Houston Conference Guidelines and Postdoctoral Residency Training in Clinical Neuropsychology

APA Division 40’s Association of Neuropsychological Students in Training (

ANST

) & Association of Postdoctoral Programs in Clinical Neuropsychology (

APPCN

) INS, Boston, Thursday February 2, 2006

Topics and Presenters

 Houston Conference History and Guidelines – H. Julia Hannay, PhD and Russell Bauer, PhD  Competitive Predoctoral and Postdoctoral Preparation – Paula Shear, PhD  Post-Doctoral Studies: Application and the APPCN Matching Program – Brad L. Roper, PhD

Houston Conference History and Guidelines

 Context:  A lot was going on nationally in Psychology, the expansion of specialty education and training at the internship and postdoctoral level and the need for each specialty to speak with one voice.

 Date: February 9,1995: Inaugural meeting of the Clinical Neuropsychology Synarchy (CNS) by Kerry Hamsher, PhD to represent most of the major US organizations in CN in order to facilitate discussion of various issues in the field and to represent the field with “one voice” to APA. Meeting held at INS in Seattle.

 Date: August, 1996; APA Council of Representatives approves the recognition of Clinical Neuropsychology as APA’s first fully approved specialty. Decision made at APA meeting in Toronto.

Houston Conference - History

 Context:  Date: August 9, 1996; Clinical Neuropsychology Synarchy (CNS) met and discussed intra-specialty policies and procedures for:  (1) establishing the specialty’s consensual acceptance for residencies within the specialty.    (2) the selection of a specialty council representative for the specialty of clinical neuropsychology (and funding thereof) no consensus was reached on issues 1 and 2.

Also, since the approval of CN as a specialty, we needed to agree on a plan to continuum of education and training in the specialty of CN, from graduate school through residency education.

Houston Conference - History

  Context: Out-of-date guidelines for CN education and training:  Reports of the INS 1987, 1, 29-34.

– Division 40 Task Force on Education, Accreditation, and Credentialing, The Clinical Neuropsychologist,  Separate (non-integrated) guidelines for education and training at doctoral, internship, and post-doctoral levels.  “Rice bowl issues” – concerns about around the country about developing new guidelines:  New guidelines for education and training in CN might have requirements and set standards that would “prevent” or make it “harder” for already licensed psychologists and ones entering the field to become clinical neuropsychologists. Would there be grandfathering?

 It might also make some CN training routes obsolete (eg., non APA approved doctoral, internship and postdoctoral programs in Clinical/or CN, workshops etc.)

Houston Conference - History

  Context: Development of CN tracks in APA approved Clinical Programs and “free standing doctoral CN programs:  Quite a few strong CN training sites had been developed at the doctoral level, primarily as tracks in APA approved Clinical Programs (eg., University of Florida, University of California in San Diego) but also in a few freestanding programs (eg., University of Houston, University of Victoria). Specialized CN training programs had also developed at the internship level ( eg., University of Florida, Brown University).  In fact, an established doctoral, internship, and post-doctoral program had included material from their programs in the CN specialty application that was approved by APA.  It was time for us all to get together, discuss what we were doing and develop an integrated model of training in the field.

Houston Conference - History

  Context: Date: October 6, 1996: Special meeting of CNS:  Initial discussion of a National Conference of CN Education and Training  A national conference was approved by CNS members and organized in 1996 and 1997.  Date: September 3-7, 1997: Houston Conference convened.

 Date: February, 1998: Special issue of Archives of Clinical Neuropsychology published on the Proceedings of the Houston Conference.

 Reference for Policy Statement in issue:  Hannay, H. J., Crosson, B.A., Hammeke, T. A., Hamsher, K. deS., & Koffler, S. P. (1998). Proceedings: The Houston Conference on Specialty Education and Training in Clinical Neuropsychology. Archives of Clinical Neuropsychology, 13(2).

Houston Conference - Guidelines

 The Houston Conference produced in

the first integrated model of professional education and training in Psychology,

an aspirational model, involving training at the following levels:  Doctoral   Internship Post-Doctoral Residency  Basically, students can acquire the necessary knowledge and skills in varying amounts at each training level as long as they end up with approximately the same expected amounts at the end of their post-doctoral training.

The Houston Conference – Guidelines Illustrations of the Integrated Model for Students A and B

Houston Conference - Guidelines

 Doctoral training level:  Specialization in CN begins at this level.

  Generic psychology and generic clinical cores SHOULD be competed.

Foundation of brain-behavior relationships SHOULD be developed to a considerable degree.

  However, variability may occur between doctoral programs to a considerable in the degree to which of brain-behavior relationships and practice of CN are emphasized.

ENTRY and EXIT CRITERIA: Those specified by the doctoral program  IMPLICATIONS: You may have a relatively weak preparation for specialization in CN at the doctoral level. You NEED to be proactive in finding ways around this in your community to make you competitive for CN internships and postdoctorates since there is not time to obtain all the didactics and perhaps practicum training at these higher levels of training.

Houston Conference - Guidelines

       Internship training level: Complete training in general practice of professional psychology.

Extend specialty preparation in science and professional practice of CN % time in CN SHOULD be determined by the training needs of the individual intern.

Internships MUST be completed in an APA or CPA approved professional psychology program.

ENTRY criteria: Completion of all graduate education requirements including doctoral dissertation. EXIT criteria: None specified in policy statement.

Houston Conference - Guidelines

  Internship training level cont. : COMMENT: The conference participants wanted to push for the internship being post meeting ALL doctoral requirements since it is a real inconvenience to have interns working on a dissertation elsewhere or on site (or train them to become ABD) when they could be learning more and (courses in CN specialty and related areas) or doing additional CN research.

