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Division of Clinical Neuropsychology
Newsletter 40
American Psychological Association
Volume III, Number 1 April, 1985
Elections Slate: Nominees
President Elect:
Raymond Dean
Charles Golden
Gerald Goldstein
Edith Kaplan
Charles Matthews
Oscar Parsons
Paul Satz
Secretary:
Kenneth Adams
A. MacNeil Horton
Member-at-Large:
Stanley Berent
Cecil Reynolds
President's Message
Advances In Clinical Neuropsychology
by Lawrence J. Hartlage
This year has shown marked progress in increased member involvement in Division activities. In response to my survey shortly after taking office, several areas of interest to members have been identified, and I've appointed interest groups to work in these areas. If any of these represent issues of concern or relevance to you and you would like to be involved in their work, you may contact the chairpersons at the addresses listed below.
Public Information -Chair, Arthur MacNeill Horton, Jr., Baltimore V.A. Medical Center, 3900 Loch Raven Boulevard, Baltimore MD 21218, (301) 467-9932.
Toxic Substances - Chair, Harvey Ross, Clinical Psychology, 14755 Ventura Boulevard, Suite 108, Sherman Oaks CA 91403, (213) 907-6380.
Cognitive Rehabilitation - Co-Chairs, John R. Crossen, Department of Medical Psychology, Oregon Health Sciences University, 31801 S.W. Sam Jackson Park Road, Portland OR 97206; and Richard H. Bauer, Department of Psychology, Middle Tennessee State University, Murfreesboro TN 37132, (615) 898-2706.
Emotional Sequelae of Neuropsychologlcal Problems - Co-Chairs, George Athey, Jr., CF Menninger Founation, Box 829, Topeka KS 66601, (913) 273- 7500; and Ruth Haak, 204 Eanes School Road, Aus-tin TX 78746, (512) 327-2203.
Pediatric Neuropsychology - Co-Chairs, Richard Berg, West Virginia University, Medical Center- Charleston Division, P.O. Box 2867,1210 Elmwood Avenue, Charleston, West Virginia 25330; and Ellen Lehr, Rehabilitation Institute of Chicago, 345 East Superior Street, Chicago IL 6061 1, (312) 649-6236.
Educational Applications - Chair, L.M. Triozzi, Greenwich High School, 10 Hillside Road, Green-wich CN 06830, (203) 869-6200.
Hospital Staff Membership - Co-Chairs, Thomas R. Hardey, 2938 McClure Street, Suite I, Oakland CA 94609, (415) 832-l 259; and Ronald M. Lazar, 450 Clarkson Avenue, Brooklyn NY 11203.
Local Meetings of Neuropsychologists - Chair, Robert L. Jenkins, Department of Psychiatry & Behavioral Sciences, The George Washington Uni-versity Medical Center, 2150 Pennsylvania Avenue, Washington, DC 20037,676-3310
Basic Science Research - Chair, Douglas L. Chute, Director of Neuropsychology, Drexel University, Philadelphia PA 19104.
Motor Vehicle Operation Following Head Injury -Chair, C. Alan Hopewell, Swiss Avenue Hospital, 3504 Swiss Avenue, Dallas TX 75204 (214) 826-7030. When returning the surveys concerning professional practice issues, many of you indicated an interest in knowing the results. A few responses are still coming in, and so the final tabulation and analyses will be deferred until it appears that all who wish to respond will have their data included. In the next issue the results will be reported, along with the highlights of the midwinter executive committee meeting March 6 at the APA offices.
Legislative Committee Report
When I gave the Legislative Committee report in Toronto last year,
I indicated that the membership of the Legislative Committee would be expanded
this year. In addition to myself, the membership now includes George Prigatano,
Ph.D., Steven Mattis, Ph.D., and Robert Hart, Ph.D. I recently also asked
two other individuals to join this committee. They are Kathleen Sullivan,
Ph.D. and Bruno Giordani, Ph.D.
