Training In Clinical Neuropsychology Research Articles

A survey of the perceptions and practices of faculty in clinical neuropsychology doctoral training programs: is heterogeneity the norm?

Objective: Doctoral education is a cornerstone in the training of clinical neuropsychologists. However, we know little about perceptions, practices, and needs of the faculty who oversee doctoral training in clinical neuropsychology (CN). Method: Seventy-one faculty from 45 doctoral programs providing CN training completed at least part of a survey assessing characteristics of their programs, current training practices and views, and challenges to CN doctoral training. Results: Over half of CN faculty reported having zero or only one CN colleague. CN faculty reported that the goals of CN doctoral training are research training, clinical training, and acquisition of knowledge and skills reflected in the Houston Conference Guidelines (HCG). CN faculty reported that doctoral trainees obtain more clinical hours than faculty would like and endorsed alternative clinical metrics, including competency-based ratings. CN faculty are divided about the benefits of a required two-year postdoctoral CN fellowship. Conclusions: The HCG states that specialization in CN begins at the doctoral level. CN faculty in doctoral programs are fully immersed in the early development and education of future CN researchers and practitioners. Tensions between clinical and research training in CN at the doctoral level—and student overemphasis on accruing clinical hours—might place CN at risk for failing to make research innovations necessary for our field to evolve and thrive. More CN doctoral faculty are needed to serve as mentors to students, especially for students from backgrounds that have been historically excluded and marginalized. A greater voice from CN doctoral faculty in CN governance is needed.

Understanding the rehabilitation psychology specialty career pathway.

Little is known about how psychologists choose their specialty practice area, and rehabilitation psychology is no exception. Specialization and specialty certification in professional psychology have been controversial topics impacting the field during the training sequence and across the span of professional careers (Drum & Blom, 2001; Robiner & Fossum, 2017). The American Board of Rehabilitation Psychology (ABRP) has been providing specialty certification since 1995 and rehabilitation psychology was recognized as a unique specialty in 2015 by the APA's Council for the Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP). There are limited established training programs and minimal information about the specialty in undergraduate course materials. The current survey is intended to provide information about how people are introduced to the field of rehabilitation psychology, specialty identification, and to identify opportunities for improvement. A survey of members of APA Division 22 and ABRP specialists was conducted to collect information about their exposure to and involvement in rehabilitation psychology. Results from 174 respondents suggest that personal relationships are the current key means of recruitment and confirms that rehabilitation psychology has limited presence in undergraduate training. Most professionals come to identify with rehabilitation psychology after training in clinical neuropsychology and health psychology. These preliminary results suggest that the current generalist training sequence does not provide sufficient exposure to, or preparation for the field of rehabilitation psychology. Recruitment opportunities should emphasize student leadership network activities and the identification of early and midcareer practitioners unaware of the rehabilitation specialty. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A-188 Starting Well: Creating Training Opportunities for Graduate Students Interested in Neuropsychological Assessment

Abstract Objective Practicum experiences are critical to internship readiness. While established guidelines for practicum training in clinical neuropsychology exist, the application of such guidelines across training sites has received little attention. The objective of this study is to compare practicum training models across different sites. Methods We surveyed training supervisors regarding the cost and benefit of training practicum students in their setting. Results Despite wide variability across settings, results indicated that on average, practicum sites spent around 6 hours per week in direct active training and onboarding during the first 1–3 months of the training year. After 3–4 months, the hours spent on supervision decreased to about 1–2 hours of individual supervision and 1–2 hours of group supervision per week. By the 8th month, each practicum student provided the clinic with approximately 36 hours of direct service (considered an administrative benefit to the clinic). Conclusion Training practicum students is a labor of love, with overall net administrative benefits to the clinic. An advantage was seen in settings with multiple trainees, trainees at multiple levels, and tiered supervision models with access to diverse didactic experiences.

