petit189

American Psychological Association Division 40 (Clinical Neuropsychology) Records

(Mss. 4745)

Text of document:

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January 8, 1995

PETITION FOR THE RECOGNITION OF A SPECIALTY IN PROFESSIONAL PSYCHOLOGY

THIS PETITION gives guidance to the types and amounts of information necessary for a formal decision to be reached. Petitioning organizations may use additional pages where necessary. The petitioning organization is free to provide any additional material deemed relevant.

AMERICAN PSYCHOLOGICAL ASSOCIATION
750 First Street, NE
Washington, D.C. 20002-4242
(202) 336-3500

PETITION PACKAGE

Criterion I. Distinctiveness. A specialty differs from other existing specialties in its body of specialized scientific knowledge and professional application, and provides evidence of these distinctions within each parameter of practice as described in PrincipleV.

1. Proposed title of the specialty: Clinical Neuropsychology

2. Provide a brief description of the specialty (e.g., one or two sentences that would adequately describe the specialty for the public.)

Clinical neuropsychology is a specialty that applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Related activities are integral to the mission and goals of the petitioning organization, the Division of Clinical Neuropsychology (40) of the American Psychological Association.

3. Identify how the following parameters differentiate the specialty from others. Describe how these parameters define professional practice in the specialty. Clinical neuropsychology has evolved as a specialized area of knowledge and practice with extensive intra- as well as interdisciplinary foundations Considered from the perspective of the sociology of the professions, the specialty is characterized by activities in a number of scientific and professional domains.These domains can be seen as having laid the foundation for the practice of clinical neuropsychology whose specialized mission encompasses roles that address psychological or behavioral manifestations of neurological, neuropathological, pathophysiological, and neurochemical changes in brain disease and the full range of aberrations

NOTE: This Petition Package was prepared by Manfred Meier, Bruce Crosson and Dan Eubanks. The directors of programs under Critrion II and III provided the documentation for their respective programs.

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in the central nervous system that may arise during development. The evolution of this mission has followed the characteristic course of scientifically-based professional role functioning, insofar as the foundations in knowledge and practice have been derived not only from the discipline of psychology, but also from the various related disciplines within the traditional professions of medicine, education and law.

Historically, three primary developmental domains appear to have provided the basis for this area of specialized knowledge and practice: basic experimental research in physiological and cognitive psychology; the development of quantitative and qualitative neuropsychological principles and procedures for clinical practice; and the syndromal analysis of the behavioral consequences of central nervous system lesions (Meier, 1992). The growth of the specialty has been influenced, as well, by the introduction of formalized procedures for accrediting educational programs and individual competencies.The developmental process, based on a considerable expansion of interdisciplinary knowledge and practices during the past half-century, appears to be following a very productive course. This is evidenced by the parallel development of participating organizations, publication of numerous books and journals, and the continued expansion of role applications beyond traditional neurological, neuropsychiatric and rehabilitation settings into the forensic, educational, and vocational arenas.

a. populations:

Adult neurological populations include cerebrovascular accidents, neoplasms, infectious and inflammatory diseases, degenerative diseases, head trauma, demyelinating disease and various forms of dementing illness. Psychiatric populations of primary interest include somatoform disorders of pseudoneurologic character; depression as a component of and/or to be differentiated from dementia; psychosis as a pseudodementing disorder and as a differential diagnostic entity to be distinguished from behavioral disturbances in selected neurological populations such as partial complex seizure disorders.

General medical and surgical populations include older individuals who may have some neuropsychological deficits associated with an early dementing illness that may complicate medical or surgical management; candidates for kidney transplant or dialysis; candidates for cardiac surgery, including transplants. and chronic pain patients with a neurological versus functional basis.

Children with learning disabilities of developmental or organic basis are referred from pediatricians, pediatric neurologists, and the schools, in addition to a marked expansion of neuropsychological evaluation and treatment of all types of pediatric neurological patients. Growing referral populations include the chemically dependent (especially polydrug users and alcoholics), AIDS dementia cases, and victims of environmental toxin exposures.

b. problems (psychological, biological, and social):

Referrals for clinical neuropsychological assessment typically include, but are not limited to, the following: differential diagnoses between psychogenic and neurogenic syndromes; differential diagnoses between two or more suspected etiologies of cerebral dysfunction; evaluation of spared and impaired functions secondary to a cerebral cortical or subcortical event; establishment of neurobehavioral baseline measures for monitoring progressive cerebral disease or recovery; comparison of pre- and postpharmacologic, surgical, or behavioral interventions; and assessment of higher cortical functions for the formulation of rehabilitation strategies.

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Intervention problems include design of procedures for utilizing available functions to compensate for an impaired functions; retraining of the impaired function to a higher level of adaptive effectiveness; and environmental (ecological) manipulations to enhance adaptive effectiveness.

It should be noted that clinical neuropsychologists function primarily on referral from health, education, and legal professionals; agencies and institutions; and in response to needs of other service systems (e.g., courts, schools, extended rehabilitation facilities and general care facilities, military installations, and chemical treatment facilities). Primary employment settings are estimated to be almost equally divided between hospital-medical centers, private practice, and a combination of (salaried) hospital or clinic-based employment, and private practice (Putnam & DeLuca, 1990, 1991).

C. procedures and technologies:

Thus, priority services include neuropsychological assessment, cognitive remediation and intervention, agency and institutional consultation, education and counseling for individuals and families, and selected psychotherapies or behavior therapies as appropriate for neurologically involved individuals. A growing armamentarium of procedures is available for neuropsychological assessment (Lezak, 1983) and for cognitive remediation and intervention (Meier, Benton & Diller, 1987). Further elaboration of procedures and technologies can be found under Criterion VI.

Differentiation of clinical neuropsychology from other psychological specialties is reflected in the distinction between generic competencies and specialized competencies as proposed by the APA Subcommittee on the Specialization (SOS) (Sales, Bricklin & Hall, 1984). Clinical neuropsychology had been evolving through an identifiable sequence of developments and was the first area of practice to provide an organized response to the SOS manual, the forerunner of this Petition Package for Specialty Recognition. Thus, a decade ago, the Division 40 TFEAC began to identify how clinical neuropsychology can be differentiated from other specialties given the SOS guidelines.

Generic applied competency requires a foundation in psychological science with a predominantly clinical emphasis, although such training may be obtained through other generic avenues if a clinical internship is included. Over the past few decades, roles of clinical counseling, and school psychologists, appeared to have converged so that there is a substantial overlap in generic applied knowledge and competency attained in related programs at the predoctoral and internship levels. Clinical neuropsychology involves the building of specialized competencies upon the generic applied knowledge and competency base obtained in a generic applied predoctoral program of a health-related nature. The generic base for clinical neuropsychology includes the structure and process of interviewing; intellectual, aptitude, interest and personality measurement; selected psychotherapy and counseling interventions; general consultation skills; and a consumer-patient education orientation, including ethics. Building upon such a generic foundation, specialized clinical neuropsychological competence includes effectiveness in comprehensive history taking; identification of neurobehavioral problems/issues to be addressed; application of a wide range of neuropsychological assessment procedures to multiple populations;test construction and validation; remedial and supportive intervention design and implementation;individual and agency consultation; and consumer education/ethics, specifically in a neuropsychological context. Such specialized competency is achieved by means of sets of skills anchored to the above parameters of practice in the settings outlined in a, b and c above. While there is overlap

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with the other health-related specialties in terms of generic applied competence, there is the elaboration, extension, and refinement of neurobehavioral applications that involve additional foundations in experimental, cognitive and physiological psychology as well as in the clinical neurosciences. Such extensions of knowledge and application are obtained by specialty track programs at the predoctoral and internship levels and/or by postdoctoral preparation in a specialized clinical neuropsychology program as exemplified under Criterion III.

4. In addition to the professional practice domains described above, describe the theoretical and scientific knowledge required for the specialty and provide references for each domain.

Competence in clinical neuropsychology requires the knowledge and skills to comprehend and integrate information in numerous areas of psychological science and the clinical neurosciences. Exemplary articles from the literature follow.At least ten (10) in each area could readily be provided.

*Selected aspects of functional neuroanatomy, neuropathology and pathophysiology.

Benton, A.L. (1991). The prefrontal region: It's early history. In: Levin, H.S., Eisenberg, H.M. and Benton, A.L. (Eds.). Frontal Lobe Function and Dysfunction. New York: Oxford.

Filskov, S.B. and Boll, T.J. (Eds.) (1986). Handbook of Clinical Neuropsychology. Vol. 2. New York Wiley. (See especially Chpaters 9, 20)

*Disorders of attention, sensory, perceptual, conceptual thinking, language, memory, and voluntary and involuntary motor and affective processes

Meier, M.J., Benton, A.L. and Diller, L. (Eds.) (1987). Neuropsychological Rehabilitation. New York: Guilford. (See especially Chapters 8, 9, 10, 11, 13, 14, 15, 16)

Margolin, D.I. (Eds.) (1992). Cognitive Neuropsychology in Clinical Practice. New York: Oxford. (See especially Chapters 2, 3, 7, 12, 13, 15) 0

*Neurological and related diseases, including their manner of presentation, course and treatment

Boll, T.J. (1986). Nontraditional and threshold conditions in neuropsychological assessment. In: Filskov, S.B. and Boll, T.J. (Eds.). Handbook of Clinical Neuropsychology. (Vol. 2). New York: Wiley.

Bornstein, R.A. and Brown, G. (Eds.) (1991). Neurobehavioral Aspects of Cerebrovascular Disease. New York: Oxford.

Many Clinical Neurology Textbooks.

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*CNS effects of systemic disorders

Tarter, R.E., Van Theil, D.H. and Edwards, K.L. (Eds.) (1988). Medical Neuropsychology: The Impact of Disease on Behavior. New York: Plenum.

Hart, R.P., Pederson, J.A., Czerwinski, A.W. and Adams, R.L. (1983). Chronic renal failure dialysis and neuropsychological function. Journal of Neuropsychology, 4,301-312.

*Child development and ontology of neuropsychological processes

Rourke, B.P. (Ed.) (1991). Neuropsychologicul Validation of Learning Disability Subtypes. New York Guilford.

Wilson, B.C. (1986). An approach to the neuropsychological assessment of the preschool child with developmental defects. In: Filskov, S.B. and Boll, T.J. Handbook of Clinical Neuropsychology (Vol. 2). New York: Wiley.

Many Developmental Psychology Textbooks.

*Expected decrements in neuropsychological processes as a function of normal aging

Scheff, S.W. (Ed.) (1984). Aging and Recovery of Function in the Central Nervous System. New York: Plenum.

Fletcher, J.M., Miner, M.E., and Ewing-Cobbs, L. (1987). Age and recovery from head injury in children: Developmental issues. In: Levin, H.S., Grafman, J. and Eisenberg, H.M. (Eds.). Neurobehavioral Recovery from Head Injury. New York: Oxford.

*Behavioral pathology and psychopharmacology

Mirsky, A.F. and Duncan, C.C. (1973). Behavioral and electrophysiological studies of absence epilepsy. In: Avioli, M., Gloor, P., Kostopoulus, G. and Naquet, R. (Eds.). Generalized Epilepsy: Neurobiological Approaches, Birkhauser, Boston.

Weinberger, D.R. Berman, K.F., and Zec, R.F. (1986). Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia.I: Regional cerebral blood flow (rCBF) evidence. Archives of General Psychiatry, 43, 114-125.

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*Psychophysiological principles underlying behavioral psychology

Mirsky, A.F. and Duncan, C.C. (1990). An introduction to modem techniques of clinical neuropsychology. In: Fava, G.A. and Wise, T.N. (Eds.). Research Paradigms in Psychosomatic Medicine. Karger: Basel.

Luria, A.R. (1966). Higher Cortical Functions in Man. Basic Books: New York.

*Sociocultural factors as co-determinants of behavior

Prigatano, G. (1987). Personality and psychosocial consequences after brain injury. In: Meier, J.J. Benton, A.L., and Diller, L. (Eds.). Neuropsychological Rehabilitation. New York: Guilford.

Dodrill, C.B. (1987). Psychosocial consequences of epilepsy. In: Filskov, S.D. and Boll, T.J. (Eds.). Handbook of Clinical Neuropsychology. (Vol. 2). New York: Wiley.

*Principles of personality assessment and interviewing skills

Spreen, 0. and Strauss, E. (1991). A Compendium of Neuropsychological Tests: Administration, Norms and Commentary. New York: Oxford. (See Chapters 1, 11)

*Principles of test administration and interpretation relating to both fixed and flexible neuropsychological batteries

Spreen, 0. and Strauss, E. (1991). A Compendium of Neuropsychological Tests: Administration, Norms and Commentary. New York: Oxford. (See Chapters 2, 3, 4, 5, 6, 7, 8, 9, 10)

Goodglass, H. and Kaplan, E. Assessment of cognitive deficit in the brain-injured patient. In: Guzzaniga, M.S. (Ed.), Handbook of Behavioral Neurobiology, Volume 2: Neuropsychology. New York: Plenum.

*Principles of cognitive remediation and their derivation of specific intervention strategies

Meier, M.J., Benton, A.L. and Diller, L. (Eds.) (1987). Neuropsychological Rehabilitation. New York Guilford. (SeeChapters 8, 9,10,11,12,13,14,15,16)

Seron, X., Van der Linden, M., Van der Kaa, M.A. (1978). The operant school in aphasia rehabilitation. In: Lebrun, X., Hoops, R. (Eds.). The Management of Aphasia. Amsterdam: Swets and Zeitlinger.

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It is immediately evident that the assessment role in clinical neuropsychology includes the derivation of intervention strategies and, by implication, an intervention role. Since clinical neuropsychologists are ordinarily specializing from a generic applied base, either in clinical, counseling, or school psychology, they have already acquired a foundation in assessment and intervention that is being extended by means of specialized training and supervised experience into the neurobehavioral domain, as it is broadly defined.A search for a core curriculum that will ensure the development of neuropsychological competency necessarily would include cognitive, physiological and experimental psychology; differential psychology; abnormal psychology and life-span developmental psychology. The curriculum would also include relevant areas of clinical neuroscience, including clinical neurology, behavioral neurology and specialized neurodiagnostic technologies as a basis for refinement of skills to extend competency into increasingly more specialized activities. The latter would appear to include design and validation of new neuropsychological procedures in order to extend neuropsychological applications in behavioral analysis and modification, learning disorders, psychopharmacology, psychophysiology, remedial interventions, behavior genetics, psycholinguistics, personality and psychopathology (functional and organic). Thus, clinical neuropsychology as practiced by psychologists would build upon a knowledge base that includes other disciplines as well as subdisciplines within psychology.

5. For each of the following core professional practice domains, provide a brief description of the knowledge that is required and provide published references in each area (e.g., books, chapters, articles in refereed journals, etc.)

a. assessment:

*Differential diagnosis between organic and non-organic syndromes and disorders

Reitan, R.M. (1955). Investigation of the validity of Halstead's measures of biological intelligence. Archives of Neurology and Psychiatry, 73,28-35.

Reitan, R. (1964). Psychological deficits resulting from cerebral lesions in men. In: Warren, J.M. and Akert, K. (Eds.). The Frontal Granular Cortex and Behavior. New York McGraw-Hill.

*Differential diagnosis between psychogenic and neurogenic syndromes and disorders (e.g., depression vs. dementia)

Matthews, C.G. (1981). Neuropsychology practice in a hospital setting. In: Filskov, S.B. and Boll, T.J. Handbook of Clinical Neuropsychology (Vol. 1). New York: Wiley.

McFie, J. (1975). Assessment of Organic Intellectual Impairment. London: Academic Press.

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*Differential diagnosis between two or more suspected etiologies of cerebral dysfunction (e.g., neoplasm vs. cerebral vascular accident)

Reitan, R.M. (1964). Psychological deficits resulting from cerebral lesions in men. In: Warren, J.M. and Akert, K. (Eds.). The Frontal Granular Cortex and Behavior. New York: McGraw-Hill.

Filskov, S.B., Grimm, B.H. and Lewis, J.A. Brain-behavior relationships. In: Filskov, S.B. and Boll, T.J. (Eds.). Handbook of Clinical Neuropsychology. (Vol. 1). New York: Wiley.

*Delineation of spared and impaired functions secondary to an episodic event (e.g., cerebral vascular accident, head trauma, infection)

Parker, R.S. Traumatic Brain Injury and Neuropsychological Impairment. New York: Springer-Verlag.

Bornstein, R.A. and Brown, G. (Eds.) (1991). Neurobehavioral Aspects of Cerebrovascular Disease. New York: Oxford.

*Establishment of baseline measures to monitor progressive cerebral disease or recovery processes (e.g., neoplasm, demyelinating disease, head injury)

Meier, M.J., Strauman, S., and Thompson, G. (1987). Individual differences in neuropsychological recovery. In: Meier, M.J., Benton, A .L ., and Diller, L. (Eds.). Neuropsychological Rehabilitation. New York: Guilford.

Levin, H.S., Grafman, J. and Eisenberg, H.M. (Eds.) (1987). Neurobehavioral Recovery from Head Injury. New York: Oxford. (See especially Chapter 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)

*Comparison of pre- and post-neuropsychological functioning following pharmacologic, surgical or behavioral interventions (e.g., drug trials, tissue excision, shunts, revascularization, language or cognitive therapy)

Jones, E.G., Henderson, M. and Welch, C.A. (1988). Executive functions in unipolar depression before and after electroconvulsive therapy. International Journal of Neuroscience, 38, 287-297.

Hermann, B.P. and Wyler, A.R. (1988). Neuropsychological outcome of anterior temporal lobectomy. Journal of Epilepsy, 1, 35-45.

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*Assessment of cognitive and affective status for the formulation of rehabilitation strategies and the design of remedial interventions

Goldstein, G. and Ruthven, L. (Eds.) (1983). Rehabilitation of the Brain-Damaged Adult. New York Plenum. (See especially Chapters 5, 6, 8)

Meier, M.J., Benton, A.L. and Diller, L. (Eds.) (1987). Neuropsychological Rehabilitation. New York Guilford. (See especially Chapters 1, 2, 3, 6, 7)

The first and still fundamental practice of clinical neuropsychology is the evaluation of psychological and behavioral disturbances associated with organic central nervous system dysfunction. The clinician is required to establish a comprehensive data base of historical and current general medical and surgical, neurological, pharmacological, developmental and psychosocial factors underlying the presenting problem. Included in this data base is the entire complement of specialized neural diagnostic procedures such as neural imaging electroencephalography, and brain-mapping techniques. An assessment strategy is derived from the data base and referral issues and requires knowledge of the various neuropsychological protocols, test procedures, and inventories that are available through a rapidly expanding literature. This function includes the application of fixed batteries at their current stage of validation and the design of flexible test batteries based on an understanding of the probably primary processes that may be affected by the underlying disease process. The assessment goal is to address relevant neurobehavioral aspects of higher psychological functioning that are considered to be central to understanding the cognitive strengths and deficits of the individual.

b. intervention:

In addition to the traditional psychotherapeutic methods and competencies derived from the neuropsychologist's previous generic applied preparation, there is a growing involvement of neuropsychologists in rehabilitation settings where they are introducing and refining cognitive interventions as guided by their increasing knowledge of the cognitive and physiological basis of neurobehavioral changes in neurological and other medical diseases. Attentional and memory dysfunctions have been given primary consideration while language therapies have remained predominantly the domain of the speech therapist and speech pathologist in such settings. They also have become engaged in behavioral management of individuals with severe neuropsychological deficits. There appears to be a marked expansion of activity in neuropsychological rehabilitation so that intervention is likely to become a stronger part of the neuropsychologist's functioning in what has been historically a more assessment-oriented specialty.

The necessary knowledge for neuropsychological intervention includes theories and procedures for modifying attentional, learning and memory, problem solving, perceptual processing, and sensory motor functioning at the basic and applied levels. c. consultation: Neuropsychological consultation activities now embrace areas of medicine beyond psychiatry and neurology including medical specialties of cardiology and cardiac surgery, infectious and inflammatory diseases, toxicology, and public health. Such consultative activities require at least an introductory knowledge in those areas of medical practice.

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Similarly, consultation to educators (e.g., learning disorders) and attorneys (personal injury cases, toxic exposure cases, and selected criminal cases where competency to stand trial or be sentenced is at issue). Such consultation requires more than a lay knowledge of the statutory context in which the case is being tried. Consultation skills are transmitted largely by example from peers and mentors. They usually require advanced competence at the diplomate level (which usually requires some postdoctoral preparation.)

d. supervision:

Engagement in the supervision of trainees in clinical neuropsychology requires the above knowledge foundations and is usually obtained in training settings such as health sciences centers which is where approximately half of persons engaged in clinical neuropsychology are employed. Mentoring and supervised experience play a heavy role in preparing individuals for supervisory roles.

e. research and inquiry:

Probably more than any other specialty within psychology, clinical neuropsychologists are expected to engage in clinical research. Thus, approximately one-half of the specialist force in clinical neuropsychology is engaged in clinical research. This is evidenced by the marked expansion in the number of journals in which neuropsychological research is published and in the expansion of postdoctoral training programs.The latter exceed 50 in number, with over 30 directed by a diplomate in clinical neuropsychology (ABPP/ABCN). The research tends to be relatively specialized in accord with individual interests and opportunities within the settings at issue. Scope of clinical neuropsychological research is indeed broad and the depth of knowledge is substantial. Even a cursory review of the major journals confirms this statement. (Again, see Appendix E.)

f. consumer protection:

The establishment of the ABPP diploma in clinical neuropsychology with examinations administered by the American Board of Clinical Neuropsychology provides the context for identifying competent individuals in the interest of the consumer. Examination includes a substantial ethics component. Each major organization has an ethics committee so that there is considerable deliberation within the specialty about ethical issues.

g. professional development:

Each of the major organizations provides continuing education opportunities for professionals in the field. Many state statutes now require continuing education for maintenance of the state's license. Attendance at scientific and professional meetings is outstanding in this specialty, as evidenced by the continuing growth of program time based on attendance figures for Division 40 of APA, for example. There is also considerable interest in obtaining the ABPP/ABCN diploma in clinical neuropsychology where requests for application for the clinical neuropsychology examination exceeded that of all other specialties in the ABPP family, including clinical psychology, in 1993.

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6. Define up to a maximum of ten professional practice activities associated with the specialty area in each of the seven core professional practice domains listed below. Each activity should be operationally defined in as concrete and succinct a fashion as possible.

a. assessment

1)Assessment based on historical information, other neurodiagnostic findings, interview data, and neuropsychological test findings for the purpose of identifying the likely presence of some form of organic cerebral or subcortical disorder.

2) Assessment based on the above information for the purpose of differentiating functional psychiatric from organic neurological disorders.

3) Assessment based on the above information for the purpose of differentiating diffuse from localized higher cortical dysfunction.

4) Assessment based on the above information for the purpose of differentiating among two or more suspected ideologies of cerebral dysfunction.

