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Doctoral Clinical Qualifying Examination Online Guidebook
May 30, 2001
Revised October 30, 2003
Carol L. Oster, Psy.D.
Table of Contents (Click to select)
Competencies 4
Introduction to the Clinical Qualifying Examination 4
Need for and Purpose of the Clinical Qualifying Examination 4
Model for the Clinical Competency Exam 5
Levels of Review in the CQE 5
Discussion of Extra-Case Issues within the Oral Examination 6
Limits to Range of Inquiry 6
CQE MEMORANDUM 7
NCSPP model 9
Contents of Clinical Qualifying Examination Binder 9
Subjects under 18 10
Executive Summary Guidelines 11
Purpose of Requirement 11
What to Include in the Executive Summary/Consultation Letter 11
CQE Comprehensive Psychological Assessment Report 12
Purpose of Requirement 13
Guidelines 13
Report Template 14
CQE Guidelines for Reports on Individual Procedures 23
Purpose of Requirement 23
Behavioral Observations 23
Results 23
Interpretation 23
Recommendations 24
Steps in Completing the WAIS-3 Record Form 25
Steps in Interpreting the Wechsler Intelligence Tests 27
Lifestyle Assessment Checklist 31
Case Conceptualization and Treatment Plan 33
CQE Taped Session Write-Up Guidelines 36
Consent Form 37
CQE Oral Examination Process 37
Anxiety Management for Oral Exams 39
Coping with Anxiety 39
Do's and Don'ts during the Exam 41
Grading Criteria for the Clinical Qualifying Examination 43
Written Report 43
Ability to administer psychological tests 43
Ability to score psychological tests 43
Ability to interpret psychological tests 44
Clarity and quality of written work 44
Understanding of psychological interpretations 44
Clinical insightfulness 45
Oral Presentation and Discussion 45
Ability to communicate clinical findings orally - including diagnosis 45
Quality of therapy tape 46
Understanding of psychological interpretations 46
Ability to deal with ethical and individual/group diversity issues related to the case 47
Willingness to receive feedback and directions; openness to supervision and alternate interpretations or instructions 47
Doctoral Clinical Qualifying Examination Online Guidebook
This Guidebook is intended to assist doctoral students preparing for the Doctoral Clinical Qualifying Examination (CQE) at the Adler School of Professional Psychology. It developed out of my syllabus for the CQE Preparatory Course and my years of teaching psychological assessment. Some of the advice contained herein should be considered my own opinion and not official policy. If you have any questions regarding what is, in fact, official policy, please consult with the Dean of Academic Affairs, Dr. Gruba-McCallister and Dr. Carolyn Gralewski, the administrator of the exam. In addition, students are encouraged to discuss any questions with core faculty members.
A CQE Preparation Course (051) is offered every term. I strongly recommend that you take the preparatory course, particularly if you typically experience anxiety sufficient to interfere with performance in class or case conferences, or if you are returning to campus after focused fieldwork/practica or a leave of absence.
Competencies
Students who successfully complete the CQE Preparatory Course or successfully utilize this online guide will be able to:
1. Explain to themselves and others the philosophy, model, purpose and process of the CQE;
2. Organize their written material according to guidelines;
3. Prepare a written case conceptualization, treatment plan, and session summaries according to guidelines;
4. Anticipate questions that may arise during the CQE based upon their case, as well as other questions;
5. Explain to themselves and others the evaluation criteria for the CQE, and apply them to their own cases in advance of the exam, and
6. Develop a plan to cope with performance anxiety.
Introduction to the Clinical Qualifying Examination
Need for and Purpose of the Clinical Qualifying Examination
The Clinical Qualifying Examination (CQE) was implemented as the first doctoral students at the Adler School approached their internship year. The question that needed to be answered was "How can the faculty, internship directors, and students know that students are 'internship-ready' - that their knowledge, skills, and values had developed enough to practice at an advanced level of training that is, in some jurisdictions, the last step prior to independent practice?" Faculty needed to be confident in the students they were "publishing" to the professional community for "peer review". Internship supervisors needed to be confident that students were capable of benefiting from, and living up to the expectations of, advanced training. Intern applicants themselves needed the assurancethat they were indeed ready for their new status.
