COURSE APPROVAL GUIDELINES APS COLLEGE OF CLINICAL NEUROPSYCHOLOGISTS

COURSE APPROVAL GUIDELINES APS COLLEGE OF CLINICAL NEUROPSYCHOLOGISTS Updated October 2000

1. General Introduction and Principles Clinical neuropsychology is a division of psychology concerned with the cognitivebehavioural expression of brain dysfunction. A clinical neuropsychologist may be involved in diagnostic assessment; patient care, management and planning; treatment and intervention; and research. These roles require a range of skills and knowledge that can be drawn from concepts in clinical science, neuroscience, neurology and psychology. The APS College of Clinical Neuropsychologists considers that post-graduate courses in Clinical Neuropsychology should equip a psychologist with the necessary neuropsychological skills to undertake a range of clinical activities, across settings, and with a broad range of neurologically impaired clients. Based on this principle, the College has developed the following guidelines for use in the evaluation of post-graduate courses of supervised training in Clinical Neuropsychology. The Course Approval Committee of the APS College of Clinical Neuropsychologists may then approve courses, which meet these guidelines. Successful completion of these courses will provide eligibility for associate membership of the APS College of Clinical Neuropsychologists and eligibility for full membership subsequent to having been actively engaged in supervised practice in the specialist field of Clinical Neuropsychology for an approved period of time (see College guidelines for membership). The following Guidelines for Course Approval are intended to provide a supplementary document to the APS Accreditation Guidelines established by the Directorate of Training and Standards. The Course Approval Guidelines are intended to help institutions in developing their courses and obtaining resources for them. In establishing these guidelines the APS College of Clinical Neuropsychologists places no restriction on additional course work or components of the course which will emphasise individual interests and strengths. These guidelines apply to all fifth and sixth year programs in psychology, which lead to a coursework Masters degree. The degree title should include the term Psychology and also the specialization of Clinical Neuropsychology, either as part of the main degree (e.g., Master of Clinical Neuropsychology) or following the main title (e.g., Master of Psychology (Clinical Neuropsychology)). The guidelines also apply to doctoral level programs that include all the components for an accredited Masters program. The title of the degree should include clear reference to the specialization of Clinical Neuropsychology. Doctoral programs should only be referred to as PhDs if they also include a program of research leading to a thesis equivalent in status to other PhDs by research only. For this reason, it would be expected that such degrees would be a minimum duration of four years or equivalent full-time study and an acceptable title would be PhD (Clinical Neuropsychology). Doctoral programs which do not include a component of research and thesis equivalent in standard to a PhD, or which have at least 50% of the program as coursework, should be referred to as either a D.Psych or a PsyD. It would be expected that these degrees would be a minimum of three years of full-time study,

or equivalent part-time study. Examples of acceptable degree titles are D.Psych (Clinical Neuropsychology) and PsyD (Clinical Neuropsychology). Page 3

2. General Program Requirements 2.1 Entry Requirements See Accreditation Guidelines 3.3.1-3.3.3. 2.2 Length See Accreditation Guideline 3.3.4. 2.3 Staffing 2.3.1 At least three staff members involved in the course should be full members of the APS College of Clinical Neuropsychologists, or eligible for full membership of the College. At least one of these staff members, who have a major responsibility for the program, will be at Level D or Level E. The dedicated specialist staff are expected to spend a substantial amount of time devoted to the program, the amount of which will be determined by the number of specialist staff and student numbers. 2.3.2 It is expected that the student: academic staff ratio for postgraduate coursework programs should be no greater than 6 to 1. This ratio will take into account the proportion of each staff member s time devoted to the program and equivalent full-time student numbers. 2.3.3 Staff members who are responsible for any practical placement supervision associated with a program should be members or eligible for membership of the APS College of Clinical Neuropsychologists, and should have at least three years relevant full-time experience, or equivalent. 2.3.4 Further staffing arrangements should be adequate to achieve specialist and general professional training and supervision (see Accreditation Guidelines 3.3.7-3.3.9). 2.4 Advisory/Liaison Committee See Accreditation Guideline 3.3.10. 2.5 Resources 2.5.1 There should be adequate facilities for training students in interviewing, testing and assessment. These facilities should include rooms, which are sufficiently well soundproofed to carry out training and confidential assessments, and