 IMPLICATIONS: You don’t have to have come from an APA or CPA Clinical program, since they are not accredited initially and it takes years for them to do so, but you MUST go through an APA or CPA approved internship. Is there grand-fathering over this in terms of the ABPP requirements.?

Houston Conference - Guidelines

        Postdoctoral residency training level: Obtain an advanced level of competence in the specialty of CN.

Complete the education and training necessary for the independent practice of the specialty.

A REQUIRED component in specialty education in CN.

The equivalent of 2 years of full-time education and training.

The residency MUST occur on at least a half-time basis.

These programs WILL pursue accreditation.

ENTRY criteria:   1. Entrance SHOULD be based upon completion an APA or CPA accredited doctoral education and training program. 2. CN residents WILL have successfully completed an APA or CPA accredited internship program which includes SOME training in CN.

Houston Conference - Guidelines

        Postdoctoral residency training level cont. : EXIT criteria: 1. Faculty include a board certified clinical neuropsychologist and other professional psychologists.

2. Training at a fixed site or affiliated and geographically near sites with primarily on –site supervision.

3. Access to clinical services and training in medical specialities and allied professions.

4. Interactions with residents in medical and allied specialties, if not other CN residents.

5. Eligibility for state or provincial licensure or certification for independent practice of psychology. 6. Eligibility for board certification in CN by APBB.

Houston Conference - Guidelines

 Postdoctoral residency training level cont. :    COMMENT: actually the responsibility of the doctoral and internship programs. COMMENT: Why ABPP? ABPP is the “at distance” Diplomate Board developed by APA and the only such board currently recognized by APA , although this is currently under lots of discussion.

IMPLICATIONS: To get the highest level of credentials in CN, that will also make it easier to move from state-to-state etc, and that are recognized by APA, get an accredited post doctorate from ABPP ABCN. This is somewhat controversial.

Competitive Predoctoral Preparation

      What didactic and practicum experiences should you obtain to maximize internship acceptance?

Go to www.APPIC.org

and look at the AAPI form for information about records that you should keep starting in your first year of graduate training.

Research is important in distinguishing yourself from other applicants.

Cultivate long-term mentoring relationships.

Defend your dissertation before internship!!!

Preparing an internship application: What do you want out of life?

Competitive Postdoctoral Preparation

 Doctoral and internship APA/CPA accreditation.

 Make sure your doctoral and internship programs together cover all ‘core’ generic bases as well as the preparatory neuroscience foundations.

 If something was lacking, supplement it with additional supervised practicum, accredited continuing education, etc.

A Word About Licensure

 If you know what state(s) you want to be licensed in following your training, check out the coursework requirements while you are still in graduate school. Even an excellent general graduate curriculum will not prepare you fully for licensure in all 50 states. It is

much

easier and cheaper to take any additional required coursework while you are still a doctoral student.

Competitive Postdoctoral Preparation

    Involvement in national organizations (e.g., APA, INS, NAN). Publications and conference presentations are a plus, particularly in the year you are interviewing for residencies.

If your dissertation is not already defended, have a realistic plan for dissertation completion.

Internship: Round-out general clinical activities: An all-neuropsych internship is not always helpful. Try for a mix that addresses any weaknesses.

Make sure to talk to your mentors about where you want to apply.

Alternative Routes into Clinical Neuropsychology     Your doctorate is not in clinical psychology You come from a small doctoral program with limited opportunities in neuropsychology You decided late in your graduate or internship career to focus your training in neuropsychology You need to remain in a limited geographic area for internship or residency

Postdocs: Judging Programs

 Residency conforms to the Houston Conference.

 At least 50% clinical service delivery and 2 hrs of supervision per week.

 Quality supervision and fair evaluation.

 Opportunities for education and research.

 Sufficient range of patient types.

  Diversity issues are addressed.

Not a “sweat shop”.

Postdocs: Judging Programs

 Evidence of staff expertise.

 Staff are professionally active.

 Adequate financial, clerical, and physical resources.

 APA accreditation: still “in process” at the postdoc level.

 Past residents have good jobs!

Postdocs: Application

 Application procedures differ across programs (but simpler than internship)  List specific goals in cover letter.

 Attend INS for interviews.

 Ask to speak with former/current fellows.

 Most important: Apply to as many. programs as you can.

Criteria for APPCN residency

 Duration of 2 years of postdoctoral training, or equivalent on at least a half time basis.

 Must include at least 50% clinical, 10% research, and 10% didactics.

 Director of Training has ABPP in CN.

APPCN Matching Program

Deadline 1/13/06 03/03/06 Applicant Program Register with NMS Interviews Submit ranks 03/13/06 Match Clearing house

APPCN Matching Program

  Computerized matching process, run by NMS on behalf of APPCN, but non APPCN programs may also participate.

Decisions are made on the applicants’ and programs’ rankings.

 Premature offers are not allowed.

 If a program does not plan to rank you, they are supposed to tell you so.

APPCN Matching Program

 Program can tell you only whether or not you are competitive.  Match is binding .

 Clearinghouse is available .

 Fees for programs and applicants .

APPCN Matching Program

Participation

120 100 80 60 40 20 0 Applicants Positions 2001 2002 2003 2004 2005

APPCN Matching Program

Success in match (%)

100 90 80 70 60 50 40 30 20 10 0 Applicants Positions 2001 2002 2003 2004 2005

APPCN Matching Program

Average # of rankings in 2005

3 2 1 0 7 6 5 4 Applicants Programs Matched Unmatched

APPCN Matching Program

 The large majority of high-quality programs take part in the match.

 Applicants can apply to many programs using the same process.

 Match outcome is binding: disciplinary action possible against programs that violate match rules.

 The match is the most fair system for applicants.

APPCN Matching Program Contact Information:

APPCN: http://www.appcn.org

NMS: http://www.natmatch.com

Questions?