The professional past, present and future for psychometrists



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The professional past, present and future for psychometrists ANNA PINEDA, MS, LPA, CSP LORI BENNETT, MA, CSP NATIONAL ASSOCIATION OF PSYCHOMETRISTS CONFERENCE 2015

Historical Past Y O U C A N T T E L L W H E R E Y O U R E G O I N G U N L E S S Y O U K N O W W H E R E Y O U H A V E B E E N

Dr. Carl Emil Seashore Discussed how psychologists could act as technicians on an interdisciplinary team Set the stage for the psychometrist/psychologist working dynamic Yet, as technician the psychologist is at the command of the superintendent and other members of the staff for the routine work which he is peculiarly qualified, and this routine work is his main business The Position of the Psychologist in the State Institution Bulletin of State Iowa Institutions, Volume 14, 1912

Early Use of psychometrists Dr. William A. Hunt Dr. Ward C. Halstead Dr. Ralph M. Reitan Unknown?

1960 s to 1980 s Different areas in general clinical psychology Increase in use over a 15 year period

The rise of clinical neuropsychology Tremendous boost for psychometrists International Neuropsychological Society (INS) - 1966 National Association of Neuropsychologists (NAN) - 1975 APA Society for Clinical Neuropsychology (Division 40) - 1980 In the 1989 Report of the Division 40 Task Force on Education, Accreditation, and Credentialing, guidelines regarding the use of nondoctoral personnel in clinical neuropsychological assessment were established.

1990 s and 2000 s Between 1989 and 1999, percentages have ranged from 44% to 71% of neuropsychologists that enlist the aid of an assistant to collect data (Sweet et al., 2000) 90 80 70 60 50 40 30 20 10 0 1990 1993 2002 2010 Percentage

Ethics and Controversy over the use of psychometrists PROS A ND CONS

Pro s Doctoral level professionals can assess more patients More time efficient manner for data collection Provider time can be used for other assessment-related activities Psychometrist utilization can increase provider salaries by over 85% (DeLuca & Putnam, 1993) Neuropsychologists that utilized testing assistants had higher job satisfaction (Sweet et al, 2011) Unbiased analysis Cost savings for patients??? Cost savings for hospital/clinic???

Con s Concerns over the appropriate and standardized training of unlicensed psychometrists without graduate level training Test misuse Scoring errors Test security Awareness of the importance of building and maintaining rapport Tests were standardized with psychologists Lack of learned clinical observational skills Hall et al. 2005

Ethical and organization s views of psychometrists roles

Guidelines Regarding the Use of Non-Doctoral Personnel in Clinical Neuropsychological Assessment Report of the Division 40 Task Force, 1989

Ethical Principles of Psychologists and Code of Conduct of the APA (1992) General Standard 1.22: (a) Psychologists delegate to their employees, supervisees, and research assistants only those responsibilities that such persons can reasonably be expected to perform competently, on the basis of their education, training, or experience, either independently or with the level of supervision being provided (b) psychologists provide the proper training and supervision to their employees and take reasonable steps to see that such persons perform services responsibly, competently, and ethically. Other APA

US Individuals with Disabillities Education Act 1997

Arkansas -2001 Arkansas Board Examiners of Psychology added Section 7.6B, Unlicensed, Non-exempt Individuals

Model Regulations - ASPPB 2002 34 of 53 in US and Canada have provisions of master s level licensure 28 U.S. states allow for licensure at the master s level

New York - 2003 The Scope of Practice Law was passed in New York. The law was then interpreted by an individual within the State Education Department in a way that disallowed the use psychometrists Many organizations supported the New York State Psychological Association (NYSPA) and the New York State Association of Neuropsychology (NYSAN) in many attempts to amend the Scope of Practice Law to fix this unintended consequence. NYSAN had been unable to convince the New York State Dept. of Education to change its interpretation of the Scope of Practice Law until YEAR

NAN Position Paper - Puente et al. (2006) Use, education, training and supervision of psychometrists, National Academy of Neuropsychology official statement 10 item list of recommendations training and supervision, test selection, data interpretation and analysis, report writing and consulation are the responsibility of the neuropsychologist who is independently licensed p. 838, recommendation #2 Supervision is at a minimum the general term utilized by Medicare Contractual relationship should be documented

Billing procedures 2006 a new American Medical Association, Current Procedural Terminology (CPT) billing codes for psychometrists were created: (96119) neuropsychological testing per hour by a technician (96102) psychological testing per hour by a technician

Texas Administrative Code on using psychometrists RULE 465.4 Employment of Individuals Not Licensed by Texas State Board-adopted in 1997 (b) Unlicensed, Non-Exempt Individuals. Psychologists may employ unlicensed, non-exempt individuals only to perform services which do not constitute the practice of psychology or the activities and services of another licensed profession. Permissible duties include: (1) Secretarial and clerical duties such as scheduling appointments or processing insurance forms; (2) Data gathering, such as administering, proctoring, or scoring non-projective tests, obtaining histories or obtaining documentation for record keeping purposes, provided that it does not require psychological education or involve the provision of psychological services; and (3) Technical, educational, or other duties that are adjunctive to and incorporated into the provision of psychological services such as providing educational information or assisting a client's work with a computer, special equipment or special materials, provided that the duties do not require psychological education or involve the provision of psychological services or the services or activities of another licensed profession.

