Current through Register Vol. 50, No. 9, September 20, 2024
A.
Statement of Purpose. As each of the other specialty areas of psychology such
as clinical psychology, counseling psychology, school psychology, and
industrial-organizational psychology typically have their own clearly defined
doctoral programs and curriculum, no separate guidelines beyond those
established by these programs are deemed necessary to declare these particular
specialty designations. Clinical neuropsychology has evolved into a specialty
area as defined by LAC 46:LXIII.Chapter 17 in that it has become identified as
having its own "history and tradition of service, research, and scholarship
(and) to have a body of knowledge and set of skills related to that knowledge
base, and which is discriminably different from other such specialties" (LAC
46:LXIII.1705.B). However, the evolution of clinical neuropsychology has cut
across several applied areas, most notably clinical, counseling, and school
psychology, resulting in the need for guidelines defining the minimal education
and training requirements necessary for specialization in this area of clinical
practice.
B. Definition of
Practice. As implied by the term, clinical neuropsychology involves the
application of both neurological and psychological knowledge and clinical
skills in the assessment, treatment or intervention with individuals with known
or suspected brain injury or disease.
1.
Clinical neuropsychology differs from the general cognitive, perceptual,
sensorimotor, intellectual or behavioral assessments of clinical, counseling,
school or industrial-organizational psychology. Its purpose is to make clinical
judgments regarding the functional integrity of the brain and of the specific
effects of known brain pathology based on assessment and analysis of these
functions.
2. Other psychologists,
licensed under this law (R.S.
37:2356) and possessing appropriate education
and training in the area of health care delivery, may also assess individuals
with known or suspected brain pathology for the purpose of defining levels of
academic or intellectual development; determining areas of relative strengths
or weaknesses in cognitive, perceptual or psychomotor skills; identifying and
categorizing behavioral or personality problems and their psychological
origins; and making differential psychiatric diagnoses.
3. Clinical neuropsychologists, however, have
as their purpose to assess and analyze cognitive, perceptual, sensorimotor and
behavioral functions in order to identify and isolate specific, elementary
neurobehavioral disturbances; differentiate neurological from possible
psychological, cultural or educational contributions to the observed deficits;
and finally, to clinically integrate this information into a neuroanatomically
and/or neuropathologically meaningful syndrome. These impressions are then
compared with the patient's known medical, psychiatric and neurological risk
factors and personal and behavioral history to arrive at a neuropsychological
diagnosis. Because of their appreciation of specific neurobehavioral deficits
and neurobehavioral syndromes in general, clinical neuropsychologists, as part
of the evaluation process, are also called upon to make specific
recommendations for the treatment and management of cognitive and
neurobehavioral deficits resulting from brain injury or disease.
4. Clinical neuropsychological intervention
includes, but is not limited to, developing strategies and techniques designed
to facilitate compensation for or recovery from these various organically
induced deficits based on the clinical neuropsychologist's understanding of
brain-behavior relationships and the underlying neuropathology. It is also
recognized that other psychologists, licensed under this law (R.S.
37:2356) and possessing appropriate education
and training in the area of health care delivery, may also provide traditional
psychotherapeutic intervention in assisting patients adjust to the emotional,
social or psychological consequences of brain injury.
5. These regulations recognize the
overlapping roles in certain aspects of clinical neuropsychological assessment
and intervention of other professionals, such as behavioral neurologists,
speech pathologists, and learning disability specialists, and are not meant to
constrain or limit the practice of those individuals as affirmatively set forth
in their relevant enabling statutes. These regulations are not meant to
constrain or limit the practice of licensed psychologists who through
education, training, and experience have acquired competence in the use of
psychological assessment instruments that measure various aspects of function
to include but not limited to general intelligence, complex attention,
executive function, learning and memory, language, perceptual motor and social
cognition.
C. Training
and Educational Requirements. The guidelines for licensure as a psychologist,
as defined in LAC 46:LXIII.301 and 303, are also applicable as minimal
requirements for consideration for the practice of clinical neuropsychology.
However, in addition to one's basic training as a psychologist, specialty
education and training is considered essential. The International
Neuropsychological Society (INS) and Division 40 of the American Psychological
Association (APA) have developed guidelines for specialty training in clinical
neuropsychology. These guidelines represent the current recommendations for the
education and training of psychologists who will engage in the delivery of
clinical neuropsychological services to the public. It is recognized that many
current practitioners of clinical neuropsychology were trained well before such
specialty guidelines were devised and such educational and training
opportunities were readily available. Additionally, it is recognized that there
are many psychologists, who were not initially trained as clinical
neuropsychologists, but who would like to respecialize and practice in this
field. The purpose of these regulations is also to address the circumstances of
these individuals. The minimum requirements set forth in the Louisiana
Administrative Code for Psychologists will also apply to all
candidates seeking a specialty designation in clinical neuropsychology.