At that board meeting, we discussed a number of legislative issues,
and responses to legislation, that are currently affecting or promise to
affect the prac-tice of clinical neuropsychology. As we all now know, these
issues are numerous and read like alphabet soup. Some of them, like DRG's
promise to impact on our field immediately and potentially, adversely.
Diagnostic related groups, for instance,
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Newsletter 40
fail often to include neuropsychological intervention as a component
of intended care. Hospital administrators may look at such intervention
as an economic risk in that they fear it will lengthen inpatient stay.
PRO's (Peer Review Organizations) may become an important vehicle for clinical
neuropsychology in efforts to insure that psychological services are recognized
as a component of clinical care in a given diagnostic category. The various
disciplines concerned with medical care are, themselves, responding to
pressures in a variety of, often uncoordinated, ways. SLE's, for example,
represent a possible response on the part of university medical centers
that may significantly affect the practice of clinical neuropsychology
in those centers and also the academic status of faculty at those centers.
SLE stands for separate legal entity.” This is a concept in which clinical
practice in a medical school becomes a separate entity, whose services
are then contracted for as in contracting with any outside agency. HMO's
(Health Maintenance organizations) are more of an immediate reality than
are SLE's. HMO's are proliferating and almost simultaneously being purchased
by large organizations. Since HMO's promise to become a major vehicle for
clinical service delivery, it is important that neuropsychology become
involved in their development.
It is probably easy to see the negative in these new legislative happenings.
For the most part, the moves are economic. Depending upon your political
leaning, you may wish to blame all of this on Reaganomics or on democrats
who you feel did not do enough while in office. Looking for someone to
blame, however, will do us little good. The fact is, we are living in an
increasingly competitive situation in the health care field. The question
is, Can psychology successfully compete?'
This is a time of change in medical service delivery. Change is difficult,
and the first aspects of change are often negative. There is a positiveside
in that change brings with it new opportunities. In this case, the opportunities
are to continue to deliver important clinical services to our patients
and to even introduce new services that might not have been readily available
before. We need to show, through visible documentation wherever possible,
that the tools of psychology are well-suited to not only contribute to
a holistic approach in the treat-ment of disease, but also in helping to
solve clinical and medical-economic problems. We need to show that the
delivery of our clinical services is good from a clinical perspective,
and also good from a view-point of cost savings. To list a few example,
good psycholgical care also contributes to speedy and accurate diagnoses
(psychiatric as well as general medical and surgical). It contributes to
shortened inpatient stays and aids in treatment compliance and outpatient
after-care. Our general psychologi-cal background also leaves us equippped
to assist management in personnel and staff development issues. Our background
in research methodology and statistics allows us to engage in clinical
and applied research. For instance, outcome studies and basic research
are likely to enhance a hospital's prestige and this may lead to increased
patient referrals.
If we can be successful in documenting these and related activities,
reflecting in that documentation an explanation of how the activity contributes
to management objectives, then I believe the answer to the question I raised
above is, yes. Psychology can compete and compete successfully.
Stanely Berent
Chairman, Legislative Committee
Report of Computer Task Force-
At a recent APA convention in Toronto, the Executive Committee of Division
40 discussed the proper mission and goals for the Task Force on the use
of computer technology in testing and remediation/retraining programs.
The Committee noted that this extremely complicated issue is also being
addressed by a number of APA Divisions, by APA Central Office, and by other
professional disciplines with whom neuropsychologists interact. Until such
time that the Task Force develops a formal docu-ment, the Executive Committee
agreed that the urgency of thequestion required our interim endorsement
of the following four major points presented by Joseph Matarazzi, Ph.D.
in a July 22,1983 editorial in Science: (1) While computer-assisted testing
has considerable potential, (2) the predictive/descriptive validity of
computer generated narrative reports remains to be demonstrated; (3) the
responsible utilization of computerized test results is therefore critically
dependent upon the education, training and experience of skilled professionals
cognizant of the limitations of such test reports and capable of integrating
the test results with other information from the person's history; (4)
the potential for abuse/misuse of the products of this new computer technology
must be clearly communicated to psychologists, to other involved disciplines,
and to the general public.