Psychometrist Organizations and Certification

National Association of Psychometrists Concept began in 1994 A survey was sent to gather interest for the organization and 98.5% were in favor In 1995 the National Association of Psychometrists (NAP) was formally incorporated in the State of Minnesota. NAP s mission is to promote the education and training of psychometrists as well as serve as a venue for professional networking among psychometrists and other professionals in the field.

Board of Certified Psychometrists In 2003 the Psychometry Certification Committee (PCC) was officially formed as a NAP committee In 2005 PCC was dissolved by NAP and was replaced with the Board of Certified Psychometrists (BCP) BCP is a separate and autonomous organization dedicated to the continuation of psychometrist certification Established as a non-profit organization in 2009 In 2005, the first Certified Specialist in Psychometry (CS) Exam was offered. As of 2014, there are 185 Certified Specialists in Psychometry in the US and Canada. (BCP website) Must obtain 20 CEU s every two years to retain their certification

Canada Ontario Association of Consultants, Counsellors, Psychometrists and Psychotherapists (OACCPP) Psychometrist/psychometricians work under a registered psychologist

International Psychometrists South Africa: Permitted to use certain psychological assessments where they can select, administer, score and interpret and report on findings. Cannot use certain personality measures (e.g. Rorschach, MMPI-2), neuropsychological measures, or perform forensic assessments Can bill for service and be independent practitioners Can be registered under the Professional Board for Psychology (under the Health Professions Council of South Africa) Bachelor s degree required Latin America: Position does not exist and practitioners do their own testing

NAP Survey results S T A R T H E R E

2007 Gender Female Male Education Bachelor's Master's Other

Educational levels According to the 2012 NAP Salary Some college= 1.2% Bachelor s degree= 54.1% Master s degree=43.5% Doctorate= 1.2%

Employment sites Majority of psychometrist respondents in a 2009 survey indicated they worked in a hospital (46%), followed by a clinic setting (18%), and private practice (18%), 4% Veteran s Administration/Government 2012 survey: 48% in a hospital, 14% Clinic, 14% Private Practice, 14% Veteran s Administration/Government

Compensation Salary ranges In 2007, most initial pay was $10 to $20 per hour Year Average Hourly rate Average Gross Annual Income Average Contract rates (Per hr/per patient) 2009 $21.19 $41,685.90 $55.12/300 2012 $23.50 $49,809.06 $45/300

2009 Education Level Average Hourly Wage Average Gross Annual Income Bachelor s $20.33 $40,159 Master s $22.62 $43,725 2012 Education Level Average Hourly Wage Average Gross Annual Income Bachelor s $24.76 $49,400 Master s $20.18 $51,100

Future

Vocational growth In-demand skills According to O*Net (date of access 01/08/15) the term psychometrist is currently not represented, yet neuropsychologists are a job that has been labeled as a bright outlook occupation which is an area that is to grow rapidly in the next several years, will have large numbers of job openings or are new and emerging occupations Increasing the need for psychometrists as neuropsychologists are increasing in numbers

Expanding practice and collecting data Currently a salary survey but can t make information public Initiation of acknowledgment in the US Government s directory of job titles and codes, O*Net Diversifying the field to meet patients linguistic needs Bilingual psychometrist model? Collecting information regarding Training history Organizational and operation practices for psychometrists Tests utilized? Languages spoken by patients and practices working with bilingual/non English individuals Expanding awareness of psychometrist career

PREP P S Y C H O M E T R I S T S R E A C H I N G O U T A N D E D U C A T I N G T H E P U B L I C

Pilot Rationale: To increase awareness of the psychometrist career for college students Aim: To present 3 times over the course of the year Supplies: Anna, PowerPoints (approximately 40 minutes long and tailored for each site), Surveys, Pens, Candy, Informational brochures Outline Background Definition of job role Education and training required Neuropsychology overview Presenter s descriptions of personal interests in the field Salary comparisons NAP introduction and benefits CSP certification Possible local work sites Suggestions for preparation

SAMPLE SLIDE What is a psychometrist? An individual that administers and scores psychological and neuropsychological tests under the supervision of a clinical psychologist or clinical neuropsychologist. Titles used Psychometrist (correct term!) Psychology technician Psychometrician/Neuropsychometrician (this term is actually intended for professionals that create tests) tech and technician (within the field) Over 250 psychometrist members of the National Association of Psychometrists plus unknown numbers of those that are not