Education/Training of Cultural Neuropsychology at the Postdoctoral Residency Level: Integration of a Competency-Based Model into Practice

Abstract Objective In recent years, much attention has been focused on the delineation of basic competencies for education and training in clinical neuropsychology. Simultaneously, neuropsychology as a field has recognized the increasing need for the inclusion of cultural neuropsychology practices (AACN Relevance 2050). Method The Clinical Neuropsychology Synarchy (CNS) released a taxonomy for education and training in clinical neuropsychology in 2017, with individual and cultural diversity identified as an essential foundational competency across all specialties. Recommendations from the Education/Training workgroup of the 2017 Cultural Neuropsychology Summit provide initial guidance regarding the training of directors for the inclusion of cultural neuropsychology across the professional lifespan: including clinical, research, and education/training. Based on these recommendations, our program has developed a post-doctoral residency track focused on bilingual/multicultural neuropsychology. Outcomes The process by which our program integrates specific, knowledge-based, and applied competencies in cultural neuropsychology is presented. Discussion Suggestions on how to integrate recommendations into the existing education/training model for postdoctoral residency are provided, as well as a discussion of barriers and challenges in creating such a program.

Limitations of Multicultural Supervision in Clinical Neuropsychology

Abstract Multicultural awareness, competency based clinical supervision, and the clinical neuropsychology subspecialties are areas of growing importance in the psychology field. Specific guidelines exist for multicultural practice, clinical supervision, as well as training in clinical neuropsychology. However, there are significantly fewer resources and training procedures that focus on multicultural supervision, very limited information regarding neuropsychology supervision, and almost non-existent resources that address multicultural considerations in clinical neuropsychology supervision. Objective: This Poster highlights the most important literature regarding general aspects of multicultural supervision in psychology, supervision in clinical neuropsychology, while also introducing ideas and considerations regarding the dire need of multicultural supervision in clinical neuropsychology. Method The authors reviewed the literature regarding general aspects of multicultural supervision in clinical psychology, supervision in clinical neuropsychology, and additionally highlighted the gaps related to supervision in multicultural neuropsychology. Finally, they introduced ideas to address some of the needs in the arena of supervision in multicultural neuropsychology. Discussion Available resources that explore, delineate, or evaluate competent multicultural supervision in clinical neuropsychology are absent. Partially, the limited understanding of - and research that focuses on - the influence of diversity in neuropsychological assessment and interventions might explain the lack of resources allotted to competent multicultural supervision in clinical neuropsychology. It is proposed that in clinical, neuropsychology supervisory process (as in therapy supervision) should include a culturally competent supervisor who can assist in the development of self-awareness, knowledge, and skills in order to provide interventions that understand, honor, and respect the clients’ multiple diversity dimensions.

Education and training in clinical neuropsychology: Recent developments and documents from the clinical neuropsychology synarchy

The Clinical Neuropsychology Synarchy (CNS) interfaces with the American Psychological Association and affiliated organizations to address issues and advances in specialty training. The past several years have seen the development and dissemination of several initiatives pertinent to specialty training. Among these initiatives was the creation of a taxonomy for education and training in clinical neuropsychology. In additional there has been a movement toward competency-based education that has become codified in the APA’s new Standards for Accreditation. Calls for competency-based education have also influenced the expectations of the APA’s Committee on Recognition of Specialties and Proficiencies in Professional Psychology. As the convener of national clinical neuropsychology organizations, the CNS has overseen the development of relevant documents for our specialty. This paper presents three documents critical to training in our field that were developed through the CNS and approved by its member organizations. The first is the Taxonomy for Education and Training in Clinical Neuropsychology. The second is Entry Level Competencies for Clinical Neuropsychology and the third is a distillation of the entry-level competency document for the purpose of identifying competencies to be addressed at the post-doctoral residency level.