5) Assessment based upon the above information for the purpose of identifying spared and impaired functions and estimating longitudinal outcome for an episodic event.

6) Baseline assessment of spared and impaired higher cortical functions for the purpose of monitoring recovery processes.

7) Comparison of pre- and post-neuropsychological functioning following pharmacologic, surgical and behavioral interventions.

8) Assessment of cognitive and affective status for the purpose of formulating rehabilitation strategies and for the design of remedial interventions.

9) Assessment based on the above sources of information for the purpose of evaluating competence to stand trial, participate in long-term intervention such as heart and kidney transplantation, and similar treatment regimens.

b. intervention

1) Devise and implement cognitive and memory remedial or retraining paradigms for application during the recovery process in head injury, stroke and other non-progressive neurological disorders.

2) Individual and group psychotherapy for individuals with neurological disorders.

3) Counseling of individuals with learning disabilities for educational and vocational purposes.

4) Devise and implement behavioral interventions for individuals with severe psychological deficits.

C. consultation

1) Consult with attorneys regarding the neuropsychological consequences of head injuries.

2) Consultation with teachers in schools regarding the neuropsychological correlates of learning disabilities.

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3) Consultation with military regarding the cognitive requirements of particular equipment designs.

4) Consultation with public health agencies regarding the neuropsychological consequences of exposure to industrial toxins and accidents.

5) Consultation with medical specialists regarding the neuropsychological consequences of medical, neurological and psychiatric illnesses.

d. supervision

1) Supervision of graduate students,interns and postdoctoral fellows in neuropsychological assessment and intervention.

2) Supervision of allied health professionals in the performance of neuropsychological and behavioral interventions.

3) Supervision of psychometric/technical personnel in the administration and scoring of neuropsychological tests.

4) Supervision of neurological and psychiatric residents in the performance of neuropsychological screening procedures.

5) Supervision of graduate students and interns in performance of psychotherapy with neurologically involved individuals.

e. research and inquiry

1) Perform research on the efficacy of neuropsychological test procedures for the differential diagnosis of organic from non-organic disease states.

2) Perform comparable research for differentiating functional from organic disorders by means of neuropsychological tests.

3) Perform research into the cognitive processes underlying particular neuropsychological deficits.

4) Perform program evaluation studies to determine the effectiveness of service delivery in particular settings.

5) Design and evaluate in single cases the effectiveness of a cognitive intervention.

6) Perform taxonomic research for the classification of neuropsychological deficit and brain-behavior disorders.

f. consumer protection

1) Seek to meet performance criteria for becoming a diplomate of ABPP/ABCN.

2) Continually develop ethical standards for the performance of various roles of neuropsychologists as above.

3) Endeavor to publish for public distribution information regarding the activities of neuropsychologists and the costs as well as effectiveness of their services.

4) Engage in program evaluation research that evaluates in a recurring and progressive fashion the effectiveness of services and activities.

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g. professional development

1) Affiliate with scientific/professional organizations whose mission it is to advance knowledge and practice in neuropsychology.

2) Engage in continuing education activities to strengthen existing compctencies and add new competencies.

3) Attain elective office and representation on selected committees and boards.

7. For each defined professional activity, check the appropriate box indicating whether this specialty is judged to be (1) an essential activity for practice in the specialty or one that is important but not essential, and (2) and activity that is unique to the specialty or shared with one or more specialties.

Professional Practice Activities (1) Essential Important (2) Unique Shared

a. assessment

1) Assessment based on historical information, other neurodiagnostic findings, interview data, and neuropsychological test findings for the purpose of identifying the likely presence of some form of organic cerebral or subcortical disorder. X X

2) Assessment based on the above information for the purpose of differentiating functional psychiatric from organic neurological disorders.
X X

3) Assessment based on the above information for the purpose of differentiating diffuse from localized higher cortical dysfunction.
X X

4) Assessment based on the above information for the purpose of differentiating among two or more suspected ideologies of cerebral dysfunction.
X X

5) Assessment based upon the above information for the purpose of identifying spared and impaired functions and estimating longitudinal outcome for an episodic event.
X X

6) Baseline assessment of spared and impaired higher cortical functions for the purpose of monitoring recovery processes.
X X

7) Comparison of pre- and post-neuropsychological functioning following pharmacologic, surgical and behavioral interventions.
X X

8) Assessment of cognitive and affective status for the purpose of formulating rehabilitation strategies and for the design of remedial interventions.
X X

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Professional Practice Activities (1) Essential Important (2) Unique Shared

b. intervention

1)Devise and implement cognitive and memory remedial or retraining paradigms for application during the recovery process in head injury, stroke and other non-progressive neurological disorders.

2)Individual and group psychotherapy for individuals with neurological disorders.

3)Counseling of individuals with learning disabilities for educational and vocational purposes.

4)Devise and implement behavioral interventions for individuals with severe psychological deficits.

C. consultation

1)Consult with attorneys regarding the neuropsychological consequences of head injuries.

2)Consultation with teachers in schools regarding the neuropsychological correlates of learning disabilities.

3)Consultation with military regarding the cognitive requirements of particular equipment designs.

4)Consultation with public health agencies regarding the neuropsychological consequences of exposure to industrial toxins and accidents.

5) Consultation with medical specialists regarding the neuropsychological consequences of medical, neurological and psychiatric illnesses.

d. supervision

1)Supervision of graduate students, interns and postdoctoral fellows in neuropsychological assessment and intervention.

2)Supervision of allied health professionals in the performance of neuropsychological and behavioral interventions.

3)Supervision of psychometric/technical personnel in the administration and scoring of neuropsychological tests.

4)Supervision of neurological and psychiatric residents in the performance of neuropsychological screening procedures.

5)Supervision of graduate students and interns in performance of psychotherapy with neurologically involved individuals. X

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Professional Practice Activities (1) Essential Important (2) Unique Shared

e. research and inquiry

1)Perform research on the efficacy of neuropsychological test procedures for the differential diagnosis of organic from non-organic disease states.

2)Perform comparable research for differentiating functional from organic disorders by means of neuropsychological tests.

3)Perform research into the cognitive processes underlying particular neuropsychological deficits.

4)Perform program evaluation studies to determine the effectiveness of service delivery in particular settings.

5)Design and evaluate in single cases the effectiveness of a cognitive intervention.

6)Perform taxonomic research for the classification of neuropsychological deficit and brain-behavior disorders.

f. consumer protection

1)Seek to meet performance criteria for becoming a diplomate of ABPP/ABCN.

2)Continually develop ethical standards for the performance of various roles of neuropsychologists as above.

3)Endeavor to publish for public distribution information regarding the activities of neuropsychologists and the costs as well as effectiveness of their services.

4)Engage in program evaluation research that evaluates in a recurring and progressive fashion the effectiveness of services and activities.

g. professional development

1) Affiliate with scientific/professional organizations whose mission it is to advance knowledge and practice in neuropsychology.

2)Engage in continuing education activities to strengthen existing competencies and add new competencies.

3)Attain elective office and representation on selected committees and boards.

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References

Lezak, M.D. (1983). Neuropsychological Assessment (2nd Ed.). New York: Oxford.

Meier, M.J. (1992). Modem clinical neuropsychology in historical perspective. American Psychologist, 47, 550-558.

Meier, M.J., Benton, A.L. and Diller, L. (Eds.) (1987). Neuropsychological Rehabilitation. New York: Guilford.

Putnam, S.H. and DeLuca, J.W. (1990). The TCN professional practice survey: Part I: General practices of clinical neuropsychologists in primary employment and practice settings. The Clinical Neuropsychologist, 4, 199-243.

Putnam, S.H. and DeLuca, J.W. (1991). The TCN professional practice survey. Part II: An analysis of the fees of neuropsychologists by practice demographics. The Clinical Neuropsychologist, 5, 102-124.

Sales, B., Bricklin, P. and Hall, J. (1984). Manual on Specialization: Principles proposed to the Board of Professional Affairs. Washington, D.C.: American Psychological Association.

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Criterion II. Structures and Models of Education and Training in the Specialty. The specialty has a variety of structures and models to implement the education and training sequence of the specialty. The structures are stable, sufficient in number and geographically distributed, and may be found at the doctoral or postdoctoral level or both.

1. Describe the characteristics of a typical sequence of training that includes courses, research, supervision, and the evaluation of students.

The current Definition of a Clinical Neuropsychologist (The Clinical Neuropsychologist, 1989, Vol. 3, No. 1, p. 22), which is the official position of APA Division 40 (Division of Clinical Neuropsychology), states that a clinical neuropsychologist must successfully complete systematic didactic and experiential training in neuropsychology and neuroscience at a regionally accredited university” and two or more years of appropriate supervised training applying neuropsychological services in a clinical setting.”Currently, the two generally used routes for becoming a Clinical Neuropsychologist involve either: a) taking a two-year postdoctoral fellowship after completing more generic training in applied psychology (i.e. clinical, counseling, school) or b) completing a Clinical Neuropsychology track in a clinical psychology program, taking a Clinical Neuropsychology internship, and receiving one year of postdoctoral supervision in clinical neuropsychology. If a postdoctoral fellow enters a two-year fellowship from a more generic program, it is expected that the didactic component of the fellowship will cover areas of knowledge that are covered in Clinical Neuropsychology tracks at the doctoral level.

The reports of the INS-Division 40 Task Force on Education, Accreditation, and Credentialing (The Clinical Neuropsychologist, 1987, Vol. 1, No. 1, pp. 29-34) [Appendix G] detail courses, research, supervision, and evaluation guidelines at the doctoral program, internship, and postdoctoral levels. These are summarized below:

Doctoral Training Programs in Clinical Neuropsychology

Division 40 guidelines for doctoral training programs in Clinical Neuropsychology (Appendix B) list the following didactic courses, supervised experiences, and research areas to be covered.

A. Generic Psychology Core

1. Statistics and Methodology
2. Learning, Cognition, and Perception
3. Social Psychology and Personality
4. Physiological Psychology
5. Life-Span Developmental
6. History

B. Generic Clinical Core

1. Psychopathology
2. Psychometric Theory

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3. Interview and Assessment Techniques

i. Interviewing
ii. Intelligence Assessment
iii. Personality Assessment

4. Intervention Techniques

i. Counseling and Psychotherapy
ii. Behavior Therapy/Modification
iii. Consultation

5. Professional Ethics

C. Neurosciences and Basic Human and Animal Neuropsychology

1. Basic Neurosciences
2. Advanced Physiological Psychology and Pharmacology
3. Neuropsychology of Perceptual, Cognitive, and Executive Processes
4. Research Design and Research Practicum in Neuropsychology

D. Specific Clinical Neuropsychological Training

1. Clinical Neurology and Neuropathology
2. Specialized Neuropsychological Assessment Techniques
3. Specialized Neuropsychological Intervention Techniques
4. Assessment Practicum (Children and/or Adults) in University-Supervised assessment facility
5. Intervention Practicum in University-Supervised Intervention Facility
6. Clinical Neuropsychological Internship of 1800 hours preferably in noncaptive facility. (As per INS-Division 40 Task Force guidelines). Ordinarily this internship will be completed in a single year, but in exceptional circumstance may be completed in a 2-year period.

E. Doctoral Dissertation

Since most doctoral Clinical Neuropsychology tracks exist in APA-approved doctoral programs, student supervision and evaluation criteria will meet APA accreditation standards.

Clinical Neuropsychology Internships

Persons entering a Clinical Neuropsychology internship are expected to have completed a designated track, specialization, or concentration in neuropsychology. The internship must devote at least 50% of its one-year full-time training experience to neuropsychology and at least 20% of the training experience to general clinical training.Supervisors are encouraged to be board-certified in clinical neuropsychology. Didactic and experiential training guidelines are as follows:

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A. Didactic Training

1. Training in Neurological Diagnosis
2. Training in Consultation to Neurological and Neurosurgical Services
3. Training in Direct Consultation to Psychiatric, Pediatric, or General Medical Services
4. Exposure to Methods and Practices of Neurological and Neurosurgical Consultation (grand rounds, bed rounds, seminars, etc.)
5. Training in Neuropsychological Techniques, Examination, Interpretation of Test Results, Report Writing
6. Training in Consultation to Patients and Referral Sources
7. Training in Methods of Intervention Specific to Clinical Neuropsychology

B. Experiential Training

1. Neuropsychological Examination and Evaluation of Patients with Actual and Suspected
2. Neurological Diseases and Disorders Neuropsychological Examination and Evaluation of Patients with Psychiatric Disorders and/or Pediatric or General Medical Patients with Neurobehavioral Disorders
3. Participation in Clinical Activities with Neurologists and Neurosurgeons (bed rounds, grand rounds, etc.)
4. Direct Consultation to Patients Involving Neuropsychological Issues
5. Consultation to Referral and Treating Professions

In general, Clinical Neuropsychology internships are APA-approved; therefore, supervision and evaluation of students will meet APA standards.General exit criteria which are used in intern evaluation are listed in the guidelines for internship training (Appendix G).

Postdoctoral Fellowships in Clinical Neuropsychology

Entry into a Clinical Neuropsychology postdoctoral program should be based upon completion of a regionally accredited Ph.D. graduate training program in one of the health service delivery areas of Psychology, or an equivalent re-specialization after obtaining a Ph.D. in another area of Psychology. Thus, postdoctoral fellows will have completed an internship program. Normally, directors are expected to be board certified. Except for individuals completing a specialty Clinical Neuropsychology track in their doctoral program and a Clinical Neuropsychology internship, the postdoctoral fellowship in Clinical Neuropsychology is expected to extend at least over a two-year period and involve at least 50% time in clinical service and at least 25% time in clinical research. Didactic and experiential training guidelines are as follows:

A. Didactic Training

1. Training in Neurological and Psychiatric Diagnosis
2. Training in Consultation to Neurological and Neurosurgical Services
3. Training in Direct Consultation to Psychiatric, Pediatric, or General Medical Services

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4. Exposure to Methods and Practices of Neurological and Neurosurgical Consultation (grand rounds, bed rounds, seminars, etc.)

5. Observation of Neurosurgical Procedures and Biomedical Tests (revascularization procedures, cerebral blood flow, Wada testing, etc.)

6. Participation in Seminars Offered to Neurology and Neurosurgery Residents (neuropharmacology, EEG, brain cutting, etc.)

7. Training in Neuropsychological Techniques, Examination, Interpretation of Test Results, Report Writing

8. Training in Consultation to Patients and Referral Sources

9. Training in Methods of Intervention Specific to Clinical Neuropsychology

10. Seminars, Readings,etc. in Neuropsychology (case conferences, journal discussion, topic-specific seminars) Didactic

11. Training in Neuroanatomy, Neuropathology, and Related Neuroscience Topics

B. Experiential Training

1. Neuropsychological Examination and Evaluation of Patients with Actual and Suspected Neurological Diseases and Disorders

2. Neuropsychological Examination and Evaluation of Patients with Psychiatric Disorders and/or Pediatric or General Medical Patients with Neurobehavioral Disorders

3. Participation in Clinical Activities with Neurologiests and Neurosurgeons (bed rounds, grand rounds, etc.)

4. Experience at a Specialty Clinic, such as a Dementia Clinic or Epilepsy Clinic which emphasizes Multidisciplinary Approaches to Diagnosis and Treatment

5. Direct Consultation to Patients Involving Neuropsychological Assessment

6. Direct Intervention with Patients, Specific to Neuropsychological Issues, and to Include Psychotherapy and/or Family Therapy where indicated

7. Research in Neuropsychology (i.e., collaboration on a research project or other scholarly academic activity, initiation of an independent research project or other scholarly academic activity, and presentation or publication of research data where appropriate)

The Association of Postdoctoral Programs in Clinical Neuropsychology is currently examining specific criteria for supervision and evaluation of postdoctoral fellows, and their standards are generally consistent with Division 40 guidelines.General exit criteria which can be used in evaluation of postdoctoral fellows are listed in the Division 40 guidelines for postdoctoral training (Appendix G).

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2. List the names of the training programs that exist in this specialty.

Appendix F is a list of doctoral, internship,and postdoctoral programs in Clinical Neuropsychology published in The Clinical Neuropsychologist, 1993, Vol. 7, No. 4, pp. 371-419. These programs profess to comply with the guidelines for doctoral, internship, and postdoctoral programs in Clinical Neuropsychology set forth by the Division 40 Task Force on Education, Accreditation, and Credentialing published in The Clinical Neuropsychologist, 1987, Vol. 1, No. 1, pp. 29-34 (Appendix G).

In general, there are now two recognized routes to becoming a Clinical Neuropsychologist. The first is to take a two-year postdoctoral fellowship in Clinical Neuropsychology after obtaining generic doctoral and internship training in some field of applied psychology (i.e., clinical, counseling, school). Such fellowships should meet Division 40 guidelines for postdoctoral training (Appendix G). The second route is to obtain doctoral education and internship training in programs meeting Division 40 guidelines for doctoral education and internship training; then, an addition year of postdoctoral training is needed. Other models have been identified but the above have become the characteristic avenues of educational preparation (See Meier, in press, in Appendix E for further discussion of these models.The program descriptions which follow under Criterion III are exemplary structures of well established programs;

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3. Select four representative doctoral and/or postdoctoral-level geographically distributed, and publicly identified programs in psychology in this specialty and provide the name, address, and telephone numbers of the directors of these programs.

Program One Doctoral _____ Postdoctoral X Both _____

Name of University, School, or institution offering program:
Medical College of Wisconsin

Name of program: Postdoctoral Program in Clinical Neuropsychology

Address: 9200 West Wisconsin Avenue, Section of Neuropsychologv

City/State/Zip: Milwaukee, WI 53226

Contact Person: Thomas Hammeke. Ph.D., ABPP

Telephone No. (414) 454-5660

Program Two Doctoral X Postdoctoral ____ Both _____

Name of University, School, or institution offering program:
Universitv of Houston

Name of program:
Clinical Psychology Program (with Clinical Neuropsychology Track)

Address: Department of Psvchologv

City/State/Zip: Houston, TX 77204

Contact Person: H. Julia Hannay, Ph.D.

Telephone No. (7 13) 743-8568

Program Three Doctoral ______ Postdoctoral X Both _____

Name of University, School, or institution offering program:
Hahnemann University

Name of program: Neuropsvchology Track

Address: 230 North Broad Street

City/State/Zip: Philadelphia, PA 19 102

Contact Person: Sandra Koffler, Ph.D.

Telephone No. (215) 762-4956

Program Four Doctoral X Postdoctoral _ Both _

Name of University, School, or institution offering program:
Universitv of Victoria

Name of program:
Clinical Psvchologv Program (with Clinical Neuropsvchology Track)

Address: Department of Psychology. P.O. Box 1700

City/State/Zip: Victoria, British Columbia. Canada V8W 3P5

Contact Person: Catherine A. Mateer, Ph.D.

Telephone No. (604) 721-8590

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4. For each of the programs listed above, designate the program administrator who will provide the information requested in Attachment A (Specifications for Education and Training in (name of specialty) Psychology”).

Program One: Thomas A. Hammeke, Ph.D., ABPP, Director of Training in Neuropsychology

Program Two: H. Julia Hannay, Ph.D., Director of Clinical Neuropsychology Track

Program Three: Sandra Koffler, Ph.D., ABPP

Program Four: Catherine A. Mateer, Ph.D., ABPP, Director of Clinical Training

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Criterion III. Doctoral Education and Training Prerequisites to Specialty Preparation. The knowledge and skills of a specialty are built upon studies in general scientific and applied knowledge in psychology.

1. Select four representative doctoral programs which are geographically distributed that provide the prerequisite preparation in this specialty.

In general, when Clinical Neuropsychology training is formally addressed at the doctoral level, it is accomplished in APA approved applied psychology programs with tracks in Clinical Neuropsychology. The route to becoming a Clinical Neuropsychologist which involves only generic training at the doctoral level and involves taking a two-year postdoctoral residency in Clinical Neuropsychology is relatively familiar. Because the route involving a Clinical Neuropsychology track in a doctoral program is less familiar, we have chosen to focus on the latter mechanism for the purposes of this application.

Program One

Name of Institution:University of Florida

Street: P.O. Box 100165, Health Science Center

City/State/Zip: Gainesville, FL 326 10-O 165

Program: Clinical Psychology

Degree(s) Offered: Ph.D.

Department: Clinical & Health Psvchologv

Administrative Personnel:
Administrative Head of Institution:

Name: John Lombardi Title: President

Chief Administrator Responsible for Instruction:

Name: Andrew Sorensen Title: Provost

Department Chair:

Name: Nathan W. Perry Telephone: 392-4551

Program Director:
Name: Cynthia D. Belar Telephone: 392-4553

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Program Two

Name of Institution:University of Victoria

Street: P.O. Box 3050

City/State/Zip: Victoria, British Columbia, Canada V8W 3P5

Program: Clinical Psychology with Specialization in Neuropsychology

Degree(s) Offered: Ph.D.

Department: Psychology

Administrative Personnel:
Administrative Head of Institution:

Name: David F. Strong, Ph.D.
Title: President

Chief Administrator Responsible for Instruction:
Name: Samuel E. Scullv, Ph.D.
Title: Vice President Academic & Provost

Department Chair:
Name: Richard May, Ph.D.
Telephone: 721-7522

Program Director:
Name: Catherine A. Mateer, Ph.D.
Telephone: 721-8590

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Program Three

Name of Institution:San Diego State University/Universitv of California, San Diego (Joint Doctoral Program in Clinical Psychology)

Street Address 1: 3427 4th Avenue, Department of Psychiatry, Universitv of California, San Diego

City/State/Zip: San Diego, CA 92103

Steet Address 2: 6363 Alvarado Court, Suite 103, San Diego State University

City/State/Zip: San Diego, CA 92120-4913

Program: Joint Doctoral Program in Clinical Psvchologv

Degree(s) Offered: Ph.D. Department: Psychiatry - UCSD

Degree(s) Offered: Ph.D. Department: Psychology - SDSU

Administrative Personnel: UCSD
Administrative Head of Institution:

Name: Richard C. Atkinson, Ph.D. Title: Chancellor

Chief Administrator Responsible for Instruction:

Name: Richard E. Attiveh, Ph.D. Title: Vice Chancellor, Office of Graduate Studies & Research

Department Chair, Department of Psychiatry:
Name: Lewis L. Judd, M.D. Telephone: (619) 534-3684

Program Director: Name: Robert K. Heaton, Ph.D. Telephone: (619) 497-6644

Administrative Personnel: SDSU
Administrative Head of Institution:

Name: Thomas B. Day, Ph.D.
Title: President

Chief Administrator Responsible for Instruction:

Name: James W. Cobble, Ph.D. Title: Dean, Graduate Division

Department Chair, Department of Psychology:

Name: Frederick Hombeck, Ph.D. Telephone: (619) 594-5909

Program Director:
Name: Richard Schulte, Ph.D. Telephone: (6 19) 594-5 135

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Program Four

Name of Institution:University of Houston

Street: 4800 Calhoun Street

City/State/Zip: Houston, TX 77204-5341

Program: Clinical Neuropsvchologv Track in Clinical Program

Degree(s) Offered: Ph.D.

