160 The Houston Conference on Special~ Education and Training in Clinical Neuropsychology

THE HOUSTON CONFERENCE ON

SPECIALTY EDUCATION AND TRAINING
IN CLINICAL NEUROPSYCHOLOGY

POLICY STATEMENT1

I. Preamble for Conference

Clinicalneuropsychologyis a specialtyformallyrecognizedby the AmericanPsychological
Association (APA) and the Canadian PsychologicalAssociation (CPA). Education and
trainingin clinicalneuropsychologyhas evolvedalongwiththe developmentof the specialty
itself. Nevertheless,there has been no widely recognized and accepted description of
integratededucationand trainingin the specialtyof clinicalneuropsychologyThe aim of the
HoustonConferencewas to advancean aspirational,integratedmodelof specialtytrainingin
clinicalneuropsychology.
The ConferencePlanning Committeesolicited participantapplicationsby way of an
announcementin the APA Monitor and letters to members of the Division of Clinical
Neuropsychology(Division40), the NationaIAcademyof Neuropsychology(NAN),and to
the directorsof trainingprogramsat the doctoral,internship,and postdoctorallevelsas listed
in The Clinical Neuropsychologist (Cripe, 1995).The committeeselected a group of 37
clinicalneuropsychologiststo reflect diversityin practice settings,educationand training
models,specializationsin the field of clinicalneuropsychology,levelsof seniority,culture,
geographiclocation,and sex. Five additionaldelegatesattendedas representativesof the
sponsoringneuropsychologicalorganizations(NAN; Division40; the American Board of
ClinicalNeuropsychology[ABCN];the AmericanAcademyof ClinicalNeuropsychology
[AACN];and the Associationof PostdoctoralProgramsin ClinicalNeuropsychology[AP-
PCN]).Thesedelegatesconvenedin Houstonfrom September3 throughSeptember7, 1997.
This documentis the productof their deliberations,[Additionaldetailsmay be foundin the
Proceedings of the Houston Conference.]

II. Introduction
The followingdocumentis a descriptionof integratededucationand trainingin the specialty
of clinicalneuropsychology.It is predicatedon the view that the trainingof the specialistin
clinicalneuropsychologymust be scientist-practitionerbased,and may lead to a combined,
primarilypractice,or primarilyacademiccareer.
The scientist-practitionermodel (Belar & Perry, 1992)as appliedto clinicalneuropsy-
chologyenvisionsthatall aspectsof generalneuropsychologyandprofessionaleducationand
trainingshouldbe integrated;this is the “horizontal”dimensionof educationand training.
Integrationshouldbeginwithdoctoraleducationand shouldcontinuethroughinternshipand
residencyeducationand training;this is the “vertical”dimensionof educationand training.

‘From Haonay,H.J.,Bieliauskas,
L.A.,Crosson,
B.A.,Harmneke,
T.A.,Hamsher,
K.deS.,&Koffler,
S.P.(1998).
ProceedingsoftheHoustonConference on$reciatty
Education
andTraining
inClinical
Neuropsychology.
Archives
of ClinicalNeuropsychology,13, 157–250.Copyright
O 1998bytheNational Academy ofNeuropsychology.
Reproduced withpermission.
 The Houston Conference on Specialty Education and Training in Clinical Neumpsychology 161

This documentpresentsa modelof integratededucationand trainingin the specialtyof

clinicalneuropsychologythat is bothprogrammaticand competency-based(see SectionXV
below).This modeldefinesexit criteriaand providestracks and means for obtainingthese
criteriaacrossall levelsof educationand training.Exitcriteriafor the completionof specialty
trainingare metby the end of the residencyprogram.The programmaticlevelat whichthese
criteriaare achievedmay vary but not the content.

[II. Who is a Clinical iVeuropsychologist?

A clinicalneuropsychologistis a professionalpsychologisttrained in the scienceof brain-
behavior relationships.The clinical neuropsychologistspecializesin the application of
assessmentandinterventionprinciplesbasedon the scientificstudyof humanbehavioracross
the lifespanas it relatesto normaland abnormalfunctioningof the centralnervoussystem.

IV Who Should Have Education and Training in the Specialty

of Clinical Neuropsychology?
A. Personswho engagein the specialtypracticeof clinicalneuropsychologyor supervise
the specialtypracticeof clinicalneuropsychology.
B. Persons who call themselves“clinical neuropsychologists”or otherwisedesignate
themselvesas engagingin the speeialtypracticeof clinicalneuropsychology.
C. Psychologistswho engagein educatingor supervisingtraineesin the specialtypractice
of clinicalneuropsychology.

V Professional and Scientific Activity

The clinicalneuropsychologist’sprofessionalactivitiesare includedwithin the seven core
domains delineated in the Petition for the Recognition of a Specialty in Professional
Psychologysubmittedby Division40 of the APAto the Commissionfor the Recognitionof
SpecialtiesandProficienciesin ProfessionalPsychology(CRSPPP).Thesecore domainsare:
assessment,intervention,consultation,supervision,research and inquiry,consumerprotec-
tion, and professionaldevelopment.The scientific activitiesof the specialistin clinical
neuropsychologycan vary widely. The specialist whose professionalactivities involve
diversecultural,ethnic,and linguisticpopulationshas the knowledgeand skillsto perform
those activitiescompetentlyand ethically.The essentialknowledgeand skill competencies
for these activitiesare outlinedbelow.

