ABSTRACT
Resumen A nivel internacional, se han elaborado modelos e instrumentos de evaluación de competencias genéricas y específicas; sin embargo, en Argentina los desarrollos han sido menores. Un relevamiento de psicoterapeutas locales concluye que al menos siete competencias clínicas básicas y cinco indicadores asociados a su desarrollo serían esenciales para desempeñarse como terapeutas (Crocamo, 2019). El objetivo de este trabajo fue construir un instrumento para su evaluación, denominado Escala de Competencias Clínicas Básicas para Psicoterapeutas (ECCBP). Para ello, se utilizó un diseño no experimental, transversal de tipo exploratorio en cuatro fases: (1) elaboración del sistema de evaluación; (2) redacción de ítems; (3) revisión de la versión preliminar; y (4) desarrollo del instrumento definitivo. Se aplicó el instrumento a 534 psicoterapeutas argentinos con título de grado de psicólogo. La versión definitiva quedó conformada por 122 ítems y para completarlo se requirieren aproximadamente 45 minutos. La elaboración de un instrumento local favorece el estudio sistemático del área y permite valorar de manera confiable la efectividad de los programas de entrenamiento.
Abstract At the international level, models and instruments for the evaluation of generic and specific competences have been developed; however, in Argentina the developments have been fewer. A survey of local psychotherapists concludes that at least seven basic clinical competencies would be essential to perform as therapists: diagnostic process and design, interventions and techniques, therapeutic bond, professional role, contextual variables and diversity, interview management and evaluation and completion of the process. Furthermore, five activities and experiences would be linked to their training, called associated indicators: basic training and updating, personal development and work on oneself, belonging to institutions and network of professionals, supervision, and personal and professional experience (Crocamo, 2019). Therefore, the objective of this work was to construct an instrument for its evaluation called Basic Clinical Competences Scale for Psychotherapists (BCCSP). To do this, a non-experimental, cross-sectional exploratory design was used in four phases: (1) development of the evaluation system; (2) writing of items; (3) review of the preliminary version; and (4) development of the final instrument. The instrument was applied to 534 Argentine psychotherapists with a degree in psychology. To attend to the particularity of each phase, three samples were used. The first one was composed of three psychotherapists summoned to participate in the selection of the different methodologies to evaluate each competence and indicator. For the second one, reviewers of the instrument made up of five therapists with different levels of professional experience summoned to assess the preliminary version of the instrument. And the third, to study the psychometric properties of the BCCSP, a snowball sample was used composed of 534 psychotherapists from 19 provinces of Argentina. As a result, different evaluation formats were incorporated in order to favor the effective evaluation of the variables, clinical vignettes, self-evaluation of perception of competences and questionnaire. A systematized procedure was carried out to review and refine the pilot version. The percentage of agreement between the reviewers of the instrument (Herrera Rojas, 1993) and the Aiken's V coefficient were calculated using software called Basic Visual Program for Aiken's V, developed by Merino Soto and Livia Segovia (2009). The final version was made up of 122 items and it takes approximately 45 minutes to complete it. The first part is composed of three vignettes which offer clinical descriptions with 15 questions for each situation. Finally, the responses are scored as correct / complete (2 points), correct / partial (1 point) or incorrect (0 points). Next, the self-assessment scale presents the following Cronbach's alpha coefficients Therapeutic link α = .833; Professional role α = .715; Contextual variables and diversity α = .853; Interview management α = .845; Evaluation and completion of the process α = .845 and Design, interventions and techniques II α = .797. Finally, the questionnaire was made up of 22 items: basic training and updating (5 items), personal and professional experience (5 items), personal development and work on oneself (4 items), supervision (4 items), membership in institutions and professional network (5 items). The answers collected will allow to obtain qualitative information on experiences or activities associated with the development of clinical competencies for psychotherapy. In the first place, it should be noted that the BCCSP is an instrument specially constructed for the local population and the study area that can be generalizable to other similar sociocultural contexts since the vast majority of evaluation models and studies have been developed in Anglo-Saxon countries. At the same time, due to the lack of local evaluation instruments, the BCCSP could become a valuable tool, both to be used in research activities and in training programs and educational monitoring.
ABSTRACT
En las últimas décadas, han aumentado los estudios sobre las competencias para el ejercicio de profesiones de la salud. En psicología y en particular, en la psicoterapia, se han elaborado diferentes escritos que detallan las competencias que deben adquirir los y las psicoterapeutas durante su formación. Sin embargo, no se encuentran estudios sistemáticos que detallen las actividades y experiencias asociadas a su desarrollo, denominadas en este trabajo como indicadores asociados. Con el objetivo de conocer cuáles son las actividades y experiencias asociadas al desarrollo de competencias clínicas, se realizaron 20 entrevistas semi-dirigidas que fueron sometidas a un análisis temático en el que complementariamente participaron expertos, quienes actuaron como jueces en diferentes etapas del proceso. Como resultado, se identificaron cinco indicadores asociados: i. Formación de base y actualización, ii. Desarrollo personal y trabajo sobre sí mismo, iii. Pertenencia a instituciones y red de profesionales, iv. Supervisión y v. Experiencia personal y profesional.
In recent decades, studies on the competencies for the exercise of health professions have increased. In psychology, particularly for psychotherapy, various writings have been produced detailing the competencies that psychotherapists must acquire during their training. However, no systematic studies are detailing the activities and experiences associated with their development, in this work called Associated Indicators. In order to know the activities and experiences associated with the development of clinical competencies, 20 semi-structured interviews were carried out subjected to a thematic analysis in which experts participated as judges in different stages of the process. As a result, five associated indicators were identified: Basic training and refresher training, personal development and work on oneself, membership of institutions and networks of professionals, supervision and personal and professional experience.