Although the present and near future emphasis of the Division 40 Task
Force will be on computer-assisted testing, the rapid proliferation and
dissemination of computer prorams in cognitive/memory retraining undoubtedly
will require the development of ethical standards and guidelines in this
area as well.
Charles G. Matthews
Task Force Chairman
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Newsletter 40
Minutes
Division of Clinical Neuropsychology (40)
Executive Committee Meeting
August 24,1984 - Toronto, Canada
Acceptance of Minutes:
The minutes of the Mid-Winter meeting were approved.
Secretary's Report:
Dr. Goldstein brought up the matter of responding to requests for information
concerning pre- and post-doctoral training in clinical neuropsychology.
The need was expressed for a systematic survey of training programs, and
Dr. Bieliauskas was asked to head a subcommittee to prepare a document
to appear in the newsletter containing the results of the survey. Other
members of the sub-committee are Drs. Goldstein, Rourke and Adams.
Membership Committee:
Dr. Barth reported that the Division now has 1947 members. 411 new
members and associates joined the Division during the past year. Dr. Barth
is in the process of setting up a national membership network in order
to promote recruitment of new associates and members. Dr. Barth's report
was accepted.
Division Mailings:
A discussion was conducted of Division mailings, and it was agreed
in principle that we would attempt to set up a system to do our own mailings
rather than use the services provided by APA. The secretary would be appropriated
funds to cover the mailing costs.
Fellows Committee:
The new Division Fellows are Kerry de S. Hamsher, Elbert W. Russell,
Donald T. Stuss, Ralph E. Tarter, Kenneth Adams, James Inglis, Cecil Reynolds,
Allen Willner and Jon Eisenson. At last year's business meeting aques-tion
was raised regarding who is eligible to vote for new Fellows. Dr. Matarazzo
reported that it is APA policy that all Division members may vote on new
Fel-lows. Dr. Matarazzo also expressed the need to seek individuals for
Fellowship status. The Fellows Committee report was accepted.
Program Committee:
Dr. Bieliauskas reported that 86 papers were submitted for the Toronto
meeting, of which 56 were accepted. 34 of these were posters. There were
two invited symposia and two invited speakers. The Division has only 18
hours of program time allocated, Dr. Bieliauskas pointing out that number
of hours is based on attendance of division members at the meeting and
moni-oring conducted by APA of attendance at inividual sessions. There
was extended discussion of expanding the Division's program time through
such means as co-sponsorship with other divisions. It was noted that the
program at the Toronto meeting contained several unfortunate conflicts
for the Division, and that efforts should be made to alleviate that situation
in the future. appreciating the complexity of the APA program. There was
also extended discussion of Division 40 sponsored workshops. The general
consensus was that this matter should not be pursued at the present time.
Nominations and Elections:
Dr. Butters reported that Muriel Lezak, Charles Matthews and Manfred
Meier were nominated for Division President. The former two individuals
declined nomination. Dr. Meier is the President-Elect. Dr. Bieliauskas
is the new member-at-large of the Executive Committee. The following motion
was made and passed by the Council because of an error in the elections
ballot. Linus Bie-liauskas who was formally elected as our representative
to council, should be appointed as an at-large member of the Executive
Committee. This appointment is necessitated by an inadvertent error in
the writing of the election ballot. Although an at-large member needed
to be elected, the ballot erroneously listed election of a council representative.
Next year, the Division will need to elect a president, secretary,
and member- at-large. A new council representative will have to be elected
if the Division is allocated an additional seat. A nominations ballot will
be mailed out around Christmas time.