Other potential psychometrist duties Clinical work Clerical work Observation notes Training/supervising others Research collaboration Assisting with cortical mapping and/or Wada testing Patient reports Professional presentations Therapy Order testing and keeping inventory Scheduling patients Insurance paperwork

Other titles for psychometrists: 1) Psychometricians 2) Neuropsychometricians 3) Psychological Assistant/Associate/Aides 4) Neuropsychology/Psycholo gy Technician 5) Testing Technician 6) Psychodiagnostic Assistant 7) Psychological Extenders 8) Paraprofessionals 9) Assessment specialist 10)Uncredentialed Personnel

University of Texas at Arlington March 30, 2015 UTA Psychology Society College located in an urban area between Dallas and Ft. Worth; 35,000 students enrolled in 2014 Undergraduate degree, Experimental Psychology, Health and Neuroscience, Industrial/Organizational 20 attendees with few questions Via Facebook quote It was really interesting! Love learning about new psychology pathways or subfields No one had heard of a psychometrist!

Survey questions Handed out at end of presentation Age Gender Open response questions What was something you learned today that was important/relevant to you? Is there any information that you were curious about that was not covered in the presentation? What are your current plans for your career (i.e. going on for your PhD in Psychology, stopping after BA/MA, working for a non-profit, etc?

Baylor University October 1, 2015 Psychology Club Private Texas college located between Dallas and Austin with over 16,000 students Undergraduate degrees (Pre-Psych); Clinical Psychology, School Psychology 14 attendees; 12 returned surveys Ages 18-21 and one unknown For important information: 83% identified the possibility of a career with a Bachelor s degree with many not aware that one could have a job in the field

University of Texas at Tyler

References https://en.wikipedia.org/wiki/psychometry http://www.merriamwebster.com/dictionary/psychometrician

Sources Brodsky, S. L. & Mixon, R.J. (1969). A survey of technician frequency and activities in clinical neuropsychology. Journal of Clinical Psychology, 25 (2), 221-223. Report of the Division 40 Task Force on Education, Accreditation, and Credentialing (1989): Guidelines regarding the use of non-doctoral personnel in clinical neuropsychological assessment Echemendia & Harris, 2004 Hall, J.D., Howertown, D.L., and Boling, A.U. (2005). The use of testing technicians: Critical issues for professional psychology. International Journal of Testing, 5(4), 357-375. Malek-Ahmadi, M., Erickson, T., Puente, A.E., Pliskin, N., Rock, R. (2012). The Use of Psychometrists in Clinical Neuropsychology: History, Current Status, and Future Directions. Applied Neuropschology, 19(), 26-31 Novotney, A. 2011. Psychological job forecast: Partly sunny. American Psychological Association. http://www.apa.org/gradpsych/2011/03/coversunny.aspx National Association of Psychometrists. http://napnet.org/about/what-is-apsychometrist/ National Association of Psychometrists Salary Surveys 2009 & 2012

Puente, A. E., Adams, R., Barr, W. B., Bush, S. S., & NAN Policy Planning Committee, Ruff, R.M., Barth, J.T., Broshek, D., Koffler, S.P., Reynolds, C., Silver, C.H., Troster, A.I. (2006). The use, education, training and supervision of neuropscyhological test technicians (psychometrists) in clinical practice. Official statement of the National Academy of Neuropsychology. Archives of Clinical Neuropsychology, 21 (8), 837-839. Richardson, R. (2003). Epilepsy and surgical mapping, British Medical Bulletin, 65(1), 179-192. Rivera Mindt, M., Byrd, D., Saez, P., & Manly, P. (2010). Increasing culturally competent neuropsychological services for ethnic minority populations: A call to action. The Clinical Neuropsychologist, 24 (), 429-453. Sweet, J.J., Meyer, D.G., Nelson, N.W., and Moberg, P.J. (2011). The TCN/AACN 2010 Salary Survey : Professional Practices, Beliefs and Incomes of U.S. Neuropsychologists. The Clinical Neuropsychologist, 25(1), 12-61. Sweet, J.J., Moberg, P.J., Suchy, Y. (2000). Ten-Year Follow-up Survey of Clinical Neuropsychologists: Part II. Private Practice and Economics. The Clinical Neuropsychologist, 14(4), 479-495. Texas Administrative Code (1997), Title 22 Examining Boards, Part 21 Texas State Board of Psychologists, Chapter 465 Rules of Practice, Section 465.4. Employment of Individuals Not Licensed by This Board, Retrieved from http://tx.eregulations.us/rule/title22_chapter465_sec.465.4.