Department: Psychology

Administrative Personnel:
Administrative Head of Institution:

Name: James H. Pickering Title: President

Chief Administrator Responsible for Instruction:

Name: Henry Trueba Title: Provost & Sr. Vice President of Academic Affairs

Department Chair:

Name: Marco Mariotto Telephone: (7 13) 743-8503

Program Director: Clinical

Name: John P. Vincent Telephone: (713) 743-8619

Clinical Neuropsychology Track Director:

Name: H. Julia Hannav, Ph.D. Telephone: (7 13) 743-8568 2.

For each of the 4 programs listed above, designate the program administrator who will provide the information requested in Attachment B (Doctoral Education and Training Prerequisites to (name of specialty) Psychology”).

Program One: Cynthia D. Belar, Ph.D., ABPP, Director of Clinical Training

Program Two: Catherine A. Mateer, Ph.D., ABPP, Director of Clinical Training

Program Three: Robert K. Heaton, Ph.D., ABPP, Co-Director of Clinical Training

Program Four: H. Julia Hannay, Ph.D., Director of Clinical Neuropsychology Track

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Criterion IV. Advanced Scientific and Theoretical Preparation. In addition to the scientific and professional foundations described above, a specialty requires advanced, specialty-specific scientific knowledge.

1. List the requirements for the advanced scientific core in the following areas, as appropriate. This refers to the specialty specific scientific knowledge that builds upon the basic common and scientific core.

a. biological bases of behavior:
b. cognitive-affective bases of behavior:
C. social bases of behavior:
d. individual bases of behavior:
e. other:

Division 40 guidelines for doctoral training programs in Clinical Neuropsychology (Appendix G) list the following areas to be covered.Superscripted letters cross-reference these areas to the areas mentioned in the application.

A. Generic Psychology Core

1. Statistics and Methodology
2. Learning, Cognition and Perception
3. Social Psychology and Personality
4. Physiological Psychology
5. Life-Span Developmental
6. History

B. Generic Clinical Core

1. Psychopathology
2. Psychometric Theory
3. Interview and Assessment Techniques
i. Interviewing
ii. Intelligence Assessment
iii. Personality Assessment
4. Intervention Techniques
i. Counseling and Psychotherapy
ii. Behavior Therapy/Modification
iii. Consultation
5. Professional Ethics

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C. Neurosciences and Basic Human and Animal Neuropsychology
1. Basic Neurosciences'
2. Advanced Physiological Psychology and Pharmacology
3. Neuropsychology of Perceptual, Cognitive, and Executive Processes
4. Research Design and Research Practicum in Neuropsychology”

D. Specific Clinical Neuropsychological Training
1. Clinical Neurology and Neuropathology”
2. Specialized Neuropsychological Assessment Techniqueshd
3. Specialized Neuropsychological Intervention Techniques”
4. Assessment Practicum (Children and/or Adults) in University-Supervised assessment facility
5. Intervention Practicum in University-Supervised Intervention Facility
6. Clinical Neuropsychological Internship of 1800 hours preferable in noncaptive facility. (As per INS-Div. 40 Task Force guidelines). Ordinarily this internship will be completed in a single year, but in exceptional circumstance may be completed in a 2-year period.

E. Doctoral Dissertation

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Criterion V. Advanced Preparation in the Parameters of Practice. A specialty requires the advanced didactic and experiential preparation that provides the basis for services with respect to the essential parameters of practice. The parameters to be considered include: a) populations,b) psychological, biological, and social problems, and c) procedures and technologies. These parameters should be described in the context of the range of settings or organizational arrangements in which practice occurs.

1. Describe the advanced didactic and experiential preparation for specialty practice in each of the following parameters of practice: ::

a. populations:
b. problems (psychological, biological, and social):
c. procedures and technologies:

Clinical neuropsychology is a practice and research specialty of psychology that deals with the relationship between the brain and behavior. Domains of knowledge considered fundamental to clinical neuropsychology includes the basic neurosciences, neuropathology, psychological theory, psychopathology, and psychometrics, among others.

Educational programs are usually based in universities, medical schools, or hospitals. The degree program is usually offered through a clinical psychology program with a special emphasis on neuropsychological training. The following article presents a list of training programs that the respective program directors believe to be in compliance with the guidelines published by Division 40.

Cripe, L.I. (1993). Listing of training programs in clinical neuropsychology -1993. The Clinical Neuropsychologist, 7, 371-419.

Recently the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) was formed to assist institutions in developing advanced postdoctoral education and training in clinical neuropsychology and to establish residence program standards for the training of students who wish to specialize in clinical neuropsychology. These programs emphasize supervised clinical and research training on a variety of patient populations -- developmental, neurological and psychiatric.Students are involved in rigorous programs of neuropsychological assessment and treatment. A description of the APPCN and a list of its founding members may be found in:

Hammeke, T.A. (1993). The association of postdoctoral programs in clinical neuropsychology (APPCN). The Clinical Neuropsychologist, 7, 197-204.

In clinical settings, neuropsychologists assess, diagnose, and provide treatment to individuals who have been born with neurological abnormalities or who have sustained central nervous system injury, or illness.Such maladies include genetic abnormalities, congenital problems, traumatic brain injury, stroke, tumors, exposure to toxic substances, metabolic diseases, and degenerative diseases of the brain. Clinical neuropsychologists also assess, diagnose, and treat children and adults with psychiatric illnesses. Treatment may include direct intervention and program development, as well as consultation with other professionals and family members.

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Individuals who have had neurological injuries or illnesses or children who are not doing well at home, in society, or in the classroom are often referred to a neuropsychologist in order to determine if their problematic behaviors are the result of the injury, illness, an attentional deficit hyperactive disorder, a learning disability, an emotional disability, or some other biopsychosocial factor.

In the neuropsychologist's attempt to make such determinations the clinician uses a set of constructs and tools believed to be valid and reliable. These constructs are:

1) The brain, a very complex biological system, is the organ” of behavior.

2) The brain is genetically determined but shaped by environmental factors.

3) Behavior, what an organism can do to effect change in its environment, is also genetically and environmentally determined.

4) Neural functioning can be measured and predicted, thereby meeting the criteria for scientific investigation.

5) Behavior is predictable and measurable, thereby also meeting criteria for scientific investigation.

6) There are meaningful correlates between neurological functions and behavior.

7) There are cause and effect relationships between brain and behavior.

8) There are valid and reliable measurement devices that may be used to define and understand neural functioning.

9) There are valid and reliable measurement devices that may be used to define and understand behavior.

10) Both neurological and behavioral systems are dynamic, change unequally over time, and are subject to manipulation.

There are a number of recognized and valid approaches to clinical neuropsychological assessment ranging from standardized batteries of test to a flexible battery approach in the assessment of neuropsychological functions. Interpretation of data generated by these tests transcends the actuarial basis of interpretation through interpretation is clearly anchored to the scientific and practice literature supporting test applications.

In analyzing the results of testing it must be kept in mind that a clinical judgment regarding an individual complements statistical interpretation in an important and crucial manner. The clinical judgment, however, must be based upon a sound knowledge of the facts and theories about cognitive science and neuropsychology as well as upon an appreciation for any emotional or psychogenic factors that can alter the patient's level of neurocognitive functioning at the time of assessment.

The results of these analyses are then used to assist with diagnosis, treatment, and rehabilitation, vocational and/or educational planning, such as determining whether a person is in need of a neurocognitive rehabilitation program, or disability assistance, or qualifies for special education.

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Important domains of neuropsychological functioning the neuropsychologist examines include the following:

1) Arousal and Attention Functions

a. awake and alert
b. focus and maintain
C. Resist distracters
d. hemiattention
e. sustain
1. simple
2. complex (concentration)
f. span of attention
g . divide attention

2) Executive Functions
a. plan
b. initiate
C. program
d. sequence
e. verify
f. alter

3) Sensory-Laterality-Motor Functions

4) Visuospatial Functions
a. primary visuoperceptual
b. secondary visuospatial
C. construction
d. organization

5) Language and Related Functions
a. speech
b. receptive language
C. expressive language
d. lexicon
e. verbal fluency
    1. semantic
    2. ortholexic
    3 . discoursive

6) Learning and Memory Functions
a. memory retrieval
    1. verbal
    2. visual
b. acquisition of novel information
    1. verbal lists
    2. verbal logical
    3. isual

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4. visual-verbal
5. procedural

7) Organizational, Problem Solving and Judgmental Functions

a. using inherent structure
    1. verbal
    2. visual
b. using explicit structure
    1. verbal
    2. visual
C. problem solving
    1. verbal
    2. visual
d. judgment
    1. verbal
    2. visual

8) Emotional

a. personality
b. anxiety
C. affect
d. reality orientation

9) Academic Achievement

a. reading
    1. spelling
    2. vocabulary
    3. comprehension
    4. rate
b. writing
    1. spelling
    2. syntax
    3. fluency
    4. content
C. mathematics
    1. operations
    2. applications
    3. metric
d. knowledge
    1. science
    2. social studies
    3. humanities

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A partial list of assessment procedures and tests which have been determined to be useful in assisting the neuropsychologist with diagnosis and treatment planning include:

A Laterality Examination
A Sensory-Perceptual Examination
Aural Comprehension
Beck Depression Inventory
Benton Visual Retention Test
Boston Diagnostic Aphasia Test
Boston Naming Test
Buschke Selective Reminding Test
California Verbal Learning Test
California Verbal Learning Test-Children
Child Behavior Checklist
Child Anxiety Scale
Children's Depression Inventory
Children's Auditory Verbal Learning Test
Cognitive Estimation Test
Collateral Interview with family and significant others
Conner's Teacher's Rating Scale
Conner's Parent's Rating Scale
Controlled Auditory Word Association Test (COWAT)
Diagnostic Interview
Figural Fluency Test
Grooved Pegboard
Halstead-Reitan Neuropsychological Assessment Battery
Hooper Visual Organization Test
Jastak Wide Range Achievement Test-Revised
Mattis Dementia Rating Scale
MLA, token test
MLA, visual naming
MLA, controlled word fluency test
MMPI
Multilingual Aphasia Test (MLA), sentence repetition
Paced Auditory Serial Addition Task
Plan of Search

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Porteus Maze Test
Raven's Progressive Matrices
Reading Comprehension
Record Review
Rey Auditory Verbal Learning Test
Rey-Osterrieth Complex Figure Test
Rey-Taylor Complex Figure Test
Rule Governed Drawing
Sequencing Span Tests
Spelling
State-Trait Anxiety Inventory
Strength of Grip
Stroop Test
Teachers' Report Form
Trail Making Test
Verbal Primary Memory Test with Interference
Visual Cancellation Test
Warrington Recognition Test
Wechsler Intelligence Scale for Children-III
Wechsler Memory Scale-Revised
Wechsler Adult Intelligence Scale-Revised
Wechsler Preschool and Primary Scale of Intelligence-Revised
Wide Range Assessment of Memory and Learning
Wisconsin Card Sorting Test
Woodcock-Johnson-Revised, Tests of Achievement
Woodcock-Johnson-Revised, Tests of Cognitive Abilities
Youth Self Report

For reviews of the tests and further information about other tests, please refer to:

Lezak, M.D. (1983). Neuropsychological Assessment, Second Ed., New York: Oxford University Press.

Spreen, O., and Strauss, E. (1991). A Compendium of Neuropsychological Tests: Administration, Norms, and Commentary. New York: Oxford University Press.

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Some clinical neuropsychologists employ technicians whose clinical duties are limited to the administration and scoring of neuropsychology is a recognized standard of practice; however, there are many clinical neuropsychologists who do not use them, and this is also acceptable. In either case, the clinical neuropsychologist is responsible for the assessment. The following article presents the current guidelines for the education and training of technicians and other nondoctoral personnel:

Report on the Division 40 task force on education, accreditation and credentialing: Recommendations for the education and training of nondoctoral personnel in clinical neuropsychology (1991). The Clinical Neuropsychologist, 5, 20-23.

The use of computers and computer programs is a relatively new development for clinical neuropsychology, and there are many significant issues yet to be resolved regarding the clinical use of such technology. Computers and programs are used for assessment and rehabilitation by some clinical neuropsychologists. For information regarding Division 40's position on the use of assessment programs, please refer to:

Division 40: Task force report on computer-assisted neuropsychological evaluation (1987). The Clinical Neuropsychologist, 2, 161- 184.

For information regarding Division 40's position on the use of computer-assisted rehabilitation programs, please refer to:

Matthews, C.G., Harley, J.P. & Malec, J.F. (1991). Guidelines for computer-assisted neuropsychological rehabilitation and cognitive remediation. The Clinical Neuropsychologist, 5, 3- 19.

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Criterion VI. Public Need for Specialty Practice. The services of the specialty are responsive to identifiable public needs and attend to human diversity.

1. Describe what procedures this petitioning organization and/or other associations associated with this speciality utilize to demonstrate identifiable public needs.

That a need for psychological services, including neuropsychological services, exists in our society is obvious. The problem is identifying, as precisely as possible, what the need is, or more appropriately, what the needs are. This is a multidimensional problem because many factors must be assessed in making this determination. These factors include the scientific and clinical expertise of neuropsychologists, the individuals who require neuropsychological services, and the publics knowledge abut the utility of neuropsychological services, including funders of those services, both public and private.

In clinical settings, neuropsychologists assess, diagnose, and provide treatment to individuals who have been born with neurological abnormalities or who have sustained central nervous system injury or illness. Such maladies include genetic abnormalities, congenital problems, traumatic brain injury, stroke, tumors, exposure to toxic substances,, metabolic diseases, and degenerative diseases of the brain. While most of the patients neuropsychologists work with have a primary neurological diagnosis, they are also asked to assess and make differential diagnoses of children and adults with suspected psychiatric illnesses in order to rule out neuropsychological problems.

Examples of the utility of neuropsychological services in total patient management: .

Diagnosis of progressive dementing diseases, including differential diagnosis of psychiatric illness .

Identification of subtle acquired neurocognitive dysfunction undermining adaptive and prosocial functioning .

Identification of subtle developmental neurocognitive dysfunction impeding academic and social functioning .

Incorporation of neuropsychological findings in treatment plans to increase the probability that specific treatment modalities can be efficacious .

Identification of medication side-effects that may attenuate cognitive functioning .
Use of neuropsychological data in refining educational plans for children .

Use of neuropsychological data in remediating vocational problems in adults .

Identification of community-based programs for remediation and rehabilitation of neurocognitive dysfunction

Referrals are usually made by physicians, psychologists, schools, and lawyers.

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2. Describe how practitioners in the specialty attend to public need and to issues of human diversity (research reports, needs assessment, market surveys, etc., are examples of some types of appropriate documentation.) Evidence that the specialty is monitoring developments and has moved to meet identified emergent needs is also appropriate.

Neuropsychology has a broad range of clinical applications and experimental support. Division 40 of the American Psychological Association is one of the largest and most rapidly growing divisions (Shapiro, & Wiggins, 1994). One way of defining the need for clinical neuropsychologists is to see where they are employed. Clinical neuropsychologists work in a variety of settings, both public and private, including independent practice, hospitals, and rehabilitation centers. The following paper presents an overview of the professional practice of clinical neuropsychology.

Putnam, S.H. & DeLuca, J.W. (1990). The TCN professional practice survey: Part I: General practices of neuropsychologists in primary employment and private practice settings. The Clinical Neuropsvchologist, 4, 199-244.

Another way of assessing the need is to demonstrate the integration of neuropsychological services into domains not necessarily thought of as psychological.” Epilepsy research and treatment is one field in which clinical neuropsychologists, through their training and practice, have made significant impacts. (c.f. Psychology and the Public Forum, American Psychologist, 1992).

An additional method of assessing the need for neuropsychological services is to examine diagnostic systems and payment schedules. The DSM-IV has diagnostic codes that are neuropsychological in intent and content. Similarly, there are ICD-10 codes for neuropsychological syndromes. The CTP-4 codes, codes upon which reimbursements are made, includes a code which is specifically neuropsychological.

Division 40, Clinical Neuropsychology, of the American Psychological Association has several committees that address special needs. These include committees on ethics, minority affairs, and international relations. A database of providers of neuropsychological services in languages other than English is being developed. A national network of neuropsychologists are working on tests and norms to insure valid and reliable assessment of Spanish-speaking individuals. Neuropsychologists are instrumental in offering services to individuals with alternate lifestyles. This is best exemplified by the contribution of neuropsychologists in the study of and treatment provided to individuals infected with Human Immunosuppressant Virus.

3. Describe how the recognition of this specialty will increase the availability and quality of services without reducing access to needed services.

Continuing assessments concerning the need for services must remain a priority in clinical research.These projected studies will not only provide data regarding the estimated need for the amount and level of services expected to be funded under current and proposed health-care policies, but also will serve to direct the development and implementation of public and private policy designed to meet public demands for psychological services. These demands would include the need for services to under- or non-served populations, such as the chronically mentally ill, rural populations, and impoverished individuals with no source of funding. These data can then be used to develop effective marketing and lobbying campaigns designed to educate the public and legislators about what neuropsychologists do. Such campaigns will help broaden

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the understanding by these groups regarding the real needs of the users of neuropsychological services.

Another issue of concern is the need for outcome measures which demonstrate that neuropsychological services have efficacy and incremental utility over other providers of similar services. Services that are neuropsychological in nature are offered not only by neuropsychologists, but also by physicians, speech and language pathologists, occupational therapists, rehabilitation counselors, and special education teachers (Murstein, & Fontaine 1993). Assessment services are offered by various nonpsychologists who have access to instruments used in psychological and neuropsychological evaluations. Companies have developed and marketed computer assessment and interpretive programs that are psychological or neuropsychological in intent and content, which are available to nonpsychologists. Federal and state mandates have given schools an increased role in the assessment and treatment of children and adolescents with developmental and acquired neuropsychological difficulties. Most of these assessments are made by nondoctoral level school psychologists. All of these other service providers have the potential to impact on the need for clinical neuropsychologists.

There are published reports about the efficacy of psychological treatment, including neuropsychology (Lipsey, & Wilson, 1993), books on the value of neuropsychological evaluation and treatment (Lehr, 1990), and several journals that support the need and value of neuropsychological intervention, e.g., The Journal of Head Trauma Rehabilitation.

References

Lehr, Ellen (Ed). (1990). Psychological Management of Traumatic Brain Injuries in Children and Adults, Rockville, Maryland: Aspen Publishers.

Lipsey, M.W. & Wilson, D.B. (1994). The efficacy of psychological, educational, and behavioral treatment: Confirmation from meta-analysis. The American Psychologist, 48, 1181-1209.

Murstein, B.I. & Fontaine, P.A. (1993). The public's knowledge and other mental health providers. The American Psychologist, 48, 839-845.

Shapiro, A.E. & Wiggins, J.G. (1994). A Psy D degree for every practitioner: Truth in labeling. The American Psychologist, 49,207-210.

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VII. Administrative Organizations. The proposed specialty is represented by one or more organizations that provide systems and structures which make a significant contribution to the organized development of the specialty.

1. Name and address of the Administrative Organization making the petition

Name: Division of Clinical Neuronsvchologv American Psychological Association Title:

Address: 750 First Street N.E.

City/State/Zip: Washington, D.C. 20002-4242

Phone: (202) 336-5500
FAX: (206) 223-3557 (Current Div. 40 President - Carl Dodrill, Ph.D.) Fax: 223-4409

2. Contact person:

Name: Manfred J. Meier, Ph.D. Title: Chair, Division 40 Planning Committee

Address: 1201 Yale Place. #1307

City/State/Zip: Minneapolis, MN 55403

Phone: (612) 341-0006 FAX:

3. Signatures of officials submitting the petition:

Manfred J. Meier, Ph.D.
Chair, Division 40 Planning Committee (title) & Past President, Division 40 c& Lg& 1 l/1/94 (d a t e)

(name) Carl Dodrill, Ph.D.
President, Division 40(title) 1 l/1/94 (date) Past President, Division 40

(name) Robert Heaton, Ph.D. (title) (date)1 l/1/94

4. Year this organization founded? 1980

5. Is this organization incorporated?Yes _ No X In what state? If so, please provide a copy of charter and articles of incorporation.

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6. Please enclose the bylaws for this petitioning organization, if any.
See Appendix A.

7. Please provide the following information for all officials in the organization, including the Executive Officer or responsible administrative staff person.

7a.
Name: Carl Dodrill, Ph.D.

Title: President, Division 40

APA membership status: Fellow 40

Address: Harborview Medical Center, Neuropsychology Laboratory, Epilepsy Center, ZA-50

City/State/Zip: Seattle, WA 98 104

Phone: (206) 223-3557

FAX: (206) 223-4409

7b.
Name: Robert Heaton, Ph.D.

Title: Past President, Division 40

APA membership status: Fellow 40

Address: University of California-San Diego, Department of Psvchiatrv Gifford Clinic, 3427 4th Avenue

City/State/Zip: San Diego. CA 92103

Phone: (619) 497-6644

FAX: (619) 497-6686

7c.
Name: Manfred J. Meier, Ph.D.

Title: Chair, Planning Committee

APA membership status: Fellow 38, 40

Address: 1201 Yale Place, #1307

City/State/Zip: Minneapolis, MN 55403

Phone: (612) 341-0006

FAX: (612) 626-4102

8. Describe the purpose and objectives of the administrative organization.

See Division 40 Planning Document - Appendix B

9. Outline the structure and functions of the single administrative organization (frequency of meetings, number of meetings per year, membership size, functions performed, how decisions are made, types of committees, dues structure, publications, etc. Provide samples of newsletters, journals, and other publications, etc.

Division 40 of the American Psychological Association meets annually in conjunction with the general meeting of the APA. As with other APA divisions, Division 40 has a Program Committee that receives submissions for platform paper presentations, poster presentation,

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symposia, invited lecturers, and conversation hours with selected individuals. The abstracts for accepted submissions are published in the Clinical NeurqxychoZogist (edited by Rourke & Adams). There are now over 3,000 members of Division 40, many of whom attend the annual meeting.

There are a number of standing committees and an Executive Committee made up of the current and immediate past president, treasurer, secretary, and various committee chair persons. The Executive Committee meets twice yearly, once during the APA meetings and again during the winter, usually during the winter meeting of the International Neuropsychological Society. Executive Committee decisions are made by voice vote. Major policy decisions are reached after consultation with the membership, usually by means of a survey conducted through the Division 40 newsletter, which is published two to four times annually.

