What makes a good clinical psychologist? Is it extensive knowledge of mental health, strong interpersonal skills, or a good understanding of research? In reality, it is the integration of all of these elements – and more.
Our newly accepted article in Clinical Psychology: Science and Practice addresses a deceptively simple question: What competencies are essential for clinical psychologists? To answer this, we conducted a qualitative meta-analysis of nine international standards and accreditation documents from Norway, Australia, the U.S., the UK, and other countries. These documents quietly shape how psychologists are trained, assessed, and licensed. They influence what students learn, how supervisors evaluate progress, and ultimately, what clients encounter in therapy. Yet, until now, no one had systematically mapped out the competencies articulated in these documents.
Why Competency Matter
Universities have been training clinical psychologists for a long time (Shakow, 1969). Yet, there is remarkably little research on how clinical training impacts skills and competencies (Knox & Hill, 2021). If universities are to improve clinical training, they need to know which competencies students should acquire and how these competencies can be meaningfully assessed. Consensus-based competency models exist, such as the Cube model (Rodolfa et al., 2005). However, less is known about how competencies are articulated in the formal standards and accreditation documents that regulate the organization of clinical training. We therefore set out to provide a systematic analysis of such documents, and to examine whether the types of competencies emphasized differ across contexts.
What is Qualitative Meta-Analysis?
Qualitative meta-analysis, also called qualitative meta-synthesis, is a research method used to systematically analyze, compare, and contrast information from multiple text-based sources. The research question guides the selection of relevant sources, which are assessed for quality before inclusion. The analysis involves a detailed and transparent process in which text relevant to the research question is identified, coded, and organized. Information from the different sources is then interpreted and synthesized, while taking their original context into account. In this way, qualitative meta-analysis allows researchers to aggregate and summarize the current state of the field in relation to their research question (Levitt, 2018; Timulak, 2009).
Key Findings
There were substantial differences across contexts in both student selection procedures and the organization of clinical training. Despite this variation, the nine documents showed considerable overlap in the competencies they described. Differences were mainly evident in the level of detail and the emphasis placed on different competencies. Our main findings were:
1. Clinical psychologists need a broad range of competencies: Our analysis identified twelve main groups of competencies, with 37 subgroups. These ranged from a strong ability to learn, critical thinking and integration of information, to self-awareness, interpersonal skills, diagnostics, ethical role conduct, and ability to influence organizations.
2. Competencies are hierarchically organized: Competencies often associated with clinical psychologists – such as assessment and the application of psychological interventions tailored to specific clients or contexts (Domain 3) – rest on essential competencies, including the ability to learn, interact respectfully with others, and understand and regulate oneself (Domain 1). Process skills, such as integration of information from multiple sources and commitment to lifelong learning (Domain 2), enable psychologists to use their knowledge and competencies flexibly and thoughtfully.
3. Many of the competencies clinical psychologists need are not specific to psychology: The essential competencies and process skills required of clinical psychologists are shared with many other professions. Strong learning abilities, interpersonal skills, critical thinking, and the integration of information are widely relevant. This highlights opportunities to draw on insights from other disciplines when seeking to improve clinical training.
Implications for Practice
The results we present form an important resource both for practicing clinical psychologists and clinical training programs:
• Supervision and Professional Development
In continuous professional development, the competency framework can help clinical psychologists analyze and identity strengths and areas for improvement. Supervisors may also use the framework as a resource when reflecting on how to best help students improve their clinical skills. For example, if a student struggles with tailoring interventions to specific clients or contexts (Domain 3), it might signal a need to strengthen critical reflection skills or ability to integrate information from multiple sources (Domain 2).
• Competency-Based Education
The framework provides a shared starting point for improving clinical training and suggests paths to move training programs beyond covering content to fostering the development observable competencies. Our findings underscore the importance of integrating self-awareness and interpersonal skills early in training, rather than treating them as secondary to academic knowledge.
• Future-Proofing the Profession
Many competencies we identified – such as adapting to complex situations and influencing systems – are crucial for addressing emerging challenges, from digital mental health to broader global crises.
Study Limitations:
All nine documents included in the qualitative meta-analysis originate from Western, Educated, Industrialized, Rich, and Democratic countries (W.E.I.R.D). In addition, all members of the research team came from the same country. These limitations point to the importance of future research incorporating a broader range of perspectives and cultural contexts. Our results should therefore be considered a preliminary conceptual framework for core competencies needed to practice as a clinical psychologist, and for understanding the relationship between these.
What’s Next?
Our findings provide a foundation for rethinking how trainees are selected, how clinical training is organized, and how competency development is assessed. They also highlight the need for more research on clinical training, and raise several important questions:
• How can these competencies be assessed reliably?
• Which competencies are trainable, and which should inform selection into training programs?
• Are current training frameworks aligned with future societal needs?
We hope this work stimulates discussion and collaboration across training programs on how to translate shared competency goals into effective training and assessment strategies.
DISCUSSION QUESTIONS
1. Which of the identified competency domains do you find most challenging, and why?
2. How can clinical training be organized to better support the development of these competencies?
3. How might competency-based frameworks influence how we select and support future clinical psychologists?
4. What strategies could help integrate essential competencies – such as self-awareness and critical thinking – into training programs more effectively?
Reference/Target Article
Curious to learn more? Check out our full article in Clinical Psychology: Science and Practice:
“Mapping Core Competencies for Clinical Psychologists – A Qualitative Meta-Analysis of Nine International Standards and Accreditation Documents.”
ABOUT THE AUTHORS
Signe Hjelen Stige, PhD, is a professor in clinical psychology at the University of Bergen, Norway. Her main research interest is clinical training, including ways to measure effect of clinical training, ways to improve clinical training, and how technology can provide trainees with new learning opportunities that prepare them better for clinical tasks.
Endre Visted, PhD, is an associate professor in clinical psychology and a specialist in adult clinical psychology at the University of Bergen, Norway. His primary research interests include clinical training and processes of change in psychotherapy, with a particular focus on emotion regulation difficulties and psychophysiological markers.
Elisabeth Schanche, PhD, Elisabeth Schanche, PhD, is a professor in clinical psychology at the University of Bergen, Norway. Her research focuses on therapist training and psychotherapy processes, with particular emphasis on mechanisms of change across different therapeutic approaches.
Jon Vøllestad, PhD, is an associate professor in clinical psychology at the University of Bergen, Norway. His research focuses on transdiagnostic psychological treatments for emotional disorders and on clinician education and training, including the development of clinical competencies and psychotherapy skills.
REFERENCES CITED
| Knox, S. & Hill, C. E. (2021). Training and Supervision in Psychotherapy: What We Know and Where We Need to Go. In M. Barkham, W. Lutz, & L. G. Castonguay, (ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change. New York: John Wiley & Sons.Levitt, H. M. (2018). How to conduct a qualitative meta-analysis: Tailoring methods to enhance methodological integrity. Psychotherapy Research, 28(3), 367–378. https://doi.org/10.1080/ Rodolfa, E., Bent, R., Eisman, E., Nelson, P., 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- Shakow, D. (1969). Clinical psychology as science and profession: A forty-year odyssey. Aldine. Timulak L. (2009). Meta-analysis of qualitative studies: a tool for reviewing qualitative research findings in psychotherapy. Psychotherapy research, 19(4-5), 591–600. https://doi.org/10.1080/ |