What defines competency for trauma-related mental health services? Cook and Newman (2014) wrote an article summarizing major findings from the New Haven Trauma Competency Consensus Conference in effort to provide a comprehensive model of “trauma-focused, empirically informed competencies” (p 300). The conference participants were nominated by peers for their expertise with trauma and varied in their professional backgrounds (e.g., psychologists, psychiatrists, and social workers), roles (e.g., independent practice, medical settings, academic affiliation) and professional organizations. The main purpose of the conference was to have subject matter experts identify empirically informed knowledge, skills, and attitudes deemed critical to developing competency in working with traumatized adults and children.
The effort to establish clinical competencies is nothing new. This practice emanates from a broader trend in the medical field to enhance the quality of care and patient safety. It also reflects the growing emphasis of competency-based training in the field of psychology. Cook and Newman (2014) highlight the lack of trauma coverage in graduate training programs, cursory knowledge of trauma by clinicians despite a growing body of trauma literature and increased demand for trauma services, lack of consistency in the application of evidence based treatments or assessments, and complexity of comorbid conditions in trauma patients as additional compelling factors to provide a foundation for establishing trauma-related competencies.
Competent trauma practice, as outlined by Cook and Newman (2014), does not simply mean the utilization of evidence-based assessments and treatments. The authors argue that competency in trauma-related work also needs to include a broader range of knowledge, attitude, and skills. Specifically, the authors presented five broad areas (i.e., scientific knowledge about trauma, psychosocial trauma-related assessment, trauma-focused psychosocial intervention, trauma-informed professionalism, and trauma-informed relational and systems) identified by the conference participants as important to ensure competency in working with traumatized adults and children. The conference participants further delineated specific knowledge, attitude, and skills deemed relevant for being competent within each trauma domain. For scientific knowledge of trauma, the authors noted that competent individuals should be knowledgeable of available science, be able to critically analyze and appropriately apply its findings. Cook and Newman (2014) also go on to indicate that knowledge of prevalence, incidence, risk, resilience factors, trajectories, trauma related mechanisms and models, and biopsychosocial factors are foundational in terms of being competent regarding scientific knowledge about trauma.
Although it was not described as a foundational aspect of trauma assessment related competency, the authors stressed the importance of assessing for lifetime trauma exposure versus focusing exclusively on an index trauma. In terms of psychological interventions, Cook and Newman (2014) stated that competent individuals would use therapeutic strategies that do not support avoidance (e.g. collaboration with family, social networks, and healthcare systems), but would foster a sense of trust, and openness in being able to address the trauma-related material presented by patients. For professionalism related trauma competency, the authors highlighted the importance of maintaining appropriate boundaries with patients. Finally, for trauma-informed relational and systems based competency, Cook and Newman (2014) emphasized the importance of utilizing consultation skills to help address any system level issues that may present barriers to trauma recovery.
The article by Cook and Newman (2014) does a terrific job at answering the question about defining competency for trauma-related mental health services. The authors outline broad areas of competency for trauma related work thereby establishing a comprehensive model of “trauma-focused, empirically informed competencies” (p 300). This comprehensive model outlined by Cook and Newman (2014) can be a wonderful tool for training purposes. For example, based on the competency domains identified and the delineation of specific knowledge, attitude and skills for each domain, Cook and Newman (2014) provide all of the necessary building blocks for a training program to build or enhance an individual’s competency to work more effectively with traumatized adults or children. In the future, the authors are hoping to provide more guidance on developing specific benchmarks for reaching the different trauma related competencies. Overall, this article is a “must read” for anybody who teaches, provides training, supervises, conducts research or provides any trauma-related services.
Dr. Timothy Rodgers is a Deployment Behavioral Health Psychologist with the CDP at Lackland Air Force Base.
Cook & Newman (2014). A consensus statement on trauma mental health: The New Haven Competency Conference process and major findings. Psychological Trauma: Theory, Research, Practice, and Policy, 6(4), 300-307.