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The social brain model emphasizes improving our understanding of the relational factors that influence treatment adherence. Consistent with this framework, which has been applied to medical adherence, it was hypothesized that insecure attachment styles, interpersonal hassles, and Iow levels of social support would explain group psychotherapy attendance. Results from 51 abused and suicidal Iow-income, African American women who attended at least 1 session of an empowerment group psychotherapy indicated that Iower attendance was related to (a) insecure attachment styles (fearful) and (b) interpersonal hassles (perceived social differences, lack of social acceptability, social victimization). Perceived social support did not predict group therapy attendance. The value of addressing attachment styles and interpersonal factors to enhance treatment participation is underscored. Keywords: social difficulties; group therapy; adherence; attachment; abused and suicidal African American women DOI: 10.1002/jclp.20628

Service utilization patterns among children with severe emotional and/or behavioral disturbances are described for 89 children and families, interviewed at two time points across a 6-month period. Children received a greater number of individual therapy sessions than family therapy sessions, and children significantly decreased their levels of internalizing and externalizing behaviors. Family therapy was associated with decreases in internalizing behaviors when children reported outcomes. Individual therapy was not associated with changes in either internalizing or externalizing behaviors regardless of reporter. Symptom severity did not dictate whether children were provided individual or family therapy. Recommendations for individualized treatment plans are offered.

This article provides information about suicide in the African American community, suicide and families, and suicide interventions, particularly those with a family focus. A culturally informed postvention model, Healing and Understanding Grieving Suicide Survivors (HUGSS), is presented. The article provides a discussion of the rationale for a culturally informed postvention program for African American suicide survivors, a description of the program and its guiding theoretical framework (symbolic interactionism), and details of the manualized 10-session protocol. Special considerations for child survivors are highlighted. Practice, research, and policy implications of this work are offered. Keywords: suicide, postvention, African American, families

Background information is provided on the link between intimate partner violence and suicidal behavior, as this association sets the stage for interventions for this population. Attention then is paid to the theoretical components of an innovative culturally competent intervention for abused and suicidal, low-income African American women, entitled Grady Nia Project. The intervention is guided by the theory of triadic influence. Cultural competence components essential to implementing an intervention with this unique population and guided by this model are articulated. The Grady Nia Project is then described in detail, focusing on the context in which the intervention is conducted, the content of the 10 sessions, and treatment satisfaction and outcome data. Implications for culturally informed practice with abused, suicidal African American women are noted. Keywords: intimate partner violence, suicide attempts, African American women, low income, culturally competent Interventions

An ecological model is used to explore the moderating effects of community-level variables on the relation between childhood sexual, physical, and emotional abuse and adult intimate partner violence (IPV) within a sample of 98 African American women from low incomes. Results from hierarchical, binary logistics regressions analyses show that community-level variables (perceived neighborhood disorder and community cohesion) moderated the relation between childhood emotional abuse and adult physical IPV. Findings support the use of an ecological approach in examining the phenomena of revictimization. Clinical implications from a community and ecological perspective are discussed. Keywords: revictimization; African American women; ecological approach; community

Measurements of intimate partner violence (IPV) based on acts of violence have repeatedly found substantial bilateral violence between intimates. However, the context of this violence is not well defined by acts alone. The objective of this research was to compare differences in women and men within each IPV status category (victim, perpetrator, and both) with respect to levels of battering as defined by their scores on the Women's Experience With Battering Scale (WEB), which asks gender-neutral questions about the abuse of power and control and fear in an intimate relationship. In our study, women disclosed higher levels of battering on the WEB, despite IPV status (victimization or both victimization and perpetration). In addition, female IPV victims were 5 times more likely than their male counterparts to disclose high rates of battering on the WEB. Depressive symptoms, symptoms of posttraumatic stress disorder, African American race, and IPV victimization were independently associated with higher WEB scores. Keywords: intimate partner violence; victim; perpetrator; battering; mental health; Women's Experience With Battering Scale

Psychological factors that influence links between intimate partner violence and suicidality in low-income African American women were examined using a multimethod approach. Results showed that suicide attempters used less coping strategies as opposed to nonattempters.