In addition to the Program Committee, other standing committees include Membership, Elections, Professional Affairs, Scientific Affairs, and Education. Ad hoc committees include Planning and a Task Force on Education, Accreditation and Credentialing. Under consideration is the possibility of a revision in the structure of the Division to conform more precisely with the changed structure of APA. Liaison persons have already been identified for working with each directorate of APA (science, practice, education, and public interest) and for working toward the addition of the Planning Committee to standing status. The Task Force on Education, Accreditation and Credentialing has added significantly to the productivity of Division 40 through the development of guidelines for predoctoral, internship, and postdoctoral education, and computer-assisted testing and intervention. The Task Force has also helped guide the development of the first new credentialing board to be added to the family of specialties within the American Board of Professional Psychology. The later has now expanded, beginning with clinical neuropsychology, to include board examinations for advanced competency in forensic psychology, family psychology, health psychology, behavioral psychology, and psychoanalysis. There are modest dues to cover costs of a newsletter, a copy of which is included in Appendix C.

10. What was your annual budget for the previous three fiscalyears?Please attach a copy of annual reports and tax returns (if available) for the last three years.

Annual fiscal reports will be submitted as Appendix D. Robert Firnhaber-White, Ph.D., is the current treasurer as well as newsletter editor, and will be providing related documents as soon as possible, if they do not arrive by the time this petition is submitted to APA.

11. List other organizations that are associated with or that have as a major focus this psychological specialty. Please provide letters from these other organizations supporting your petition.

Other organizations involved in clinical neuropsychology include the International Neuropsychological Society, the National Academy of Neuropsychology, and the American Board of Clinical Neuropsychology, a member board of the American Board of Professional Psychology (ABPP). Letters of support will be provided by these organizations after they have had an opportunity to review this petition package.

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12. Present a rationale for your organization as nationally representative and responsible for dominant views and practices of your specialty area.

The Division of Clinical Neuropsychology was established by a steering committee comprised of leading clinical neuropsychologists from the United States and Canada who were members of the governing board of the International Neuropsychological Society (either past or current at that time). Since the INS was both an international and interdisciplinary organization, it encouraged North American neuropsychologists to establish mechanisms, within the discipline of psychology and for North America, for sharing information and developing standards for education, accreditation and credentialing. Division 40 quickly became the primary organization in North America for generating new knowledge and for establishing educational and practice standards. The latter have emphasized competency evaluation by means of examinations developed by the American Board of Clinical Neuropsychology, a board established by a group of Division 40 fellows. See Meier (In Press), a copy of which is attached in Appendix E.

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Criterion VIII. Effectiveness. Petitions demonstrate the effectiveness of the services provided by its specialist practitioners.

PLEASE NOTE: If the same article illustrates more than one of these items, it may be referenced under each applicable category.

1. Provide at least five psychological manuscripts published in refereed journals (or equivalent) that demonstrate the efficacy of the specialty's services for dealing with the types of clients or populations (including groups with a diverse range of characteristics and human endeavors) usually served by this specialty.

References on the efficacy of neuropsychological services for dealing with types of clients or populations.

Bondi, M.W., Monsch, A.U., Butters, N., Salmon, D.P., & Paulsen, J.S. (1993). Utility of a modified version of the Wisconsin Card Sorting Test in the detection of dementia of the Alzheimer's type. The Clinical Neuropsychologist, 7 161-170.

Hanlon, R., Clontz, B., & Milton, T. (1993). Management of severe behavioral dyscontrol following subarachnoid hemorrhage. Neuropsychological Rehabilitation, 3 63-76.

Lewington, P.J. (1993). Counseling survivors of traumatic brain injury. Canadian Journal of Counseling, 27,274288.

Prigatano, G.P.,Klonoff, P.S., O'Brien, K.P., Altman, I.M. et al. (1994). Productivity after neuropsychologically oriented milieu rehabilitation. The Journal of Head Trauma Rehabilitation, 9, 91- 102.

Ryan, T.V., Sautter, S.W., Capps, C.F., Meneese, W., et al. (1992). Utilizing neuropsychological measures to predict vocational outcome in a head trauma population. Brain Injury, 6, 175- 182.

2. Provide at least five psychological manuscripts published in refereed journals (or equivalent) that demonstrate the efficacy of the specialty's services for dealing with the types of psychological, biological, and social problems usually confronted and addressed by this specialty.

References on neuropsychological services dealing with psychological, biological, and social problems.

Baker, D.B. (1994). Parenting stress and ADHA; A comparison of mothers and fathers. Journal of Emotional & Behavioral Disorders, 2, 46-50.

Heaton, R.K., Velin, R.A., McCutchan, J.A., Gulvich, S.J. et al. (1994). Neuropsychological impairment in human immunodeficiency virus-infection: Implications for employment. Psychosomatic Medicine, 56, 8- 17.

Lang, R.A. (1993). Neuropsychological deficits in sexual offenders: Implications for treatment. Paraphilias, Sexual & Martial Therapy, Special Issue, 8, 181-200.

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Mapou, R.L. & Law, W.A. (1994). Neurobehavioral aspects of HIV disease and AIDS: An Update. Professional Psychology: Research and Practice, 25, 132-140.

Parsons, Oscar A. (1994). Determinants of cognitive deficits in alcoholism: The search continues. The Clinical Neuropsychologist, 8 39-58.

3. Provide at least five psychological manuscripts published in refereed journals (or equivalent) that demonstrate the efficacy of the specialty's procedures and technologies when compared with services rendered by other specialties or practice modalities.

References of efficacy of nemopsychological services when compared to services provided by other specialties or practice modalities.

Baryza, M.J. & Haley, S.M. (1994). Use of the Children's Orientation and Amnesia Test at hospital discharge for children with neurological and non-neurological traumatic injuries. Brain Injury, 8 167- 173.

Benton, Al L., Van Grop, W.G., Stuck, A.E., Mitrushina, M. & Beck, J. (1994). Early detection of cognitive decline in higher cognitive functioning older adults: Sensitivity and specificity of a neuropsychological screening battery: Neuropsychology, 8, 3 l-38.

Mitrushina, M., Abra, J., & Blumfield, A. (1994). The Neurobehavioral Cognitive Status Examination as a screen tool for organicity in psychiatric patients. Hospital and Community Psychiatry, 151, 252-256.

Ruff, R.M., Wylie, T., & Tennabt, W. (1993). Malingering and malingering-like aspects of mild closed head injury. Journal of Head Trauma Rehabilitation, 8, 60-73.

4. Provide at least five psychological manuscripts published in refereed journals (or equivalent) that demonstrate the efficacy of the specialty's services for dealing with the types of settings or organizational arrangements where this specialty is practiced.

References on the efficacy of neuropsychological services for dealing with the types of settings or organizational arrangements where neuropsychology is practiced.

Bemier, J.C. & Siegel, D.H. (1994). Attention-deficit hyperactivity disorder: A family and ecological systems perspective. Families in Society, 75, 142- 152.

Carr, J.S. & Marshall, M. (1993). Innovation in long-stay care for people with dementias. Reviews in Clinical gerontology, 3, 157-167.

Kay, T. (1993). Neuropsychological treatment of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8 74-85.

Putnam, S.H. & DeLuca, J.W. (1990). The TCN professional practice survey: Part 1: General practices of neuropsychologists in primary employment and private practice settings. The Clinical Neuropsychologist, 4 199-243.

Weinstein, C.S., Seidman, L.J., Ahern, G. & McClure, K. (1994). Integration of neuropsychological and behavioral neurological assessment in psychiatry: A case example involving brain injury and polypharmacy. Interpersonal and Biological Processes, 57,62-76.

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Criterion IX. Quality Improvement. A specialty promotes ongoing investigations and procedures to develop further the quality and utility of its knowledge, skills, and services.

1. Provide a description of the types of investigations that are designed to evaluate and increase the usefulness of the skills and services in this specialty. Estimate the number of researchers conducting these types of studies, the scope of their efforts, and how your organization and/or other organizations associated with the specialty will act to foster these developments. It also is appropriate to provide evidence of current efforts in these areas.

Most of the research related to the evaluation of services and usefulness of this specialty has addressed primarily issues of reliability and construct validity relative to the use of neuropsychological tests in addressing the types of problems identified in Meier (In Press -- see Appendix E). The specialty is cognizant of the need for program evaluation studies to measure the impact (favorable or unfavorable) of neuropsychological services in particular settings. Comprehensive program evaluation studies have not been done, but his is not unusual in the psychological specialties, including the traditional specialties, since our techniques are logically subject to methodologies that emphasize criterion-referenced validation research, including the efficacy of particular techniques in addressing specific diagnostic and intervention issues. The Division 40 Planning Committee has recognized the need for broader program evaluation research, and is encouraging members of Division 40 to take the initiative for such research. This is a major item on Division 40's agenda for the next decade. Division 40 hopes, therefore to conduct model research that will be of use to the other psychological specialties as well.

Characteristic validation research is quite extensive, judging by the proliferation of journals in clinical neuropsychology and the numerous criterion-referenced predictive studies and construct validation studies appearing in the neuropsychological literature. Meier (In Press, see Appendix E) has listed journals that are edited by a neuropsychologist, a list that is not all-inclusive since many other journals that are edited by someone of another profession publish neuropsychological studies done by psychologists.

The sheer volume of the publications that have arisen from these journals is reflected, as well, in a list of twenty books in the above publication (Meier, In Press, see Appendix E) and attests to the breadth and depth of the existing knowledge for specialized practice in clinical neuropsychology.

2. Describe how the specialty seeks ways to improve the quality and usefulness of its practitioners' services beyond its original determinations of effectiveness.

The specialty seeks to improve the quality and usefulness of its practitioners' services by conducting numerous conferences and workshops. Many of these are offered under the auspices of Division 40, but many also appear by means of structured presentations and conferences under the auspices of the International Neuropsychological Society and the National Academy of Neuropsychology. Individuals may request recognition for their continuing education offerings through the APA Continuing Education Committee, so that there is an elaborate network of resources engaged in the expansion of competence and of the knowledge base for practice of any neuropsychologist seeking to expand her/his knowledge and skills. The assessment of competence in educationally qualified practitioners has become the primary goal of the American Board of Clinical Neuropsychology within the structure of ABPP. The diploma in clinical neuropsychology has now been granted to approximately 250 individuals by means of peer review examinations conducted by ABCN, with full counsel and guidance from other specialty examining boards within ABPP. The history of recognition of ABCN in this credentialing

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context and of the expansion of ABPP into other specialized areas of practice is also summarized in Meier (In Press), a copy of which is enclosed in Appendix E.

3. Describe how the research and practice literature are regularly reviewed for developments which are relevant to the specialty's skills and services, and how this information is publicly disseminated.

4. Describe how the specialty promotes and participates in the process of accreditation in order to enhance the quality of specialty education and training.

The research and practice literatures are regularly reviewed for developments which are relevant to the specialty skills and services by the Task Force on Education, Accreditation and Credentialing (TFEAC) of Division 40 and, in the future, by the Planning Committee of Division 40. Liaison activities, in cooperation with the International Neuropsychological Society, ABCN/ABPP, and the National Academy of Neuropsychology, enhance Division 40's efforts to identify this literature and to disseminate relevant information to the public. The primary mechanisms for information dissemination are the Division 40 newsletter, the NAN newsletter, and the Clinical Neuropsychologist (which publishes reports from the Division 40 Task Force on Education, Accreditation and Credentialing), in addition to the many journals and books relating to Clinical Neuropsychology. Therefore, there is an extensive network of publications for sharing developments in this specialty with clinical neuropsychologists, other psychologists, other professions and the public. The journal, Neuropsychology Review, in addition to selected APA journals, publishes broad review articles that summarize the state of our knowledge and practice in particular applications.The Division 40 TFEAC has been the most vital group in pursuit of this goal.

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Criterion X. Standards for Specialty Service Delivery.Specialty practitioners conform their professional activities, not only to the profession'sgeneral practice standards and ethical principles but also to appropriate specialty standards.

1. Describe how the specialty's practitioners assure effective and ongoing communication to members of the discipline and the public as to the specialty's practices, practice enhancements, and/or new applications.

Communication regarding practices, practice enhancements, and/or new applications happens through several mechanisms. Some of these include:

1) Division 40 publishes a Newsletter twice a year which often contains information useful to practitioners, such as a recent statement on Current Procedural Terminology (CPT) codes. Activities of standing and ad hoc committees (e.g. Ethics Committee, Professional Affairs Committee) are also covered.

2) Division 40 sponsors a scientific and professional program at the Annual Meeting of the American Psychological Association (APA). This program includes scientific papers and posters, invited speakers on current advances in the field, and special sessions on professional practice.In addition to the invited speakers and scientific presentations, discussion hours were held at the 1994 APA Meeting on topics like neuropsychological assessment with Hispanic populations, managed care, ethics in Clinical Neuropsychology, process versus battery approaches to assessment, and problems in Clinical Neuropsychology. A schedule for the 1994 program is included in Appendix C.

3) Division 40 has maintained a close relationship with The Clinical Neuropsychologist, a journal in the field oriented toward the practitioner. Various statements relevant to the practice of Clinical Neuropsychology have been published in this journal, as noted above. The Clinical Neuropsychologist publishes the abstracts from Division 40's scientific program at APA.

4) The Division 40 Professional Affairs Committee has developed a brochure to communicate about the practice of Clinical Neuropsychology to other professionals and patients (Appendix L).

5) In addition to Division 40, two other prominent organizations have programs at meetings which include scientific and practice aspects. The International Neuropsychological Society has North American meetings in the winter and European meetings in the summer of every year. Programs include workshops which usually have topics of both clinical and scientific interest and scientific papers and posters. The National Academy of Neuropsychology has a meeting in the fall of each year which covers practice and scientific aspects in its program with emphasis upon continuing education workshops for practitioners.

2. How does your specialty encourage the development of standards of practice?

Considered as a whole, the various developments outlined in this petition characterize a specialty in relatively rapid evolution. An underlying value on the part of the specialty toward achieving excellence in clinical practice has been a primary propelling force in the development of the specialty to its current developmental status. Most of these converging developments have been described elsewhere in the petition but warrant additional comment in the context of this particular question:

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1) The establishment of an INS/Division 40 Task Force on education, accreditation and credentialing in the 1970s led to the development and subsequent divisional endorsement of guidelines for pre-doctoral, internship, and postdoctoral education and training activities for the specialty. The work of that Task Force also produced guidelines for computer-assisted neuropsychological assessment, responsible and effective use of subdoctoral personnel in neuropsychological application, and continuing education. Those guidelines have influenced educators of applied personnel in neuropsychology and, thereby, helped prepare programs in the field for future accreditation review following recognition of the specialty and the incorporation of related educational programs into the acccreditation process within APA and elsewhere where appropriate.

2) Formation of the Association of Postdoctororal Programs in Clinical Neuropsychology was a natural outgrowth of the work of the Division 4O/INS Task Force. APPCN has developed self-study forms and site visit evaluation forms for future accreditation purposes. These procedures have been piloted among these programs which now exceed 50 in number, with over 35 directed by a ABPP/ABCN diplomate in clinical neuropsychology. A comparable group is being formed for developing similar procedures for pre-doctoral and internship programs. A representative of APPCN is seated on the Interorganizational Council for Postdoctoral Programs in Professional Psychology, an organization consisting of representatives from APA, ABPP, the National Register, AASPB, CPA. This interorganizational council will assure that the reliability, relevance, and effectiveness of future accreditation procedures for neuropsychological education and training programs at all levels.

3) The development of a relationship between ABCN and ABPP yielded an increasingly more refined credentialing procedure for identifying knowledgeable and competent clinical neuropsychologists.ABCN has been working under the aegis of ABPP and in collaboration with the Professional Examination Service (PES) to develop objective written as well as multiple oral examination procedures. These procedures are monitored by ABPP and progressively refined by means of rigorous procedural reviews and studies to determine the reliability and the validity of the examination.

4) The Joint Committee on Standards for Educational and Psychological Testing is currently engaged in its work toward producing a revision of the 1985 standards. The Joint Committee deliberating upon the inclusion of standards for neuropsychological testing/assessment in the forthcoming revision.The articulation of those standards is expected to be achieve with the assistance of a panel of experts in clinical neuropsychology. This panel has been named and approved by the Joint Committee to assist in the development of practice standards for neuropsychological testing/assessment. Manfred Meier chairs that panel which is already engaged in this effort.

5) The research results being presented at meetings of Division 40, INS and NAN is designed to increase the standard of application in neuropsychology. In addition, there are groups within these organizations, such as the NAN Research Consortium, that are attempting to identify the empirical basis for changes in practice as they are warranted by the results.

6) It has been proposed that an interorganizational mechanism be established for increasing the effectiveness of collaborative efforts among organizations and individuals for pursuing excellence in education, research, and practice. This group would be known as the Clinical Neuropsychology Synarchy. It would be modeled upon cooperative interorganizational efforts such as the Interorganizational Council (above) and the Psychology Executive's Roundtable. The latter models are themselves relatively recent

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in origin but they exemplify a trend toward interorganizational cooperation toward the establishment of practice standards.

The clinical neuropsychological community has been providing leadership in these interorganizational contexts so that clinical neuropsychology is becoming recognized as a major contributor to the setting and the continued refinement of practice standards. Such standards are expected to become focused in terms of achieving the necessary competence for effective practice based upon an organized program of educational preparation and supervised applied activities within the framework of programs that have met specific accreditation criteria.

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Criterion XI. Provider Identification and Evaluation. A specialty recognizes the public benefits of developing sound methods for permitting individual practitioners to secure an evaluation of their knowledge and skill and to be identified as meeting the qualifications for competent practice in the specialty.

1. Describe how and by whom the specialty identifies those who are qualified to practice in the specialty.

Identification of persons qualified to practice Clinical Neuropsychology occurs at two levels:

1) The Definition of a Clinical Neuropsychologist published in The clinical Neuropsychologist 1989, Vol. 3, No. 1, p. 22 (Appendix I) sets forth guidelines for use of the title Clinical Neuropsychologist.” According to this definition, a Clinical Neuropsychologist is a doctoral level psychologist who a) has completed systematic didactic and experiential training in neuropsychology at a regionally accredited university,b) has to or more years of supervised training in Clinical Neuropsychology, c) is licensed or certified in the state or province in which she/he practices, and d) has submitted to review by peers as a test of these competencies. This definition has been widely accepted among practitioners, but there are currently no enforcement mechanisms to prevent use of the title by someone who is not qualified. Thus, compliance is largely voluntary.

It should also be noted that the Division 40 Task Force on Education, Accreditation, and Credentialing in its Guidelines for Continuing Education in Clinical Neuropsychology published in The Clinical Neuropsychologist, 1988, Vol. 2, No. 1, pp. 25-29 (Appendix M) has clearly stated that continuing education is not a method for development of basic competence in the clinical practice of neuropsychology. ” Thus, the mere acquisition of continuing education credits does not qualify one to use the title of Clinical Neuropsychologist.

2) The American Board of Clinical Neuropsychology (ABCN) offers a Diploma in Clinical Neuropsychology under the auspices of the American Board of Professional Psychology. In order to obtain diplomate statue, a candidate must a) pass a credentials review regarding training in applied psychology and Clinical Neuropsychology, b) submit and pass the review of a work sample in Clinical Neuropsychology, c) pass a written examination in Clinical Neuropsychology, and d) pass an oral examination administered by an ABCN examining committee. Although diplomas such as the ABPP or ABCN have been seen as representing an elite group in the past, ABPP is currently making an effort to change them to a criterion for entry level practice within specialties, similar to the boarding system for medical specialties. This process, if successful, will probably take several years. ABPP has reorganized into a federation of specialty boards to enhance the effectiveness of this system.

In general, Clinical Neuropsychology has not yet been recognized as a specialty at the level of state psychology boards. However, in Louisiana, Clinical Neuropsychology has been recognized as a specialty in which one must be qualified to practice.A copy of the relevant rule for the Louisiana State Board of Examiners of Psychologists is attached (Appendix N).

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2. Describe how and by whom the specialty assesses the actual knowledge and skills of individuals who wish to be identified as practitioners in this specialty.

Assessment of the knowledge and skills of individuals wishing to practice Clinical Neuropsychology is carried out at two levels:

1) The first is at the training level. As noted in response to previous questions in this application, there are currently two characteristic routes to becoming a Clinical Neuropsychologist. The first involves obtaining generic training in applied psychology and taking a 2-year postdoctoral fellowship in Clinical Neuropsychology, and the second involves obtaining training in Clinical Neuropsychology at the doctoral level (usually in a specialty Clinical Neuropsychology track of a Clinical Psychology program), taking an internship which meets Division 40 standards, and obtaining an additional year of training at the postdoctoral level. At each level, the Clinical Neuropsychologists responsible for training must assess whether the knowledge and skills of the candidate will be adequate to practice at the next level of training or practice.Ultimately, then, the postdoctoral supervisors must decide whether a trainee's knowledge and skills are adequate to practice Clinical Neuropsychology.

With respect to quality control and postdoctoral programs, it should be noted that the field is moving toward development of accreditation procedures with the establishment of the Interorganizational Council on the Accreditation of Postdoctoral Programs in Professional Psychology. For Clinical Neuropsychology, the Association of Postdoctoral Programs in Clinical Neuropsychology is working on these issues (see Appendix 0 from The Clinical Neuropsychologist, 1993, Vol. 7, No. 2, pp. 197-204). Thus, training in Clinical Neuropsychology at the postdoctoral level should continue to move toward uniform standards of quality control.

2) The American Board of Clinical Neuropsychology (ABCN) examines candidates for diplomate status, which is issued under the auspices of ABPP. As noted in response to the previous question, the examination involves a credentials review, a written examination, a work sample review, and an oral examination.Eventually, it is hoped that this examination process will provide the definitive evidence of competence at the entry level, much the same as boards in medicine do. Steps haven been taken by ABPP to achieve this goal.

3. Describe how and by whom the specialty educates the public and the professional concerning those who are identified as a practitioner of this specialty.

There are multiple mechanisms for educating the public and other professionals about practitioners of Clinical Neuropsychology:

1) The Professional Affairs Committee of Division 40 of APA makes efforts to educate the public and other professionals regarding Clinical Neuropsychologists. For example, a brochure has been devised for distribution to potential clients and other professionals (Appendix L). Also, the Task Force on Education, Accreditation, and Credentialing has made the various statements approved by Division 40 (e.g., Definition of a Clinical Neuropsychologist; Guidelines for Doctoral, Internship, and Postdoctoral Training in Clinical Neuropsychology) available to other APA divisions which may have an interest in them. This Task Force is also making efforts to communicate with other APA divisions about overlapping interests and potential areas of conflict.

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2) The American Board of Clinical Neuropsychology makes efforts to educate the public regarding the existence of its Diploma as an indicator of competence to practice Clinical Neuropsychology.

3) The Program Committee of Division 40 frequently invites speakers from other professions such as Neurology, Psychiatry and the Neurosciences to speak at the Annual Meeting of APA. One by-product of these interchanges is the contact these prominent other professionals have with Division 40 and what they learn about Clinical Neuropsychologists.

4) The International Neuropsychological Society (INS) is an interdisciplinary organization with Speech Pathologists, Neurologists, Psychiatrists, and other professionals in addition to Clinical Neuropsychologists as members. The interchanges which occur through INS make other professionals familiar with the roles and interests of Clinical Neuropsychologists.

