C3. Competency Assessment Instrument Measures

Relevant Functional Domains from the Integration Framework: 


Chinman, Matthew, Ph.D. (MIRECC); Young, Alexander S., M.D., M.S.H.S. (MIRECC); Sandy Forquer (Comprehensive Neuroscience Inc.); Edward Knight (ValueOptions); Anita Miller (ValueOptions); Melissa Rowe (RAND)


The Competency Assessment Instrument measures 15 competencies needed to provide high quality care for those with severe and persistent mental illness (SPMI).


June 2003

Relevant submeasures: 

a.     Competency Assessment Instrument (CAI): the “Client Preferences” scale

b.     Competency Assessment Instrument (CAI): the “Community Resources” scale

c.     Competency Assessment Instrument (CAI): the “Evidence-Based Practice” scale

d.     Competency Assessment Instrument (CAI): the “Family Education” scale

e.     Competency Assessment Instrument (CAI): the “Goals” scale

f.      Competency Assessment Instrument (CAI): the “Holistic Approach” scale

g.     Competency Assessment Instrument (CAI): the “Intensive Case Management” scale

h.     Competency Assessment Instrument (CAI): the “Medication Management” scale

i.      Competency Assessment Instrument (CAI): the “Natural Supports” scale

j.      Competency Assessment Instrument (CAI): the “Rehabilitation” scale

k.     Competency Assessment Instrument (CAI): the “Skill Advocacy” scale

l.      Competency Assessment Instrument (CAI): the “Stigma” scale

m.   Competency Assessment Instrument (CAI): the “Stress scale

Format/data source: 

The CAI measures 15 provider competencies that were viewed as central to recovery-oriented care. Each competency is measured with its own scale, which is made of a combination of three to five Likert items. The instrument also collects demographic questions including race/ethnicity, gender, education level, job title, job duties, and number of years in mental health care. 

Development and testing: 

The instrument was evaluated by health care providers who deliver services to SMI clients at several clinics within five publicly financed treatment organizations under a behavioral managed care company. Using the baseline and two-week data from the project, Chinman et al. conducted psychometric analyses on the 15 CAI scales and found most scales are reliable and valid.

Past or validated applications: 

  • Setting: Behavioral Health Care
  • Population: Clinicians
  • Level of evaluation. Individual or groups of health care professionals.


National Quality Measures Clearinghouse (NQMC). Available at:

a.     http://qualitymeasures.ahrq.gov/content.aspx?id=27480&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder.  Accessed January 23, 2013.

b.     http://qualitymeasures.ahrq.gov/content.aspx?id=27488&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder. Accessed January 23, 2013.

c.     http://qualitymeasures.ahrq.gov/content.aspx?id=27492&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder. Accessed January 23, 2013.

d.     http://qualitymeasures.ahrq.gov/content.aspx?id=27483&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder. Accessed January 23, 2013.

e.     http://qualitymeasures.ahrq.gov/content.aspx?id=27478&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder. Accessed January 23, 2013.

f.      http://qualitymeasures.ahrq.gov/content.aspx?id=27482&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder. Accessed January 23, 2013.

g.     http://qualitymeasures.ahrq.gov/content.aspx?id=27481&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder. Accessed January 23, 2013.

h.     http://qualitymeasures.ahrq.gov/content.aspx?id=27489&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder. Accessed January 23, 2013.

i.      http://qualitymeasures.ahrq.gov/content.aspx?id=27486&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder.  Accessed January 23, 2013.

j.      http://qualitymeasures.ahrq.gov/content.aspx?id=27484&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder.  Accessed January 23, 2013.

k.     http://qualitymeasures.ahrq.gov/content.aspx?id=27485&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder.  Accessed January 23, 2013.

l.      http://qualitymeasures.ahrq.gov/content.aspx?id=27487&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder.  Accessed January 23, 2013.

http://qualitymeasures.ahrq.gov/content.aspx?id=27479&search=%22mental+health%22+OR+anxiety+OR+depression+OR+%22bipolar+disorder. Accessed January 23, 2013.


For more information on using this instrument, you should refer to the published articles:

Chinman M, Young AS, Rowe M, Forquer S, Knight E, Miller A. An instrument to assess competencies of providers treating severe mental illness. Ment Health Serv Res 2003; Jun;5(2):97-108.

Young AS, Forquer SL, Tran A, Starzynski M, Shatkin J. Identifying clinical competencies that support rehabilitation and empowerment in individuals with severe mental illness. J Behav Serv Res. 2000;27;321-3. PMID 10932445.