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Division of Clinical Neuropsychology
Newsletter 40
American Psychological Association
Volume IV, Number 1 May 1986

Presidential Message
by Manfred J. Meier, Ph.D.

The tradition of the presidential message encourages one to pause and reflect upon the course of the Division's development and prompts a search of the neuropsychological horizon to identify key issues that warrant transmission via a message.” Reflection gives the satisfaction of seeing the Division grow, consistent with an ever increasing number of clinical neuropsychologists. Continued growth prompts consideration of a key issue that seems to be more sharply defined now that educational and credentialing activities have been established, that of subspecialty recognition for clinical neuropsychology.

The history and background of this issue begins with the work of the Task Force on Education, Accreditation and Credentialing of the International Neuropsychological Society. The forces set in motion by this initiative contributed to the formation of Division 40 and extension of the Task Force into APA through the Division. The Task Force has generated guidelines for predoctoral internships, postdoctoral training programs, and predoctoral degree programs to assist educational institutions and training hospitals in the preparation of effective and competent clinical neuropsychologists.

An external credentialing mechanism has now been established jointly with the American Board of Professional Psychology (ABBP). Over 150 individuals have undergone the examination with another 50 or more scheduled to sit for the examination during the remainder of this year.

The APA Education and Training Board, which oversees the creditation office, is in the process of expanding accreditation procedures beyond the traditional specialty areas of clinical, counseling, school, and industrial/organizational psychology. TheAPABoardofProfessionalAffairs(BPA), through its Subcommittee on Specialization (SOS), is examining options and developing criteria for the identification and continued recognition of new specialties and special proficiencies. A tentative set of guidelines (Manual on Specialization-MOP) will be reviewed at a Pre-Conference on Specialization” being planned by SOS. The conference will bring together representatives of the applied divisions of APA, the central APA governance groups, and major external credentialing bodies such as the National Register, ABPP, and AASPB.

Clinical neuropsychology stands at the forefront of these developments as the first new specialty to be considered. The introduction of new specialties introduces a challenge to provide effective models for specialty development and requires keen atten-tion to the dangers of excessive proliferation of new specialties and counterproductive fragmentation of professional psychology. It is also necessary to be sensitive to the political complexities of APA, an organization with strong traditional specialties out of which clinical neuropsychology, in part, has grown. Change necessarily grows out of conflict and conflict, as psychologists well know, characteristically produces ambivalence or resistance.

My impression is that the traditional specialties will accommodate to change and that Division 40 and ABPP are providing leadership for the difficult task of achieving constructive change. At the request of SOS our Task Force prepared a response to the guidelines (MOP) as an example of how they could be applied to a new specialty. This document is available upon request.

The dialogue between Division 40 representatives and the traditional specialty divisions led SOS to develop the concept of generic applied core(s). This core (or cores) is conceived as an applied body of knowledge and sets of skills between the scientific core (e.g., research methodology, statistics and measurement, psychological measurement, history and systems, scientific and professional standards and ethics, and the social, cognitive, affective, biological and individual bases of behavior) and the more circumscribed body of knowledge and sets of skills that characterize a specialty. A specialty emanates from the generic applied core”as it operates across specific populations, techniques/technologies, problems and settings constituting specialization in psychology. The important conclusion arising from these discussions is that knowledge of the generic applied core is necessary for the professional practice of any specialty. The generic applied core has not as yet been defined, but it would appear to include principles and practice of interviewing; cognitive and personality assessment; design and evaluation of interventions; clinical research design and implementation, and standards and ethics.

This brings me to the point of this message. The concept of a generic applied core may facilitate resolution of a key issue in clinical neuropsychology. Many cognitive, physiological, and developmental

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 psychologists have contributed to the development of knowledge in our specialty. Some of these individuals have acquired professional role competencies of a highly specialized nature while functioning as researchers in clinical settings. While their specialized skills are valued, they sometimes lack the generic applied knowledge and skills to function fully independently in a private practice, for example, where a broad range of psychopathological and neuropsychological variables and problems present themselves. The missing component in their professional preparation would appear to be the generic applied core being discussed in the specialization context. Respecialization in a traditional specialty appears to be the only presently available mechanism for acquiring the necessary generic applied knowledge and skills, an unrealistic or unfeasible option for most individuals. It has been argued that clinical neuropsychologists whose educational and experiential base lies in a traditional specialty, such as clinical psychology, have a corresponding deficiency in scientific core knowledge. There is considerablevalidity to this argument if one assumes that each generic component is equally crucial for professional practice. Extensive scientific background is certainly desirable but not at the expense of adequate generic applied preparation since the roles and responsibilities of the professional are heavily anchored in the generic applied core. What seems to be needed is an alternative to respecialization to assist individuals lacking generic applied knowledge and skills to achieve them. It is the responsibility of Division 40 to contribute to the identification of the generic applied core(s), define the specialized knowledge and skills necessary for competency as a neuropsychologist, and define the necessary scientific knowledge core. This should contribute to desired integration of basic and applied interests in the specialty.

