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neuropsychology might be required. Certainly, some clinical neuropsychologists
have research as a major defining activity. Group members pointed out that
with the advent of managed care, neuropsychologists will need to provide
better documentation of outcome effectiveness. Developing appropriate outcome
research skills will be important. As to whether one needs specific training
in neuropsychology to perform such research, however, was unclear to many
group members. The group did reach consensus that clinical neuropsychologists
should be able to plan, conduct, and evaluate research, but that it may
not be a role unique to this profession.
Other issues were raised throughout the discussion and group members
were in agreement on these. They recognized that some clinical neuropsychologists
apply these professional roles in rehabilitation settings. They felt that
clinical neuropsychologists in all of their professional roles need to
be sensitive to linguistic and cultural diversity issues. In addition,
an appreciation for lifespan/developmental issues was seen as a requirement.
In general, a clinical neuropsychologist needs to be cognizant of his/her
competency in working with certain populations and the limitations of techniques
with certain populations.
SUMMARY OF BREAKOUT GROUP FIVE
Question I
Thomas J. Boll and Randi Dorman
Members: Thomas J. Boll (Chair), Randi Dorman (Recorder); Jack Spector,
Paula Shear, Darlene Nemeth, Robin Morris, Carl Dodrill, Kenneth Adams
The chair opened the discussion by proposing that the group consider
the definition of a clinical neuropsychologist put forth in the Division
40 Petition (Meier et al., 1995) to the Commission for the Recognition
of Specialties and Proficiencies in Professional Psychology (CRSPPP). There
was general agreement that the definition adequately represented the role
of the clinical neuropsychologist. The group did question whether or not
it would be necessary/possible to clarify further activities practiced
exclusively by clinical neuropsychologists, shared across health professions
(e.g., rehabilitation), and those typically considered within the domain
of other medical fields. Discussion ensued regarding the feasibility of
anticipating all of the possible roles in which a clinical neuropsychologist
may serve. It was unanimously agreed that clinical neuropsychology as a
profession should not define, and consequently limit, where clinical neuropsychologists
can serve. Instead, the field should strive to generally describe the roles,
and not discuss the locations, where these roles can be served, At this
time, the group s attention was directed to pages 7-15 of the Division
40 Petition (Meier et al., 1995). There was general agreement that this
description of roles should serve as a standard and that further clarification
of this document should be made when discussing knowledge base and skills
needed in Question 11.
A second major topic discussed by the group was the training necessary
for a professional to call him/herself a clinical neuropsychologist. Training
designed for a doctoral track in clinical neuropsychology, an internship,
a postdoctoral fellowship, and continuing education in clinical neuropsychology
were considered. The group first focused on who should be responsible for
training at the aforementioned levels. More specifically, the group asked
whether there were certain training capacities in which only a clinical
neuropsychologist should serve. An initial distinction was made between
the necessary credentials for running a neuropsychology program versus
teaching neuropsychology courses. Most group members felt that it was not
necessary for a clinical neuropsychologist to serve as chair of the psychology
department, but imperative that a clinical neuropsychologist direct the
clinical neuropsychology program. Some members felt that this should depend
on whether the program director is restricted to administrative duties
or influences the program curriculum. There was agreement that supervision
and teaching specific to clinical neuropsychology should be provided by
a clinical neuropsychologist. This does not imply however, that a clinical
neuropsychologist should necessarily teach other related courses (e.g.,
neuroanatomy, psychopathology, etc.) that are required for the completion
of a degree in clinical neuropsychology.
A concern was raised regarding the acceptance of individuals without
a doctorate serving in clinical neuropsychology roles. Specifically, some
States have grandfathered individuals with a master s degree into clinical
neuropsychology roles. Can individuals without a doctorate call themselves
clinical neuropsychologists? The consequences of whether or not nondoctoral
trained practitioners may bill under clinical neuropsychology CPT codes
was also addressed. Some members of the group proposed that the use of
the CPT codes specifically labeled for neuropsychology testing be limited
to clinical neuropsychologists. Others cautioned that limiting who can
use those codes, may in turn limit the ability of clinical neuropsychologists
to bill within other disciplines. The MMPI for example, can not he billed
as clinical neuropsychology testing. Some felt that this concern was unjustified
because every discipline has a code that is specifically within their domain.
The consensus was that neuropsychological testing belongs to the field
of clinical neuropsychology and should be protected.
SUMMARY OF BREAKOUT GROUP SIX
Question I
Melissa A. Friedman and Wilfred van Gorp
Members: Wilfred van Gorp (Chair), Melissa A. Friedman (Recorder), Ida
Sue Baron. C. Munro Cullum,. Anne L. Hess, Neil H. Pliskin, Robert
J. Sbordone, Barbara C. Wilson
Group members agreed that before the roles of a neuropsychologist could
be discussed, the term clinical neuropsychologist needed to be defined.
Thus the session began by the group discussing the definition of a
clinical neuropsychologist and what key elements should be included in
this definition.
After considerable discussion, the group decided to adopt the definition
of a clinical neuropsychologist given in the Report of the Division 40
Task Force (Crosson et al., 1995) with no changes.
The group next considered which aspects of our professional roles are
most relevant. It was decided that roles for the clinical neuropsychologist
could be subsumed under three broad areas: Assessment/Intervention, Education/Training,
and Research. It was noted that referrals for neuropsychological assessments
typically come from either physician or psychologist colleagues (though
individuals could also be self-referred) and that the neuropsychologist
most often would be asked to address issues regarding cognitive functioning,
including competence of the individual. Group members concluded that assessments
are typically completed for one of two purposes: (1) to evaluate an individual
s cognitive functioning related to an illness or injury or aberrent neurocognitive
development; and/or (2) to recommend or conduct intervention approaches
for a neurobehavioral condition. Intervention services might include rehabilitation
of the individual following brain injury or psychotherapeutic/counseling
services to an individual or his/her family. Group members emphasized the
importance of neuropsychologists being educated and trained to work with
individuals
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