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proposal
3. Eligibility for licensing in the state or province in which the
residency program is located
4. Eligibility for external certification in clinical neuropsychology
by the American Board of Professional Psychology
5. Competency in areas designated in the Reports of the INS-Division
40 Task Force (1987)
6. Passing of a formal evaluation that might include written and oral
examination.
SUMMARY OF BREAKOUT GROUP TWO
Question III A and B
Doctoral Emphasis
Byron P. Rourke and Brian D. Hoyt
Members: Byron P. Rourke ((hair), Brian D. Hoyt (Recorder), Russell
L. Adams, William B. Barr, Christina S. Wilson, Andrew J. Saykin, and John
L. Woodard.
The first breakout session began with the group examining the guidelines
for an established training program in clinical neuropsychology, which
is a specialty track embedded within an APA and CPA accredited clinical
psychology training program. Specific requirements for the track include
the completion of the basic psychology core, the clinical psychology core
(including a two-course sequence in some kind of therapy), the specialty
requirements (neuropsychology core), a master s thesis, dissertation, 500-hour
practice, and internship. In addition, students must take comprehensive
examinations and present both a minor and major paper. Their specialty
training abides by the guidelines of the Reports of the INS-Division 40
Task Force on Education, Accreditation, and Credentialing (1987) for training
in clinical neuropsychology. The specific program considered was designed
to be completed in 5 years, but is usually completed in 6 or 6 1/2 years.
Discussion moved to consideration of the faculty requirements for a
training program in clinical neuropsychology. In training programs that
are embedded within a clinical psychology program, the basic psychology
courses are taught by the departmental faculty and the clinical psychology
courses are taught by the clinical psychology faculty. Such programs typically
have a few neuropsychology faculty members, perhaps three, to teach the
core neuropsychology courses and adjunct faculty to teach specialty courses
in neuropsychology. Concerns were raised about the resources required in
order to have such a training program. Group members pointed out that some
universities will not have the resources necessary for such a training
program to be offered, such as access to adult faculty members and affiliation
with local medical schools.
The group next considered the issue of free-standing training programs
in clinical neuropsychology and the possibility that they may not be able
to meet the proposed guidelines. It was pointed out that the existence
of such free-standing training programs may become an impossibility due
to the need to have persons from other specialty areas teach some of the
generic psychology, clinical psychology, and specialty neuropsychology
requirements.
The implementation of the training guidelines at the doctoral level
was considered next. It was agreed that the Generic Psychology Core and
the Clinical Psychology Core requirements could be completed in doctoral
training programs. Discussion moved to the ability of doctoral training
programs to provide all of the educational requirements for the Basic and
Clinical Neurosciences. It was pointed out that not all programs will have
the resources necessary to fulfill these requirements. This point led to
a discussion of how complete training should be at the doctoral level for
each specific area listed in the training guidelines. The group agreed
that learning is a lifelong process and that students cannot become 100%
proficient in all knowledge and skill areas at the doctoral level. The
point was made that although it may not be possible to have specific courses
in all of the areas listed in the training guidelines, it should be possible
to expose students to them. The amount of time devoted to each training-area,
having specific courses versus general exposure, and the implementation
of the courses or exposure can be left at the discretion of the individual
training program. It was pointed out that the recommended guidelines have
to allow individual programs the freedom to establish their own identities.
The question then was raised as to what level of training at the doctoral
level is considered sufficient for each of the knowledge and skill areas.
The point was made that the guidelines being considered should not specify
how much training in each area is enough, but that all of the knowledge
and skill areas should be introduced, touched upon. and built upon. The
notion of required degrees of proficiency in each training area to be obtained
at each level of training (doctoral, internship, and residency) was briefly
discussed.
Group members next raised concerns about how the guidelines under consideration
would apply to students from clinical psychology programs who then wish
to obtain specialty training in neuropsychology. It was pointed out that
this set of guidelines should focus on the "ideal" doctoral training program
for the specialist in clinical neuropsychology, but that other pathways
are possible, although they may be labeled as being "less desirable."
In summary, two principles applying g to doctoral education in clinical
neuropsychology were advanced by the group. The first principle was that
the specialist in clinical neuropsychology is a scientist-practitioner,
and that knowledge and skill experiences should be intertwined throughout
the educational process. The second principle was that learning is a lifelong
process; thus, some training areas may be refined at the doctoral level,
but other training areas can only be touched upon at this level and will
have to be refined and built upon at later levels, that is, during internship
and residency. Regarding the specific knowledge and skills necessary for
the specialist in clinical neuropsychology, it was agreed that the Generic
Psychology and Clinical Psychology Core knowledge bases could be refined
at the doctoral level. Some areas within the Basic and Clinical Neurosciences
(i.e., functional microanatomy, neuropsychology of behavior) would need
to be refined at the doctorate level, while some other areas should be
introduced at this level and refined in later levels of training. The content
areas within Specific Clinical Neuropsychological Training should be introduced
and refined at an intermediate level in doctoral training programs. It
was agreed that most of the refinement of the skills required of a clinical
neuropsychologist should take place at the internship and residency levels.
Discussion then turned to a consideration of alternative pathways to
training in clinical neuropsychology, specifically those applying to students
not coming out of established neuropsychology training programs. Group
members expressed concerns for students coming from other types of training
programs or from training programs that offer only some generic neuropsychological
training. Three possible pathways to training in neuropsychology were addressed:
the ideal, as delineated by the proposed integrated model; a pathway involving
clinical psychology students who wish to seek training in neuropsychology;
and a pathway for students from other disciplines who wish to seek training
in neuropsychology. With respect to the latter two training pathways, it
was agreed that students in clinical psychology training programs should
have completed the generic psychology and clinical psychology core requirements
and that students from other disciplines may have completed various aspects
of the training requirements. It was stated that one can view the training
requirements listed in the integrated model as the exit criteria for doctoral
education. It would be possible to meet these exit criteria in more than
one way, as long as the training that the student receives can be documented.
The point was also made that these exit criteria
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