Such assurance could not be gained from a paper-and-pencil test such as the Written Qualifying Examination. It demanded actual demonstration of skill, application of knowledge, and explication of values in action as they applied to real-life problems students were apt to encounter in internship and beyond.
Model for the Clinical Competency Exam
The model for competency assessment in the professional community is the ABPP examination in professional psychology, or "Diplomate exam". ABPP examinations generally have three components: a "paper review" or examination of the applicant's vita and application; a written, extensively annotated example of actual clinical work; and an oral examination of the applicant on professional psychology in general and matters pertinent to the presented case in particular. In some cases, actual direct observation of clinical work with a "test client" takes place. In most cases, demonstration of clinical skill in progress is by review of audio or videotapes of the applicant's work. The oral examination may last from 4 hours to 2 days, depending on the specialty area.
The Clinical Qualifying Examination at Adler, similarly to clinical competency exams at other NCSPP programs and schools, consists of a "mini-ABPP".
Levels of Review in the CQE
As with ABPP exams, there are three levels of review in the CQE process. The first level of review consists of transcript review and discussion between the student and the exam coordinator. It establishes that the student has reached a point in academic progress and clinical training sufficient to undertake the task, and that the student understands the major requirements.
The second level of review consists of the written material submitted by the student a minimum of 2 weeks in advance of the final, oral component of the examination. This provides students with an opportunity to demonstrate their best work in writing, with ample opportunity to review and experience supervision on the material before submission. It also provides faculty with an opportunity to review the student's best work in depth.
The third level of review consists of a one-hour oral examination of the student by two core doctoral faculty members. The oral examination provides the student with the opportunity to demonstrate the ability to work collegially, to "handle" supervision and consultation professionally, to communicate clinical material orally, to empathize with listeners, to explain or educate others about clinical matters, and to clarify any issues that arose in the faculty review of the written material.
Discussion of Extra-Case Issues within the Oral Examination
While the oral examination takes as its starting point the material and case submitted by the student, faculty may examine the student on other material, as they deem appropriate and relevant, provided they hold each student to the appropriate expected level of performance, given that the student is typically examined one year prior to internship. The examination may address knowledge, skills, and attitudes (values, ethics, clinical suitability) only peripherally related to the actual clinical case. Examples of such "peripheral" issues includea transition in the student's professional identity from R.N. to Psy.D.; the ethics of choice of subject/client for the exam; the students' professional development or career plans, the student's countertransference issues or receptivity to supervision and consultation, and so forth.
Limits to Range of Inquiry
In general, while issues related to ethics, academic integrity, and clinical suitability may be discussed during the exam, the examination may not amount to an ethics or academic committee review. Under only extremely unusual circumstances would issues that arise during the examination lead to a referral to the school's Ethics Committee. Examples of issues demanding such referral would be clear evidence of violation of major ethical principles such as boundary violations, deliberate failure to follow reporting requirements for abuse, or academic dishonesty related to the exam.
Clinical suitability, countertransference, attitudinal/values, or career development issues may be addressed during the exam. Other questions of a personal nature are not likely to occur or to be relevant to the assessment purposes of the CQE.
CQE MEMORANDUM
TO: Doctoral Students and Faculty
FROM: Dr. Carolyn Gralewski, Coordinator
TOPIC: Clinical Qualifying Examination (CQE)
DATE: January 1988 (with minor revisions by the Editor)
The following guidelines for the Clinical Qualifying Examination (CQE) were reviewed by the Curriculum Committee and the Faculty. These guidelines must be followed in preparing for the CQE as of this date.
1. Students must obtain written permission from Dr. Gralewski. Prerequisite for the CQE is successful completion of the Written Qualifying Examination.
2. All data and reports must be assembled in a 3-ring binder, with divisions to mark the tests, reports, etc.
3. Each test, test protocol, and interpretive notes must be presented separately. A separate section on Life Style Assessment is required.
4. A comprehensive assessment report of 8 - 10 pages is required.
5. A separate 1 - 2 page Executive Summary of the above is required.
6. A Case Management/Treatment Plan of 4-6 pages must be submitted along with tapes of 2 intervention sessions.
7. One, and only one, of the two intervention tapes may be an initial interview. [Editor's note: However, the interview may NOT be a structured interview, life-style questionnaire, and the like. Remember that the goal is to demonstrate your clinical skills. See guidelines elsewhere on this webpage.]