Training models and status of clinical neuropsychologists in Europe: Results of a survey on 30 countries

Objective: The aims of the study were to analyze the current European situation of specialist education and training within clinical neuropsychology, and the legal and professional status of clinical neuropsychologists in different European countries. Method: An online survey was prepared in 2016 by a Task Force established by the European Federation of Psychological Associations, and representatives of 30 countries gave their responses. Response rate was 76%. Results: Only three countries were reported to regulate the title of clinical neuropsychologist as well as the education and practice of clinical neuropsychologists by law. The most common university degree required to practice clinical neuropsychology was the master’s degree; a doctoral degree was required in two countries. The length of the specialist education after the master’s degree varied between 12 and 60 months. In one third of the countries, no commonly agreed upon model for specialist education existed. A more systematic training model and a longer duration of training were associated with independence in the work of clinical neuropsychologists. Conclusions: As legal regulation is mostly absent and training models differ, those actively practicing clinical neuropsychology in Europe have a very heterogeneous educational background and skill level. There is a need for a European standardization of specialist training in clinical neuropsychology. Guiding principles for establishing the common core requirements are presented.

Education and Training in Clinical Neuropsychology: Recent Developments and Documents From the Clinical Neuropsychology Synarchy

The Clinical Neuropsychology Synarchy (CNS) interfaces with the American Psychological Association and affiliated organizations to address issues and advances in specialty training. The past several years have seen the development and dissemination of several initiatives pertinent to specialty training. Among these initiatives was the creation of a taxonomy for education and training in clinical neuropsychology. In additional there has been a movement towards competency-based education that has become codified in the APA’s new Standards for Accreditation. Calls for competency-based education have also influenced the expectations of the APA’s Committee on Recognition of Specialties and Proficiencies in Professional Psychology. As the convener of national clinical neuropsychology organizations the CNS has overseen the development of relevant documents for our specialty. This paper presents three documents critical to training in our field that were developed through the CNS and approved by its member organizations. The first is the Taxonomy for Education and Training in Clinical Neuropsychology. The second is Entry Level Competencies for Clinical Neuropsychology and the third is a distillation of the entry-level competency document for the purpose of identifying competencies to be addressed at the post-doctoral residency level.

Core competencies in clinical neuropsychology training across the world

Objective: This work aimed to review main competency requirements from training models in countries with well-established specialties in clinical neuropsychology and to extract core competencies that likely will apply to clinical neuropsychologists regardless of regional and cultural context. Method: We reviewed standards for post-graduate training in clinical neuropsychology from countries in Europe, Australia, and North America based on existing literature, presentations at international conferences, and from description of the training models from national psychological or neuropsychological associations. Results: Despite differences, the reviewed models share similar core competencies considered necessary for a specialty in clinical neuropsychology: (1) In-depth knowledge of general psychology including clinical psychology (post-graduate level), ethical, and legal standards. (2) Expert knowledge about clinically relevant brain–behavioral relationships. (3) Comprehensive knowledge about, and skills in, related clinical disciplines. (4) In-depth knowledge about and skills in neuropsychological assessment, including decision-making and diagnostic competency according to current classification of diseases. (5) Competencies in the area of diversity and culture in relation to clinical neuropsychology. (6) Communication competency of neuropsychological findings and test results to relevant and diverse audiences. (7) Knowledge about and skills in psychological and neuropsychological intervention, including treatment and rehabilitation. Conclusions: All the models have undergone years of development in accordance with requirements of national health care systems in different parts of the world. Despite differences, the common core competency requirements across different regions of the world suggest generalizability of these competencies. We hope this summary can be useful as countries with less established neuropsychology training programs develop their models.

Taxonomy for Education and Training in Clinical Neuropsychology: past, present, and future

Objective: Historically, the clinical neuropsychology training community has not clearly or consistently defined education or training opportunities. The lack of consistency has limited students’ and trainees’ ability to accurately assess and compare the intensity of neuropsychology-specific training provided by programs. To address these issues and produce greater ‘truth in advertising’ across programs, CNS, with SCN’s Education Advisory Committee (EAC), ADECN, AITCN, and APPCN constructed a specialty-specific taxonomy, namely, the Taxonomy for Education and Training in Clinical Neuropsychology. The taxonomy provides consensus in the description of training offered by doctoral, internship, and postdoctoral programs, as well as at the post-licensure stage. Although the CNS approved the taxonomy in February 2015, many programs have not adopted its language. Increased awareness of the taxonomy and the reasons behind its development and structure, as well as its potential benefits, are warranted. Methods: In 2016, a working group of clinical neuropsychologists from the EAC and APPCN, all authors of this manuscript, was created and tasked with disseminating information about the taxonomy. Group members held regular conference calls, leading to the generation of this manuscript. Results: This manuscript is the primary byproduct of the working group. Its purpose is to (1) outline the history behind the development of the taxonomy, (2) detail its structure and utility, (3) address the expected impact of its adoption, and (4) call for its adoption across training programs. Conclusions: This manuscript outlines the development and structure of the clinical neuropsychology taxonomy and addresses the need for its adoption across training programs.