This article describes characteristics of alternative assessment models deployed in the measurement of professional competencies across the professional life span based on the work of the American Psychological Association Task Force on the Assessment of Competence in Professional Psychology. Assessments of knowledge, decision making, performance and personal attributes, as well as integrated practice-based skills and tasks are described and compared on the basis of their validity, feasibility and practicality, fidelity, and relevance at difference stages of professional development. It is acknowledged that no single assessment can evaluate all competencies and that assessments can be combined in complementary ways. Assessments deployed in the nursing, dental, and medical professions are reviewed and contrasted with current practices in psychology. At the licensure level, differences in the assessments deployed among the 4 healthcare professions are described, and their candidate fees and number of candidates assessed annually are documented. Ideas for developing new assessments in psychology are discussed on the basis of the needs and financial resources available to psychology and the experiences of other healthcare professions. Keywords: assessments, validity, reliability, feasibility, fidelity to practice

Challenges to the assessment of competence and competencies in professional psychology are discussed in this article. These include difficulties in defining competencies in precise and measurable terms; reaching agreement within the profession about the key elements of each competence domain; establishing an armamentarium of tools for assessing all components of competence, including the knowledge base, skills, and attitudes (and their integration); determining appropriate agreed-upon minimal levels of competence for individuals at different levels of professional development and when 'competence problems' exist for individuals; assuring the fidelity of competency assessments; and establishing mechanisms for providing effective evaluative feedback and remediation. But even if these challenges

The authors provide a recitation of events in recent years that document an increased focus on competency-based models of education, training, and assessment in professional psychology, particularly clinical, counseling, and school psychology, based on the work of the American Psychological Association's (APA's) Task Force on Assessment of Competence in Professional Psychology. The article begins with the inclusion of competencies as part of the 'Ethical Principles of Psychologists and Code of Conduct' (APA, 2002). Next, accreditation practices in the United States and Canada are summarized. Competency-based education, training, and credentialing efforts in professional psychology are reviewed, including graduate, practicum, internship, and postdoctoral levels; licensure; postlicensure

This article presents guiding principles for the assessment of competence developed by the members of the American Psychological Association's Task Force on Assessment of Competence in Professional Psychology. These principles are applicable to the education, training, and credentialing of professional psychologists, and to practicing psychologists across the professional life span. The principles are built upon a review of competency assessment models, including practices in both psychology and other professions. These principles will help to ensure that psychologists reinforce the importance of a culture of competence. The implications of the principles for professional psychology also are highlighted. Keywords: competence, assessment, education and training, guiding principles

Working collaboratively, psychologist educators and trainers at the doctoral, internship, and postdoctoral levels; credentialers; practitioners; and students offer 8 proposals for psychologists to consider in recognizing, assessing, and intervening with problems of professional competence in students and practicing professionals. In the proposals, the authors address the following topics: definitions and categories; preparing the system; self-assessment; remediation; diversity; communication across various levels of the system; confidentiality; and ethical, regulatory, and legal underpinnings. They also propose future directions for the assessment of problems in professional competence in both students and practicing psychologists. Keywords: competence, assessment, self-assessment, diversity, ethics

Spirituality has been identified as one component of a culturally competent therapeutic intervention for African American women. The present study was designed to investigate the ability of factors, such as level of hopelessness and the use of positive religious coping strategies, to predict spiritual well-being over time. Seventy-four low-income African American women were administered self-report questionnaires measuring hopelessness, use of religious coping strategies, and two domains of spiritual wellbeing. Path analysis indicated that hopelessness, existential well-being, religious well-being, and positive religious coping are correlated with one another. Further, lower levels of hopelessness predict increases in existential well-being over time; higher levels of positive religious coping predict increases in religious well-being over time. Results were consistent with the study hypotheses and highlight the need to attend to predictors of spiritual well-being when implementing culturally relevant interventions with abused, suicidal African American women. Therapeutic strategies for reducing hopelessness and enhancing positive religious coping to improve spiritual and existential well-being are presented; such strategies will ensure the interventions are more culturally competent. Keywords: spirituality; spiritual well-being; African American women; intimate partner violence; culturally competent intervention