VI. Knowledge Base

Clinicalneuropsychologistspossessthe followingknowledge.This core knowledgemay be
acquiredthroughmultiplepathways,not limited to courses,and may come through other
documentabledidacticmethods.
A. GenericPsychologyCore
1. Statisticsand methodology
2. Learning,cognitionand perception
3. Socialpsychologyand personality
4. Biologicalbasis of behavior
5. Life span development
 162 The Houston Conference on SpecialQ Education and Training in Clinical Neuropsychology

6. History
7. Culturaland individualdifferencesand diversity
B. GenericClinicalCore
1. Psychopathology
2. Psychometrictheory
3. Interviewand assessmenttechniques
4. Interventiontechniques
5. Professionalethics
C. Foundationsfor the studyof brain-behaviorrelationships
1. Functionalneuroanatomy
2. Neurologicaland related disordersincludingtheir etiology,pathology,course and
treatment
3. Non-necrologicconditionsaffectingCNS functioning
4. Neuroimagingand other neurodiagnostictechniques
5. Neurochemistryof behavior(e.g., psychopharmacology)
6. Neuropsychologyof behavior
D. Foundationsfor the practiceof clinicalneuropsychology
1. Specializedneuropsychologicalassessmenttechniques
2. Specializedneuropsychologicalinterventiontechniques
3. Researchdesignand analysisin neuropsychology
4. Professionalissuesand ethicsin neuropsychology
5. Practicalimplicationsof neuropsychologicalconditions

VII. Skills
Clinicalneuropsychologists
possessthe followinggenericclinicalskillsand skillsin clinical
neuropsychology.Thesecore skillsmay be acquiredthroughmultiplepathways,not limited
to courses,and may come throughother documentabledidacticmethods.Domainsof skills
and examplesare:
A. Assessment
Informationgathering
Historytaking
Selectionof tests and measures
Administrationof tests and measures
Interpretationand diagnosis
Treatmentplanning
Reportwriting
Provisionof feedback
Recognitionof multiculturalissues
B. Treatmentand Interventions
Identificationof interventiontargets
Specificationof interventionneeds
Formulationof an interventionplan
Implementationof the plan
Monitoringand adjustmentto the plan as needed
Assessmentof the outcome
Recognitionof multiculturalissues
C. Consultation(patients,families,medicalcolleagues,agencies,etc.)
Effectivebasic communication(e.g., listening,explaining,negotiating)

—— —..——
VIII. Doctoral Education in Clinical Neuropsychology
S

IX. Internship Training in Clinical Neuropsychology

X. Residency Education and Training in Clinical Neuropsychology

164 The Houston Conference on Specialty Education and Training in Clinical Neuropsychology

chologyand to completethe educationand trainingnecessaryfor independentpracticein the

specialty.Thepostdoctoralresidencyprogramis a requiredcomponentin specialtyeducation
in clinicalneuropsychology.The expectedperiodof residencyextendsfor the equivalentof
2 yearsof full-timeeducationand training.The residencyexperiencemust occuron at least
a half-timebasis.
These programswill pursueaccreditationsupportingthe followingassurances.
1. The faculty is comprisedof a board-certifiedclinical neuropsychologistand other
professionalpsychologists;
2. Training is provided at a fixed site or on formally affiliated and geographically
proximatetrainingsites,with primarilyon-sitesupervision;
3. There is access to clinicalservicesand trainingprogramsin medicalspecialtiesand
alliedprofessions;
4. Thereare interactionswithotherresidentsin medicalspecialtiesand alliedprofessions,
if not other residentsin clinicalneuropsychology;
5. Each residentspendssignificantpercentagesof time in clinical service,and clinical
research, and educationalactivities,appropriateto the individualresident’straining
needs.
Entry into a clinicalneuropsychologyresidencyprogramshouldbe based upon completion
of an APAor CPAaccrediteddoctoraleducationand trainingprogram.Clinicalneuropsy-
chologyresidentswill have successfullycompletedan APA or CPA accreditedinternship
programwhich includessome trainingin clinicalneuropsychology.
Exit criteriafor the residencyare as follows:
1. Advanced skill in the neuropsychologicalevaluation,treatmentand consultationto
patientsand professionalssuftlcientto practiceon an independentbasis;
2. Advancedunderstandingof brain-behaviorrelationships;
3. Scholarly activity,e.g., submissionof a study or literaturereview for publication,
presentation,submissionof a grant proposalor outcomeassessment;
4. A formalevaluationof competencyin the exit criteria 1 through3 shall occur in the
residencyprogram;
5. Eligibilityfor stateor provinciallicensureor certificationfor the independentpractice
of psychology;
6. Eligibilityfor board certificationin clinicalneuropsychologyby the AmericanBoard
of ProfessionalPsychology.

XI. Nature and Place of Subspecialties Within Clinical Neuropsychology

In the future, subspecialtiesin clinical neuropsychologymay be recognized (e.g., child,
pediatric,geriatric,rehabilitation).In fact, many clinicalneuropsychologistscurrentlycon-
centratetheir professionaland scientificactivitiesin relativelyfocusedareas of the clinical
neuropsychologyspecialty.Thus, it is expectedthat some or all of these areas of concen-
trationwilleventuallybe seenas bonafidesubspecialties.Oneimplicationof thisviewis that
residenciesmay emergethat reflect concentrationsin these subspecialties.

XII. Continuing Education in Clinical Neuropsychology

All specialistsin clinical neuropsychologyare expected to engage in annual continuing
education.The goalof continuingeducationis to enhanceor maintainthe alreadyestablished
competenceof clinicalneuropsychologistsby updatingpreviouslyacquiredknowledgeand
 The HoustonConferenceon SpecialtyEducationand Trainingin ClinicalNeuropsychology165

a n e

XIII. Diversityin Educationand Training

XIV Applicationof the Model

n e

XV Model of IntegratedEducationand Trainingin Clinical

Neuropsychology
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 166 The Houston Conference on Specialty Education and Training in Clinical Neuropsychology

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FIGURE1. An illustrationof an integratedmodelof educationand trainingin clinicalneuropsychology.