which have video-recording equipment and/or one way viewing facilities. These rooms should also be appropriately furnished for formal testing and for interviewing. (See Accreditation Guideline 3.3.11). 2.5.2 Adequate administration and clerical support is required to ensure the efficient implementation of the professional training course requirements. 2.5.3 A test library within the department should possess adequate holdings of tests in clinical neuropsychology, and the University library should provide substantial holdings of journals relevant to clinical neuropsychology (see Accreditation Guidelines 3.3.12, 3.3.13). 2.5.4 Students should have access to computers with a range of software for wordprocessing and data analysis and presentation, as well as access to Internet. It is also recommended that students should be provided with space for personal study that should include at least a shared desk, filing cabinet and telephone (see Accreditation Guideline 3.3.14). 3. Program Structure See Accreditation Guidelines 3.3.15-3.3.19. 4. Coursework 4.1 In addition to the APS Accreditation Guidelines (3.3.21 3.3.23), formal knowledge at an advanced level, in the following core subjects is considered essential. Each specified area will require sufficient teaching hours to allow comprehensive coverage as well as balance across the total coursework content. Within a masters program, at least 50% of the coursework component must be devoted to these core coursework areas. Any single core coursework area must receive coverage of at least one hour per week for one semester (i.e., 13 hours). It is anticipated that most core coursework areas will receive far greater taught hours in order to achieve the expected weighting required for overall coverage of topics essential to clinical Neuropsychology. Designated core areas may be taught in various streams, e.g., neuropathology may be taught in lecture streams covering neuropsychological syndromes. When this occurs this needs to be clearly indicated. Core coursework subjects in neuropsychology must be completed within the first two years of full-time (or equivalent part-time study) for a coursework doctorate program. 4.1.1 Neuropsychological assessment techniques and approaches to assessment -

approaches and models of neuropsychological practice psychological tests applied psychometrics 4.1.2 Neuropsychological syndromes - This should include the neuropsychological manifestations of the following major disorders: alcohol and drug related disorders degenerative disorders developmental disorders neurological and neurosurgical conditions traumatic brain injury vascular disorders psychiatric disorders 4.1.3 Neuropsychological theories/models of cognition and behaviour - Areas addressed should include: attention memory executive processes perception spatial skills and skilled motor behaviour language emotional behaviour development across the lifespan 4.1.4 Neuroanatomy - Students should gain a thorough understanding of human neuroanatomy through both theoretical and practical work. This would normally entail students undertaking a course of approximately 40 hours. Specific course guidelines for acceptable course structure are available from the Secretary, College of Clinical Neuropsychologists. 4.1.5 Rehabilitation - This should include: theories of recovery models of rehabilitation management of neuropsychological disorders including but not limited to behaviour modification principles and techniques interdisciplinary management 4.1.6 Neuropathology and basic neurology -

Students should gain a thorough understanding of the basic neurological examination and other neurological investigative techniques. An understanding should also be gained of the neuroanatomical/neurological bases of the various neuropsychological disorders described above. 4.1.7 Psychopathology - Major areas of psychopathology including depression, anxiety, schizophrenia and posttraumatic stress disorder should be introduced. Issues of differential diagnosis are to be covered. 4.1.8 Professional and ethical issues - Using the APS Accreditation Guideline 3.3.21 the following topics should be included: confidentiality accountability legal report writing, reporting and appearing as an expert witness teamwork intercultural and ethnic issues, working with interpreters 4.2 In addition, formal knowledge in the following areas is considered desirable: cognitive neuropsychology psychotherapeutic techniques basic neuropharmacology aging and psychogeriatrics cognitive behaviour therapy developmental neuropsychology 4.3 Skills should be obtained in the following areas: interviewing and history taking test administration, scoring, interpretation diagnostic evaluation report writing and consultation patient and family management, and counselling 5. Research In addition to the APS Accreditation Guidelines 3.3.24 to 3.3.32, the following specialist issues should be addressed: 5.1 The research topic should be one that is clearly relevant to clinical neuropsychology and preferably include a clinical sample. 5.2 Formal teaching of research methodology is essential.

5.3 The supervisor may be any member of the Psychology Department staff of the institution, although it is highly desirable that they have a strong interest/background in neuropsychology and be eligible for membership of the APS College of Clinical Neuropsychologists. Furthermore, if participants for the study were provided by an institution that has a clinical neuropsychologist working in that area, input from that neuropsychologist would be desirable. 6. Practical Placements In addition to the APS Accreditation Guidelines (3.3.33 3.3.44) the following specialist issues should be addressed: 6.1 For a masters program, practical experience should result in a logbook of at least 50 cases and a casebook of at least 10 detailed cases. These should include at least one case from each of the five populations stipulated in 6.3 below, and could include issues related to assessment, management or intervention. The logbook should contain an accurate record of all of the clients that the student has seen during the training program. Each log entry should provide details of the location, date of service, referral question, synopsis of report or intervention program, and diagnostic category. Each logbook entry is to be countersigned by the placement supervisor. The casebook should demonstrate practical and theoretical understanding with a wide range of neuropsychological syndromes and should constitute part of the formal assessment of students overall course results. The case reports should include the referral question, details of the client s past developmental, medical and psychological history and any other relevant background material. Any references or general orientations to literature that contributes to the case should be included in the introductory discussion of the case. There should also be a section which outlines the hypotheses that were tested with the assessment, based on the referral question and the background, and how the examination addressed these areas of interest in terms of tests or techniques employed. Results of the tests administered and highlights of the assessment should always be included. A summary section including the interpretation of the results in line with the hypotheses, recommendations and treatment options should be provided. The same hypothetico-deductive model can equally well be applied to intervention case reports. In these cases the therapeutic models need to be clearly described and the means of evaluation of outcome carefully elaborated. A case report is expected to contain more detail than the report that was submitted to the organisation from which the client came. 6.2 For a professional doctorate program, practical experience should result in submission of a logbook and casebook as detailed for a masters program but the casebook should

