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SUMMARY OF BREAKOUT GROUP THREE
Question III A and B
Emphasis on Doctoral Training
Eileen B. Fennell and Jennifer Cass
Members: Eileen B. Fennell (Chair), Jennifer Cass (Recorder), Bruce Becker, Joan Borod Lloyd I. Cripe, Marc W. Haut, James F. Malec, and. Michael Seidenberg.
The group unanimously agreed that education and training in the specialty of clinical neuropsychology cannot be accomplished at a single level. Much of the initial discussion of the group focused on whether there should be a single pathway or multiple pathways of specialty training. Several group members felt that there should be at least two different pathways into the specialized field of clinical neuropsychology and that students with certain training would apply for internships consistent with their needs and training. Issues of entry levels of training, later-developed interest in neuropsychology and respecialization were raised. Final agreement by the group was of a dual pathway model: (1) training via a neuropsychology specialty track within a doctoral level program and, (2) some doctoral level course work in neuropsychology. Individuals who have completed a specialty track in clinical neuropsychology at the doctoral level would meet the requirements for specialty designation upon completion of a one year postdoctoral program in clinical neuropsychology. Individuals who had some course work at the doctoral level would meet specialty designation requirements upon completion of a two year postdoctoral training program in clinical neuropsychology. Hospital-based clinical experiences were deemed to be a critical part of specialty training in clinical neuropsychology and should be part of training at the internship and postdoctoral level. Postgraduate workshops in clinical neuropsychology were not considered to be sufficient for future specialty designation. Specific entry and exit criteria were then discussed for doctoral, internship and postdoctoral trainees. The group agreed that entry and exit criteria for the doctoral level of training should be set by the graduate program to which the individual seeks admission. However, the group recognized that programs were obligated to conform to specific institutional and national accreditation guidelines. Current APA procedures for accreditation of generic postdoctoral training programs were briefly discussed (American Psychological Association, 1996a) and the group expressed concerns about the criteria whereby accreditation of training programs at all levels would be accomplished. Finally, the issues of licensing and the impact of current licensing laws on postdoctoral training were briefly addressed.
SUMMARY OF BREAKOUT GROUP FOUR
Question III A and B
Internship Emphasis
Ann C. Marcotte and Rosario Castillo
Members: Ann C. Marcotte (Chair), Rosario Castillo (Recorder), Lydia
Artiola i Fortuny, Richard C. Delaney, John DeLuca, David C. Garron, Thomas
Novack, and J. Michael Williams.
The group quickly reached consensus that training in clinical
neuropsychology is complex, and cannot be accomplished at any single level
of training. This is in part due to the common clinical knowledge and skills
that the field shares with clinical psychology, as well as the need for
didactic work, clinical practica, and research education and training specifically
relevant for becoming a clinical neuropsychologist. The group recognized
that there are respecialization programs in clinical psychology and neuropsychology;
such programs, however, at least require a clinical internship year, and,
in neuropsychology, may also require a postdoctoral residency. The group
viewed the education and training in clinical neuropsychology as a continuous
but flexible process progressing from graduate school to internship to
residency, with each level of training providing more advanced knowledge
and skills.
Discussion focusing on internship requirements began with a general
acknowledgment that the background and training in clinical neuropsychology
that current interns bring to the clinical internship year has dramatically
changed over the course of the 10 years. This is in large part due to the
emergence of graduate level training programs offering more specialized
training and education in clinical neuropsychology. The group further recognized
some of the problems with this shift in the training model, especially
the fact that some programs were providing less generic clinical psychology
education and training experiences than may be desirable for future clinical
neuropsychologists. Nevertheless, the group thought that there is a need
to remain open-minded about interns, and to recognize that many students
often have little to no exposure to neuropsychology until the internship
stage in their training. Keeping the door open for all would be important
at this level of training. The tremendous diversity of the interns
prior experiences in clinical neuropsychology needed to be recognized and
appreciated. Flexibility in training programs will be vital such that interns
can receive more extensive training in their "weak" areas and less intensive
training in already well developed areas of competency.
In exploring models of organization for clinical internship training,
the group reviewed the results of the recently completed survey of clinical
internships (Association for Internship Training, in Clinical Neuropsychology,
1997). In general, the group again believed that flexibility is the key,
and that no one organizational model is "best." The group felt that internship
programs developed around tracks, or rotations in clinical neuropsychology
have worked well to date. The group was less clear about the future role
of independent clinical neuropsychology internship programs (e.g., freestanding
and independent internship training programs providing training in clinical
neuropsychology but not other aspects of clinical psychology).
There was reaffirmation in the group that an important role of
the internship year is the refinement of generic clinical skills in diagnosis,
assessment, and treatment. To be a competent neuropsychologist, one must
first be a competent and proficient generic clinician. The group believed
that quotas should not be set for how much time within the clinical internship
training year should or should not be devoted to clinical neuropsychological
activities. Rather, it was agreed that the amount of time spent in such
activities should be flexible, and meet the unique needs of the individual
intern.
With this groundwork laid, the group moved forward to review current
internship training guidelines, and to generate guidelines for the future.
In performing this exercise, the guidelines for internship training outlined
in the Reports of the INS-Division 40 Task Force on Education, Accreditation,
and Credentialing (1987) as well as Division 40 Petition (Meier et al.,
1995) to the Commission for the Recognition of Specialties and Proficiencies
in Professional Psychology for specialty recognition for clinical neuropsychology
were considered. In general, the group believed that many of the content
areas already Outlined were quite good, but needed to be broadened from
the heavily weighted emphasis on neurology in the presently existing documents
to include newer areas in which neuropsychologists are involved, including
rehabilitation, psychiatry, and other medical 42
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