What is a Neuropsychologist?

Appendix A.

NAN DEFINITION OF A CLINICAL NEUROPSYCHOLOGIST 2001

A clinical neuropsychologist is a professional within the field of psychology with special expertise in the applied science of brain–behavior relationships.

Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and/or rehabilitation of patients across the lifespan with neurological, medical, neurodevelopmental and psychiatric conditions, as well as other cognitive and learning disorders.

The clinical neuropsychologist uses psychological, neurological, cognitive, behavioral, and physiological principles, techniques and tests to evaluate patients’ neurocognitive, behavioral, and emotional strengths and weaknesses and their relationship to normal and abnormal central nervous system functioning.

The clinical neuropsychologist uses this information and information provided by other medical/healthcare providers to identify and diagnose neurobehavioral disorders, and plan and implement intervention strategies....

The clinical neuropsychologist (minimal criteria) has:

• A doctoral degree in psychology from an accredited university training program.

• An internship, or its equivalent, in a clinically relevant area of professional psychology.

• The equivalent of 2 (full-time) years of experience and specialized training at the post-doctoral level under the Houston Conference Guidelines (below), in the study and practice of clinical neuropsychology These 2 years include supervision by a clinical neuropsychologist.

• A license in his or her state or province to practice psychology and/or clinical neuropsychology independently, or is employed as a neuropsychologist by an exempt agency.

HOUSTON CONFERENCE GUIDELINES

Professional and scientific activity.

The clinical neuropsychologist's professional activities are included within the seven core domains delineated in the Petition for the Recognition of a Specialty in Professional Psychology submitted by Division 40 of the APA to the Commission for the Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP). These core domains are: assessment, intervention, consultation, supervision, research and inquiry, consumer protection, and professional development.

The scientific activities of the specialist in clinical neuropsychology can vary widely. The specialist whose professional activities involve diverse cultural, ethnic, and linguistic populations has the knowledge and skills to perform those activities competently and ethically. The essential knowledge and skill competencies for these activities are outlined below.

Knowledge base.

Clinical neuropsychologists possess the following knowledge. This core knowledge may be acquired through multiple pathways, not limited to courses, and may come through other documentable didactic methods.

1. Generic Psychology Core

• Statistics and methodology

• Learning, cognition and perception

• Social psychology and personality

• Biological basis of behavior

• Life span development

• History

• Cultural and individual differences and diversity

2. Generic Clinical Core

• Psychopathology

• Psychometric theory

• Interview and assessment techniques

• Intervention techniques

• Professional ethics

3. Foundations for the study of brain-behavior relationships

• Functional neuroanatomy

• Neurological and related disorders including their etiology, pathology, course and treatment

• Non-neurologic conditions affecting CNS functioning

• Neuroimaging and other neurodiagnostic techniques

• Neurochemistry of behavior (e.g., psychopharmacology)

• Neuropsychology of behavior

4. Foundations for the practice of clinical neuropsychology

• Specialized neuropsychological assessment techniques

• Specialized neuropsychological intervention techniques

• Research design and analysis in neuropsychology

• Professional issues and ethics in neuropsychology

• Practical implications of neuropsychological conditions

Skills. Clinical neuropsychologists possess the following generic clinical skills and skills in clinical neuropsychology. These core skills may be acquired through multiple pathways, not limited to courses, and may come through other documentable didactic methods. Domains of skills and examples are:

1. Assessment o Information gathering

• History taking o Selection of tests and measures

• Administration of tests and measures

• Interpretation and diagnosis

• Treatment planning

• Report writing

• Provision of feedback

• Recognition of multicultural issues

2. Treatment and Interventions

• Identification of intervention targets

• Specification of intervention needs

• Formulation of an intervention plan

• Implementation of the plan

• Monitoring and adjustment to the plan as needed

• Assessment of the outcome

• Recognition of multicultural issues

3. Consultation (patients, families, medical colleagues, agencies, etc.)

• Effective basic communication (e.g. listening, explaining, negotiating)

• Determination and clarification of referral issues

• Education of referral sources regarding neuropsychological services (strengths and limitations)

• Communication of evaluation results and recommendations

• Education of patients and families regarding services and disorder(s)

4. Research

• Selection of appropriate research topics

• Review of relevant literature

• Design of research

• Execution of research

• Monitoring of progress

• Evaluation of outcome

• Communication of results

5. Teaching and Supervision

• Methods of effective teaching

• Plan and design of courses and curriculums

• Use of effective educational technologies

• Use of effective supervision methodologies (assessment, intervention, and research)

• It is recognized that the relative weightings of these dimensions may vary from one program to another.

