Core Therapist Competencies for Child Conduct Problems: Conceptualisation, Case Complexity and Clinical Applications

Abstract

Effective early intervention for child conduct problems (CPs) is essential due to negative long-term social, academic and mental health ramifications if such problems persist. The gold-standard treatments for CPs are social learning-based parenting interventions (PIs). Therapist training in these interventions is important to their implementation but has received much less research attention than intervention manuals and components. Competency-based training has been effectively used to increase both quality and reach of other psychological interventions and may offer similar benefits for PIs. Through four studies, the current research project sought to conceptualise the core competencies for therapists delivering PIs for CPs; conceptualising drivers of case complexity and how core competencies can support responses to each driver; and using these conceptualisations to construct and test the utility of a competency-based therapist training tool. The Delphi method was employed with an international panel of expert practitioners, to construct a model of core competencies (Study 1) and a model of drivers of case complexity (Study 2). Co-design focus groups and interviews with an international group of supervisors were then conducted to translate the core competency model into a competency rating tool (Study 3). Finally, the effect of competency-based training on trainee therapist reflective practice was examined in a single case experimental design (SCED) using multiple baselines (Study 4). Resultingly, this project produced three key outcomes: a consensus-validated model of core therapist competencies for PIs; a consensus-validated model of drivers of case complexity for CPs; and a validated 15-item expandable competency rating tool that was shown to improve reflective practice competence for some trainee therapists. Implications for research and clinical practice are discussed, particularly regarding opportunities for improved scale and quality of delivery of PIs.