Unemployment and depression are problematic at both individual and societal levels, and research suggests that the two phenomena are related. More thorough and longitudinal analyses, particularly ones within low-income minority populations, are needed to guide the development of programs to increase employment in persons with mental health problems. The current study aimed to specify the relations over time between depressive symptoms and employment status within a sample of 46 low-income African American women participating in an intervention study for intimate partner violence and suicidal behavior. Hierarchical logistic regression analysis indicated that baseline levels of depressive symptoms predicted employment status at the end of a 10-week intervention period, controlling for baseline employment status. Chi-square analysis and qualitative analyses of trends in depression scores showed that changes in employment status during the 10-week intervention period predicted 6-month and one-year follow-up levels of depressive symptoms. Results imply that, for women in the currently sampled population, depressive symptoms create vulnerability for job loss, but the ability to gain employment despite high levels of depressive symptoms is linked to lowered depression levels over the long term. Community programs assisting such women could therefore not just lower the vulnerability to job loss by treating depressive symptoms, but they could potentially lower long-term depression levels through interventions that enhance employability and motivation to pursue work. Keywords: employment; African American women; depression

Quality health care must be informed by the best available scientific knowledge. This article offers research evidence supporting 'health care for the whole person.' We present an integrative biopsychosocial framework that can serve as a useful foundation for translational research endeavors and the development, evaluation, and dissemination of evidence-based health and mental health interventions. Pain and depression are used as exemplars of the biopsychosocial model. Empirical support for mental health interventions in primary care settings is highlighted, with particular emphasis on the treatment of depression across the life span. Research, practice, and policy implications based on the extant evidence base for health care for the whole person are offered. Keywords: biopsychosocial, culture, evidence-based practice, intervention

The current study aims to further our understanding of the applicability of the transtheoretical model (TM) to intimate partner violence (IPV), with particular focus on mental health symptoms (depression, posttraumatic stress disorder symptomatology, suicidal ideation) in a sample of low-income African American women seeking medical services at an inner city emergency department. Results revealed that of the 121 abused African American women, the majority (95%) were in the precontemplation and contemplation stages of the change process. Further, contrary to predictions. bivariate analyses revealed those at further stages of change endorsed more severe mental health symptoms. However, a multivariate analysis of variance examining differences in level of mental health symptoms between women high and low on stages of change was inconclusive due to the small number of women at the higher stages of the TM model. These findings contribute to the growing body of literature supporting the TM as applied to IPV. Results are discussed in terms of applicability to intervention design. Keywords: intimate partner violence; African American women; transtheoretical model

Coping variables that mediate the relation between intimate partner violence (IPV) and mental health outcomes among African American women were investigated. The study sample included 143 economically disadvantaged African American women ranging in age from 21 to 64 years old who were receiving services at an urban public health system. Sixty-five had experienced IPV within the past year and 78 had never experienced IPV. Results indicated that (a) the IPV status--depressive symptoms link was mediated by multiple ways of coping, spiritual well-being, and social support; (b) the IPV status--anxiety symptoms link was mediated by multiple ways of coping, social support, and ability to access resources; and (c) the IPV status--parenting stress link was mediated by multiple ways of coping, spiritual well-being, and social support. Implications of these findings for clinical practice with abused women are discussed. Keywords: intimate partner violence; coping; African American women; depression; anxiety: parenting stress

A comparative study of suicidal behavior first-time and repeat suicide attempters among low-income African American women was conducted. Findings showed that the two groups were similar across sociodemographic characteristics and relative to first-time attempters, the attempts of repeat attempters involved higher levels of intent, planning and perceived lethality and were associated with more psychological distress, hopelessness, substance abuse and childhood trauma.

Although women are often criticized for not leaving abusive relationships, most abused women actively attempt to protect themselves. This study proposed an ecological model to explain strategic responses to abuse, evaluating factors at four levels: Childhood, Relationship, Individual Impact of Abuse, and Community. Data was retrospectively collected from 85 incarcerated women, a population that is disproportionately affected by trauma and has unique intervention needs. A series of hierarchical multiple regression analyses confirmed that the proposed ecological model accounts for variance in six strategic response categories: placating, resisting, safety, legal, formal, and informal. Findings are discussed in terms of intervention implications. doi: 10.1300/J015v29n03_06 KEYWORDS. Incarcerated women, intimate partner violence, abuse, strategic response, help-seeking, ecological

This study was designed to examine the relationship between suicide acceptability and religious well-being, and to investigate the differences that may exist between African American suicide attempters and non-attempters on [...]