contain an additional section with cases reflecting the specialist experience and knowledge gained during a third year of training in Clinical Neuropsychology. Mindful of the goal of diversity and of the variation in professional experience provided in particular settings, there would be greater flexibility with respect to satisfying the third year casebook requirements. Discretion will be left to the coordinators of particular Doctor of Psychology training programs to provide specific guidelines for the students in their programs and this may include individually tailored requirements that take into account the placement experience of the student, their educational needs and their expertise in particular areas. However, the casebook for the third year internship should represent a separate section which should include at least SIX separate items representative of any of the options listed below: An intensive theory-driven assessment of a case, or cases, of neuropsychological impairment. This will typically include a review of the clinical syndrome or issue in clinical neuropsychology that has been part of the clinical experience of the student during the third year program. The detailed case report may highlight the features of a relatively uncommon condition that incorporates appropriate reference to the literature. Alternatively, the case may isolate the features of the clinical presentation, which provide a basis for differential diagnosis and diagnostic opinion. A report and evaluation of the issues related to recovery, intervention and management for both the individual with neuropsychological impairment and for his/her carers. This may include: a serial assessment of a client that highlights the changes in his/her cognitive and behavioural functioning over an appropriate time period, whether this constitutes recovery, decline or fluctuation; an assessment prior to a medical intervention and a post-assessment; a longitudinal study of intervention with a client during a rehabilitation program; a case study of a specific intervention in the cognitive or behavioural domain; a description and critique of an individual, family or group-based intervention where the student had an active role in the development of content and/or delivery of the intervention; a review of an adjunctive treatment for clients with neuropsychological deficits. Examples would be a specific medication, a treatment program, a support group etc. A report identifying and reviewing the diversity of purpose that a neuropsychology report can be targeted for. This may include: a collection of reports about one particular case or assessment where the reports have been tailored to different target audiences (e.g. a child case where there is a report to the referring doctor, a report to school, a report for integration assistance and a report to the family); a specifically prepared forensic report of a neuropsychological assessment; a detailed descriptive report of a client s neuropsychological functioning aimed at educating other professionals or non-professionals involved with the client about the nature of the cognitive/behavioural deficits.

A critical review of the role of clinical neuropsychology and/or a clinical neuropsychologist in the organization where the internship is conducted. This may include analysis of service delivery and policy decisions within the organization which are pertinent to the profession of neuropsychology. In addition to the above cited options the student, in consultation with the internship supervisor and the program field co-ordinator, may select any other project selected by staff in the Doctor of Psychology program that reflects the development of additional skills and/or knowledge in a student during the third year. 6.3 Within a masters program, students are expected to complete a minimum of 1000 hours (125 days) of placement. In a doctorate program, students are expected to complete a minimum of 1500 hours (200 days) of placement, of which 125 days are completed in the first two years of full-time (or equivalent part-time) study. It is mandatory that placements expose students to acute neurology/neurosurgery, rehabilitation, psychiatric, geriatric and paediatric populations. 6.4 Students should participate in supervised practicums within the second year of the course and preferably during the latter part of their first year. In the third year of a doctorate program placements may take the form of internships within which students are expected to take a more independent role in the placement agency. 6.5 It is recommended that students will have developed sufficient skills and understanding of neuropsychological theories, syndromes and assessment strategies before undertaking placement in an external agency. 6.6 The agencies, organisations or settings in which students are placed will be ones in which one or more clinical neuropsychologists are appointed in an employed or honorary capacity. In exceptional cases where the supervising neuropsychologist is not appointed to the agency, formal links should be established between the supervising neuropsychologist and the agency. 6.7 At least 80% of clinical supervision must be conducted by a full member of the APS College of Clinical Neuropsychologists (or person eligible for full membership of the College). 6.8 The institution, which offers the course, should ensure that the supervisors are clearly informed as to their expected role and responsibilities. 6.9 If a placement is failed the student is required to undertake and pass another placement of the same duration and, wherever possible, in a similar setting.

6.10 It is the responsibility of the University to liaise with the supervisor to ensure communication throughout the placement. The University should provide the means for issues raised on placement to be discussed with forthcoming supervisors where appropriate. 7. Assessment 7.1 Students are required to successfully complete all three components of the course (coursework, practical placement and research) in order to complete the degree (see Accreditation Guideline 3.3.45). 8. Credit See Accreditation Guidelines 3.3.46 3.3.48