Postdoctoral training in clinical neuropsychology in America: how did we get here and where do recent applicants suggest we go next?

Objective: The United States appears to be the only country which typically requires completion of a two-year postdoctoral fellowship for one to be considered competent to practice clinical neuropsychology. We review the history of how this came to be in the United States. Further, we describe obstacles that postdoctoral trainees face during this stage of training. Method: We first describe the most significant events leading to the requirement of a two-year fellowship in clinical neuropsychology. Next, we describe factors that trainees face when selecting and completing postdoctoral training. Finally, we review the results of the most recent annual survey of applicants for postdoctoral training to measure their experiences. Results: Postdoctoral training in the United States is a relatively recent requirement in neuropsychology. Trainees face many obstacles when obtaining a postdoctoral position some of which can be addressed by the field. Conclusions: Training in Clinical Neuropsychology in the United States has evolved considerably over at least the last 45 or so years to the point that a two-year postdoctoral fellowship is now required for one to be a candidate for board certification through the American Board of Clinical Neuropsychology. We review many of the challenges that postdoctoral trainees face and provide survey data to describe their experiences and preferences.

Desafios para a Formação do Neuropsicólogo Clínico no Brasil

A Neuropsicologia Clínica é um campo de trabalho recente no Brasil, no entanto, existe uma forte demanda no mercado por profissionais qualificados. Embora o Conselho Federal de Psicologia já tenha esboçado este campo como uma especialidade da formação em Psicologia, ainda não existe um consenso sobre como deve ser delineada a formação desse profissional. O presente artigo busca, através de uma análise histórica da área, delimitar esse campo de conhecimento para, então, observando os processos de formação do neuropsicólogo clínico em outros países mais avançados nesta discussão, traçar um breve perfil das competências, atitudes e comportamentos desse profissional. Finalmente, apontar os desafios que a formação do neuropsicólogo clinico representa no contexto brasileiro.

Response to Bodin and Grote regarding postdoctoral recruitment in clinical neuropsychology

Bodin and Grote convey their opinion that the field of clinical neuropsychology would be best served by a match system for recruitment into postdoctoral training. We critically review their arguments and offer an alternative point of view. Our view considers the current state of the match system in neuropsychology, incorporates comparisons with other disciplines that rely on a match system, and addresses the role of postdoctoral training and the specialization that takes shape at this level. We make recommendations aimed at promoting greater unity among postdoctoral training programs with the goal of focusing leadership efforts on advancing our shared mission of providing the highest quality training in clinical neuropsychology.

Official Position of the American Academy of Clinical Neuropsychology (AACN): Guidelines for Practicum Training in Clinical Neuropsychology

Practical experience is central to the education and training of neuropsychologists, beginning in graduate school and extending through postdoctoral fellowship. However, historically, little attention has been given to the structure and requirements of practicum training in clinical neuropsychology. A working group of senior-level neuropsychologists, as well as a current postdoctoral fellow, all from a diverse range of settings (The AACN Practicum Guidelines Workgroup), was formed to propose guidelines for practicum training in clinical neuropsychology. The Workgroup reviewed relevant literature and sought input from professional organizations involved in education and training in neuropsychology. The proposed guidelines provide a definition of practicum training in clinical neuropsychology, detail entry and exit criteria across competencies relevant to practicum training in clinical neuropsychology, and discuss the relationship between doctoral training programs and practicum training sites. The proposed guidelines also provide a methodology for competency-based evaluation of clinical neuropsychology practicum trainees and outline characteristics and features that are integral to an effective training environment. Although the guidelines discussed below may not be implemented in their entirety across all clinical neuropsychology practicum training sites, they are consistent with the latest developments in competency-based education.