As a step toward achieving this integration, I intend to develop in my presidential address at APA an alternative to respecialization as a means of providing the generic applied core for basic scientists. A similar attempt will be made for individuals from the traditional applied specialties to acquire scientific knowledge of cognitive, physiological, and developmental psychology and the clinical neurosciences through continuing education as an alternative to the full respecialization model.

Since I will be representing the Division at the proposed Pre-Conference on Specialization, I would welcome any suggestions or recommedations to better represent you in those proceedings (Box 390 Mayo, University of Minnesota, Minneapolis, MN, 55455, (612) 624-2679).

Elections Slate: Nominees

President elect (1):
Gerald Goldstein
Oscar Parsons
Byron Rourke

Treasurer (1):
Robert Bornstein
Raymond Dean

Member-at-large (1):
Jeffrey Barth
Roberta White

Council representatives (2):
Stanley Berent
Linas Bieliauskas
Gordon Chelune
Manfred Meier

Executive Committee, Division 40, 1985-86
President: Manfred Meier
President-elect: Edith Kaplan
Past president: Lawrence Hartlage
Secretary: Kenneth Adams
Treasurer: Raymond Dean
Members-at-large:
Linas Bieliauskas
Cecil Reynolds
Byron Rourke
Council representative: Thomas Boll
Newsletter editor: Roberta While
Chairpersons, standing committees:
Membership: Gordon Chelune
Fellowships: Ottfried Spreen
Program: Linas Bieliauskas
Chairpersons, ad hoc committees:
Division 40/INS Task Force, and Legislation: Stanley Berent
Ethnic minorities: Alonzo Campbell
Gay concerns: James Quinlan
Computers in neuropsychology: Charles Matthews

Newsletter 40 is the official newsletter of the Division 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

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Newsletter 40
Minutes
Division of Clinical Neuropsychology (40) Executive Committee Meeting
August 23, 1995, Westin
Bonaventure Hotel, Los Angeles

Attending:
Raymond Dean, Lawrence Hartlage, Joseph Matarazzo, Roberta White, Jeffrey Barth, James Quinlan, Edith Kaplan, Linas Bieliauskas, Charles Matthews, Stanley Berent, Manfred Meier, Byron Rourke, Thomas Boll, Kenneth Adams, Gerald Goldstein

Guests: Shaul Saddick, Pat Moylan

Treasurer's Report:
A financial statement is attached. A motion was made that thespecial assessment for Division members remain at $7. The motion was seconded and passed unanimousy by the Executive Committee. Dr. Dean's proposed budget was changed to reflect an allocation of $400 to the Membership Committee and of $200 to the Legislative Affairs Committee. The budget for the Program Committee was changed to $350. With these modifications, Dr. Dean's report was accepted.

Fellowship Committee:
New fellows of the Division are Stan-ley Berent, Francois Boller, Susan Fils-kov, Charles Golden, Robert Heaton, George Prigatano. Old Fellows” elected to Fellowship in the Division are Russell Adams and Doreen Kimura. Dr. Matarazzo offered his resignation from the Chair of the Fellowship Committee, which was regretfully accepted by the Executive Committee. A new Chair will be sought.

Secretary:
Minutes of the mid-year meeting in Washington, D.C. were approved.

Program:
Details of the Los Angeles program were contained in the minutes of the mid-year meeting. Dr. Bieliauskas offered his resignation as Chair of the Program Committee, but agreed to serve one additional year before his resignation is effective.

Membership:
Dr. Barth reported that the Division has a membership of 1800, with an additional 416 applications being processed. Dr. Barth offered his resignation as Chair of the Membership Committee, which was regretfully accepted by the Execu-tive Committee.

