Summer 2000, Vol. 8, No. 3.

Special Article: Core Competencies for Organizational and Occupational Psychiatry

By Len Sperry, M.D., Ph.D.**
Wuston, FL.

What are the basic knowledge and skills needed for psychiatrists to competently extend the scope of their practice to include workplace issues? This question has been leisurely discussed over the years with no real immediacy in finalizing a list of core competencies or a model curriculum derived from it. Lately, there has been increasing interest in specifying such core competencies as individual psychiatrists seek alternatives to traditional clinical practice and the profession of psychiatry more seriously considers of partnering with business and industry.

The following list attempts to specify the basic conceptual and skill competencies adjudged necessary for psychiatrists to effectively deal with workplace issues in a manner than is consistent with ethical and professional standards. This list was compiled by Len Sperry, MD, PhD based on input from Steve Heidel, MD, Ronald Schouten, MD, Harry Prosen, MD, and Edgardo Perez, MD, as well as on the description of the fellowship program in Organizational Psychiatry at the Medical College of Wisconsin. It is intended as a working document, rather than a final draft.

This listing assumes and defines the competent practice of Organizational and Occupational Psychiatry (OOP) to require a knowledge and skill-base integrating both individual and organizational dynamics. Accordingly, this definition would not classify the traditional independent medical evaluation (IME) as an OOP activity unless the IME report includes a recognition and formulation of organizational dynamics and possible person--organizational intervention(s).

CONCEPTUAL KNOWLEDGE

• importance of work and personal identity and the place of work in self-esteem and adult development
  
• organizational factors, including organization sub-systems and developmental stage
  
• group dynamics and worker--team dynamics in team functioning and performance
  
• the Job Demand-Control Theory and other models of organizational stress
  
• personal and organizational dynamics, particularly the person-organization fit
  
• functionality vs. symptomatology in individuals, work teams and organizations
  
• leadership style and power and impact on corporate culture and productivity
  
• relationship of productivity and health
  
• traditional consultation interventions vs. clinical-consultation interventions
  
• Job accommodation and provisions of the Americans for Disability Act
  
• occupational/forensic issues re: sexual harassment and workplace violence
  
• dual career couples and family-work stress and conflicts
  
• Occupational Problems (V 62.2) vs. work disorders, especially manifestations of anxiety and depression in the workplace
  
• corporate financial statement
  
• management functions, including human resources
  
• work-focused psychotherapy contrasted with traditional psychotherapy
  
• multi-cultural issues and issues of security in the workplace
  

CONSULTATION SKILLS

1.  Entry, Engagement and Exit Skills

• capacity to identify the client system and consultee(s) and attend to double agentry issues and confidentiality issues
  
• capacity to work with the client and consultee comfortably and without being intimidated
  
• capacity to identify the actual consultation problem vs. the stated problem
  
• capacity to structure the consultation and define roles
  
• capacity to establish a contract for services
  
• capacity to define and maintain boundaries for consultation
  
• capacity to effectively join with the client system and consultee(s), i.e., establish a working relationship
  
• capacity to report orally and in writing, when indicated, the findings of consultation to the client.
  
• capacity to exit the system and/ or re-contract for additional services
  

2.   Assessment Skills

• capacity to appreciate and assess functionality as well as symptomatic distress
  
• capacity to think systemically and formulate problems and issues in terms of both personal and organizational dynamics
  
• capacity to perform a basic organizational assessment which includes the components of structure, strategy, leadership, corporate culture, environment, and organizational stage
  
• capacity to recognize and assess impairment, interpersonal conflicts, productivity problems, discrimination, sexual harassment, and worker-family conflicts.
  
• basic level of competence in performing the following assessments: psychiatric disability evaluation, fitness for duty evaluation , job fit and threat assessment.
  

3.  Intervention Skills

• capacity to initiate and evaluate at least one change process with a worker, i.e, fitness for duty consultation or executive coaching
  
• capacity to initiate and evaluate at least one change process with a work group, i.e., team development.
  
• capacity to initiate and evaluate at least one change process with an organizational unit, i.e., critical stress debriefing (CISD).
  

 
Return to Top