Houston Conference Guidelines and Postdoctoral Residency Training in Clinical Neuropsychology

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Houston Conference Guidelines and Postdoctoral
ResidencyTraining in Clinical Neuropsychology

• APA Division 40s Association of
  Neuropsychological Students in Training (ANST)
• Association of Postdoctoral Programs in Clinical
  Neuropsychology (APPCN)
• INS, Boston, Thursday February 2, 2006

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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

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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 APAs first fully
  approved specialty. Decision made at APA meeting
  in Toronto.

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Houston Conference - History

• Context
• Date August 9, 1996 Clinical Neuropsychology
  Synarchy (CNS) met and discussed intra-specialty
  policies and procedures for
• (1) establishing the specialtys 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.

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Houston Conference - History

• Context
• Out-of-date guidelines for CN education and
  training
• Reports of the INS Division 40 Task Force on
  Education, Accreditation, and Credentialing, The
  Clinical Neuropsychologist, 1987, 1, 29-34.
• 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.)

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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.

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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).

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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.

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The Houston Conference GuidelinesIllustrations
of the Integrated Model for Students A and B
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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.

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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.

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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 dont 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.?

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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.

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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.

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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.

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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?

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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.

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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.

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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.

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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

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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.

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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!

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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.

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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.

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APPCN Matching Program
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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.

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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 .

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APPCN Matching Program
Participation
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APPCN Matching Program

• Success in match ()

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APPCN Matching Program

• Average of rankings in 2005

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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.

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APPCN Matching Program

• Contact Information
• APPCN http//www.appcn.org
• NMS http//www.natmatch.com

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• Questions?