Selection Criteria for Internships in Clinical Neuropsychology

Criteria used in the evaluation and selection of applicants for clinical neuropsychology internships were identified by a survey of programs that met guidelines for specialty training. The number of internships that offer training with specialization in clinical neuropsychology has more than doubled during the past 10 years. Supervising neuropsychologists from 75 programs replied to the survey, yielding a 72.8% response rate. Clinical experience in neuropsychological assessment, specialization in clinical neuropsychology during graduate education, personal interview, and letters of recommendation were reported to be the most salient selection criteria. Practica that provide experience with flexible or functional systems assessment approaches at university-affiliated or VA (U.S. Department of Veterans Affairs) medical centers and doctoral curricula that follow International Neuropsychological Society/Division 40 course guidelines, with teaching and supervision provided by neuropsychologists, were preferred prerequisites to internship. These results are consistent with selection criteria reported over a decade ago and indicate continued endorsement of the vertically integrated model of education and training outlined by the Houston Conference on Specialty Education and Training in Clinical Neuropsychology.

The Inter-Organizational Summit on Education and Training (ISET) 2010 Survey on the Influence of the Houston Conference Training Guidelines

A conference specific to the education and training of clinical neuropsychology was held in 1997, which led to a report published in the Archives of Clinical Neuropsychology (Hannay, J., Bieliauskas, L., Crosson, B., Hammeke, T., Hamsher, K., & Koffler, S. (1998). Proceedings of the Houston Conference on Specialty Education and Training in Clinical Neuropsychology. Archives of Clinical Neuropsychology, 13, 157–250.). The guidelines produced by this conference have been referred to as the Houston Conference (HC) guidelines. Since that time, there has been considerable discussion, and some disagreement, about whether the HC guidelines produced a positive outcome in the training of neuropsychologists. To explore this question and determine how widely the HC guidelines were implemented, a meeting was held in 2006. Present and past leaders of the American Psychological Association Division 40 (Clinical Neuropsychology), the National Academy of Neuropsychology, and the Association of Postdoctoral Programs in Clinical Neuropsychology met to discuss the possible need for an Inter-Organizational Summit on Education and Training (ISET). A decision was reached to have the ISET Steering Committee conduct a survey of clinical neuropsychologists that could address the extent to which HC guidelines were present in the specialty and whether the influence of the HC guidelines was positive. An online survey was constructed, with data gathered in 2010. The current paper presents and discusses the ISET survey results. Specific findings need to be viewed cautiously due to the relatively low response rate. However, with some direct parallels to a larger recent survey of clinical neuropsychologists, the following general conclusions appear well founded: (a) the demographics of respondents in the ISET survey are comparable with a recent larger professional practice survey and thus may reasonably represent the specialty; (b) the HC guidelines appear to have been widely adopted by training programs, in that a large proportion of younger practitioners endorsed having had HC-adherent training; and (c) HC-adherent training is associated with a higher frequency endorsement of being well prepared to engage in key professional activities subsequent to the completion of training when compared with those not having HC-adherent training. Overall, the ISET Steering Committee has concluded that the HC guidelines have been widely adopted and that trainees associate participation in HC-adherent training as advantageous. A potential revision based on unfavorable outcomes is deemed unnecessary. Nonetheless, the ISET Steering Committee recognizes that training needs change as a function of the broadening of our field and the introduction of related new technologies, which may prompt updates. The ISET Steering Committee supports the idea that periodic review and updating of training models may be is prudent.

