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Competency Assessment Instrument (CAI)

One approach to improving the quality of care for severe mental illnesses (SMI) such as schizophrenia is through the improvement of provider competencies; the attitudes, knowledge, and skills needed to deliver high-quality care. This paper describes a new instrument designed to measure such a set of competencies. A total of 341 providers of services to clients with SMI at 38 clinics within 5 publicly financed treatment organizations in 2 western states were asked to complete a paper-and-pencil survey including the new Competency Assessment Instrument (CAI: 15 scales, each assessing a particular provider competency), and additional measures used to establish validity (Recovery Attitude Questionnaire--7, Client Optimism Scale). Seventy-nine percent (N = 269) responded at baseline, 83% (N = 282) responded at 2 weeks. Ninety-seven percent of baseline respondents completed the survey at 2 weeks. Most CAI scales have good internal consistency (Cronbach's alphas = .52-.93), test-retest reliability (scales ranged from .42 to .78), and validity, and should be useful in efforts to improve care.

Additional Papers:

Young AS, Forquer SL, Tran A, Starzynski M, Shatkin J: Identifying clinical competencies that support rehabilitation and empowerment in individuals with severe mental illness.Journal of Behavioral Health Services & Research. 2000; 27: 321-333.PMID: 10932445.

Chinman M, Young AS, Rowe M, Forquer S, Knight E, Miller A: An instrument to assess competencies of providers treating severe mental illness. Mental Health Services Research. 2003; 5: 97-108. PMID: 12801073.

Hoge MA, Paris M, Adger H, Collins FL, Finn CV, Fricks L, Gill KJ, Haber J, Hansen M, Ida DJ, Kaplan L, Northey WF, O'Connel MJ, Rosen AL, Taintor Z, Tondora J, Young AS: Workforce competencies in behavioral health: an overview. Administration and Policy in Mental Health. 2005; 32: 593-631. PMID: 16082798.

Young AS, Chinman M, Forquer SL, Knight EL, Vogel H, Miller A, Rowe M, Mintz J: Use of a consumer-led intervention to improve provider competencies. Psychiatric Services. 2005; 56: 967-975. PMID:

For further information contact: 

Alexander S. Young, M.D., M.S.H.S.


CAI Measure

CAI Scales and Items

CAI Additional Non-Scale Items

CAI How to calculate the scales


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