4. Estimate how many practitioners there are in this specialty (e.g., spend 25% or more of their time in services characteristic of this specialty and provide whatever demographic information is available.).

Appendix P is a list of the most recent ABCN Diplomates in Clinical Neuropsychology (27ze Clinical Neuropsychologist, 1994, Vol. 8, No. 2, pp. 239-240). This list contains 222 names of Diplomates. However, this list does not include all those who practice Clinical Neuropsychology. While Division 40 membership neither includes all those who practice Clinical Neuropsychology nor requires that one practice Clinical Neuropsychology, its membership numbers may help to provide the best estimate of the number of practitioners today. Based upon Division 40 membership, it is estimated that there are in excess of 3,000 practitioners of Clinical Neuropsychology. This number is based on the number of members and associate members in Division 40, which is 3933. INS numbers over 3,000, of which about 85% are psychologists. NAN now exceeds 2,000, most of which are practicing clinical neuropsychology.

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Criterion XII. Continuing Professional Development and Education. A specialty provides its practitioners a broad range of regularly scheduled opportunities for continuing professional development in the specialty practice and assesses the acquisition of knowledge and skills.

1. Describe the opportunities for continuing professional development in the specialty practice.

Clinical neuropsychologists have a wide range of specific and related continuing education programs available at national meetings, state meetings, and through other local sources. The major national meetings at which a variety of continuing education programs are offered by leading clinicians and researchers include the annual American Psychological Association meeting, the biannual meetings of the International Neuropsychological Society (INS), and the annual meeting of the National Academy of Neuropsychology (NAN). One of the biannual INS meetings is held in Europe or Australia,thereby offering educational opportunities from distinguished neuropsychologists from other countries.

There are many less formal continuing educational opportunities for professional development. These include presentations and courses offered by related disciplines, Grand Rounds, and programs offered by local neuropsychological societies.Additionally, neuropsychologists have access to peer-reviewed domestic and international journals that publish research and practice information of concern to clinical neuropsychologists.Four journals that focus exclusively on neuropsychological issues are The Clinical Neuropsychologist, which serves as an associated journal of Division 40 of the American Psychological Association; Archives of Clinical Neuropsychology, which is the official journal of the National Academy of Neuropsychology; The Journal of Clinical and Experimental Neuropsychology, and Neuropsychology.Please refer to Appendix E for a comprehensive library or to the American Psychological Association's PsychSCAN: Neuropsychology for a more complete list of journals that publish articles concerning neuropsychological issues.

2. Describe the formal requirements for continuing professional development in the specialty.

Clinical neuropsychologists must be licensed psychologists in order to practice. Specific requirements for continuing professional development for clinical neuropsychologists is formally defined by state and provincial government agencies that issue the licenses. In some instances specific continuing education programs may be required by the licensing board, but typically a board specifies hour requirements.These programs usually have to be authorized Category I APA approved programs and therefore all APA requirements must be met by the program provider.

3. Describe how the assessment of an individual's professional development is accomplished in the specialty.

At the present time only one state, Louisiana, offers accreditation in clinical neuropsychology. Other states and provinces have laws regulating the practice of psychology, including clinical neuropsychology. In most states and provinces, psychologists are cautioned that they must practice only in their area(s) of competency. This ethical commitment implies that the practitioner of clinical neuropsychology has adequate education and training, including supervised clinical experience in this specialty.

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The American Board of Professional Psychology (ABPP) certifies that an individual is competent to practice clinical neuropsychology. The certification process involves extensive peer review of an applicant's education, knowledge of the subject matter and ethics, and written neuropsychological reports. Although the ABPP certification is not necessary or required to practice clinical neuropsychology, it is a clear statement of competency. Less formal identification of competency is achieved by peer review and qualifications requirements imposed on clinicians by hospitals, insurance companies, and employers.

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Attachment A - Medical College of Wisconsin

Specifications for Education and Training in Clinical Neuropsychology

Program One
Doctoral _ Postdoctoral X Both _
Name of University, School, or institution offering program: Medical College of Wisconsin

Name of program: Postdoctoral Program in Clinical Neuropsvchologv

Address: 9200 West Wisconsin Avenue, Section of Neuropsychologv

City/State/Zip: Milwaukee, WI 53226

Contact Person: Thomas Hammeke. Ph.D., ABPP

Telephone No. (4 14) 454-5660 Director of Training in Neuropsychology

1. Provide a list of names, addresses, and telephone numbers of all the graduates from your program from the past year (use separate page.)

See Medical College of Wisconsin Program Appendix A, following question 6.

There were extra graduates in 1992 because we had additional research funding that year and one resident was completing her training after maternity leave.

2. Psychology Faculty. Provide the names of the designated psychologist in the above listed program who has responsibility for the integrity and quality of the program, and a description of the education, training and credentials of each psychologist in charge of the educational and/or training program.

There are five full-time neuropsychological faculty in the Section. Four of the faculty are board-certified in clinical neuropsychology by American Board of Professional Psychology and the American Board of Clinical Neuropsychology.The fifth faculty member (Sara Swanson) is board eligible and is currently in the midst of the board examination process.

See Medical College of Wisconsin Program Appendix B (following question 6) for summary of education and credentials of each faculty member.

3. Setting.Provide evidence that each of the above listed programs, regardless of setting, (a) maintains a full-time psychology faculty; (b) provides opportunities for scholarly inquiry and practice by the faculty; and (c) provides for social and financial support for trainees and expanded opportunities for breadth of learning.

A) The Section: The Neuropsychology Section is located at the Medical College of Wisconsin (MCW), a private, free-standing, non-profit medical college. MCW is affiliated with many hospitals in the Milwaukee area, but has four primary teaching hospitals. These include Froedtert Memorial Lutheran Hospital, John Doyne Hospital, Children's Hospital of Wisconsin, and Zablocki VA Medical Center_ The Section is housed in an ambulatory care clinic attached to three of the teaching hospitals on the grounds of the Milwaukee Regional Medical Center. Office and clinic space currently dedicated to the Section is 40,000 square feet which includes 16 rooms and additional administrative and clerical space.

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The Section was formally established as a separate section in the Department of Neurology in July of 1979. Prior to 1979, Neuropsychology's presence in the Department of Neurology consisted of one neuropsychologist, one postdoctoral fellow, one technician, and one secretary. In 1979, the Section hired three additional faculty and increased the scope of service provided on the campus at Milwaukee Regional Medical Center.The number of full-time faculty in the Section has remained stable over the years with 4-5 faculty positions. Number of residents, students and support staff increased for a number of years, but has been stable since approximately 1988 (4 postdoctoral residents, an administrative secretary, and a receptionist, 2.5 FTE technicians).

The mission of the Neuropsychology Section has always been four-fold: a) to provide clinical assessment and treatment to adults and children who have suspected or demonstrated neurologic disorders, often with behavioral sequelae; b) to undertake research in a variety of areas related to neuropsychology, psychopharmacology, and medical psychology; c) to provide instruction to undergraduate and postgraduate students of MCW and affiliated institutions; and d) to foster the advancement of neuropsychology in Southeastern Wisconsin via clinical service and education of lay and professional public.

B) Institutional Status: The Section of Neuropsychology is well respected at the Medical College of Wisconsin and its hospital affiliates for its contributions to clinical service, teaching, research, and community relationships.With respect to clinical service, the Section provides neuropsychological services for the entire campus at the Milwaukee Regional Medical Center.It has a formal role in integrated programs with the Departments of Neurology (Dementia Clinic, Comprehensive Epilepsy Program, Multiple Sclerosis Clinic), Neurosurgery (Epilepsy and Spinal Cord Injury Programs), Physical Medicine & Rehabilitation (Head Trauma Clinic), and Neuroradiology and Biophysics (Functional Magnetic Resonance Imaging Program).

With respect to teaching activities, the Section has a long-standing tradition of providing a number of lectures to undergraduate medical students on campus (currently four lectures given annually) as well as tutorial training in clerkships. At the postgraduate level, the Neuropsychology Section provides eight lectures annually to resident groups in Neurology, Psychiatry, and Physical Medicine and Rehabilitation. In addition, Neuropsychology is a rotational participant in Neurology Grand Rounds and Neurology Case Conferences, presenting in approximately 15 conferences annually. Neuropsychology faculty serve on a number of Department of Neurology administrative committees including Research, Faculty Recruitment, Resident Recruitment, Strategic Aims, and Faculty Promotion.

With respect to research, Neuropsychology's faculty have generated more than 3 million dollars of grant supported research since its inception in 1979. In addition, the faculty have published 7 books, 40 book chapters and reviews, and more than 135 manuscripts in refereed journals, and made more than 150 presentations at scientific meetings. One faculty (Dr. Rao) serves on a MCW research steering committee for Functional Magnetic Resonance Imaging and is a nationally recognized expert in the area.

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boards, including the National Multiple Sclerosis Society, State Psychology Ethics Board, Wisconsin Multiple Sclerosis Society, Wisconsin Learning Disability Association, Wisconsin Psychological Association Research Award Committee, and the Epilepsy Society of Southeastern Wisconsin.

C) Financial Support and Sustainability Issues: While the Section is part of the Department of Neurology, it has its own budget and is held responsible for generating sufficient income through service-generated fees, grants, and professional courses to offset operating budgeting expenses. Postdoctoral salaries and fringe benefits are included in the budget. Small subsidies from the Department of Neurology and from affiliated teaching hospitals are received. With these subsidies the Section has essentially remained fiscally sound since 1985, although there has been fluctuation in income levels on an annual basis.

D) Training Program: The general program training plan involves a) orientation to facility and clinical operations, b) evaluation of individual resident's training needs and goals, c) development of a training plan that hinges on intensive supervision of clinical and research activities, and provision of appropriate didactics, d) provision of adequate opportunity and resources in order to enable an optimal learning experience, and e) periodic re-evaluation of resident progress to revise education and training priorities as needed.

On arrival residents are provided a period of orientation that enables them to become familiar with the educational facilities and routinely used clinical instruments, instruction in standard clinic inpatient and outpatient operations protocols, exposure to the general character of written reports generated from the clinic, and instruction in the commitments of the clinic to other program son campus. During the first month, the resident's knowledge and skills in administration and scoring of standard tests used in our clinic are assessed by faculty and technician staff with training provided as needed. In addition, each resident's goals for training and career aspirations are reviewed in order to incorporate these into the overall training plan.

The core of the educational and training experience in clinical work occurs in intensively supervised experiences in clinical assessment and treatment of a broad range of neurobehavioral disorders. Clinical training is divided into adult and pediatric tracks. In addition, the residency program provides a number of didactic learning experiences and requires residents to participate in scholarly and/or research activities.Trainees, as residents of MCW, have full access to the whole range of library resources and academic coursework that is available at the Medical College.

Required didactic learning experiences include participation in a) a two year neurobehavioral science course that meets twice monthly devoted to review an update of basic neuroscience, b) a weekly neuroanatomy review,c) a weekly Neuropsychology Case Conference, d) a weekly Neuropsychology Journal Club, e) a weekly Neurology Grand Rounds and f) a weekly Neurology Case Conference. Optional learning experiences include bedside neurology and neurosurgery rounds, brain cuttings, observation of neurosurgical procedures (e.g., temporal lobectomies), neurology resident lectures,observation and participation in neuroimaging techniques (Magnetic Resonance Imaging, Functional Magnetic Resonance Imaging, Single Proton Emission Computerized Tomography, CT scans) offered by the Departments of Radiology and Nuclear Medicine, and Psychiatry Grand Rounds.

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Postdoctoral residents are required to develop a scholarly project or participate in a research endeavor during their residency. The resident may collaborate on an ongoing research project or initiate an independent project. A few resident shave completed a scholarly review of the literature and made a presentation. It is anticipated that this activity will lead to presentation of results at scientific meeting and/or publication of findings in a peer reviewed journal. Also, residents are expected to make occasional presentations in Neuropsychology Journal Club, case conferences, neuroanatomy review, Neurology Grand Rounds, and Neurology Case Conferences.

Research opportunities and resources are made available to the residents. Most of the neuropsychology and adjunct faculty have research programs and invite residents to participate or develop a project either in that area, or to develop an independent research protocol under the supervision of the faculty. There are substantial databases available that include neuropsychological and neuropathological data on a) multiple sclerosis, and b) dementia, and a rapidly growing database in c) epilepsy with specific data collected on patients undergoing temporal lobe lobectomies.A less formal database exists in the area of traumatic grain injury. The Section provides access to library holdings, and maintains a modem access to the library for computer searches that are free to the residents.The Section also has several computers with statistical programs available to the residents for data analysis and graph production. MCW also maintains a professional audio and visual graphics center on campus, and a biostatistic department.

Postdoctoral residents are socialized into the profession and specialty by being a) given copies of state and national standards for practice as a psychologist, b) given a title of postdoctoral resident in clinical neuropsychology, c) given an office comparable to that of the faculty in Neuropsychology on campus,d) encouraged to take the National Exam for state licensure while in their residency,e) encouraged to attend professional meetings with a $500 annual business account to defray costs of meeting expenses, and f) encourage to join state, national, and other professional organizations, both for matters of scientific presentations, as well as professional integration.

The residents have individual offices in the same location as the Neuropsychology faculty offices to encourage peer interaction and consultation. In addition they have convenient access to residents in Neurology for consultation and peer interaction (Neurology resident offices are located across the corridor from Neuropsychology Clinic rooms).

4. Procedure for Evaluation.Describe the formal procedures for monitoring each trainee's progress and assuring the continuous development of the trainee's knowledge, skills, attitudes, and values in your program.

Trainee evaluation is provided in the form of ongoing a) supervision of professional and research activity as well as periodic b) written evaluation of the resident's progress.

a) The supervision process begins with a thorough evaluation of the resident's familiarity with testing instruments used in the clinic. Emphasis early in the training is given to ensuring administration and scoring proficiency with tests used in the clinic. Subsequently emphasis shifts to delineation of referral questions,targeted interviewing, differential diagnosis and case formulation, treatment and referral planning, and report writing. Supervision is provided by the faculty for each of the adult and child tracks with faculty serving as supervisors on weekly cycles of rotation. Thus, each resident has exposure to supervision by each of the faculty in their respective subspecialty areas.Professional responsibility resides with the supervising faculty.

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Hours spent in weekly individual, face-to-face supervision vary from 1 to 10 hours depending on the resident's clinical proficiency and clinical caseload for that week. On average individual supervision is closer to 2-3 hours per week.

b) Written evaluation of the resident's progress occurs at six month intervals throughout their training program. The evaluation (See MCW Appendix C in general Appendix H) is completed by all supervisors of the resident and individually discussed with the resident. The resident is given a written copy of this evaluation, and the original, signed by faculty and the resident, is maintained in the resident's personnel file. At the same time the resident is asked to provide written feedback on the quality of supervision received from each of his/her supervisors and to provide a tabulation of the characteristics of cases evaluated and educational experiences received (see MCW Appendix D, following question 6, for forms).

5. Admission to the Program. Provide evidence from your program that published descriptions of the programs specify whether they are designed to satisfy current licensing and certification requirements for psychologists as well as whether or not graduates can satisfy the education and training requirements for advanced recognition in the specialty.

The postdoctoral supervision provided in the residency program satisfies that required for licensure in the State of Wisconsin; however, the program does not formally advertise this. To date there are 14 graduates of the residency program. All have gained licensure in Wisconsin or the State of their residence.

The residency program is designed to develop the knowledge and skills necessary for independent practitioner level competence in the discipline of clinical neuropsychology. This is formally stated in the program brochure (see MCW Appendix E, page 2, first paragraph, following question 6). Of the 14 program graduates to date, all but one hold professional positions as clinical neuropsychologists and are eligible for board certification in clinical neuropsychology from the American Board of Professional Neuropsychology and American Board of Clinical Neuropsychology. One has achieved board certification and three others have successfully completed the written exam for this certification.

6. Admission to the Program. Provide evidence that your program has procedures that take into account the trainee's prior academic and professional record.

Our program requires a doctoral degree in a professional area of psychology and specific training in a clinical core of coursework that has been suggested by education and training guidelines endorsed by Division 40 and the International Neuropsychological Society (see The Clinical Neuropsychologist, 1987, 1, 29-34). Completion of an APA approved graduate program is preferred. Completion of an internship is required, preferably also one that is APA approved.

Applications require a vita, two sample written reports, academic transcripts, and three letters of reference. Also, applicants who have not defended their dissertations are asked to solicit a letter from their dissertation chair that endorses the application and indicates the likelihood of completing the dissertation prior to the starting date of the residency. Typically most prospective residents are interviewed at the International Neuropsychological Society Annual Meeting in early February, a meeting that is commonly attended by the majority of postdoctoral applicants. Additional inquiries from the program and the applicant are often completed subsequently by phone.

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Applicants are ranked regarding their apparent commitment to a career in clinical neuropsychology and readiness for postdoctoral training. Consideration is given to whether the applicant's training needs and interests match resources available in our program. The strongest applicants generally are those whose academic and clinical training have provided them with a good foundation of general clinical and basic science knowledge and skills, whose professional achievements indicate a strong commitment to psychology in general and neuropsychology in specific, and whose interests match the specific programmatic clinical and research features of our program.

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MCW Neuropsychology, Page 1

CRITERION III. .Structures and Models of Education and Training in the Specialty.

1. Example: Postdoctoral Residency in Clinical Neuropsychology at the Medical College of Wisconsin.

2. Type of Program: Postdoctoral.
School: Medical College of Wisconsin
Name of Program: Department of Neurology, Section of Neuropsychology
Address: MCW Clinic at Froedtert 9200 West Wisconsin Ave Milwaukee, WI 53226
Contact Person: Thomas A. Hammeke, Ph.D, ABPP Director of Training in Neuropsychology
Phone: (414) 454-5660
Fax: (414) 259-9012

3. See A p p e n d i x A . There were extra graduates in 1992 because we Recent Program Graduates: had additional research funding that year and one resident was completing her training after maternity leave.

4. Psvchologv Facultv: There are five full-time neuropsychological faculty in the Section. Four of the faculty are board-certified in clinical neuropsychology by American Board of Professional Psychology and the American Board of Clinical Neuropsychology. The fifth faculty member (Sara Swanson) is board eligible and is currently in the midst of the board examination process.See Appendix B for summary of education and credentials of each faculty member.

5. The Setting:
(A) The Section: The NeuropsychologySection is located at the Medical College of Wisconsin (MCW), a private, free-standing, non-profit medical college. MCW is affiliated with many hospitals in the Milwaukee area, but has four primary teaching hospitals. These include Froedtert Memorial Lutheran Hospital, John Doyne Hospital, Children's Hospital of Wisconsin, and Zablocki VA Medical Center. The Section is housed in an ambulatory care clinic attached to three of the teaching hospitals on the grounds of the Milwaukee Regional Medical Center.Office and clinic space currently dedicated to the Section is 40,000 square feet which includes 16 rooms and additional administrative and clerical space.

The Section was formally established as a separate section in the Department of Neurology in July of 1979. Prior to 1979, Neuropsychology's presence in the Department of Neurology consisted of one neuropsychologist, one postdoctoral fellow, one technician, and one secretary. In 1979, the Section hired three additional faculty and increased the scope of service provided on the campus at Milwaukee Regional Medical Center. The number of fulltime faculty in the Section has remained stable over the years with 4-5 faculty positions. Numbers of residents, students and support staff increased for a number of years, but has been stable since

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MCW Neuropsychology, Page 2

approximately 1988 (4 postdoctoral residents, an administrative secretary, and a receptionist, 2.5 FTE technicians).

The mission of the Neuropsychology Section has always been fourfold:(a) To provide clinical assessment and treatment to adults and children who have suspected or demonstrated neurologic disorders, often with behavioral sequelae; (b) To undertake research in a variety of areas related to neuropsychology, psychopharmacology, and medical psychology; (c) To provide instruction to undergraduate and postgraduate students of MCW and affiliated institutions; and (d) To foster the advancement of neuropsychology in Southeastern Wisconsin via clinical service and education of lay and professional public.

(B) Institutional Status: The Section of Neuropsychology is well respected at the Medical College of Wisconsin and its hospital affiliates for its contributions to clinical service, teaching, research, and community relationships. With respect to clinical service, the Section provides neuropsychological services for the entire campus at the Milwaukee Regional Medical Center. It has a formal role in integrated programs with the Departments of Neurology (Dementia Clinic, Comprehensive Epilepsy Program, Multiple Sclerosis Clinic), Neurosurgery (Epilepsy and Spinal Cord Injury Programs), Physical Medicine & Rehabilitation (Head Trauma Clinic), and Neuroradiology and Biophysics (Functional Magnetic Resonance Imaging Program).

With respect to teaching activities, the Section has a longstanding tradition of providing a number of lectures to undergraduate medical students on campus (currently four lectures given annually) as well as tutorial training in clerkships. At the postgraduate level, the Neuropsychology Section provides eight lectures annually to resident groups in Neurology, Psychiatry, and Physical Medicine and Rehabilitation. In addition, Neuropsychology is a rotational participant in Neurology Grand Rounds and Neurology Case Conferences, presenting in approximately 15 conferences annually. Neuropsychology faculty serve on a number of Department of Neurology administrative committees including Research, Faculty Recruitment, Resident Recruitment, Strategic Aims, and Faculty Promotion.

With respect to research, Neuropsychology's faculty have generated more than 3 million dollars of grant supported research since its inception in 1979. In addition the faculty have published 7 books, 40 book chapters and reviews, and more than 135 manuscripts in refereed journals, and made more than 150 presentations at scientific meetings. One faculty (Dr. Rao) serves on a MCW research steering committee for Functional Magnetic Resonance Imaging and is a nationally recognized expert in the area.

With respect to community relationships, the Section is recognized as a center of excellence in diagnosis and treatment of Attention Deficit Disorder in children and adults throughout the state of Wisconsin and northern Illinois. In addition, it has established itself as providing diagnostic and consultative expertise in areas of learning disability, head injury, dementia, multiple sclerosis, and epilepsy. Professional courses have been offered to community professionals since 1983. These have been uniformly well received. Faculty members serve on state, regional, and national boards, including the National Multiple Sclerosis Society, State Psychology Ethics Board, Wisconsin Multiple Sclerosis Society, Wisconsin Learning Disability Association, Wisconsin Psychological Association Research Award Committee, and the Epilepsy Society of Southeastern Wisconsin.

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MCW Neuropsychology, Page 3

(C) Financial Support and Sustainability Issues:While the Section is part of the Department of Neurology, it has its own budget and is held responsible for generating sufficient income through service-generated fees, grants, and professional courses to offset operating budgeting expenses. Postdoctoral salaries and fringe benefits are included in the budget. Small subsidies from the Department of Neurology and from affiliated teaching hospitals are received.With these subsidies the Section has essentially remained fiscally sound since 1985, although there has been fluctuation in income levels on an annual basis.