Liaisons:
1. Committee of Gay Concerns: Dr. Quin-Ian made the following report.
Sev-eral important achievements have been accomplished over the past year.
a. There is now insurance coverage for spouse equivalents” for APA
and Division members through Liberty Mutual. It is anticipated that spouse
equivalent coverage will be advertised in the APA Monitor.
b. Division status was achieved by C. . the Society for the Psychological
Study of Lesbian and Gay issues. (It is Division #44.)
c. Information on AIDS (biophysical and psychological) is available
through APA to assist with treatment, referral, and prevention issues.
d. COGC has also completed work on the monograph: Some Information
for Parents and Families of Lesbians and Gays.”
e. There is available a roster of li-censed psychologists skilled in
the treatment of Lesbian and Gay clients.
f. Despite mediation efforts, the International Congress on the Rorschach
continuesto include homosexuality under the category of perversions.”
g. Further information and details are available to Division 40 members
through Jim Quinlan in Chicago.
2.Committe on Women in Psychology: Dr. White made the following report.
The liaison comittee of the Division 40 to theAPA Committe on women in
psychology has been working on nominations of women Fellows to the Division.
At the encouragement of the Executive Committee members, we will also become
involved in nominating women members for Division Officers and for editorship
publications on APA journals.
Newsletter:
Dr. White requested some discussion of the mechanisms for mailing the
Newsletter. It was agreed that the Newsletter should be sent by first class
mail directly from Boston University. It was also agreed that a membership
application should be printed in the Newsletter. Dr. White was congratulated
by the Executive Committee for the excellent appearance and content of
the Newsletter under her editorship.
Legislative Committee:
Dr. Berent provided the following report. The following summarizes
the report of the Legislative Committee of Division 40, presented to the
Executive Committee of Dvision 40 in Toronto, Canada, August 1984.
The activities of the committee during this past year were summarized.
To a great extent, rapidly changing events necessitated a wait-and-see”
attitude on the part of the committee. During this
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Newsletter 40
coming year, the committee plans to expand its membership, to continue
to monitor legislative activities on both a state and national level, and
to develop suggested responses to legislative actions. The committee will
also prepare an informational item for the Division Newsletter and submit
that to the newsletter editor before February 1985. This will be in time
for the next mailing of the Newsletter.
Current membership of the Legislative Committee consists of Stanley
Berent, Ph.D. (Committee Chair), George Prigatano, Ph.D., and Steven Mattis,
Ph.D. It was announced at this meeting that Robert Hart, Ph.D. has also
been asked to join the committee. Dr. Berent indicated that the committee
is likely to expand its membership this year in order to provide broader
coverage in monitoring legislative events.
The rationale for budget requests was explained. These monies are primarily
for long distance telephone calls and other routine office expenses.
Some current items of interest were reviewed. These are descri bed
in the following paragraphs.
Some activities by state licensing boards were summarized. For instance,
it was noted that the state of Virginia has engaged in development of guidelines
to recognize proficiency in clinical neuropsychoiogy. Using existing licensing
laws, the State of Virginia plans to use these guidelines to specify who
may and who may not practice clinical neuropsychology. Nospecific licensing
of clinical neuropsychologists is planned. Rather, licensing would occur
under the generic mechanism that now exists.
It was also noted that the state of Flor-ida has engaged in some licensing
activity of clinical neuropsychologists. The details of these activities
are not yet known, and the committee will attend to this matter as soon
as possible.
The majority of the report was concerned with a review of new funding
formulae which are being developed and implemented around the nation. Principally,
this has to do with DRG (Diagnostic Related Groups) and related activities.
These administrative activities continue to pose a potential threat for
the practice of clinical neuropsychology. However, some positive events
of the past year were also noted. For instance, medical planning and review
groups on local and regional levels present a potentially positive way
of influencing DRG implementation. Through such groups, guidelines for
good” clinical care can be specified. These guidelines can service to balance
a purely fiscal consideration presented by DRG schema. For instance, if
a clinical practice guideline describes that neuropsychological evaluation
will be included in diagnosis of dementia, hospital administration must
include such clinical activity in their practice. Without such guideline
specification, fiscal con-siderations alone might exclude such clinical
practice.
