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Calamia M, Ready RE, Kapoulea EA, Farrell A, Runk A, Babicz-Boston MA, Woods SP, Cirino PT. A survey of the perceptions and practices of faculty in clinical neuropsychology doctoral training programs: is heterogeneity the norm? Clin Neuropsychol 2024:1-26. [PMID: 38453891 DOI: 10.1080/13854046.2024.2325168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
Objective: Doctoral education is a cornerstone in the training of clinical neuropsychologists. However, we know little about perceptions, practices, and needs of the faculty who oversee doctoral training in clinical neuropsychology (CN). Method: Seventy-one faculty from 45 doctoral programs providing CN training completed at least part of a survey assessing characteristics of their programs, current training practices and views, and challenges to CN doctoral training. Results: Over half of CN faculty reported having zero or only one CN colleague. CN faculty reported that the goals of CN doctoral training are research training, clinical training, and acquisition of knowledge and skills reflected in the Houston Conference Guidelines (HCG). CN faculty reported that doctoral trainees obtain more clinical hours than faculty would like and endorsed alternative clinical metrics, including competency-based ratings. CN faculty are divided about the benefits of a required two-year postdoctoral CN fellowship. Conclusions: The HCG states that specialization in CN begins at the doctoral level. CN faculty in doctoral programs are fully immersed in the early development and education of future CN researchers and practitioners. Tensions between clinical and research training in CN at the doctoral level-and student overemphasis on accruing clinical hours-might place CN at risk for failing to make research innovations necessary for our field to evolve and thrive. More CN doctoral faculty are needed to serve as mentors to students, especially for students from backgrounds that have been historically excluded and marginalized. A greater voice from CN doctoral faculty in CN governance is needed.
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Affiliation(s)
- Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Rebecca E Ready
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Eleni A Kapoulea
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Abby Farrell
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Ashlyn Runk
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Michelle A Babicz-Boston
- Department of Psychology, University of Houston, Houston, TX, USA
- Mental Health and Behavioral Sciences Service, James A. Haley Veterans' Hospital, Tampa, FL, USA
| | | | - Paul T Cirino
- Department of Psychology, University of Houston, Houston, TX, USA
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Stucky KJ, Baker LN, Rush BK, Waldron-Perrine B, Dean PM, Tlustos SJ, Barisa M. Training in Neurorehabilitation Psychology: Defining Competencies, Requisite Skill Sets, and a Proposed Developmental Pathway. Arch Phys Med Rehabil 2024; 105:604-610. [PMID: 37657530 DOI: 10.1016/j.apmr.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/18/2023] [Accepted: 08/17/2023] [Indexed: 09/03/2023]
Abstract
Psychologists have been applying neurorehabilitation models of care for many years. These practitioners come from different training backgrounds and use a variety of titles to refer to themselves despite considerable overlap in practice patterns, professional identification, and salary. Titles like 'neurorehabilitation psychologist' and 'rehabilitation neuropsychologist' are sometimes used by practitioners in the field to indicate their specialty area, but are not formally recognized by the American Psychological Association, the American Board of Professional Psychology, or by training councils in clinical neuropsychology (CN) or rehabilitation psychology (RP). Neither the CN or RP specialties alone fully address or define the competencies, skill sets, and clinical experiences required to provide high quality, comprehensive neurorehabilitation psychology services across settings. Therefore, irrespective of practice setting, we believe that both clinical neuropsychologists and rehabilitation psychologists should ideally have mastery of specific, overlapping competencies and a philosophical approach to care that we call neurorehabilitation psychology in this paper. Trainees and early career professionals who aspire to practice in this arena are often pressured to prioritize either CN or RP pathways over the other, with anxiety about perceived and real potential for falling short in their training goals. In the absence of an explicit training path or formal guidelines, these professionals emerge only after the opportunity, privilege, or frank luck of working with specific mentors or in exceptional patient care settings that lend themselves to obtaining integrated competencies in neurorehabilitation psychology. This paper reflects the efforts of 7 practitioners to preliminarily define the practice and philosophies of neurorehabilitation psychology, the skill sets and competencies deemed essential for best practice, and essential training pathway elements. We propose competencies designed to maximize the integrity of training and provide clear guideposts for professional development.
