What counts? A Delphi consensus-based approach to interpreting accreditation standards for Direct Client Activities in clinical psychology and clinical neuropsychology programs

ABSTRACT Objective Despite operating from the same professional accreditation standards, discrepancies in what is recorded as Direct Client Activities (DCA) in postgraduate psychology trainee logbooks have been noted across training programs in Australia. The aim of this study was to create a consensus-based list of DCA to guide the completion of trainee logbooks while undertaking practicums in clinical psychology or clinical neuropsychology. Method A modified Delphi approach was used to gather data across three rounds. Two expert panels, representing the two areas of practice endorsement (AoPEs), rated the degree to which they agreed or disagreed with a range of activities being recorded as DCA in trainee logbooks. Activities with over 80% agreement or disagreement during any round were accepted or rejected from the final list, respectively. Results Sixteen activities for clinical psychology and 30 activities for clinical neuropsychology were endorsed by the expert panels. Only nine activities across the two panels did not reach consensus over the three rounds. Conclusions This study has created a list of consensus activities within these two AoPEs which will facilitate benchmarking activities, and reduce confusion and anxiety for trainees, supervisors, and placement coordinators. Discrepancies do, however, remain across the AoPEs, warranting further clarification and definition refinement. Key Points What is already known about this topic: Logbooks are a key strategy in ensuring individual trainees and postgraduate training programs are meeting minimum standards set by accrediting bodies. Although required by the Australian Psychology Accreditation Council (APAC) to be recorded in trainee logbooks, there is a lack of consensus across Australian postgraduate psychology program providers as to what constitutes “Direct Client Activities”. Inconsistent logging practices prevents benchmarking and creates confusion and anxiety for trainees, supervisors, and placement coordinators. What this topic adds: This paper was the first, to our knowledge, to obtain expert consensus on trainee Direct Client Activities for logbook recording within the clinical psychology and clinical neuropsychology areas of practice endorsement. The list provides greater certainty for “what counts” as Direct Client Activities for logbook recording within these two areas of practice endorsement, with 16 clinical psychology and 30 clinical neuropsychology activities endorsed. There is a need to better clarify the rationale and principles for recording Direct Client Activities across areas of practice endorsement, to inform ongoing practices in these areas.