Abstract
At heart, competence is about safe and effective performance. When that performance has the potential to benefit or seriously harm people, practitioners' competence is of vital concern. As Thomas et al highlight (vol 10(7), 2003, p.321), competent performance rests on a blend of generic and specific attributes and skills that are developed through sustained practice. The knowledge developed in practice contributes to therapists' ability to make reliable clinical judgments in a timely manner. At issue, is more than having scientific, medical and practice knowledge. There is the greater complexity of being fluent in the knowledge so that it can be applied intuitively, to achieve the independent, fast and flexible tasks of problem identification, treatment planning and evaluation of the patient's responses that are required.
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