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The need for more deliberate formulation of educational guidelines for
clinical neuropsychology becomes overwhelmingly evident from an analysis
of this developmental sequence over time. By the mid- 1960s, the International
Neuropsychological Society (INS) was being formed partially because there
was no ready place for neuropsychology within the American Psychological
Association (APA) at that time. Although primarily comprised of psychologists,
INS became both an interdisciplinary and an international organization
and, therefore, regarded the sharing of new scientific knowledge as its
primary purpose. Nevertheless, as the need to address professional issues
became more apparent in the 1970s, the INS decided to form a Task Force
on Education, Accreditation, and Credentialing (TFEAC) to begin to explore
directions for each of those areas. Also in the 1970s, the National of
Neuropsychology (NAN) was formed and a steering committee emanating from
the TFEAC began advocating for a new Division of Clinical Neuropsychology
within APA.
Division 40 (Clinical Neuropsychology) was established in 1980
and soon began sharing responsibility for the TFEAC with the INS. This
responsibility was transferred gradually to Division 40. The TFEAC then
became the responsibility of Division 40 which soon published preliminary
guidelines for pre-doctoral, internship, postdoctoral programs, and continuing
education programs (Costa, 1997; Meier, 1981, Reports of the INS-Division
40 Task Force on Education, Accreditation, and Credentialing, 1987).
During the early 1980s, the TFEAC moved from education to credentialing
as the next focus of its effort. Since Division 40 was part of a professional
association (i.e., APA), it was deemed inappropriate to develop a credentialing,
mechanism within APA. Therefore, a steering committee was formed outside
of Division 40 and INS to explore this purpose. The American Board of Clinical
Neuropsychology (ABCN) was established in 1981 and proceeded to design
eligibility criteria and a set of examining procedures, following the assessment
center approach. Earlier, in the late 1970s, the American Board of Professional
Psychology (ABPP) had considered developing an examination for competence
in clinical neuropsychology. However, that development did not materialize
until 1983 when ABPP invited officers of ABCN to present the case for clinical
neuropsychology as a specialty and ABCN was ready to participate in an
organizational relationship with ABPP in order to develop a definitive
competency-based examination. This relationship became operational in 1983.
Almost three hundred diplomas have now been granted under the joint sponsorship
of ABPP and ABCN. Other emerging specialties quickly followed ABCN in establishing
a relationship with ABPP. These included Forensic Psychology, Family Psychology,
Health Psychology, and Behavioral Psychology. Furthermore, at the urging
of ABCN, ABPP changed its organizational structure from a regional board
to a federated board model, thereby assigning exclusive responsibility
for examinations to the constituent boards. Thus, ABCN was instrumental
in fostering organizational change within ABPP and in encouraging the other
specialties to develop increasingly standardized and competence-focused
examining procedures. In turn, this was expected to lead to higher levels
of reliability and validity in competency determination under the ABPP
aegis.
As the credentialing, activities of the 1980s were more recognized,
new postdoctoral programs emerged in the United States and Canada, particularly
in the Midwest, where the neuropsychology laboratories in most of the major
medical schools were directed by ABPP/ABCN Diplomates. The Midwest Neuropsychology
Consortium was formally established about 1990 and developed self-study
guidelines for programs and formats for describing, programs, each program
s primary mission, populations being served, the settings to which access
was available, and the types of roles and responsibilities offered to prospective
neuropsychology residents. About that time, the ABPP Board of Trustees
was beginning to articulate the need for more deliberate communication
between residency program activities and external credentialing procedures,
such as those available through the ABCN/ABPP structure. Interestingly,
the TFEAC had never addressed accreditation issues and probably could not
have done so effectively until developments in the field had reached a
level that would be acceptable to APA, the primary accreditation body for
the profession of psychology. The Midwest Neuropsychology Consortium was
very eager to begin conducting accreditation reviews of each other s programs
but refrained from doing so until the discipline of psychology as a whole
was ready to expand the scope of accreditation to include residency education
and training and new specialty programs. Such expansion implies both recognition
of a given new specialty and the presence of active training activity,
in this case at a postdoctoral level.
ABPP sponsored a special Conference on Postdoctoral Education
and Training on September 19-21, 1991 (Minneapolis Conference) that gave
the Midwest Neuropsychology Consortium the opportunity to describe the
various accreditation procedures that they had devised. Various organizations
were invited to the Minneapolis Conference including representatives of
the APA Board of Education Accreditation Committee (CoA), the National
Register for Health Services Providers in Professional Psychology, the
State and Provincial Licensing Boards in the United States and Canada,
the various specialties already recognized by ABPR the National Association
of Professional Schools in Psychology, and the Association of Postdoctoral
Program and Internship Centers.
A multiorganizational commitment to postdoctoral accreditation
grew out of that conference and led immediately to the formation of an
Interorganizational Council for Postdoctoral Education in Professional
Psychology (IOC). At the program level, the addition of residency programs
in Clinical Neuropsychology throughout the United States and Canada to
the core group in the Midwest lead to the formation of the Association
for Postdoctoral Programs in Clinical Neuropsychology (APPCN). Thus, an
initiative from a group of neuropsychologists affected change in psychology
as a whole by prompting the establishment of the IOC and a more deliberate
emphasis on the part of the profession on accreditation of postdoctoral
education and training. For clinical neuropsychology, additional initiatives
quickly arose as evidenced by the formation of the Association of Internship
Training in Clinical Neuropsychology (AITCN) and the Association for Doctoral
Education in Clinical Neuropsychology (ADECN). These various interests
are now being integrated through the Clinical Neuropsychology Synarchy
(CNS) in what is expected to become a systematic effort on the part of
the specialty to deal with all issues that are germane to its future growth
and effectiveness.
Another key development in the 1990s was the establishment by
APA of the Commission for the Recognition of Specialties and Proficiencies
in Professional Psychology (CRSPPP). Proceeding from the work of the Subcommittee
on Specialization (SoS) of the APA Board of Professional Affairs (Sales,
Bricklin, and Hall, 1984) and the APA Task Force on Scope and Criteria
of Accreditation within the Board of Education, CRSPPP developed procedures
for recognizing new specialties to be recommended for approval by the APA
Council of Representatives. Division 40 established a planning committee
which generated a mission statement and then addressed the CRSPPP guidelines
for pursuing recognition as a new specialty. This was achieved with subsequent
approval by the Council of Representatives. Accordingly, clinical neuropsychology
was recognized as the first new specialty in over 30 years and the only
specialty to have justified its claim to be a specialty in accord with
the accepted procedures implemented by the CRSPPP as the determining mechanism
for documenting claims to specialty status. With the establishment of CRSPPP
and the recognition of clinical neuropsychology as a specialty, the APA
CoA has assumed now responsibility for the accreditation of postdoctoral
(residency) programs.
It can be seen that clinical neuropsychology has followed a very
remarkable developmental course in education, accreditation, and credentialing.
Coincidentally, clinical neuropsychology has demonstrated how a new specialty
evolves realistically as a function of its knowledge and practice base.
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