Doctoral education in clinical neuropsychology. Specialization in clinical neuropsychology begins at the doctoral level which provides the generic psychology and clinical core. In addition, it includes foundations for the study of brain-behavior relations and the practice of clinical neuropsychology. All of these are specified above sections.

Doctoral education in clinical neuropsychology occurs at a regionally accredited institution. All basic aspects of the generic psychology and generic clinical cores should be completed at the doctoral level. The foundation of brain-behavior relationships should be developed to a considerable degree at this level of training. Yet, variability may occur between doctoral programs in the degree to which foundations of brain-behavior relationships and clinical neuropsychology practice are emphasized. Entry and exit criteria for this level are those specified by the doctoral program.

Internship training in clinical neuropsychology. The purpose of the internship is to complete training in the general practice of professional psychology and extend specialty preparation in science and professional practice in clinical neuropsychology. The percentage of time in clinical neuropsychology should be determined by the training needs of the individual intern. Internships must be completed in an APA or CPA approved professional psychology training program. Internship entry requirements are the completion of all graduate education and training requirements including the completion of the doctoral dissertation.

Residency education and training in clinical neuropsychology. Residency education and training is designed to provide clinical, didactic and academic training to produce an advanced level of competence in the specialty of clinical neuropsychology and to complete the education and training necessary for independent practice in the specialty. The postdoctoral residency program is a required component in specialty education in clinical neuropsychology. The expected period of residency extends for the equivalent of two years of full-time education and training. The residency experience must occur on at least a half-time basis.

These programs will pursue accreditation supporting the following assurances.

• The faculty is comprised of a board-certified clinical neuropsychologist and other professional psychologists;

• Training is provided at a fixed site or on formally affiliated and geographically proximate training sites, with primarily on-site supervision;

• There is access to clinical services and training programs in medical specialties and allied professions;

• There are interactions with other residents in medical specialties and allied professions, if not other residents in clinical neuropsychology;

• Each resident spends significant percentages of time in clinical service, and clinical research, and educational activities, appropriate to the individual resident's training needs. Entry into a clinical neuropsychology residency program should be based upon completion of an APA or CPA accredited doctoral education and training program. Clinical neuropsychology residents will have successfully completed an APA or CPA accredited internship program which includes some training in clinical neuropsychology.

Exit criteria for the residency are as follows:

• Advanced skill in the neuropsychological evaluation, treatment and consultation to patients and professionals sufficient to practice on an independent basis;

• Advanced understanding of brain-behavior relationships;

• Scholarly activity, e.g., submission of a study or literature review for publication, presentation, submission of a grant proposal or outcome assessment.

• A formal evaluation of competency in the exit criteria 1 through 3 shall occur in the residency program.

• Eligibility for state or provincial licensure or certification for the independent practice of psychology.

• Eligibility for board certification in clinical neuropsychology by the American Board of Professional Psychology.

Nature and Place of subspecialties within clinical neuropsychology. In the future, subspecialties in clinical neuropsychology may be recognized (e.g., child, pediatric, geriatric, rehabilitation). In fact, many clinical neuropsychologists currently concentrate their professional and scientific activities in relatively focused areas of the clinical neuropsychology specialty. Thus, it is expected that some or all of these areas of concentration will eventually be seen as bona fide subspecialties. One implication of this view is that residencies may emerge that reflect concentrations in these subspecialties.

Continuing education in clinical neuropsychology. All specialists in clinical neuropsychology are expected to engage in annual continuing education. The goal of continuing education is to enhance or maintain the already established competence of clinical neuropsychologists by updating previously acquired knowledge and skills or by acquiring new knowledge or skills. Continuing education is not a method for acquiring core knowledge or skills to practice clinical neuropsychology or identify oneself as a clinical neuropsychologist. Continuing education also should not be the primary vehicle for career changes from another specialty area in psychology to clinical neuropsychology.

Full article:

Houston Conference Guidelines for Training