Committee on Gay Concerns:
Dr. Quinlan submitted the following report: The APA committee met March 22, 1985. Many issues were raised and discussed. Some of the more relevant items for Division 40 members include the following:

1. The committee will encourage the Monitor to run guideline articles for therapists who have a client who has AIDS.
2. There is a COGC publication entitled Therapist Roster” which provides a listing of therapists who are able and willing to work with clients who are gay or lesbian. New categories of registration were suggested. The roster will be publicized in the Monitor.
3. The World Health Organization has proposed a change in the classifica-tion of homosexuality in the draft 10th revision of the ICD. The planned ICD-10 will follow the DSM-III model and delete the classification of homosexuality as a mental disorder. The revision will use the term ego dystonic homosexuality” that will include only cases in which it is perceived by thesubject himself/herself as a psychological problem and leads to a self-initiated request for treatment.”
4. The APA Insurance Trust extended spouse equivalent” health insurance coverage to now include the life-insurance coverage at $10,000.
5. The use of aversive therapy to change sexual orientation will be considered in a pending APA training module.
With the passage of time and effort, there has been the re-emergence of the recognition that there may in fact be inherent beauty in both genders of the species, which can therefore be legitimately appreciated and enjoyed by all persons, male and female.

Task Force on Computers in Neuropsychology: Draft APA Guidelines for computer based tests and interpretation prepared by the Committee on Professional Standards and the Committee on Psychological Tests and Assessment were distributed. There was extended discussion of the use of computers in neuropsychological assessment and rehabilitation. It was suggested that the Division participate in compiling a compendium of programs available, and there be an invited symposium on the topic of computers in neuropsychology at the next APA meeting. It was indicated that the Division has an interest in both assessment and rehabilitation computerized systems The Task Force was asked to refine its policy statement on the basis of the discussion conducted.

Legislative Affairs:
Dr. Berent briefed the Executive Committee on recent legislative issues, stressing the impact of budget curtailments and the need to look at the role of neuropsychologists in HMO's

Council of Representatives:
Dr. Boll briefly updated the Executive Committee on recent Council activities. Issues discussed were the model licensing bill, advances in the accreditation process and a movement developing in APA to seek either a ban on boxing or mandating training of referees in neurobehavioral examinations at ringside.

Elections:
Edith Kaplan is the president-elect. Kenneth Adams is the secretary and Cecil Reynolds is the new member-at-large of the Executive Committee. The Executive Committee agreed to aid in the support of President-Elect Kaplan's attendance at an APA sponsored meeting for new Division officers to be held in Alexandria, Virginia in May of 1986.

Division/INS Task Force:
Dr. Meier indicated that the Task Force met at the APA meeting in Los Angeles to discuss pre-doctoral training in neuropsychology. A document will be forthcoming.

Statement of Appreciation: The Executive Committee wishes to express their appreciation for the splendid work done by Drs. Bieliauskas, Barth and Matarazzo as chairs of their respective committees.

Adjournment:
The meeting was adjourned at 7:50 p.m. The mid-winter meeting will probably be held in March.
Gerald Goldstein, Ph.D.
Secretary, Division 40

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 APA Division 40 1985-1986 Budget

                                         &nb sp;                                    1984-l985              1984-l 985                1985-l 986
                                           ;                                     Budget                Expenses                 Budget

Secretary's Office                                                     1 ,000.00               47.65                        1 ,000.00
Committees
Program                                        &nbs p;                             100.00                                         &nb sp;           100.00
Fellowship                                        & nbsp;                          150.00                                         &nb sp;           150.00
Membership                                        & nbsp;                       600.00                                         &nb sp;           200.00
Newsletter                                        & nbsp;                      1,800.00           2,298.60                          2,100.00
Legislative                                                                      100.00
Representative to APA Council                                 1 ,000.00                                                1 ,000.00
Miscellaneous Proiects/Donations                              1,500.00                                         & nbsp;      1,500.00
Reserve                                        &nbs p;                           2,000.00                                         & nbsp;      2,000.00

Committee Reports
Division 40/INS Task Force
Dr. Stanley Berent has been named Division 40's co-chairman of the task force, which met at the International Neuropsychology Society (INS) convention February in Denver. Majortopic at the meeting was finalization of the guidelines for doctoral training programs which have been prepared by the task force. These guidelines were approved by the Division 40 Executive Committee March 14. They will be presented to the INS executive board at its June meeting in Holland.