1. Doctoral Training in Clinical
Neuropsychology after 1993. Because of the diversity of training programs in
clinical neuropsychology, some discretionary judgment as to the adequacy of any
educational and training program must be left to the board. However, the basic
model for training in clinical neuropsychology will be in keeping with the
guidelines developed by INS/APA Division 40. These are as follows:
a. a basic core psychology curriculum as
defined in LAC 46:LXIII.303.C.11;
b. a clinical core that includes
psychopathology; didactic and practicum experiences in the assessment of
individual differences (psychometric theory, interviewing techniques,
intelligence and personality assessment); didactic and practicum experiences in
psychotherapeutic intervention techniques; and professional ethics;
c. specific courses relating to training in
clinical neuropsychology including, but not limited to: basic neurosciences
such as advanced physiological psychology; advanced perception and cognition;
research design and/or research practicum in neuropsychology;
psychopharmacology; functional human neuroanatomy; neuropathology; didactic and
practicum experiences in clinical neuropsychology and clinical
neuropsychological assessment; and principles of clinical neuropsychological
intervention;
d. specialty
internship in clinical neuropsychology, followed by the completion of a formal
post-doctoral fellowship (one year minimum) in clinical neuropsychology, or the
equivalent of one full year (2,000 hours) of post-doctoral experience in
clinical neuropsychology under the supervision of a qualified clinical
neuropsychologist (as defined here and in LAC 46:LXIII.307.C.2, 3, and 4). The
majority of these hours must involve clinical neuropsychological assessment,
and some portion of the remaining hours should be related to rehabilitation of
neuropsychological deficits. The supervision, as defined above, should involve
a minimum of one hour of face-to-face supervision a week, though additional
supervisory contact may be required during training phases and case
discussions. The 2,000 total hours must be obtained in no more than two
consecutive years;
e. as with any
specialty area of psychology, being licensed to practice with a specialization
in clinical neuropsychology will depend on the successful completion of both
written and oral examinations as defined by the board.
2. Respecialization for Psychologists with
Other Designated Specialty Areas
a. The
requirements for any given individual may vary depending on his or her previous
education, training, supervised practica, and clinical experiences.
Documentation of one's relevant training and clinical experience, along with a
formal plan for respecialization in clinical neuropsychology, will be submitted
to the board for approval.
b.
Continuing education in clinical neuropsychology, regardless of its nature and
content, will not be considered, in and of itself, sufficient for
respecialization. Any such educational experiences must be supplemented by
formal applied clinical experiences under the supervision of a qualified
clinical neuropsychologist.
c.
While a formal course of post-doctoral graduate training in clinical
neuropsychology may be considered ideal, matriculation in such a graduate
program may not be essential for someone already trained in an area of health
care delivery psychology. Such an individual may undertake an informal course
of studies outlined by the supervising clinical neuropsychologist. Such a
program of studies should be designed to supplement whatever may be lacking
from the basic educational requirements listed under LAC 46:LXIII.307.C.1.c and
must be submitted to the board for prior approval.
d. specialty internship in clinical
neuropsychology (one year minimum), followed by the completion of one year of
post-doctoral supervised experience in clinical neuropsychology; or, the
equivalent of two full years (4,000 hours) of post-doctoral experience in
clinical neuropsychology under the supervision of a qualified clinical
neuropsychologist (as defined here and in LAC 46:LXIII.307.C.2, 3, and 4). The
majority of these hours must involve clinical neuropsychological assessment,
and some portion of the remaining hours should be related to rehabilitation of
neuropsychological deficits. The supervision, as defined above, should involve
a minimum of one hour of face-to-face supervision a week, though additional
supervisory contact may be required during training phases and case
discussions;
e. Following the
completion of this program, the candidate for respecialization will be required
to pass an oral examination administered by the board or a committee of its
choosing relating to the practice of clinical neuropsychology.
3. Psychologists Trained Prior to
1993 with Demonstrated Expertise in Clinical Neuropsychology
a. Those psychologists whose training and
experience qualify them as having particular expertise in this field, may
petition for a specialty designation in clinical neuropsychology. The following
may be offered as evidence of such expertise:
i. diplomat status (ABPP/ABCN or ABN) in
neuropsychology;
ii. formal
training and supervised practicum experiences in clinical neuropsychology as
defined in LAC 46:LXIII.307.C.1;
iii. extensive clinical practice in the area
of clinical neuropsychology, such that one has a regional or national
reputation among his or her peers as having competence in this field;
iv. in addition to the clinical practice of
neuropsychology, one has significant scholarly publications in the area or
teaches courses in clinical neuropsychology at a graduate level in an
accredited psychology program.
b. These credentials would be subject to
review and approval by the board.
c. After having met all other requirements
for licensure under this Chapter, the candidate may be required to pass an oral
examination administered by the board or a committee of its choosing relating
to the practice of clinical neuropsychology.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
37:2353 and
R.S.
37:2356.
