Every six months, all Trainees are provided with feedback from their primary supervisors about their performance and progress with regard to the following training objectives. If more intensive remediation is judged to be necessary, the supervisor’s recommendations for remediation will be provided in writing to the Fellow, and the Fellow will be encouraged to submit a written remediation plan that can be signed by both parties. The evaluation procedure is primarily useful as a tool to guide the subjective impressions of the supervisor into more specific feedback to support the continued progress of the Trainee.

Assessment, evaluation, and diagnosis: Trainee makes optimal use of scientifically rigorous psychological and personality theory to structure and organize observations of patients’ self-reports, historical data, and current behavior. Trainee formulates and tests hypotheses both systematically and opportunistically. Trainee is aware of his or her own limitations in training and experience, and seeks supervision or referral as indicated. Diagnoses are adequately supported by criteria and are carefully selected to minimize harm while maximizing therapeutic utility.

Case conceptualization: Trainee continually refines hypotheses about patients’ most important learning needs within a developmentally, culturally, and interpersonally appropriate context. Patients are understood to be theorists of their own environments and internal resources. Trainee seeks to understand as clearly as possible both the functionality and dysfunctionality of patients’ theories. Trainee routinely invites patients to formulate and discuss their own strategies for increasing their comfort and function. Using expert judgment on behalf of patients’ long-term best interests, trainee independently formulates optimal emotional learning goals, philosophical learning goals, and skill learning goals for the patient, and Trainee remains able to articulate these goals, seeking the patient’s agreement, at all times. Trainee uses case conceptualization transparently and collaboratively as a therapeutic learning task.

Selection of evidence-based treatments: Trainee selects treatment tasks based on the individualized case conceptualization, with careful consideration of the empirical status of the treatments selected and not selected. Trainee shows adequate understanding of the mechanisms underlying empirically-supported treatments, and is able to effectively customize these treatments to the specific needs of each patient.

Utilization of the therapeutic alliance: Trainee continually reviews agreements with patients about the goals of therapy and the tasks used to pursue those goals. Trainee is able to articulate his or her case conceptualization in ways that encourage the patient to provide feedback and functional refinement of the shared conceptualization. Trainee encourages and reinforces each patient’s ability and willingness to become his or her own best therapist. Trainee prioritizes safety and handles patient crises effectively while continuing to pursue patients’ central therapeutic learning goals. Trainee is able to make optimal use of ruptures in the therapeutic alliance as therapeutic learning opportunities, in explicit accordance with the shared case conceptualization. Trainee is able to disagree with patients about the goals and tasks of therapy, and is able to explicitly refuse to pursue non-therapeutic goals. Trainee custom-designs cognitive-behavioral interventions using patients’ own language, constructs, and memorable learning experiences. Trainee is able to identify and remediate his or her own counter-therapeutic emotional reactions, including counter-therapeutic processing of irritation, anxiety, or affiliation. Trainee is increasingly able to use his or her emotional reactions in furtherance of the goals and tasks of therapy.

Adequacy of documentation: Progress notes and other documentation is adequate to establish the diagnosis, the treatments selected, the patient’s response, and meets state and federal requirements. Documentation shows sensitivity to privacy concerns, and only necessary information is documented. Documentation is as brief and concise as possible under legal and ethical requirements.

Collaboration and consultation: Trainee makes optimal use of other Institute staff in assessment, case conceptualization, treatment, and utilization of the therapeutic alliance. Trainee participates as a reliable resource on a highly collaborative, mutually supportive team.