Academic and internship training directors (TDs) were surveyed regarding practicum training. The most frequently endorsed definition was that a variety of specific activities at a practicum site constituted a legitimate part of a practicum hour, including supervised clinical assessment, clinical intervention, and community consultation, advocacy, or training. Academic and internship TDs differed in their views regarding the minimum number of practicum hours necessary and whether the number of hours should be capped, Implications for points of agreement and disagreement are discussed, and applications of these data to future education and training initiatives are proposed. Suggestions for turning the focus toward competencies rather than hours obtained are provided. Keywords: practicum, internship, training, education, competency

During the past 50 years, a number of models of training (scientist practitioner, practitioner--scholar, clinical scientist) have been developed. This study examined how these models are conceptualized and implemented at internship and postdoctoral training programs. Surveying 248 internship programs (42% response rate), the authors found that the model name (i.e., scientist-practitioner) was not related to how programs were conceptualized or how their training was implemented, raising questions about accreditation requirements. Implications for training sites and the American Psychological Association Committee on Accreditation are explored.

The Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology was organized around eight competency-focused work groups, as well as work groups on specialties and the assessment of competence. A diverse group of psychologists participated in this multisponsored conference. After describing the background and structure of the conference, this article reviews the common themes that surfaced across work groups, with attention paid to the identification, training, and assessment of competencies and competence. Recommendations to advance competency-based education, training, and credentialing in professional psychology are discussed. This is one of a series of articles published together in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist. Keywords: competencies; education and training; credentialing

Supervision is a domain of professional practice conducted by many psychologists but for which formal training and standards have been largely neglected. In this article, supervision is proposed as a core competency area in psychology for which a number of elements reflecting specific knowledge, skills, and values must be addressed to ensure adequate training and professional development of the trainee. Supra-ordinate factors of supervision viewed as permeating all aspects of professional development are proposed. These include the perspective that professional development is a lifelong, cumulative process requiring attention to diversity in all its forms, as well as legal and ethical issues, personal and professional factors, and self- and peer-assessment. A competencies framework is presented with particular elements representing knowledge (e,g.. about psychotherapy, research, etc.), skills (including supervising modalities, relationship skills, etc.), values (e.g., responsibility for the clients and supervisee rests with supervisor, etc.), and meta-knowledge. Social contextual factors and issues of education and training, assessment, and future directions also are addressed, with specific elements listed. Suggestions for future work in this area are addressed, including the need to refine further and operationalize competences, develop clear expectations for accreditation and licensure regarding supervision competencies, and expand the description of developmental levels of supervisors from minimal to optimal competence. This is one of a series of articles published together in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference. Future Directions in Education and Credentialing in Professional Psychology will appear in Professional Psychology: Research and Practice and The Counseling Psychologist. Keywords: supervision; competencies; training; standards

This article provides an overview of issues related to the development and evaluation of competency in psychological assessment. Specifically. we delineate the goals, ideas, and directions identified by the psychological assessment work group in the Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology. This is one of a series of articles published in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference will appear in Professional Psychology: Research and Practice and The Counseling Psychologist. The psychological assessment group was charged with the tasks of: (a) identifying the core components of psychological assessment competency; (b) determining the central educational and training experiences that will aid competency development; (c) explicating strategies for evaluating competence; and (d) establishing future directions for furthering the identification, training, and evaluation of competence in psychological assessment. We present a set of eight core competencies that we deemed important for achieving psychological assessment competency and discuss four guidelines for training in the domain of psychological assessment. A variety of methods for evaluating competencies in this domain are suggested, with emphasis on using a collaborative model of evaluation. Recommendations for future directions include strengthening the academic prerequisites for graduate school training; increasing training in culturally sensitive measures; incorporating innovative assessment-related technologies into training; and addressing discontinuities between academic training, internship, and practice environments. Keywords: psychological assessment; competency; training