8. In every case, the second tape must be an example of an intervention session.
9. Regular cassette tapes must be used. Mini-cassettes are not acceptable.
10. Each tape must be accompanied by a description of the purpose and goals of the session. The intervention tape must be accompanied by a written plan that addresses the session in its total context and provides detailed commentary of the session contained on the tape.
11. If tape fidelity for listening is judged unacceptable, the student must provide a written transcript.
12. It is preferable to use a single client for both the assessment and therapy portions of the exam; however, if necessary, there can be one client for the assessment portion, and a second client for the intervention portion of the exam.
13. Include an authorization [consent] form. Delete all client personal identification from the data.
14. Students must register for 997: Doctoral Clinical Qualifying Examination.
15. Submit two copies of the notebook and two copies of intervention tapes to Dr. Gralewski. Dr. Gralewski will assign two core doctoral faculty members as examiners, and inform the student. The student is then responsible for contacting the examiners to arrange a mutually agreeable date and time for the exam.
16. The CQE is a prerequisite for internship application and for the dissertation proposal.
NCSPP model
The education and training model that organizes the doctoral program in clinical psychology at Adler is based on the NCSPP model, with unique modifications to fit the mission and purpose of the Adler School. The domains within Adler’s model include Relationship, Assessment,Intervention, Research, Management &Supervision, Consultation & Education, Diversity, and Adlerian Theory & Methods. The CQE seeks to evaluate students’ knowledge, skills, and values in these domains. We suggest that students re-read the article linked above to become familiar with the content of each of these domains.
Contents of Clinical Qualifying Examination Binder
- Executive Summary
- Comprehensive Report
- Interpretation hypothesis sheets and raw data for individual procedures:
- WAIS-III
- Bender
- House-Tree-Person
- Sentence Completion
- MMPI-2
- Thematic Apperception Test (TAT)
- Rorschach
- Life Style Assessment
- Optional instruments
- Case Management/Treatment Plan
- Session Summaries for Taped Sessions
- Consent Form (Keep the original for your record. On the submitted copies, white out all but the client's initials and/or alias.)
- Tapes
Use a three-ring binder. Each area should have its own section, separated by dividers.
If you need to deviate from the required list of instruments, you must present a written rationale for such deviation to Dr. Carolyn Gralewski, and you must have the signed consent of Dr. Gralewski for the deviation.
Subjects under 18
MEMO
To: Doctoral Students
From: Carol Oster, Psy.D.
Dean of Students
Re: Modification of Clinical Qualifying Exam requirements
Date: October 10, 2003
By decision of the faculty at the October 2003 faculty council meeting, students who plan to work primarily with children and adolescents may submit the testing/assessment portion of their Clinical Qualifying Exam on an adolescent 14 years old or older.
The requirements for the assessment battery are as follows:
WISC-III or WISC-IV
(Beginning September 2004, only the WISC-IV will be accepted.)
Bender Gestalt
House-Tree-Person
Sentence Completion
MMPI-A (adolescent version of the MMPI)
TAT or Roberts Apperception Test
Rorschach
Woodcock Johnson, WIAT, or WRAT (current version)
Parent Rating Form appropriate to the referral question
Life Style assessment is generally appropriate for individuals 18 and older. If you feel that the Life Style Assessment would be appropriate and useful for a younger adolescent, you will need to consult with an Adlerian faculty member regarding the case.
If you submit an adolescent assessment case, you must still submit an intervention tape, treatment plan, and case write-up with an adult. In most cases, you will submit a LifeStyle Assessment on the adult whose case you are presenting.
You may add instruments to the required list. If you choose to add instruments to tailor the battery for the referral question, you must be able to demonstrate competency with those instruments.
Additional tests are not required. Nor are you required to report on such instruments, if used. However, be sure to limit your report to sources of information actually demonstrated in your data inclusion (and clinical or collateral interview, records review, consultations, etc. as appropriate).
Executive Summary Guidelines
1 - 2 Pages
Purpose of Requirement
This requirement demonstrates your ability to communicate test results concisely, as often required in professional practice when consulting with other professionals whose time is limited. This report should be in narrative form, as if a consultation report or letter to another professional. Thus, this requirement speaks not only to the assessment competency, but also to relationship and consultation competencies of the Adler/NCSPP model of education and training.