Legislation Committee
A Few Thoughts on New York Skyscrapers and HMO's
If there are two things that characterize the time in which we are living, it is change and the rapidity with which change is taking place. The last few years alone, for instance, have witnessed total turnover in dozens of governments -- Iran, Haiti, Argentina, to name but three. War has broken out which involved each of the top three superpowers. DuValier has fled Haiti. Before you read this, Marcos will most likely have left the Philippines. Even now, it reported that he is in the process of selling a couple of Manhattan skyscrapers for $250,000,000.00. I guess he needs the money for a trip.
In business, big companies like AT&T are being broken into smaller ones. Companies I never heard of (Texas Air?) are taking over corporations that I believed to be the biggies (Eastern”). In short, we seem to be living in the midst of tremendous social, political, and economic change. It is no wonder that the way in which we finance our health care is also shifting. By the year 1990, it has been said that 40% of all medical services will be delivered by way of HMO's,
There is so much change, that it is diffcult to say from one moment to the next what will develop and in what direction development will move. In the fast food business, what's in” is changing so rapidly that there is a new reason for the name. Cookies are out” and fancy ice cream is in.” Fortunes are being made by people whose only role is to either direct these changes or (of much greater value) predict the direction of change. I recently met a man (a wealthy one, by the way) whose sole job is to predict the changes that are going to take place in the international oil market. Closer to home, it is reported that in the health care field over 25% of costs are now accounted for by administrative activities.
The majority of us can be only aware in part of the major developments that areoccurring even though these changes will potentially have a major impact on our professional lives. We can, and should, strive to stay informed. If possible, we need to develop the methods (similar to my oil price friend) that will allow for prediction of the direction of change. Since a part of this evolving scenario will be sharpened competition between professions who wish to reach the same markets, we must also remain vigilent of changes in laws and other actions that would unduly restrict our ability to deliver needed services to patients and to take appropriate action when the need arises.
Feelings of frustration should be tempered with the realization that the future may be only partially predictable. It is just as likely that neuropsychology is on the ascending edge of change as on the descending. While maintaining the methods, and the values, that have provided our clientele with needed services and us with professional and personal success, we will need to meet this change with creative responses. If you are fortunate enough to own a skyscraper in New York, keep it! You may need the office space. Stanley Berent, Ph.D.
Chairperson, APA
Division 40 Legislative Committee

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 Membership Committee
The Membership Committee of Division 40 is seeking to compile a list of any formal or informal regional, state or local neuropsychology interest groups. If you belong to such an organization or group and would be willing to serve as a contact person, please send the name of your group, your mailing address, and phone number to: Gordon J. Chelune, Ph.D., Division 40 Membership Chair, Department of Psychiatry, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, 0hio44106.

Division 40 Program Convention Abstracts to be Published
Abstracts of papers presented in the Division of Clinical Neuropsychology program at the annual APA convention can be published beginning in 1987 in The Clinical Neuropsychologist. The journal, which will begin publication in January, 1987, has agreed to reproduce abstracts for all authors who desire this service. Authors of papers submitted to the Division 40 Program Committee will be asked at the time of submission to indicate whether they want their abstracts published. Editors of the journal, which will be published by Swets, are Kenneth Adams and Byron Rourke.