Related to medical district, regional, and local planning, PRO (Peer
Review) also shows promise or positively influencing implementation of
DRG. For instance, peer review can specify good clinical practice and again
insure that such a practice is included in hospital activities. SLE (Separate
Legal Entities), another new event of the past year, was reviewed. SLE's
have surfaced at a num-ber of medical schools around the nation. Representing
another attempt to deal with the impact of DRG, these SLE's manifest through
removal of current medical faculty from the university hospital, making
them a legal and separate entity within the community. The hospital then
contracts for clinical services with these faculty. The SLE does not affect
the academic appointment of the individual, rather only the individual's
clinical practice. Implications of such activities for the practice of
neuropsychology were discussed. For instance, it is conceivable that simple
dollars and cents considerations in SLE's would adversely impact on inclusion
of clinical neuropsychology activities. It is also conceivable that other
local and private groups would compete with medical school faculty for
delivery of clinical services to the medical center. These groups could
be in a position to offer lower bids on clinical services. The con-cern
is that such services might be sub-standard in relation to those currently
employed in the medical centers. The needs to include teaching and other
academic activities in the delivery of clinical care might not be attended
to in such a process.
Other items discussed at this time were HMO's (Health Maintenance Or-ganizations).
HMO's have been developing rapidly in response to DRG funding activities.
The place for clinical neuropsychology in such organizations will need
further exploration in coming months. A current bill in the Senate which
allows the Veterans Administra-tion to pay a bonus to awardees of the ABBP
was described. Other current trends of the Veterans Administration were
also discussed. These include the possible recognition of specialties by
the VA although such recognition is likely not to occur in the immediate
future. It was also indicated that there is a future possibility of implementation
of post-doctoral training within the VA sys-tern and that clinical neuropsychology
is a likely area for such training.
With regards to DRG funding formu-lae in hospitals, the clinical neuropsy-chologist
will likely need to demonstrate to hospital administrators the value of
neuropsychological evaluation, and treat-ment for such clinical activities
as speedy and accurate diagnosis, treatment compliance by patients, contribution
to a timely discharge of patients, and identification of those patients
needing rehos-pitalization. Wherever possible, clinical neuropsychologists
may wish toattempt to influence DRG's themselves in order to insure that
neuropsychology activi-ties are included in cost projections. At the present
time, this does not seem to be the case except perhaps generally in the
area of rehabilitation.
The next report of the Legislative Committee is scheduled for the Division
40, Mid-Winter meeting.
Council Representative:
Dr. Boll briefly reviewed major activities of Council including their
deliberations concerning Psychology Today, the establishment of two new
divisions (Family Psychology and the Society for the Psychological Study
of Lesbian and Gay Issues), the dues increase from $89 to $110, progress
on designation and accreditation and the two lawsuits involving council.
He also indicated that there would be a national conference on graduate
education in psychology at West Virginia University.
Task Forces:
1. Physical Interventions: Dr. Adams discussed his communications with Dr. Rogers Wright regarding the response of the Executive Committee to the draft report of the Psychologist'sTask Force on Physical Interventions.
2. Dr. Matthews, following a meeting of interested individuals in Toronto, has issued the following proposed policy statement on the use of computer technology in testing and remediation/ retraining programs. At the recent APA convention in Toronto, the Executive Committe of Division 40 discussed the proper mission and goals for the Task Force on the use of com-puter technology in testing and re-mediation/ retraining programs. The Committee noted that this extremely complicated issue is also being addressed by a number of APA Divisions, by APA Central Office, and by other professional disciplines with whom neuropsychologists interact. Until such time that the Task Force
[Page 5]
Newsetter 40
develops a formal document, the Exe-cutive Committee agreed that the
ur-gency of the question required our interim endorsement of the following
four major points presented by Joseph Matarazzo, Ph.D. in a July22, 1983
editorial in Science: (1) While computer-assisted testing has considerable
potential, (2) the predictive/-descriptive validity of computer gen-erated
narrative reports remains to be demonstrated; (3) the responsible utilization
of computerized test results is therefore critically dependent upon the
education, training, and experience of skilled professionals cog-nizant
of the limitations of such test reports and capable of correlating the
test results with other information from the person's history; (4) the
potential for abuse/misuse of the products of this new computer technology
must be clearly communicated to psychologists, to other involved disciplines,
and to the general public.
