized by blending and interpenetration. It is argued that this observation has extended generalizability in respect to the organization of personality, rendering moot and suspect taxonomic systems that postulate categorical entities. The Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) used in the "diagnosis" of purported derangements of personality is one such system, one that would therefore be expected to yield certain predictable anomalies. These problems are illustrated with reference to the widespread occurrence of artifactual "comorbidities" among psychiatric diagnoses.

(1994). Reflections on SASB and the Assessment Enterprise. Psychological Inquiry: Vol. 5, No. 4, pp. 317-319.

The advent of automated assessment contains the seeds of both threat and promise for professional assessors. Placing the problem in the historical and sociological contexts, this article examines computer-based test interpretation (CBTI) and the frequently misunderstood role of actuarial data in relation to it. I argue that sound clinicianship is central not only to the development of adequate CBTI systems, but also to the systems' appropriate and skillful use in practice. When properly utilized by otherwise well-qualified clinicians, CBTI can substantially enhance practice.