Service user views of clinical psychologist competence : a thesis submitted in partial fulfilment of requirements for the degree of Doctor of Clinical Psychology at Massey University, Albany, Aotearoa New Zealand

Abstract

People who engage with mental health services are often not included when developing professional practice guidelines, including clinical psychology core competencies. There is a lack of research regarding how service users view psychologist competence, and service users have never been explicitly involved in generating related competencies. This leads to a limited understanding of whether existing conceptualisations of competence and competencies align with service user views. I aimed to inform current theoretical and practical understandings of competence and competencies by asking what service users identify as competent practice for clinical psychologists (CPs) and how service user views of clinical psychology (CP) competence aligned or contrasted with existing aspects of the New Zealand Psychologist’s Board (NZPB) core competencies. I adopted a social constructionist, user-led orientation based on co-production principles. This informed a mixed methods survey (n = 73) and individual interviews (n = 12) that asked A-NZ adults who had seen CPs for mental health support how they viewed CP competence. Analyses included descriptive statistics for quantitative data, content analysis for the qualitative survey data, and thematic analysis for the qualitative interview data. The analyses were then compared with the existing core competencies. The findings included five main areas that participants highlighted as important for CP competence: Interpersonal Skills and Relational Presence; Responsive Contact; Cultural Responsivity; Mental Health-Related Stigma, Discrimination, Exclusion, and Power (MHSDEP); and Safe Processes and Profession. A major aspect of service user views that contrasted with the NZPB competencies was the area of MHSDEP, especially in reference to power. Service user views of competence inform contemporary conceptualisations of competence and provide information about what is needed to make the current competencies more responsive and fit for purpose. I recommend that service user views be incorporated into the current competencies. It is clear from this study that the views of people with lived experience of mental distress are crucial for informing professional practice processes and guidelines for psychologists and mental health services more widely.