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Affiliation(s)
| | | | - Beth K Rush
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL
| | - Brigid Waldron-Perrine
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | | | - Sarah J Tlustos
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO
| | - Mark Barisa
- Psychology Department, University of North Texas, Denton, TX; Performance Neuropsychology, Frisco, TX
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Wong D, Pestell C, Oxenham V, Stolwyk R, Anderson J. Competencies unique to clinical neuropsychology: A consensus statement of educators, practitioners, and professional leaders in Australia. Clin Neuropsychol 2024; 38:1-20. [PMID: 37073481 DOI: 10.1080/13854046.2023.2200035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/01/2023] [Indexed: 04/20/2023]
Abstract
Objective: To delineate the unique role of clinical neuropsychologists in contemporary Australian clinical practice and present a comprehensive consensus-based set of clinical neuropsychology competencies to guide and standardize the training of clinical neuropsychologists. Method: Twenty-four national representatives of the clinical neuropsychology profession (71% female, M = 20.1, SD = 8.1 years clinical practice), including tertiary-level educators, senior practitioners and members of the executive committee of the peak national neuropsychology body, formed the Australian Neuropsychology Alliance of Training and Practice Leaders (ANATPL). Informed by a review of existing international competency frameworks and Australian Indigenous psychology education frameworks, a provisional set of competencies for clinical neuropsychology training and practice were developed, followed by 11 rounds of feedback and revisions. Results: The final set of clinical neuropsychology competencies achieved full consensus and falls into three broad categories: generic foundational (i.e. general professional psychology competencies applied to clinical neuropsychology); specific functional (i.e. specific to clinical neuropsychology areas of practice) competencies relevant to all career stages; and functional competencies relevant to advanced career stages. Competencies span a number of knowledge and skill-based domains including neuropsychological models and syndromes, neuropsychological assessment, neuropsychological intervention, consultation, teaching/supervision and management/administration. Conclusion: The competencies reflect recent advances in the field of clinical neuropsychology, including expanded intervention competencies, culturally-informed neuropsychological practice and use of emerging technologies. They will be available as a resource to guide curriculum development for clinical training, as well as providing a useful framework for professional practice and advocacy more broadly within the discipline of clinical neuropsychology.
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Affiliation(s)
- Dana Wong
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Carmela Pestell
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | - Vincent Oxenham
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Renerus Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Jacqueline Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
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Wong D, Pinto R, Price S, Watson L, McKay A. What does competently delivered neuropsychological assessment feedback look like? Development and validation of a competency evaluation tool. Clin Neuropsychol 2024; 38:116-134. [PMID: 37081825 DOI: 10.1080/13854046.2023.2200205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
Objective: Neuropsychological assessment (NP) feedback helps patients and caregivers understand assessment results to maximise their utility and impact in everyday life. Yet feedback practices are inconsistent and there are no evidence-based guidelines for how feedback should be most effectively delivered. The aim of our study was to develop a psychometrically sound feedback competency checklist, the Psychology Competency Assessment Tool - Feedback (PsyCET-F), for use in research, training, and clinical settings. Method: The Delphi method of expert consensus was used to establish checklist items that clearly described competencies important for NP feedback. To examine the inter-rater reliability of the checklist, two experienced neuropsychologists rated the competencies demonstrated by trainee neuropsychologists across four feedback sessions. Results: After two Delphi rounds, consensus was reached on the 20-item checklist. Consensus was defined as at least 80% agreement amongst the panel of 20 experts. Four item categories resulted from the Delphi: (a) Opening the Session; (b) Applying Specific Feedback Techniques; (c) Engagement, Collaboration, and Alliance; and (d) Structuring and Ending the Session. Inter-rater reliability was moderate (κW = 0.79, p <.001, 80.52% agreement) when using a simple coding system, coded as Beginner, Intermediate, Competent, and Skilful; and strong (κW = 0.82, p <.001) when competency level was coded using an 8-point, detailed coding method. Conclusions: The PsyCET-F is psychometrically sound and fit-for-purpose for measuring competencies in giving NP feedback. It can be used in the training of clinicians to develop effective feedback skills. International benchmarking and usability testing will be conducted in a future study.
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Affiliation(s)
- Dana Wong
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Robyn Pinto
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Sarah Price
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
- McKellar Centre, Barwon Health, North Geelong, Australia
| | - Lily Watson
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Adam McKay
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Department of Psychology, Epworth HealthCare, Melbourne, Australia
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Begali VL. Neuropsychology and the dementia spectrum: Differential diagnosis, clinical management, and forensic utility. NeuroRehabilitation 2020; 46:181-194. [PMID: 32083596 DOI: 10.3233/nre-192965] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The utility of neuropsychology in the treatment and evaluation of neuropsychological disorders and neurodegenerative diseases is supported by scientific study. As a discipline, neuropsychology's value and efficacy when applied to the dementia spectrum are rooted in its inherent adaptability as a practical, cost-effective, and scientifically based resource for differential diagnosis, treatment planning, and forensic decision making. OBJECTIVES This article provides a framework for conceptualizing dementia as a spectrum of disorders and outlines a rationale for preferential reliance upon neuropsychological tenets. The function of neuropsychology in differential diagnosis, clinical management, integrative care, and forensic applications is delineated for use as a contemporary interdisciplinary reference. METHODOLOGY An overview of the literature on dementia as a spectrum of disorders has been integrated with the science and practice of neuropsychology. CONCLUSIONS The utility of neuropsychology emanates from its focus on brain functioning and the discipline's appreciation for the relationship between brain functioning and cognition, mental state, and behavior. Early and routine referral for neuropsychological assessment allows for the objective determination of normal versus abnormal neurocognitive functioning, provides a baseline for serial reassessment, and leads to the more rapid deployment of effective treatments. Beyond the hospital and clinic, neuropsychological expertise is increasingly sought after as integral to the legal system when decisions regarding eligibility for long term care and questions about capacity require objective and reliable measurement.
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Affiliation(s)
- Vivian L Begali
- Neuropsychology and Psychological Healthcare, Fountain Park Medical Offices, 9327 MidlothianTurnpike, Suite 1-C, Richmond, VA 23235, USA Tel.: +1 804 728 2964; E-mail: ; Web: http://www.drvivianbegali.com
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