Although the present and near future emphasis of the Division 40 Task
Force will be on computer-assisted testing, the rapid proliferation and
dissemination of computer programs in cognitive/memory retraining undoubtedlywill
require the development of ethical standards and guidelines in this area
as well.
3. Dr. Meier reported on progress regarding specialty designation by the APA. A model application for clinical neuropsychology is being reviewed by the Board of Professional Affairs. It is anticipated that a procedures manual on specialization in psychology will be approved by council within the next two years. Note: The secretary recently received from APA a draft report of the BPA Subcommittee on Specialization for review and comment.
Budget:
Dr. Dean submitted the attached financial report. The Executive Committee
accepted the report with thanks, and approved the proposed budget contained
in its face sheet ($17,750). It was moved and passed that the special Division
assessment should be $7.
The Executive Committee adjourned at 5 p.m.
APA Division 401984-1985 Budget
1984-85 1983-84
;
Budget Expenses
President's Office
General Fund
$2500.00 982.81
Mid-Winter Meeting
6,000.00 5,239.97
INS-Div. 40 Task Force
1,000.00 1,217.49
Secretary's Office 1.000.00 140.23
Committees
Program &nbs
p;
100.00
Fellowship &
nbsp;
150.00 150.00
Membership
600.00 155.30
Newsletter
1,800.00 604.90
Legislative
100.00
Representative to APA Council 1 ,000.00 444.56
Miscellaneous Projects/ Donations 1,500.00
Reserve ; 2,000.00
Totals $17,750.00 $8,935.26
Training Programs Compiled
A large number of requests for information on internships and post doctoral training programs in neuropsychology is received by Gerald Goldstein. As a result, he is compiling a list of programs available and asks that full information be sent to him regarding programs in which Division 40 members are involved as soon as possible.
Address:
Gerald Goldstein, Ph.D.
V.A. Medical Center
Highland Drive
Pittsburgh, PA 15206
[Page 6]
Newsletter 40
Officers: Division 40
President: Lawrence J. Hartlage
President-Elect: Manfred Meier
Past President: Thomas J. Boll
Secretary: Gerald Goldstein
Treasurer: Raymond Dean
Members-at-Large: Linus Bieliauskas
Byron Rourke
Kenneth Adams
Council Representative: Thomas J. Boll
Newsletter 40 is the official newsletter of the Div-ision of Clinical Neuropsychology (Division 40) of the American Psychological Association. It is published biannually.
Staff:
Roberta Firnhaber White, Editor
Mark B. Moss, Associate Editor
Boston University Medical Center
Department of Neurology
720 Harrison Ave., Suite 707
Boston, MA 02118
[Page 7]
Please print or type
American Psychological Association
Clinical Neuropsychology
Division 40
Name ______________________________________________________________________________________________________________
Preferred Mailing Address (include zip) ____________________________________________________________________________________________________________________
Degree _________________________________________________From _________________________________Date
___________________
Specialty Field of Degree ________________________________________________________________________________________________
What is your current status within APA* (check one):
Member ___
Associate Member ___
Student Affiliate ___
(*Membership in Division 40 requires the attainment of a comparable
or higher category of membership in the American Psychological Association.)
Title and Work Affiliation _____________________________________________________________________________________________________________________
Other APA Divisions with which you are affiliated ______________________________________________________________________________
In order to help us evaluate your qualification for membership (which requires a demonstrated interest in the field of neuropsychology and its development”), please list any activity, research, continuing education, professional practice, teaching focus, or other demonstration of interest in the field of neuropsychology and its development. Brevity is entirely appropriate.
Return this form to:
Jeffrey T. Barth, Ph.D., Director
Neuropsychology Assessment Laboratory
Box 203, University of Virginia Medical Center
Charlottesville, Va 22908
Phone: 804/ 923-2718
Date
(End of text)