The Inter-Organizational Summit on Education and Training (ISET) 2010 Survey on the Influence of the Houston Conference Training Guidelines

A conference specific to the education and training of clinical neuropsychology was held in 1997, which led to a report published in the Archives of Clinical Neuropsychology (Hannay, J., Bieliauskas, L., Crosson, B., Hammeke, T., Hamsher, K., & Koffler, S. (1998). Proceedings of the Houston Conference on Specialty Education and Training in Clinical Neuropsychology. Archives of Clinical Neuropsychology, 13, 157-250.). The guidelines produced by this conference have been referred to as the Houston Conference (HC) guidelines. Since that time, there has been considerable discussion, and some disagreement, about whether the HC guidelines produced a positive outcome in the training of neuropsychologists. To explore this question and determine how widely the HC guidelines were implemented, a meeting was held in 2006. Present and past leaders of the American Psychological Association Division 40 (Clinical Neuropsychology), the National Academy of Neuropsychology, and the Association of Postdoctoral Programs in Clinical Neuropsychology met to discuss the possible need for an Inter-Organizational Summit on Education and Training (ISET). A decision was reached to have the ISET Steering Committee conduct a survey of clinical neuropsychologists that could address the extent to which HC guidelines were present in the specialty and whether the influence of the HC guidelines was positive. An online survey was constructed, with data gathered in 2010. The current paper presents and discusses the ISET survey results. Specific findings need to be viewed cautiously due to the relatively low response rate. However, with some direct parallels to a larger recent survey of clinical neuropsychologists, the following general conclusions appear well founded: (a) the demographics of respondents in the ISET survey are comparable with a recent larger professional practice survey and thus may reasonably represent the specialty; (b) the HC guidelines appear to have been widely adopted by training programs, in that a large proportion of younger practitioners endorsed having had HC-adherent training; and (c) HC-adherent training is associated with a higher frequency endorsement of being well prepared to engage in key professional activities subsequent to the completion of training when compared with those not having HC-adherent training. Overall, the ISET Steering Committee has concluded that the HC guidelines have been widely adopted and that trainees associate participation in HC-adherent training as advantageous. A potential revision based on unfavorable outcomes is deemed unnecessary. Nonetheless, the ISET Steering Committee recognizes that training needs change as a function of the broadening of our field and the introduction of related new technologies, which may prompt updates. The ISET Steering Committee supports the idea that periodic review and updating of training models is prudent.

Providing effective supervision in clinical neuropsychology

A specialty like clinical neuropsychology is shaped by its selection of trainees, educational standards, expected competencies, and the structure of its training programs. The development of individual competency in this specialty is dependent to a considerable degree on the provision of competent supervision to its trainees. In clinical neuropsychology, as in other areas of professional health-service psychology, supervision is the most frequently used method for teaching a variety of skills, including assessment, report writing, differential diagnosis, and treatment. Although much has been written about the provision of quality supervision in clinical and counseling psychology, very little published guidance is available regarding the teaching and provision of supervision in clinical neuropsychology. The primary focus of this article is to provide a framework and guidance for the development of suggested competency standards for training of neuropsychological supervisors, particularly at the residency level. In this paper we outline important components of supervision for neuropsychology trainees and suggest ways in which clinicians can prepare for supervisory roles. Similar to Falender and Shafranske (2004), we propose a competency-based approach to supervision that advocates for a science-informed, formalized, and objective process that clearly delineates the competencies required for good supervisory practice. As much as possible, supervisory competencies are related to foundational and functional competencies in professional psychology, as well as recent legislative initiatives mandating training in supervision. It is our hope that this article will foster further discussion regarding this complex topic, and eventually enhance training in clinical neuropsychology.

The Houston Conference revisited

This paper presents a review and critique of the Houston Conference on Specialty Education and Training in Clinical Neuropsychology, together with an informal summary of opinions of a number of neuropsychologists. Issues regarding the role of the Clinical Neuropsychology Synarchy (CNS) and the applicability of the conference policies are offered. Several deficiencies and limitations of the policy statement are discussed. An informal survey of neuropsychologists interested in the Houston Conference indicates rather different opinions concerning the training and education of neuropsychologists. It is our contention that the results of the Houston Conference can only be considered controversial at best and that there is still much diversity of opinion in the field regarding the proper training of neuropsychologists. We hope to stimulate further discussion and greater involvement of the profession before final criteria for education and training are developed and adopted.

Proceedings of the Houston Conference on specialty education and training in clinical neuropsychology, september 3-7, 1997, University of Houston Hilton and Conference Center

Proceedings of the Houston Conference on specialty education and training in clinical neuropsychology, september 3-7, 1997, University of Houston Hilton and Conference Center