(D) Training Program: The general program training plan involves (a) orientation to facility and clinical operations, (b) evaluation of individual resident's training needs and goals, (c) developmental of a training plan that hinges on intensive supervision of clinical and research activities, and provision of appropriate didactics, (d) provision of adequate opportunity and resources in order to enable an optimal learning experience, and (e) periodic re-evaluation of resident progress to revise education and training priorities as needed.

On arrival residents are provided a period of orientation that enables them to become familiar with the educational facilities and routinely used clinical instruments, instruction in standard clinic inpatient and outpatient operations protocols, exposure to the general character of written reports generated from the clinic, and instruction in the commitments of the clinic to other programs on campus. During the first month, the resident's knowledge and skills in administration and scoring of standard tests used in our clinic are assessed by faculty and technician staff with training provided as needed. In addition, each resident's goals for training and career aspirations are reviewed in order to incorporate these into the overall training plan.

Required didactic learning experiences include participation in (a) a two year neurobehavioral science course that meets twice monthly devoted to review and update of basic neuroscience, (b) a weekly neuroanatomy review, (c) a weekly Neuropsychology Case Conference, (d) a weekly Neuropsychology Journal Club, (e) a weekly Neurology Grand Rounds and (f) a weekly Neurology Case Conference. Optional learning experiences include bedside neurology and neurosurgery rounds, brain cuttings, observation of neurosurgical procedures (e.g., temporal lobectomies), neurology resident lectures, observation and participation in neuroimaging techniques (Magnetic Resonance Imaging, Functional Magnetic Resonance Imaging, Single Proton Emission Computerized Tomography, CT scans) offered by the Departments of Radiology and Nuclear Medicine, and Psychiatry Grand Rounds. Postdoctoral residents are required to develop a scholarly project or participate in a research endeavor during their residency. The resident may collaborate on an ongoing research project or initiate an independent project. A few residents have completed a scholarly review of the literature and made a presentation.It is anticipated that this activity will lead to presentation of results at scientific meeting and/or publication of findings in a peer reviewed journal. Also,

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MCW Neuropsychology, Page 4

residents are expected to make occasional presentations in Neuropsychology Journal Club, case conferences, neuroanatomy review, Neurology Grand Rounds, and Neurology Case Conferences.

Research opportunities and resources are made available to the residents.Most of the neuropsychology and adjunct faculty have research programs and invite residents to participate or develop a project either in that area, or to develop an independent research protocol under the supervision of the faculty.There are substantial data bases available that include neuropsychological and neuropathological data on (a) multiple sclerosis and (b) dementia, and a rapidly growing data base in (c) epilepsy with specific data collected on patients undergoing temporal lobe lobectomies.A less formal data base exists in the area of traumatic brain injury. The Section provides access to library holdings, and maintains a modem access to the library for computer searches that are free to the residents. The Section also has several computers with statistical programs available to the residents for data analysis and graph production. MCW also maintains a professional audio and visual graphics center on campus, and a biostatistic department.

Postdoctoral residents are socialized into the profession and specialty by being (a) given copies of state and national standards for practice as a psychologist, (b) given a title of postdoctoral resident in clinical neuropsychology, (c) given an office comparable to that of the faculty in Neuropsychology on campus, (d) encouraged to take the National Exam for state licensure while in their residency, (e) encouraged to attend professional meetings with a $500 annual business account to defray costs of meeting expenses, and (I') encouraged to join state, national, and other professional organizations, both for matters of scientific presentations, as well as professional integration.

The residents have individual offices in the same location as the Neuropsychology faculty offices to encourage peer interaction and consultation.In addition they have convenient access to residents in Neurology for consultation and peer interaction (Neurology resident offices are located across the corridor from Neuropsychology Clinic rooms).

6. Procedure for Evaluation: Trainee evaluation is provided in the form of ongoing (a) supervision of professional and research activity as well as periodic (b) written evaluation of the resident's progress.

(a) The supervision process begins with a thorough evaluation of the resident's familiarity with testing instruments used in the clinic.Emphasis early in the training is given to ensuring administration and scoring proficiency with tests used in the clinic. Subsequently emphasis shifts to delineation of referral questions, targeted interviewing, differential diagnosis and case formulation, treatment and referral planning, and report writing. Supervision is provided by the faculty for each of the adult and child tracks with faculty serving as supervisors on weekly cycles of rotation.Thus, each resident has exposure to supervision by each of the faculty in their respective subspecialty areas. Professional responsibility resides with the supervising faculty. Hours spent in weekly individual, face-to-face supervision vary from 1 to 10 hours depending on the resident's clinical proficiency and clinical caseload for that week. On average individual supervision is closer to 2-3 hours per week.

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(b) )Written evaluation of the resident's progress occurs at six month intervals throughout their training program. The evaluation [see Appendix c] is completed by all supervisors of the resident and individually discussed with the resident. The resident is given a written copy of this evaluation, and the original, signed by faculty and the resident, is maintained in the resident's personnel file.At the same time intervals the resident is asked to provide written feedback on the quality of supervision received from each of his/her supervisors and to provide a tabulation of the characteristics of cases evaluated and educational experiences received [see Appendix D for forms].

7. Admission to the Program: The postdoctoral supervision provided in the residency program satisfies that required for licensure in the State of Wisconsin; however, the program does not formally advertise this. To date there are 14 graduates of the residency program. All have gained licensure in Wisconsin or the State of their residence.

The residency program is designed to develop the knowledge and skills necessary for independent practitioner level competence in the discipline of clinical neuropsychology. This is formally stated in the program brochure [see Appendix E, page 2, first paragraph].Of the 14 program graduates to date, all but one hold professional positions as clinical neuropsychologists and are eligible for board certification in clinical neuropsychology from the American Board of Professional Neuropsychology and American Board of Clinical Neuropsychology. One has achieved board certification and three others have successfully completed the written exam for this certification.

8. Admission to the Program. Our program requires a doctoral degree in a professional area of psychology and specific training in a clinical core of coursework that has been suggested by education and training guidelines endorsed by Division 40 and the International Neuropsychological Society [see ?he Clinical Neuropsychologist, 1987, I, 29-34]. Completion of an APA approved graduate program is preferred.Completion of an internship is required, preferably also one that is APA approved.

Applications require a vita, two sample written reports, academic transcripts, and three letters of reference.Also, applicants who have not defended their dissertations are asked to solicit a letter from their dissertation chair that endorses the application and indicates the likelihood of completing the dissertation prior to the starting date of the residency.Typically most prospective residents are interviewed at the International Neuropsychological Society Annual Meeting in early February, a meeting that is commonly attended by the majority of postdoctoral applicants. Additional inquiries from the program and the applicant are often completed subsequently by phone.

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Appendix A, Page 6

POSTDOCTORAL RESIDENCY GRADUATES IN NEUROPSYCHOLOGY AT MCW

Graduated 1994:
Peter Amett, Ph.D.
Washington State University
Department of Psychology
Pullman, WA 99164
(509) 335-2802

Louanne Lisk, Ph.D.
St. Agnes Hospital
Counseling Center
430 E. Division Street
P.O. Box 385
Fond du Lac, WI 54936-0385
(414) 929-1212

Graduated 1993:
Brad Anderson, Ph.D.
Mid-America Rehabilitation Hospital
5701 West 110th Street
Overland Park, KS 66211
(913) 491-2400

Evelyn Bartfield-Donate
2117 North 122nd Street
Wauwatosa, WI 53213
(414) 453-7132

Graduated 1992 :
Angela Flynn, Ph.D.
Mapleton Center
3 11 Mapleton Avenue
P.O. Box 9130
Boulder, CO 80301
(303) 4654020

AM Hempel, Ph.D.
Minnesota Epilepsy Group
3 10 N. Smith Avenue, Suite 300
St. Paul, MN 55102
(6 12) 220-5290

Fran Karo, Ph.D.
300 S. Main Street #1308

Yardley, PA 19067
(215) 3214612

Sara Swanson, Ph.D.

Medical College of Wisconsin
Section of Neuropsychology
9200 W. Wisconsin Avenue
Milwaukee, WI 53226
(4 14) 454-5660

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APPENDIX IB
Page 7

Psychologist Summary

Name: Mariellen Fischer
Hours per week employed at the institution: full-time
Roles in program:
Program administration Hours per week: 2.0
Supervision Hours per week: 4. o
Research consultation Hours per week: 1.0
Didactic instructor Hours per week: 0.5
Other: Hours per week:

Highest degree, institution, program & year awarded: Ph.D., University of Vermont, Clinical Psychology, 1984.
Internship program, year completed: distributed Clinical Internship (APA-approved), University of Vermont, completed 1992.
Postdoctoral residency program, specialty, year completed
Psychology licensure/jurisdiction: #1091, Wisconsin
Listed in current edition of National Register: yes X no
Listed in current edition of Canadian Register: yes no X
ABPP Diplomate: yes X no specialty: Clinical Neuropsychology
Fellow of APA: yes no x divisions:
Fellow of CPA: yes no x sections:
Number of peer-reviewed publications in past five years: 12
Professional Leadership Activities: Chair of State Ethics Board
7

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APPENDIX 3
Page 8

Psychologist Summary

Name: Thomas A. Hammeke
Hours per week employed at the institution: Fu11-t ime
Roles in program:
Program administration Hours per week: 4
Supervision Hours per week: 5
Research consultation Hours per week: 1
Didactic instructor Hours per week: 1
Other: Hours per week:

Highest degree, institution, program & year awarded: Ph.D., University of South Dakota
Internship program, year completed: Zablocki VA Medical Center, 1978.
Postdoctoral residency program, specialty, year completed Medical College of Wisconsin, Neuropsychology, 1979. Psychology licensure/jurisdiction: #728, Wisconsin Listed
Listed in current edition of National Register: yes x no-
Listed in current edition of Canadian Register: yes no X
ABPP Diplomate: yes X n o ~_ specialty: Clinical Neuropsychology
F e l l ow of APA: yes no X divisions:
Fellow of CPA: yes no X sections:
Number of peer-reviewed publications in past five years: 8 manuscripts 29 abstracts
Professional Leadership Activities: Co-director Neuropsvchology Section. MCW: Director Postdoctoral Neuropsvchologv Proaram. MCW; Chair - Association Postdoctoral Programs in Clinical Neuropsychology; Board of Directors, ABCN; Board of Directors, Division 40.
7

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APPENDIX B
Page 9

Psychologist Summary

Name: Robert F. Newby
Hours per week employed at the institution: 55
Roles in program:
Program administration Hours per week: 5. 0
Supervision Hours per week:0 .5
Research consultation Hours per week: 0.5
Didactic instructor Hours per week: 2.0
Other: Hours per week:

Highest degree, institution, program & year awarded: Ph.D.,University of Kansas, 1982.
Internship program, year completed: University of Wisconsin Health Science Center, 1982.
Postdoctoral residency program, specialty, year completed University of Wisconsin Health Science Center, 1983.
Psychology licensure/jurisdiction: #l000, Wisconsin
Listed in current edition of National Register: yes X no -
Listed in current edition of Canadian Register: yes no X
ABPP Diplomate: yes X no specialty: Clinical Neuropsychology
Fellow of APA: yes no x divisions:
Fellow of CPA: yes no x sections:
Number of peer-reviewed publications in past five years: 7
Professional Leadership Activities: Research: Milwaukee Dyslexia Program, Early Intervun prop- Drug-Placebo Program. Advisorv: Professional Advisory Board of Wisconsin Learning Disabilities Association.
7

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APPENDIX B
Page 10

Psychologist Summary

Name: Stephen M. Rao
Hours per week employed at the institution: full-time
Roles in program:
Program administration Hours per week: .5
Supervision Hours per week: 3
Research consultation Hours per week: 3
Didactic instructor Hours per week: 1
Other: Hours per week:

Highest degree, institution, program & year awarded: Ph.D., Wayne State University, 1979.
Internship program, year completed: Rush-Presbyterian-St. Luke's Medical Center, Chicago, 1979.
Postdoctoral residency program, specialty, year completed
Psychology licensure/jurisdiction: #804, Wisconsin
Listed in current edition of National Register: yes X no
Listed in current edition of Canadian Register: yes no X
ABPP Diplomate: yes x no specialty: Clinical Neuropsychology
Fellow of APA: yes no x divisions:
Fellow of CPA: yes no X sections:
Number of peer-reviewed publications in past five years: 25 manuscripts, 38 abstracts
Professional Leadership Activities: Co-director Neuropsychology Section, MCW; Director Clinical Neuroscbe Tlpsparrh - Neurologv. MCW; Medical Advisor Board - National MS Societv: Board of Directors ABCN.
7

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APPENDIX B
Page 11

Psychologist Summary

Name: Sara J. Swanson
Hours per week employed at the institution: 32
Roles in program:
Program administration Hours per week: 0.5
Supervision Hours per week: 5-6
Research consultation Hours per week:
Didactic instructor Hours per week: 0.5
Other: Hours per week:
Highest degree, institution, program & year awarded: Ph.D.,Washington State University, Clinical Psychology, 1989.
Internship program, year comp!eted: University of Washington School of Medicine, 1989.
Postdoctoral residency program, specialty, year completed Medical College of Wisconsin, Neuropsychology, 1992.
Psychology licensure/jurisdiction: 1507, Wisconsin
Listed in current edition of National Register: yes X no
Listed in current edition of Canadian Register: yes no '
ABPP Diplomate: yes no X specialty: in progress
Fellow of APA: yes X no _ divisions
Fellow of CPA: yes X no _sections
Number of peer-reviewed publications in past five years: 5 manuscripts, 7 abstracts Professional Leadership Activities:
7

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APPENDIX C
Page 12

POSTDOCTORAL FELLOW EVALUATION FORM

NAME
SUPERVISOR(S)
DATE OF EVALUATION
PERIOD EVALUATION COVERS:

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APPENDIX C Page 13

SKILL LEVEL FOR LEVEL OF TRAINING

[Page 75]

SKILL LEVEL FOR LEVEL OF TRAINING

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APPENDIX D Page 15

POSTDOCTORAL FELLOW EVALUATION FORM

NAME
SUPERVISOR(S)
DATE OF EVALUATION
PERIOD EVALUATION COVERS:

SKILL LEVEL FOR LEVEL OF TRAINING

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APPENDIX D Page 16

FELLOW PROGRAM EVALUATION

Fellov Name:
Date:
Period of Evaluation Begins: Ends:
Clinical Activity: (for period)
Total # Evaluation Cases: Inpts: oupts:
Total # Therapy Contacts: Inpts: oupts:

(Please indicate frequency of occurrence in each category.)

Referral Sources:
Neurology
Neurosurgery
Cen. Medicine
Rehabilitation
Other
Medical
Psychiatry
Ped./Fam. Pract.
School System
DVR
Other

Neurobehavioral Category:
Dementia
Aphasia
Confusional State
Nonaphasia Dominant Hemisphere
Dementia + Confusion
Nondominant Hemisphere
Amnesia
Frontal Lobe Syndrome
Attentional Disorder
Developmental Disorder
Learning Disability
Other Behavioral Disorder

Pathophvsiologic & Psvchiatric Categories:

Trauma
Vascular
Neurodegenerative
Infectious
Toxic
Sleep Disorder
Seizure Disorder
Movement Disorder
Syncope
Neoplasm
Demyelinating Disease
Affective Disorder
Schizophrenia
Anxiety Disorder
Somatoform Disorder
Dissociative Disorder
ADHD
LD
Adjustment Disorder
Conduct/Oppositional/ Personality Disorder
Other:

Didactic Training: (frequency of attendance)
Neuroanatomy Course:
Neuropsychology Course:
Neurology Grand Rounds:
Neurology Resident Seminars:
Neuropsych Journal Club:
Guest Faculty Lecture:
Brain Cutting:
Other: (list)

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APPENDIXE, Page 17

POSTDOCTORAL RESIDENCY' PROGRAM IN ADULT AND CHILD CLINICAL NEUROPSYCHOLOGY

Section of Neuropsychology
Department of Neurology
Medical College of Wisconsin'
9200 West Wisconsin Avenue
Milwaukee, Wisconsin 53226
(414) 454-5660
FAX: (414) 259-9012

Member of the Association of Postdoctoral Programs in Clinical Neuropsychology

The term "residency” is used here in place "of fellowship” to better convey the breadth of training provided in the specialty of clinical neuropsychology. '

The Medical College of Wisconsin is an Affirmative Action/Equal Opportunity Employer.

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Introduction

The Section of Neuropsychology of the Department of Neurology at the Medical College of Wisconsin offers two-year postdoctoral residencies in child and adult neuropsychology. The purpose of the training program is to provide doctoral level psychologists with sufficient clinical and research skills to practice independently in the field of clinical neuropsychology.Our postdoctoral training program is a member of the Association of Postdoctoral Programs in Clinical Neuropsychology (Ihe Clinical Neuropsychologist, 1993, 7, 197-204) and adheres to INS - APA Division 40 guidelines (nte Clinical Neuropsychologist, 1987, I, 29-34) for specialty training in clinical neuropsychology.

The Section of Neuropsychology was founded in 1979 and is located at MCW Clinic at Froedtert Hospital on the grounds of the Milwaukee Regional Medical Center.It is one of four sections of the Department of Neurology. The Section consists of three adult and two child neuropsychologists; the clinical background and research interests of the faculty are presented below. The Section also includes six clinical and research psychometrists.

Postdoctoral Residency in Adult Neuropsychology:

The adult neuropsychology residency emphasizes assessment of the full rangeof neurobehavioral disorders in patients ranging in age from 16 through 100. Neurobehavioralsyndromes include dementia, confusional states, primary amnesia, attentional disorders, aphasic disorders, and frontal lobe disorders, among other focal brain disorders of both the dominant and nondominant hemisphere. Common clinical populations include head trauma, primary dementias, seizure disorders, tumors, multiple sclerosis, stroke, learning disabilities, attention deficit hyperactivity disorder, hydrocephalus, and pseudoneurologic and somatoform disorders.Other developmental disorders include those that are manifest in adulthood. The majority of referrals come from departments of neurology, neurosurgery, and psychiatry on the campus of Milwaukee Regional Medical Center, in addition to geriatric, general medicine, and organ transplant programs on campus. Also, significant numbers of referrals are received from the Wisconsin Department of Vocational Rehabilitation, regional attorneys, and private practice physicians and psychologists.The Neuropsychology Section maintains an active involvement in the department's Dementia Research Clinic, Comprehensive Epilepsy Clinic, Multiple Sclerosis Clinic, and participates in a multidisciplinary clinic for head trauma. Neuropsychology faculty and. residents direct the intracarotid amobarbital testing for determination of language and memory laterality and participate in drug studies for new anti-epileptic medications. Primary inpatient experience is obtained at Froedtert Memorial Lutheran Hospital and John Doyne Hospital, two teaching hospitals located on the grounds of Milwaukee Regional Medical Center.Seventy-five percent of clinical work is with outpatients and the remaining with inpatients.

Intensive supervision is provided in the assessment and diagnosis of the full range of neurobehavioral and developmental disorders as they present in adults. The Section stresses a tlexible assessment battery approach to neuropsychological assessment that is tailored to addressing referral questions, generating meaningful recommendations,and working closely with referring professionals in development of a treatment plan.Brief psychotherapeutic services in the form of patient and family education and crisis intervention are typical, and supervision in more extended therapy involving cognitive rehabilitation and disability adjustment counseling can be arranged.

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APPENDIX E, Page 19

Postdoctoral Residency in Child Neuropsychology:

The child neuropsychology residency offers the opportunity to acquire and refine nemopsychological assessment and diagnostic skills in pediatric populations. Clinical and research emphases are in attention deficit disorder, learning disabilities,epilepsy, head injury, and inpatient psychiatry in addition to general neurology consultation.The Section is actively involved in the Comprehensive Epilepsy Program sponsored by the Department's Child Neurology Section.
This Section consists of six pediatric neurologists located at the Children's Hospital of Wisconsin, a teaching hospital for the Medical College of Wisconsin that also is located on the campus of Milwaukee Regional Medical Center. The resident also may serve as a consultant in staffings of the multidisciplinary brain injury program and provide consultations to community hospitals, physicians, and schools.

The Section often provides follow-up treatment after initial evaluations of children and adolescents. Behavioral intervention and parent training approaches to treatment are emphasized, but opportunity for individual and family therapy interventions also exists.The postdoctoral resident is provided some latitude in selecting evaluation and treatment cases, allowing the resident to individually design the clinical experiences desired. The Section stresses a flexible assessment battery approach to neuropsychological assessment that is tailored to addressing referral questions, generating meaningful recommendations, and working closely with referring professionals in development of a treatment plan. Intensive supervision is given in all areas.

Educational and Teaching Opportunities

Postdoctoral residents are required to attend and participate in the Section's weekly meetings for Journal Club and Neuropsychology Case Conference, and the Department's weekly Grand Rounds and Neurology Case Conference.Residents also are required to attend a two-year course (meets twice per month) in neurobehavioral neuroscience that is jointly sponsored by the Departments of Neurology and Psychiatry. Residents can elect to audit relevant medical school courses, attend bedside neurology or neurosurgery rounds,brain cuttings and/or neurosurgical procedures, participate in intracarotid amobarbital (Wada) testing for determination of laterality in language and memory functions, and attend lectures and seminars offered at the school. The resident can elect to learn more about state-of-the-art neuroimaging techniques (e.g.,Magnetic Resonance Imaging and Functional MRI, Single Proton. Emission Computed Tomography) through the Departments of Radiology and Nuclear Medicine. Opportunities are available for gaining familiarity with electrophysiologic diagnostic procedures, including evoked potentials and neuromuscular studies. The resident also will gain experience in teaching neurology/psychiatry residents and psychology graduate students.

Research

Postdoctoral residents are provided with training in clinical research. The resident may collaborate on an ongoing research project or initiate an independent project.It is anticipated that this activity will lead to presentation of results at a scientific meeting and publication in a peer-reviewed journal.

Resident Responsibilities and Time Commitment

Residents are expected to interview and evaluate patients with neurobehavioral and psychiatric disorders and participate in all those activities that are necessary to make an inpatient and outpatient clinical service operational (e.g.,informal consultation, participation in case conferences, etc.). Residents

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APPENDIX E, Page 20

learn through doing their own testing and report transcription. Participation in several didactic exercises (see above) is required. Residents are expected to make occasional presentations at Neurology Case Conference and Neurology Grand Rounds. The residents also are expected to participate in some type of research activity and/or complete a scholarly exercise during their training.

On average clinical activities require approximately three days of the week.Residents are encouraged to reserve one day per week for research activities.The remainder of time is consumed in various didactic and informal educational activities. Weekly time requirement is about 45 hours, though most residents average about 50 hours per week.

Benefits

Postdoctoral residents are provided a stipend, health insurance (currently for $20/month), dental insurance, life insurance, 10 days annual vacation, 12 days annual sick leave, and an $500 annual expense account that may be used to purchase educational materials or attend a professional meeting per year. DOS and Macintosh computers are available for word-processing (WordPerfect, WordStar, Word for Mac) and data analysis.

