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Discussion moved to the required knowledge base for the specialty of
clinical neuropsychology. The questions of what specific training and which
domains of knowledge need to be included were discussed. The possibility
of creating a comprehensive list of the required knowledge base for the
specialist in clinical neuropsychology was considered. Group members suggested
the addition of training requirements in neuroanatomy, neuroradiology,
and psychiatry.
The group agreed to use the Reports of the INS-Division 40 Task Force
on Education, Accreditation, and Credentialing (1987) as a starting point
for determining the required knowledge base for training, in clinical neuropsychology.
Specifically, the content areas listed as Generic Psychology Core, Generic
Clinical Core, Neurosciences and Basic Human and Animal Neuropsychology,
and Specific Clinical Neuropsychological Training were agreed upon as providing
a good outline for delineating the required knowledge base in clinical
neuropsychology. The group agreed upon the necessity of including training
in cultural and individual differences and diversity in generic psychology
training. The group also was concerned that ethics and the application
of ethical principles be included in the required knowledge base. The group
decided to change the title of the content category "Neurosciences and
Basic Human and Animal Neuropsychology" to "Basic and Clinical Neurosciences."
The group also modified the content in the Basic and Clinical Neurosciences
and Specialized Clinical Neuropsychological Training categories as listed
below.
C. Basic and Clinical Neurosciences
1. Neuroanatomy and neurophysiology
2. Advanced physiological psychology and psychopharmacology
3. Clinical and behavioral neurology, neuropathology, specialized neurodiagnostic
techniques, and neuropsychiatry
4. Medical conditions affecting CNS functioning
D. Specialized Clinical Neuropsychological Training
1. Specialized neuropsychological Assessment techniques
2. Specialized neuropsychological intervention techniques
3. Cognitive neurosciences
4. Research design and research practice in neuropsychology
Then the skills required for clinical neuropsychologist were
discussed. The group focused on specifying the required skills for
the following five activities of clinical neuropsychology
Lists: assessment, intervention, consultation, research, and teaching
and supervision.
For the role of assessment, the group agreed that the clinical neuropsychologist
should have skills in information gathering, history taking, selection
of tests and measures, administration of tests and measures, interpretation,
treatment planning, report writing, and providing feedback. For the role
of intervention, necessary skills identified by the group were counseling,
psychotherapy, behavioral therapy, and rehabilitation. For the role of
consultation, the group stated that clinical neuropsychologists should
have the necessary skills enabling them to consult with individuals, families,
other professionals, agencies, treatment settings, and the courts. For
the role of research, necessary skills identified by the group were the
design, execution, communication, and evaluation of research, and grant
preparation. For the role of teaching and supervision, necessary skills
agreed upon were the use of effective teaching strategies, course and curriculum
design, course planning, the use of educational technologies, and the supervision
of assessment, intervention, and research.
SUMMARY OF BREAKOUT GROUP THREE
Question II
Eileen B. Fennell and Jennifer Cass
Members: Eileen B. Fennell (Chair), Jennifer Cass (Recorder), Bruce
Becker, Joan Borod, Lloyd 1. Cripe, Marc W. Haut, James F. Malec, and,
Michael Seidenberg
The discussion began with a consensus that generic psychology and generic
clinical areas of knowledge and skills first need to be defined and only
then should more specific clinical neuropsychology domains of knowledge
and skills be addressed. Considerable discussion centered around the guidelines
for training in clinical neuropsychology given in the Reports of the INS-Division
40 Task Force on Education, Accreditation, and Credentialing (1987). It
was agreed that these guidelines needed to be addressed and expanded to
reflect both current training programs at the doctoral, internship, and
postdoctoral level, as well as future needs of the specialty. The recognition
of training specificity at the doctoral level was discussed as were the
future roles of internship and postdoctoral training given the level of
doctoral training now available in many universities. Following an examination
of the current APA Guidelines for Accreditation of Doctoral Programs in
Clinical Psychology (American Psychological Association, 1996a) and a brief
discussion of future accreditation of postdoctoral programs, the group
developed specific coursework requirements which were very similar to those
given in the Reports of the INS-Division 40 Task Force on Education, Accreditation,
and Credentialing (1987). The Generic Psychology Core and Generic Clinical
Core were left the same. The "Neurosciences and Basic Human and Animal
Neuropsychology" area was divided into the areas "Anatomical and Physiological
Foundations of Human Behavior" and "Foundations of Human Neuropsychology,
Basic Neurosciences" and "Advanced Physiological Psychology and Pharmacology"
were subsumed under the first of these headings while "Neuropsychology
of perceptual, cognitive, executive, and emotional processes" and "Research
design and research practice in neuropsychology" were subsumed under the
second. The title of the area "Specific Clinical Neuropsychology Training"
was changed to "Clinical Neuropsychology and Neuropsychological consultation"
and "Ethical and professional neuropsychology" were added to this area
while internship was removed. The group felt that neuropsychological theory
and research were missing from the guidelines for didactic areas. Such
topics did not need to be addressed necessarily in an entire course, but
they should be covered in certain courses. The specific coursework in each
of these defined areas was presented at the plenary session.
Much of the subsequent discussion focused on how broad or narrow the
necessary skills in clinical neuropsychology should be. The group considered
whether listing necessary skills in the areas of evaluation, intervention,
consultation, and research was sufficient or if a more detailed approach
outlining skills in these broad areas should be taken. Several members
of the group felt that specific skills are already given in other documents
and did not need to be addressed here. In addition, several group members
felt that survival issues, such as billing, reimbursement, and managed
care, should be introduced at the postdoctoral level while others felt
that these issues should be learned once the individual was in practice.
Finally, requisite skills in clinical neuropsychology were identified by
the group. These included: (a) independent examination and evaluation of
patients with actual or suspected neurological disorders, psychiatric disorders,
and medical or pediatric disorders with neurobehavioral effects, (b) independent
and competent 34
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