Report from the Council of Representatives
Since the last newsletter the Council of Representatives has met on two occasions. It met in Los Angeles before and during the American Psycho-logical Association meeting and again in Washington, D.C. at the end of January for its annual mid-winter three-day meeting. The agendas for each meeting were, as always, jam-packed. However, the issues of substantial significance for neuropsychologists were substantially more limited.
In August a resolution was passed recommending that all boxers be required to have neuropsychological examinations on a periodic (every year or two years) basis, to enchance their capacity to give informed consent when making decisions with regard to pursuit and continuation of their career in this sport. Second, it was resolved that all efforts would be taken to promote the use of either neuropsychologists or, more adequately, neuropsychologically trained ring-side personnel to do immediate post-injury screening. It is clear that, at this stage of the game, boxers receive only the most cursory kind of examination following a knock-out or other form of head injury, which is inadequate to determine their capacity to continue. The ultimate desirability of banning boxing, at least from a neuropsychological point of view, was not contested. However, the reality of the difficulty involved in this moved the Council to attempt to put its weight behind an action that would be maximally helpful to the boxers and, at the same time, maximally likely to produce positive results. This action item has been forwarded to the American Association of State Psychology Boards, which has major impact on licensing and other legislative actions. This matter should be brought before every state association, sports organization, and other units that might have impact on boxing, including medical associations. This is something in which every neuropsychologist can participate. It is also something that, without concerted effort, will languish in the minutes of a legislative notebook. It is up to each neuropsychologist to do something or share responsibility for what is not done.
The issue of reorganization of APA continues. The initial proposal to divide APA into four assemblies, each with its own relatively independent president and legislative organization, continues to be discussed. These assemblies would be the Research/ Academic Assembly, the Applied Research and Industrial Organizational Assembly, the Clinical/ Health Care Providers Assembly, and the Assembly for psychologists who are interested in issues related to public interest. Much oppposition to this has developed, simply because there seems to be a relatively clear single issue, around which divisions are forming, and that is the division between the professional/ practice oriented groups and the research/ scientific oriented groups. The attempt to keep APA together as a general organization and still address efficiently, as well as competently, the specific issues of those two groups is the driving force behind the reorganizational effort. Issues of efficiency and streamlining are present, but clearly secondary to the over-arching concern of develop-ing differences in the general life view of the two constituencies.
A task force has been charged by the Education and Training Board, and approved by the Council of Representatives, to expand the scope and criteria for accreditation. This could be done by specific title in order to add other specialties, such as neuropsychology, to those eligible to apply for accreditation. This, of course, would necessitate the development of accreditation standards, and so, is not something that is going to happen immediately. Another alternative is to have a generic professional accreditation, which could take under its umbrella all applied activities and then allow for a second level of specialty accreditation by some outside group, such as the National Register or ABPP, that

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 would go beyond that and be purely optional. In addition, active discussion is being held about the value of accreditation procedures for post doctoral activities in applied areas and, so far, this has received approval from most of the governance structure and encouragement from the Education and Training Board, as well.
A national conference on graduate education in psychology continues in the planning stages. An issues paper has been distributed and those interested can seek a copy of it through the American Psychological Association. The conference is tentatively planned for June of 1987 and a number of divisions and boards are either having pre-conference meetings or planning to send position papers, to aid in the eventual deliberations. Also, nominations are being sought for individuals involved in education at the graduate level, to form the list of eventual participants in this conference.
A statement of a model licensing bill was passed, in principle, by the Council of Representatives, that included a definition of practice. Individuals interested in contributing to this should seek from APA a copy of the bill. Division 40 has already discussed the bill and suggested modifications that would make it more appropriate to the practice of clinical neuropsychology.
An Office of Professional Advocacy was formed and funded, with a special assessment to applied members of APA, to provide a more focused arm for dealing with professionally-based activities that now seem to take up much of the time of the entire association.
An Office of Scientific Advisor to the Executive Officer was also formed and funded, to provide sub-stantial and focused input on issues of scientific concern to the entire association. This puts the association in a position to respond in a competent and prompt fashion to issues of scientific concern.
Finally, the American Psychological Association will be meeting in Washington, D.C., beginning August 21, 1986. The Council of Representatives will meet on August 21 and on August 24. These meetings are open to all members. Division 40 received sufficient vote allocations to obtain a second Council representative, and elections for both of those representatives will be held this spring. This is a substantial improvement in Division 40's position, and should allow for increased effec-tiveness in its representation on th e floo r of Council.
Thomas Boll, Ph.D.
Council Representative
Division 40

Internships Division 40 is currently compiling a list of internships which offer training in clinical neuropsychology which state that they are in compliance with the Report on the Subcommitte eon Psychology Internships of the joint Division 40/INS Task Force. The subcommittee report was published in Newsletter 40, Volume II, No. 1, April, 1984.
If you feel that your program is generally in compliance with these guidelines and you would like it to be listed, please provide the following information:
1. Name and address of person and institution
2. Phone number for contact
3. APA accreditation status
Send this information to the coordinator of training listings in clinical neuropsychology:
Lloyd Cripe, Ph.D.
Clinical Neuropsychology Fellowship
Madigan Army Medical Center
Tacoma, Washington 98431

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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___
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:
Gordon Chelune, Ph.D.
Clinical Neuropsychology
Department of Psychology, Cleveland Clinic
9500 Euclid Ave.
Cleveland, Ohio  44106
Phone:  216/444-5984

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 Newsletter 40
Boston University Medical Center
720 Harrison Ave.
Boston, MA 02118

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