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APPENDIX E, Page 21

Faculty

Mariellen Fischer, Ph.D. is an Associate Professor of Neurology and a Diplomate in Clinical Neuropsychology (American Board of Professional Psychology and the American Board of Clinical Neuropsychology). She specializes in the evaluation and treatment of children with neurological, behavioral and learning disorders. She has published primarily in the areas of developmental psychopathology, Attention Deficit Hyperactivity Disorder (ADHD), and stimulant response. Dr. Fischer is a Co-Principal Investigator in NIH-funded follow-up studies of a group of young adults diagnosed with ADHD as children.

Thomas A. Hammeke, Ph.D. is an Associate Professor of Neurology and Psychiatry and Co-Director of the Neuropsychology Section,and Director of the Postdoctoral Training Program. He is a Diplomate in Clinical Neuropsychology (American Board of Professional Psychology and the American Board of Clinical Neuropsychology) and specializes in the clinical evaluation of adult neurological patients. His primary research interests are in functional magnetic resonance imaging in clinical populations, closed head injury, the assessment of malingering in forensic evaluations, and the effects of cardiac surgery and myelogram contrast media on neuropsychological functioning. He has received grants from the Wisconsin Heart Association and several pharmaceutical companies.

Robert F. Newby, Ph.D. is an Associate Professor of Neurology and a Diplomate in Clinical Neuropsychology (American Board of Professional Psychology and the American Board of Clinical Neuropsychology). He received his Ph.D. in Child Clinical Psychology and completed a postdoctoral fellowship in neuropsychology. His primary research interests are in dyslexia and Attention Deficit Hyperactivity Disorder.He has been a principal investigator on several private foundation grants for the evaluation of tutoring programs with subgroups of dyslexic children, and a co-investigator on an early reading intervention research program sponsored by a local school district.

Stephen M. Rao, Ph.D. is a Professor of Neurology, Co-Director of the Neuropsychology Section,, and Director of Clinical Neuroscience Research for the Department of Neurology.He is a Diplomate in Clinical Neuropsychology (American Board of Professional Psychology and the American Board of Clinical Neuropsychology). His primary research interests and publications involve the cognitive, personality, and neuroimaging changes associated with multiple sclerosis and the functional magnetic resonance imaging of human motor control. He has been a recipient of several research grants from the National Institutes of Health and the National Multiple Sclerosis Society, and was awarded a Research Career Development Award from NIH.

Sara J. Swanson, Ph.D. is an Instructor in Neurology. She has published articles and received grants for research in physiological psychology. She specializes in the clinical evaluation of adult epilepsy patients and intracarotid amobarbital testing. Her current research interests involve personality and neurobehavioral correlates of epilepsy and temporal lobectomy, and functional MRI in epilepsy patients.

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Attachment A - University of Houston

Specifications for Education and Training in Clinical Neuropsychology

Program Two
Doctoral X Postdoctoral _ Both _

Name of University, School, or institution offering program:Universitv of Houston

Name of program: Clinical Neuropsychology Track in Clinical Program

Address: Department of Psychology, University of Houston

City/State/Zip: Houston, TX 77204-5341

Contact Person: H. Julia Hannav, Ph.D. Telephone No. (713) 743-8568

1. Provide a list of names, addresses, and telephone numbers of all the graduates from your program from the past year (use separate page.)

Training in Clinical Neuropsychology has a long history at the University of Houston. A dcotoral program in Clinical Neuropsychology was initiated by Dr. Daniel Sheer in 1973 and had its first graduate in 1976. Dr. Sheer stepped down as Director in 1987 and Dr. H. Julia Hannay was brought in to modify and update the program. Faculty overhauled the curriculum so that it would meet hte criteria1 used to accredit programs in clinical psychology.Students took all of the core courses in the APA approved Clinical Program in the department except their interventions sequence. A general clinical practicum of a minimum of 300 hours was introduced to supplement the neuropsychology practica, and students were required to obtain internships at APA approved sites. In 1992 the Clinical Neuropsychology and Clinical Psychology Program faculty decided that it would be of beneift to the faculty and student sin both programs to merge.It was decided that the students currently in the Clinical Neuropsychology Program should graduate from that program and that no more students should be admitted to that program after the fall of 1992. The Clinical Psychology Program underwent a major curriculum revision in preparation for the APA Accreditation Site Visit of January 26-27, 1994 and the Clinical Neuropsychology Track was created as one of three specialty tracks int he program. The track has maintained all of the special features of the Clinical Neuropsychology Program: an extenisve list of course offerings in clinical neuropsychology, a wide range of neuropsychology training experiences in research and clinical practice in paid practica in Texas Medical Center settings, and close ties with clinical neuropsychologists through their adjunct clinical appointments in the Psychology Department of the University of Houston. Not all of the neuropsychologists from the Clinical Neuropsychology Program have become members of the lcnical faculty. Dr. Paul Massmand and Dr. H. Julia Hannay have joined the lcinical faculty.Others are affiliated with the Clinical Program but have their primary affiliation in other programs.For instance, Dr. Merrill Hiscock has joined the Developmental Program.

Since we only began admitting students to the Clinical Neuropsychology Track in the Clinical Porgram two years ago, we do not yet have graduates of that rack.A list of graduates of the Clinical Neuropsychology Program for 1992-1994 is given here instead. See the earlier description of the similarities and differences between these.

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1992

Karen Red, Ph.D. TEL: (409) 762-6661
Director, Department of Neuropsychology
Transitional Learning Community
Galveston, TX

Kevin Davidson, Ph.D.

1993
Douglas Bloom, Ph.D. TEL: (713) 792-5330 Ext. 3042
Assistant Professor
Department of Pediatrics
University of Texas
Houston Health Science Center, MSB 3.600
6431 Fannin
Houston, TX 77030

Joshua Breier, Ph.D. TEL: (713) 792-5760
Assistant Professor
Department of Neurosurgery
University of Texas
Houston Health Science Center
643 1 Fannin, 7.149
Houston, TX 77030

Karen Evankovich, Ph.D. TEL: (713) 770-3707
Coordinator of Assessment Services
Learning Support Services
Texas Children's Hospital, MC3-2340
6621 Fannin Houston, TX 77030

Isabella Iovino (Jackson) TEL: (713) 335-1000 Ext. 2328
Staff Neuropsychologist
Devereaux Hospital
1150 Devereaux Drive
League City, TX 77573

Ronald Ridder, Ph.D. TEL: (308) 234-6029
The Center for Psychological Services, P.C.
205 West 17th Street
Keamey, NE 68847

1994
Jerome Caroselli, Ph.D.
Postdoctoral Fellow
TEL (410) 328-7396
University of Maryland Medical School
Baltimore, Maryland

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Kimberley Espy, Ph.D. TEL: (602) 626-1994
Instructor of Research
Department of Pediatrics
University of Arizona School of Medicine
150 1 North Campbell Avenue
Tucson, AZ 85724

Joe Scott Estes, Ph.D. TEL: (414) 929-1200
Therapist, Behavioral Health
St. Agnes Hospital
430 East Division Street
P.O. Box 385
Fond du Lac, WI 54936-0385

Penne-Roll Sims, Ph.D.
Instructor
Department of Neurology
Baylor College of Medicine
6550 Fannin, Suite 1801
Houston, TX 77030 TEL: (713)

2. Psychology Faculty. Provide the names of the designated psychologist in the above listed program who hase responsibility for the integrity and quality of the program, and a description of the education, training and credentials of each psychologist in charge of the educational and/r training program.

The Director of the Clinical Neuropsychology Track is H. Julia Hannay, Ph.D. who obtained a M.A. in Experimental-Clinical Psychology from the University of Western Ontario in 1968 and a Ph.D. in Child Psychology from the University of Iowa in 1972. She then completed a post-doctoral traineeship in Clinical Neuropsychology with A.L. Benton, Ph.D. in 1973. Since that time she has had academic appointments in psychology departments, at Auburn University for 14 years and now at the University of Houston for 7 years. In both places she has also been associated with Medical Schools and is currently an Adjunct Professor of Psychiatry at the University of Texas - Houston Health Science Center and Adjunct Professor of Neurology and Neurosurgery at Baylor College of Medicine.Dr. Hannay has extensive experience directing doctoral programs. At Auburn University, she directed the Experimental Program and then directed the Clinical Program, taking it successfully through accreditation the first time.At the University of Houstin, Dr. Hannay continues to direct the Clinical Neuropsychology Program (as it is being phased out) and the Clinical Neuropsychology Track in the Clinical Program. Dr. Hannay has been productive in the fields of clinical and experimental neuropsychology as evidenced by her publication record, appointment as Associate Editor of the APA journal, Neuropsychology, and her funded research.

a) See Graduate Study Fall 1994 brochure and Catalog (p. 248 of General Appendix H, University of Houston section)

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b) Faculty in the psychology department are on 9 month appointments and are thus free to pursue scholarly inquiry full-time in the summers. The Department of Psychology also has been open to innovative ways of helping faculty to have opportunity for scholarly inquiry and practice and to integrate the two. For instance, Dr. Paul Massman was hired in joint tenure track position in the Department of Psychology at the University of Houston and the Department of Neurology at Baylor College of Medicine.Dr. Massman teaches one course a semester at the University of Houston and supervises graduate student theses and dissertations. At Baylor College of Medicine, Dr. Massman's primary responsibility is conducting and supervising neuropscyhological research in the Alzheimer's Disease Research Center. Both departments appear to be pleased with this arrangement. To give another example, Dr. Hannay has privileges at Ben Taub General Hospital of the Harris County Hospital District in the Texas Medical Center. Ben Taub General Hospital is a teaching hospital for Baylor College of Medicine and is one of the two Jclass I Trauma Centers in Houston. By arrangement with the University of Houston through a subcontract to a 5 year NIH Grant on the Treatment of Physiological Disturbances After Head Injury,” Dr. Hannay spends 20% of her time in the NICU assessing and following severely head injured patients and int he Neurosensory Center assessing head injured rats for the animal protocols in this grant, with the help of technicians. Dr. Hannay has been provied with testing rooms in Ben Taub General Hospital and with animal facilities and equipment in the Neurosensory Center.In general, the Texas Medical Center provides tremendous resources for the clinical neuropsychology faculty.

c) The recent report of the site visit on accreditation noted the high morale and cohesiveness of the students in the Clinical Program. This has come about through active efforts of the students and faculty who attempt to provide social support for the students. The clinical students have developed a buddy system in which each first year student is paired with an advanced student who helps them with the transition to graduate school and/or the move to the University of Houston. Advanced students also host a party for the first year students and the faculty each year in the fall. This provides an informal way for us to get together. The Clinical Program also holds a Clinical Forum every second week in which faculty and students meet for an hour to listen to speakers from the department and the community and to discuss such things as clinical cases and program issues.Students in the Clinical Neuropsychology Track also are involved in Grand Rounds in Neuropsychology in the Texas Medical Center. Each month one of the practicum sites sponsors Grand Rounds and practicum students at the site are expected to make case presentations. Also, student membership in the Houston Neuropsychological Society is encouraged. Their monthly meetings provide an opportunity for students to interact with other neuropsychologists in the community and to hear up-to-date discussions of topics in neuropsychology.

Students in the Clinical Neuropsychology Track are supported on l/2 time Teaching Assistantships at the University of Houston their first year. After the first year, they are supported on l/2 time contracts which are paid practicum placements in clinical neuropsychology that Dr. Hannay maintains in the Texas Medical Center. As a result, the students in this track are employees of the University of Houston throughout their training and receive in-state tuition and employee benefits which include medical insurance, workman's compensation and payment of $965 of their Social Security each year.

The Clinical Program ensures students' breadth of understanding about psychology in general and related disciplines regardless of their specialization through several mechanisms. In our clinical course offerings we attempt to draw upon the larger field of psychology through course readings, lectures, and class discussion. Clinical students are also required to demonstrate mastery in at least four foundational areas of psychology other than in their area of specialization through the

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following departmental course offerings in the major areas of psychology: Foundations of Developmental Psychology, Foundations of Neuropsychology, Foundations of Cognitive Psychology, Foundations of Social Psychology, Foundations of Industrial/Organizational Psychology, and Biological Bases of Behavior. The departmental Education Committee is charged with the ongoing evaluation of these foundations courses to make sure that each course accomplishes the goal of providing sufficient breadth of exposure to the basic concepts and methods of psychology. In addition to their exposure to individual differences through the Psychopathology I course, students must also successfully complete course work in Biological Bases of Behavior, Social Bases of Behavior and Cognitive/Affective Bases of Behavior. As indicated in the summary of our curriculum, students have some choice about the particular courses that they can take to satisfy these foundations requirements. Students are also encouraged to take additional coursework within other programs in the department , as well as from related departments in the University and the Texas Medical Center.In fact, the suggested curricula for each of the new specialty tracks include a number of nonclinical sources. Unfortunately, given the student's course load, practicum training assignments and commitments associated with teaching, research and clinical assistantships, few students have the time available to pursue many outside course offerings beyond those associated with the specialty tracks.

Depth of understanding in clinical psychology as well as the student's area of specialization is accomplished through our beginning clinical course offerings, advanced specialty track offerings, participation on clinical research teams, involvement in basic and advanced practica, and through interactions with faculty members in less structured settings. The mechanisms described above are used to assess the depth of understanding about clinical psychology, and include course exams, practicum evaluations, the comprehensive exam, and feedback from colleagues both inside and outside the department.

4. Procedure for Evaluation. Describe the formal procedures for monitoring each trainee's progress and assuring the continuous development of the trainee's knowledge, skills, attitudes, and values in your program.

Progress of students is assessed through a variety of program mechanisms. Student progress each semester is monitored through course grades, evaluations from practicum supervisors and through informal interactions with the student's advisor and other program faculty. Progress is also assessed through the written product and oral defenses associated with the masters thesis and dissertation, as well as through the comprehensive examination. IN addition, a part of each biweekly meeting of the Clinical Training Committee is devoted to addressing any concern about student progress.The program also conducts a formal evaluation of each student at the end of each academic year, as well as at the end of the first semester for first-year students. In conjunction with the annual evaluation, students schedule two meetings with their advisor. In the first meeting, training plans are reviewed and progress over the preceding year is discussed. Students also update their student evaluation form, which is kept in their file. Following discussion of each student by the faculty, the second meeting is scheduled to provide feedback to each student and address any problems that may have been identified.

During the evaluation meeting, student progress is addressed by the entire program faculty in seven areas: progress toward completion of degree requirements, performance in courses, research performance, teaching evaluations, practicum performance, involvement in program/department/and interpersonal effectiveness. Input is solicited from the student's advisor; course instructors, both inside and outside the program; practicum supervisors; thesis, dissertation and comprehensive committee members; and research team leaders. Based on this information,

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each of the seven dimensions of performance is rated on a four-point scale: outstanding, satisfactory, caution, and unsatisfactory. Important student accomplishments and examples of superior performance are also acknowledged. Students are advised about any problems that are identified and, depending on the nature of any problem, specific remedies are suggested. In addition to verbal and written feedback, these remedies may include repeating courses or practica, specific time tables to complete program requirements, reassignment of advisor, or counseling students to pursue other career paths than clinical psychology. In the event that a personal problem is identified that interferes with the student's academic or clinical progress, a referral for psychotherapy is made. The program maintains a referral network of competent therapists in the community, most of whom will see graduate students from our program at reduced fees. Benefits for mental health treatment of graduate students are included in the state-sponsored health insurance plan.In addition to feedback from the student's advisor, unsatisfactory performance may also trigger a letter from the Director of Clinical Training that spells out the nature of faculty concerns and steps that may be taken if problems are not corrected.In some cases, the Director of Clinical Training may meet with students who are experiencing problems to explore ways to address deficiencies. In some cases, contingencies are specified in the event that remedial actions are not completed. In circumstances where serious problems are identified, the student may be placed on probation. If the problem is not corrected in a timely fashion and all reasonable means for addressing the difficulty have not been successful, steps are initiated to terminate the student from the program.

Termination from the program is our last resort, and the program faculty recommends this action only after the student has been given ample opportunities to resume good standing in the program. Information about departmental procedures for termination are spelled out in the student handbook, which every graduate student receives when they enter the program. The termination procedures are as follows:

1) Before formal termination procedures are begun, the student receives written notification from the Director of Clinical Training that his/her academic performance is being evaluated by the clinical faculty for possible termination, and if appropriate, the conditions for continued enrollment in the Department. If the program faculty deem it appropriate that termination be initiated, steps 2-5 are initiated.

2) The Director of Clinical Training submits a written memo to the Director of Graduate Studies indicating that program faculty members have reached a decision requesting the student's termination from the program and the Department.

3) The Director of Graduate Studies and the Department Chairperson independently review the student's records and reach a joint decision regarding termination.

4) If the request is approved, the student is notified in writing of his/her termination from the department. This letter is signed by the Department Chair, Director of Graduate Studies, and the Director of Clinical Training.

5) If the student wishes to appeal, he/she will notify the Chair of the Psychology Department. Appropriate review procedures will be determined by the Education Committee depending on the nature of the appeal.

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Student's overall competence to practice professionally is assessed through three principal mechanisms: coursework evaluations, practicum/internship evaluations, and the comprehensive examination. Given the integration of professional practice issues in all clinical courses, in addition to mastery of course content domains, course papers, midterm and final exams provide opportunities to assess the student's conceptual grasp of the implications of each course for professional practice,ethical/professional conduct,and ethnic/cultural/lifestyle diversity. Student's command of professional practice issues, ethics, and standards of practice is specifically addressed through their performance in our required Professional Problems course. There students are given thorough exposure to these issues and their command of this area is assessed through class participation and mid-term and final essay exams that assess the student's ability to identify appropriate courses of action when confronted with common ethical dilemmas.

Professional competence, grasp of ethical and professional issues, and knowledge appropriate to serve diverse populations is also assessed through the comprehensive examination. The comprehensive exam is a two-day sit-down exam where students are asked to answer eight out of ten questions (two of which are required) on topics subsumed across domains of theory, research and practice in the following areas:interventions, assessment, psychopathology, methodology, and ethics/professional issues, and practice standards. Questions also incorporate the student's knowledge of the generalizability of content across diverse populations clinically, ethnically, and culturally. Each answer is graded on a 4-point scale by three faculty readers. In order to pass the exam, students must receive a total score of 64 points, as well as pass 6 out of 8 questions with a score of 7 or better, summed across the three graders.Students who fail on one of the two criteria can take a retake exam covering the content area subsumed under any question that the student received a score of less than 7.Re-take answers must receive a score of 8 or better in order to pass. Students who fail the comprehensive exam on both criteria and students who fail the retake, may take the entire exam a second time.If the student fails a second time, they are dropped from the program. Before a student is eligible for taking the sit-down comps, the masters thesis must have been completed.

In addition to the sit-down comprehensive exam, each student is also required to complete a specialty comprehensive exam, which consists of a Psychological Bulletin type paper over a topic of their choosing and an oral examination over its contents. Each student has a comprehensive specialty paper committee consisting of two clinical and one nonclinical psychology faculty members. After an acceptable outline of the proposed paper is given to his or her specialty paper committee, the student has thirty days to deliver the final product to the committee. The final oral is then held where both the written product as well as the oral defense is evaluated in terms of the student's mastery of theory and research in addition to their grasp of ethical considerations, diversity issues, and practice implications.Unacceptable papers that demonstrate insufficient grasp of these domains must be re-written to the committee's satisfaction.

Hands-on competency to practice competently as well as the student's grasp of ethics/professional conduct, practice standards, and their knowledge base for serving populations diverse with respect to ethnicity, culture, gender, lifestyle, and disability status is assessed primarily through evaluations by practicum and internship supervisors. Supervisors monitor the student's progress on a five-point scale across the following dimensions: 1) overall performance, 2) treatment/therapy (case conceptualization/problem identification, treatment planning, general conduct of therapy, implementation of specific techniques, and effective use of self -- e.g. warmth/sensitivity to clients, rapport, management of personal feelings) 3) psychological assessment (selection of appropriate assessment procedures, administration of assessment measures, interpretation of assessment information,report writing, and appropriateness of assessment feedback to clients), 4) consultation (skill in clarification of problem focus, delivery

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of actual consultative services, and professional demeanor with other clients, staff, and other agencies, 5) professional conduct (dependability in meeting appointments, keeping records, and communication with others; maintenance of confidentiality, agency citizenship, and initiative) and 6) response to supervision (utilization of supervisory experience, response to criticism, and independence in supervision).

In selection of training cases and practicum training sites, we endeavor to give students broad exposure to diverse populations and cultures, and the professional issues involved with each are addressed and evaluated through the practicum supervisory process. Supervisors provide written and oral evaluations to students on the dimensions listed above, and overall progress on each is reviewed during the annual student evaluation or whenever the need arises. In the event that problems are identified, appropriate plans for remediation are designed and implemented to resolve any deficiencies in professional competence or in understanding ethical, professional or ethnical/cultural/gender/lifestyle issues.Remedial plans may include repeating either a basic or advanced practicum until acceptable mastery is achieved, referral for psychotherapy to address personal problems that impact professional competence or, if indicated, counseling to choose a nonclinical career path. Our students continue to get very high marks from practicum/internship supervisors in relation to staff professionals and trainees from other programs. This feedback attests to the success of our training efforts in preparing our students to practice professionally in line with current ethical and practice standards and to address the special needs of clients from diverse backgrounds.

Published materials describing the Clinical Program do not say that it is designed to satisfy current licensing and certification requirements for psychologists since the faculty consider that it would be unethical to do so given that certification and licensing requirements vary from state to state. The Clinical Program (and thus the Clinical Neuropsychology Track) simply states that it is APA approved (see brochure on Graduate Psychology Fall 1994) and thus meets the education and training in this specialty. The program does meet requirements for certification and licensing in the State of Texas although this is not explicitly stated in brochures and catalogs. Since APA does not have standards for specialty training in Clinical Neuropsychology, no statements are made about meeting standards for this specialty.

6. Admission to the Program. Provide evidence that your program has procedures that take into account the trainee's prior academic and professional record.

For the departmental admissions procedures see the Brochure on Graduate in Psychology and the Catalog (p. 241) which note that transcripts from institutions previously attended, GRE Test Scores, letters of recommendation and a career statement are required of each applicant. Also note that while successful applicants to all graduate programs in the Department of Psychology have had a mean GPA of 3.6, and GRE scores of 634 on the Verbal, 607 on the Quantitative, and 544 on the Analytic portions, these scores are higher for the Clinical Program being 683 on the Verbal, 681 on the Quantitative, and t30 on the Analytic portions for students admitted in the academic year 1994-95. The Clinical Program currently admits 4 students to the Clinical Neuropsychology Track each year. Usually students are admitted who have had some experience in neuropsychology, perhaps working asa technician for a neuropsychologist in a

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clinical/research situation. This experience is an important consideration for admission since the Clinical Neuropsychology Track is a very demanding specialty in terms of coursework and practicum experience. In fact, most students who apply to the program have had such experience and we do require letters of recommendation from the neuropsychologists with whom they have worked. Occasionally a student is admitted who does not have such experience but who is clearly able to demonstrate that he/she understands the demands of this particular specialty.

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Attachment A - Hahnemann University

Specifications for Education and Training in Clinical Neuropsychology

Program Three
Doctoral _ Postdoctoral _ Both X

Name of University, School, or institution offering program: Hahnemann Universitv
Name of program: Neuropsvchologv Track
Address: 230 North Broad Street, M.S. 341
City/State/Zip: Philadelphia, PA 19102
Contact Person: Sandra Koffler, Ph.D. Telephone No. (215) 762-4956

1. Provide a list of names, addresses, and telephone numbers of all the graduates from your program from the past year (use separate page.)

Practicum Students
Mr. Drew Wisloski
34 Maple Avenue
Sellersville, PA

Mr. Comeilus Furgueson
22 East Eager Street
Baltimore, MD 21202

Ms. Lynn DellaPietra
205 S.E. 16th Avenue
Gainsville, FL 32601

Intern
Mr. James Lewis
Hahnemann University
Philadelphia, PA 19 102

Postdoctoral Resident
Dr. Soraya Amanullah
491 South 9th Street
Quakertown, PA 18951

Sandra P. Koffler, Ph.D.
Yeshiva University, New York, 1970
Director: Neuropsychology Service
ABPP/ABCN

J. Michael Williams, Ph.D.
University of Vermont
Vermont Neuropsychology Research Test Construction

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3. Setting. Provide evidence that each of the above listed programs, regardless of setting, (a) maintains a full-time psychology faculty; (b) provides opportunities for scholarly inquiry and practice by the faculty; and (c) provides for social and financial support for trainees and expanded opportunities for breadth of learning.

See attached brochures, following question 6.

4. Procedure for Evaluation. Describe the formal procedures for monitoring each trainee's progress and assuring the continuous development of the trainee's knowledge, skills, attitudes, and values in your program.

a. Grades for track courses
Introduction to Clinical Neuropsychology
Practicum in Neuropsychological Appraisal
Advanced Seminar in Clinical Neuropsychology

b. Supervision of evaluations, report writing, interventions.
Written report to students training program.

C. Scheduled conferences to discuss progress and make recommendations.

5.Admission to the Program. Provide evidence from your program that published descriptions of the programs specify whether they are designed to satisfy current licensing and certification requirements for psychologists as well as whether or not graduates can satisfy the education and training requirements for advanced recognition in the specialty.

See appended brochures.

6. Admission to the Program. Provide evidence that your program has procedures that take into account the trainee's prior academic and professional record.

See appended brochures.

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1 1 1 -5 -a

CO RE FA C U L TY A ND RE S E A R CH IN T E R E S TS

Donald N. Bersoff, J.D., Ph.D., ABBP (Yale University; New York University), Professor and Director, J.D./Ph.D. Program. Social science applications to law; legal regulations of psychology; mental health policies: forensic assess-ment (Fellow, American Psychological Association).

Carolyn Brodbeck, Ph.D. (University of Pittsburgh), Assistant Professor. Knowledge representation and modification of information associated with fear; cognitive-behavioral treatment of anxiety disorders; prediction and prevention of violence.

Leonard R. Derogatis, Ph.D. (Catholic University), Professor and Director, Division of Clinical Psychology and Associate Chair for Graduate Studies and Research, Department of Mental Health Sciences. Development of psych-ological assessment instruments; quantitative models of clinical decision-making; stress and psychopathology; psychopharmacology: human sexual behavior: health psychology.

PR O F E S S OR LE O N A RD R. DEROGATIS. PH.D., L E A D S A I DISCUSSION ON THE BENEFITS O F E X E R C I S E F O R P A T I E N TS W I T H A N X I E T Y D I S O R D E R S.

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111-5-a)
ames D. Herbert, Ph.D. (University of North Carolina-Greensboro), Assist-nt Professor and Director of Student Mental Health Services. Behavioral ssessment and cognitive-behavioral treatment of social phobia and related onditions of adults and adolescents; depression; personality disorders: sychopharmacology; behavioral assessment.

andra Koffler, Ph.D., ABBPlABCN (Yeshiva University), Associate rofessor and Co-director, Neuropsychology Services. Higher cortical func-oning; medical-neuropsychological syndromes (e.g., lupus erythematosus); europsychological assessment.

lichael R. Lowe, Ph.D. (Boston College), Associate Professor. RestraIned ating and obesity: functional gastrointestinal disorders; social skills assess-lent and treatment.

rthur M. Nezu, Ph.D. (State University of New York at Stony Brook), rofessor and Director, Ph.D. Program in Clinical Psychology. Multivariate onceptualizations of affective disorders; social problem-solving; coping with medical illness; psycho-oncology; psychopathology of persons with develop lental disabilities; psychotherapy outcome; empirical models of clinical ecisron-making and judgment; sex offenders with mental retardation ellow, American Psychological Association).

hristine Maguth Nezu, Ph.D. (Fairleigh Dickinson University), ssistant Professor and Director, Predoctoral Internship Program in Clinrcal sychology. Behavioral assessment; mental retardation/mental illness (dual ragnoses); coping with chronic illness and disabilities: stress and depres-on: integrative approaches to psychotherapy; sexual aggressron; cllnlcal ecision-making.

ouisa Seraydarian, Ph.D. (Temple University), Assistant Professor. iultivariate statistical techniques; program evaluation: tardive dysktnesia; -ereotyping.
13

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Myrna B. Shure, Ph.D. (Cornell University), Professor. Prevention of psy-chopathology; social-cognitive development of social competence; interper-sonal cognitive problem-solving skills (Fellow, American Psychological Association).

J. Michael Williams, Ph.D. (University of Vermont), Associate Professor and Co-director, Neuropsychology Services. Early cognitive sequelae of traumat-ic brain injury, clinical neuropsychological assessment; recovery from car-diac illness; rehabilitation.

PR I M A RY PA R T I C I P A T I NG FA C U L TY

Helen Coons, Ph.D., Adult Psychiatric Outpatient Services
Carol Groves, Ph.D., Adult Psychiatric Inpatient Services
Patrick McGuffin, Ph.D., Child/Adolescent Inpatient Psychiatric Services
Ralph Petrucci, Ph.D., Heart Failure/Cardiac Transplant Unit
Frank Schwoeri, Ph.D., Child/Adolescent Outpatient Psychiatric Services

PROGRAM FACILITIES
Computers
Several IBM personal computers are located within the student area of the program's office suite. A wide variety of software is available for student use including word processing, statlstical analysis and graphics programs.

Additional computer resources for student use include over 20 personal computers (IBM, Macintosh) available in the library and 10 IBM PCs avail-able in the computer laboratory. Both facilities are tn close proximity to the Division of Psychology. In both locations, word-processing and biostatistics software are available.

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quipment

esting equipment for classroom instruction is available to psychology grad-iate students. The program also has videotape and audiotape equipment vailable for classroom instruction and research activities.

FINANCIAL AID

The University's Office of Student Financial Aid helps students obtain the funds needed to pursue their education, The staff can provide students with n approximation of the cost of financing their education and will offer counselling in what sources may be best for individual students.

Prospective applicants seeking financial assistance, grants, scholarships nd loans are required to apply for financial aid each academic year. Incoming students are sent a complete financial aid packet. All students nould file a financial aid application regardless of acceptance status.

Prospective applicants are welcome to make an appointment. write or call the office:

Hahnemann University
Office of Student Financial Aid
Broad & Vine, Mail Stop 439
Philadelphia, PA 19102-l 192
Hours: 8:30 a.m. to 4:30 p.m., Monday through Friday (215) 762-7739

Stipends ne Clinical Psychology Program attempts to provide all first- and second-ear students with some level of stipend support. Actual amounts vary yearly depending on levels of grant support and University resources. Stipends will Kely range between $1,000 and $5,000 per year, per student. 15

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INTRODUCTlON TO THE CLINICAL PSYCHCLCGY PROGRAM

The Ph.D. in Clinical Neuropsychology is one of several doctoral degrees offered by Graduate School. The program is housed with the Division of Clinical Psychology of the Department of Mental Health Sciences and is fully accredited by the American Psychological Association. The program encompasses five years of full-time study and provides graduate students with a strong foundation in relevant psychological the practice of psychological assessment and in the conduct of meaningful clinical research.

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I I I -8

ADMISSION REQUIREMENTS

E A C H Y E A R, THREE STUDENTS IN THE PROGRAM ARE ADMITTED S P E C I F I C A L LY F O R T H E NEUROP S Y C H O L O GY T R A C K.

Listed below are the flexible guidelines used by the faculty to evaluate each applicant's credentials. In addition to the application, each year approximately 30 to 40 candidates are invited to Hahnemann for a personal interview by the faculty. If financial hardship prevents someone from traveling to Hahnemann, the interview may be conducted by telephone or waived.

Successful applicants should meet the following criteria:

B.A. or B.S. degree from an accredited university or college (a major in psychology is highly desirable);

Combined Verbal and Quantitative Graduate Record Examination (GRE) score of 1100 or higher. Statistics regarding the most recent entering class are as follows: mean Verbal GRE = 558; mean Quantitative GRE = 617; mean Analytical GRE = 643;

Score of 550 or higher on the GRE Advanced Psychology Subtest (most recent entering class had a mean of 587);

Undergraduate cumulative grade point average of 3.00, based on a 4.00 system (most recent entering class had a mean GPA of 3.40); and

Three letters of recommendation (at least two of which are from current or former professors). Each incoming class has 15 students, three of whom are admitted specifically for the neuropsychology track subspecialty program (see page 70).

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Attachment A - Universitv of Victoria

Specifications for Education and Training in Clinical Neuropsychology

Program Four

Doctoral X Postdoctoral _ Both _

Name of University, School, or institution offering program: Universitv of Victoria

Name of program: Clinical Psychology Program (with Clinical Neuropsychology Track)

Address: Department of Psychology, P.O. Box 1700

City/State/Zip: Victoria, British Columbia, Canada V8W 3P5

Contact Person: Catherine A. Mateer, Ph.D. Telephone No. (604) 721-8590

1. Provide a list of names, addresses, and telephone numbers of all the graduates from your program from the past year (use separate page.)

See names of graduates in Victoria Program Appendix 1 within general Appendix H.

Psychology Faculty responsible for the training program in neuropsychology include the following (full CV's are included in response to item 5 on page 10 of the Petition Form in Victoria Program Appendix 6a-6i under general Appendix H):

Catherine A. Mateer, Ph.D., ABPP/ABCN
Professor and Director of Clinical Training
Graduated from University of Western Ontario

Dr. Mateer is a licensed and board certified clinical neuropsychologist. She is widely published in the areas of cognitive rehabilitation, traumatic brain injury, and biological substrates of attention, memory and language.

Louis D. Costa, Ph.D.
Professor and Dean of Social Sciences
Graduated from Columbia University

Dr. Costa is widely published in the area of dementia and neuropsychological evaluation of the elderly. He has been very active in the governance of INS and of both the American and Canadian Psychological Associations.

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Esther H.. Strauss, Ph.D.
Professor
Graduated from the University of Toronto

Dr. Strauss is a registered psychologist in B.C. She is widely published in the following areas: neuropsychological test procedures, the prediction of speech dominance and the effects of early brain damage.

Roger E. Graves, Ph.D.
Associate Professor
Graduated from Massachusetts Institute of Technology

Dr. Graves is a registered psychologist in B.C. He is widely published in the areas of hemispheric specialization and interhemispheric transfer. visual-spatial attention and neglect, dichotic listening, and memory function in the elderly.

Kimberly A. Kerns, Ph.D.
Assistant Professor
Graduated from University of Health Sciences, Chicago Medical School

Dr. Kerns is a licensed psychologist with research interests in the cognitive and behavioral correlates of developmental and acquired disorders of childhood including attention deficity hyperactivity disorder and traumatic brain injury.

Michael Joschko, Ph.D.
Visiting Assistant Professor (l/3 time)
Graduated from the University of Windsor

Dr. Joschko is a registered psychologist with clinical and research interests in a broad range of neuropsychological and neuropsychiatric disorders in children. He is also appointed (Y3 time) as Director of Psychological Services at the Queen Alexandra Centre for Children in Victoria.

In addition to these core faculty with expertise n neuropsychology, there are three other members of the clinical program who contribute to the lifespan Development and Aging track (the other area of specialization). They include (CV's are found in Victoria Program Appendix in general Appendix H.

Pam Duncan, Ph.D., Professor (graduated University of Wisconsin)

Marion Ehrenberg, Ph.D., Assistant Professor, Registered Psychologist (graduated Simon Fraser University)

Marsha Runtz, Ph.D., Assistant Professor, Registered Psychologist (graduated University of Manitoba)

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3. Setting. Provide evidence that each of the above listed programs, regardless of setting, (a) maintains a full-time psychology faculty; (b) provides opportunities for scholarly inquiry and practice by the faculty; and (c) provides for social and financial support for trainees and expanded opportunities for breadth of learning.

a) The Ph.D. Program in Clinical Psychology with specialization in neuropsychology or life-span development and aging is offered within the Faculty of Graduate Studies through the Department of Psychology at the University of Victoria. The University of Victoria operates under authority of the University Act (R.S.B.C. 1979). As such it maintains a Board of Governors, Senate and full time teaching and research faculties. The Department of Psychology currently appoints 30 full time faculty and 21 visiting or adjunct faculty. At the present time there are 8 l/3 faculty FTE's designated as Clinical Training faculty.

b) The university provides extensive opportunities for scholarly inquiry trough administration of grants and contracts, and regular lecture and seminar series in a broad range of topics including not only clinical, but experimental, developmental, cognitive, life-span, physiological and social psychology as well as behavioral neuroscience. Regular full time faculty teach no more than four courses per year and can receive course reductions for research activity. The department is located in the Comett Building on the University of Victoria campus. Fully equipped facilities include a psychology clinic operating as an outpatient service and teaching clinic, observation rooms and audio and video recording equipment, microcomputer-based cognition laboratories, animal research facilities, electrophysiological recording rooms and equipment and specialized labs for the study of visual and auditory perception.There is a data analysis center with four mainframe computers. The Department has strong liaisons with several local community hospitals (general, rehabilitation and extended care), schools, private and government agencies, with opportunities for both research and clinical practicum experiences.

c) Trainees (graduate students may be eligible for a variety of studentships, traineeships and awards through a variety of granting agencies. There is also support for approximately 2/3 of the graduate students in the form of teaching or research assistantships. There is an active office of student financial aid. Socially, the university offers many cultural and athletic activities and a variety of opportunities for involvement in student governance and volunteer activities.

4. Procedure for Evaluation. Describe the formal procedures for monitoring each trainee's progress and assuring the continuous development of the trainee's knowledge, skills, attitudes, and values in your program.

Trainees (graduate students) are admitted to the program under a faculty member in the clinical program who provides research mentoring during the first two years of the program. The Clinical Director oversees the curriculum for each clinical student. Student progress is monitored and formally evaluated each February by at least two clinical faculty members (not including the primary supervisor) who have had the student in the clinical assessment and intervention courses. A statement regarding progress, both in terms of completion of course requirements and development of clinical skills, is provided to the student each Spring. Prior to proposing a dissertation, each student must pass comprehensive examinations: one in general clinical psychology and one in neuropsychology. These examinations involve reading and judging by at least four separate clinical faculty. Examinations are offered twice yearly, in September and February). In addition to evaluation in formal coursework, evaluations are made by supervisors in each of at least three separate clinical practicum placements in the community.All practicum supervisors are registered psychologists in B.C. One member of the clinical faculty is designated

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as a practicum coordinator; another is an internship coordinator. Make-up of supervisory and dissertation committees is undertaken in accordance with guidelines of the university's Faculty of Graduate Studies.

At the present time, the published description of the Clinical Psychology program does indicate that it is designed to develop competent and ethical psychologists” and to prepare graduate students for clinical practice, teaching and research.” It does not specifically state that is designed to satisfy current licensing and certification requirements for psychology. However, the brochure was prepared before accreditation came into effect and the next version of the brochure will be more explicit in this regard.(See enclosed brochure in the Victoria Program Appendix 2 under general Appendix H.)

6. Admission to the Program. Provide evidence that your program has procedures that take into account the trainee's prior academic and professional record.

The admission requirements for both admission to the graduate program in Psychology and the Clinical Program (see reference to Clinical Applicant”) are provided in the copy of the graduate admissions policy from the 1994-1995 University of Victoria Calendar. (See Victoria Program Appendix 3 under general Appendix H.)

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Attachment B - Universitv of Florida Health Science Center

Doctoral Education and Training Prerequisites to Clinical Neuropsychology

Name of Institution:University of Florida

Street: Box 100165, Health Science Center

City/State/Zip: Gainesville, FL 326 l0-01 65

Program: Clinical Psvchologv

Degree(s) Offered: Ph.D. Department: Clinical & Health Psvchology

Administrative Personnel:
Administrative Head of Institution:

Name: John Lombardi Title: President

Chief Administrator Responsible for Instruction:
Name: Andrew Sorensen Title: Provost

Department Chair Name: Nathan W. Perrv Telephone: 392-455 1

Program Director: Name: Cynthia D. Belar Telephone: 392-4553

1. Indicate the date of approval of your institution by the appropriate regional accrediting body recognized by the Commission on Recognition of Postsecondary Accreditation (CORPA). January 12, 1994

2. If your program is fully or provisionally accredited by the American Psychological Association, indicate the date of the last site visit: May 21-22, 1990

Signatures:
Department Chair:
Program Director:

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3. Enclose relevant current program descriptive materials (e.g. catalogs, brochures, etc.) with date of issue.

See University of Florida program specifications insert under general Appendix H, University of Florida Program Appendix.

IF YOUR PROGRAM IS APA APPROVED, STOP HERE

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Attachment B - Universitv of Victoria

Doctoral Education and Training Prerequisites to Clinical Neuropsychology

Name of Institution:University of Victoria

Street: P.O. Box 3050

City/State/Zip: Victoria, British Columbia, Canada V8W 3P5

Program: Clinical Psychology with Specialization in Neuropsychology

Degree(s) Offered: Ph.D. Department: Psychology

Administrative Personnel:
Administrative Head of Institution:

Name: David F. Strong. Ph.D. Title: President

Chief Administrator Responsible for Instruction:
Name: Samuel E. Scully. Ph.D. Tide: Vice President Academic & Provost

Department Chair: Name: Richard May, Ph.D. Telephone: 721-7522

Program Director: Name: Catherine A. Mateer. Ph.D. Telephone: 721-8590

1. Indicate the date of approval of your institution by the appropriate regional accrediting body recognized by the Commission on Recognition of Postseeondary Accreditation (CORPA). APA Accreditation October 1993

2. If your program is fully or provisionally accredited by the American Psychological Association, indicate the date of the last site visit: January ll-12, 1993

Signatures:
Department Chair: Date:

Program Director: Date:

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3. Enclose relevant current program descriptive materials (e.g. catalogs, brochures, etc.) with date of issue.

Current materials describing the program are provided in Victoria Program Appendix 2 and 4 in general Appendix H.

IF YOUR PROGRAM IS APA APPROVED, STOP HERE

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Attachment B - (Combined) San Diego State Universitv/Universitv of California, San Diego Program

Doctoral Education and Training Prerequisites to Clinical Neuropsychology

Name of Institution:San Diego State Universitv/Universitv of California, San Diego (Joint Doctoral Program in Clinical Psychology)

Street Address 1: 3427 4th Avenue, Department of Psvchiatry, University of California, San Diego

City/State/Zip: San Diego, CA 92103

Steet Address 2: 6363 Alvarado Court. Suite 103. San Diego State University

City/State/Zip: San Diego, CA 921204913

Program: Joint Doctoral Program in Clinical Psvchology

Degree(s) Offered: Ph.D. Department: Psvchiatry - UCSD

Degree(s) Offered: Ph.D. Department: Psvchology - SDSU

Administrative Personnel: UCSD
Administrative Head of Institution:

Name: Richard C. Atkinson, Ph.D. Title: Chancellor

Chief Administrator Responsible for Instruction:

Name: Richard E. Attiveh, Ph.D. Title: Vice Chancellor.

Office of Graduate Studies & Research Department Chair, Department of Psychiatry:

Name: Lewis L. Judd, M.D. Telephone: (619) 534-3684

Program Director:
Name: Robert K. Heaton, Ph.D. Telephone: (6 19) 497-6644

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Administrative Personnel: SDSU
Administrative Head of Institution:

Name: Thomas B. Day. Ph.D. Title: President

Chief Administrator Responsible for Instruction:
Name: James W. Cobble, Ph.D. Title: Dean. Graduate Division

Department Chair, Department of Psychology:
Name: Frederick Hombeck. Ph.D. Telephone: (619) 594-5909

Program Director:
Name: Richard Schulte. Ph.D. Telephone: (619) 594-5135 1.

1. Indicate the date of approval of your institution by the appropriate regional accrediting body recognized by the Commission on Recognition of Postsecondary Accreditation (CORPA).

October 1990

2. If your program is fully or provisionally accredited by the American Psychological Association, indicate the date of the last site visit:

March 21-23, 1995

Signatures - SDSU:

Department Chair:

Program Director:

Signatures - UCSD:

Department Chair

Program Director:

3. Enclose relevant current program descriptive materials (e.g. catalogs, brochures, etc.) with date of issue.

See general Appendix H, San Diego State University/University of California-San Diego Program Appendix.

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Attachment B - Universitv of Houston

Doctoral Education and Training Prerequisites to Clinical Neuropsychology

Name of Institution:University of Houston

Street: Deuartment of Psychology

City/State/Zip: Houston, TX 77204-5341

Program: Clinical Neuropsychology Track in Clinical Program

Degree(s) Offered: Ph.D.
Department: Psychology

Administrative Personnel:
Administrative Head of Institution:

Name: James H. Pickering Title: President

Chief Administrator Responsible for Instruction:
Name: Henrv Trueba Title: Provost & Sr. Vice President of Academic Affairs

Department Chair:
Name: Marco Mariotto Telephone: (7 13) 743-8503

Program Director: Clinical
Name: John P. Vincent Telephone: (713) 743-8619

Director Clinical Neuropsychology Track: H. Julia Hannav, Ph.D. Telephone: (7 13) 743-8568

1. Indicate the date of approval of your institution by the appropriate regional accrediting body recognized by the Commission on Recognition of Postsecondary Accreditation (CORPA).

January 17, 1994

2. If your program is fully or provisionally accredited by the American Psychological Association, indicate the date of the last site visit:

January 25-27, 1994

Signatures:

Department Chair: Date:

Program Director: Date:

Clinical Neuropsychology Track Director: Date:

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3. Enclose relevant current program descriptive materials (e.g. catalogs, brochures, etc.) with date of issue.

See general Appendix H, University of Houston Program Appendix.

IF YOUR PROGRAM IS APA APPROVED, STOP HERE

(End of text)

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