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Postdoctoral Training in Neuropsychology: A Review of the History, Trends,

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Training and Education in Professional
Psychology
Postdoctoral Training in Neuropsychology: A Review of
the History, Trends, and Current Issues
Doug Bodin, Brad L. Roper, Kathleen O’Toole, and Mary E. Haines
Online First Publication, June 2, 2014. http://dx.doi.org/10.1037/tep0000057

CITATION
Bodin, D., Roper, B. L., O’Toole, K., & Haines, M. E. (2014, June 2). Postdoctoral Training in
Neuropsychology: A Review of the History, Trends, and Current Issues. Training and
Education in Professional Psychology. Advance online publication.
http://dx.doi.org/10.1037/tep0000057
 Training and Education in Professional Psychology © 2014 American Psychological Association
2014, Vol. 8, No. 2, 000 1931-3918/14/$12.00 http://dx.doi.org/10.1037/tep0000057

Postdoctoral Training in Neuropsychology: A Review of the History,

Trends, and Current Issues

Doug Bodin Brad L. Roper

The Ohio State University and Nationwide Children’s Hospital, Memphis Veterans Affairs Medical Center, Memphis, Tennessee
Columbus, Ohio and University of Tennessee Health Science Center

Kathleen O’Toole Mary E. Haines

Children’s Healthcare of Atlanta, Atlanta, Georgia University of Toledo Medical Center
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.

Clinical neuropsychology is a specialty within professional psychology that involves the scientific study of
brain-behavior relationships and the application of this knowledge to the evaluation and treatment of
individuals with known or suspected central nervous system dysfunction. Training guidelines for clinical
neuropsychology began to be developed in the 1970s and were refined during a national conference in the
1990s (i.e., the Houston Conference), which identified a two-year post-doctoral residency as a required part
of training and the capstone experience for independent practice. The Association of Postdoctoral Programs
in Clinical Neuropsychology (APPCN) was formed in the early 1990s to promote and maintain training
standards in clinical neuropsychology. Specialty accreditation in clinical neuropsychology by the American
Psychological Association is also available but not widely pursued at this time. Despite the strong organiza-
tional structure of postdoctoral training in clinical neuropsychology, problems remain within the field. This
article describes the history and status of postdoctoral training in clinical neuropsychology, defines problems
facing the specialty, and outlines future areas to be addressed.

Keywords: post-doctoral training in neuropsychology, neuropsychology training, neuropsychology res-

idencies, neuropsychology fellowships

Brief History of Clinical Neuropsychology
Neuropsychology can be defined as the scientific study of
brain-behavior relationships. Clinical neuropsychology involves
the application of this knowledge to understand normal and ab-
normal brain development and the effect of brain disease and
injury on cognitive, emotional, and behavioral functioning. As a
health-care discipline, the roots of clinical neuropsychology can be
traced back to the 1940s when clinicians were asked to examine
the cognitive and behavioral effects of penetrating head injuries in
veterans of World War II (Benton, 1987). The discipline began to

Emory University School of Medicine. Her areas of professional interest

DOUG BODIN received his PhD in clinical psychology from The University of
Alabama. He is board certified in clinical neuropsychology by the American
Board of Professional Psychology. He is a pediatric psychologist at Nation-
wide Children’s Hospital, Columbus, Ohio where he directs the post-doctoral
training program. He is also an assistant clinical professor of pediatrics at The
Ohio State University College of Medicine. His areas of professional interest
include neuropsychology training, epilepsy, and concussion.
BRAD L. ROPER received his PhD in clinical psychology from the University of
Minnesota. He is board certified in clinical neuropsychology by the American
Board of Professional Psychology. He is the director of the neuropsychology
program at the Memphis VA Medical Center, Memphis, Tennessee and is an
associate professor in the departments of Psychiatry and Neurology at the
University of Tennessee Health Science Center. His areas of professional
interest include neuropsychology training, the ecological validity of neuropsy-
chological tests, and symptom validity science.
KATHLEEN O’TOOLE received her PhD in school psychology with a special-
ization in developmental neuropsychology from Georgia State University. She
is board certified in clinical neuropsychology by the American Board of
Professional Psychology. She is the post-doctoral training director in pediatric
neuropsychology at Children’s Healthcare of Atlanta, Atlanta, Georgia and
include neuropsychology training, transition of care for adolescents with
neurological/medical disorders and cognitive remediation.
MARY E. HAINES received her PhD in clinical psychology from Texas A&M
University. She then completed a two-year post-doctoral fellowship in clinical
neuropsychology at Baylor College of Medicine and The Institute for Reha-
bilitation and Research in Houston, Texas. She is board certified in clinical
neuropsychology by the American Board of Professional Psychology. She is
currently the neuropsychologist for the rehabilitation services at the University
of Toledo Medical Center, the director of clinical training for the clinical
neuropsychology post-doctoral fellowship. She is also a clinical professor in
the Department of Psychiatry and Department of Physical Medicine and
Rehabilitation, University of Toledo Medical Center. Research interests in-
clude traumatic brain injury and cognitive effects of advanced heart failure.
DOUG BODIN, KATHLEEN O’TOOLE, and MARY E. HAINES were officers of
APPCN at the time of the manuscript submission. Brad L. Roper is a former
officer of APPCN.
CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Doug
Bodin, Section of Pediatric Psychology and Neuropsychology, 3rd floor
JW, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH
43205. E-mail: Doug.Bodin@nationwidechildrens.org

1
 2 BODIN, ROPER, O’TOOLE, AND HAINES
flourish in the 1960s with the establishment of the first two
neuropsychology journals (Neuropsychologia and Cortex) and the
establishment of the International Neuropsychological Society
(INS) as an international and multidisciplinary scientific organi-
zation with an emphasis on research. In 1975, the National Acad-
emy of Neuropsychology (NAN) was formed as the first profes-
sional organization for neuropsychologists with a clinical
emphasis (Bush, 2011). In 1980, Division 40 (Clinical Neuropsy-
chology) of the American Psychological Association (APA) was
formed. Recently renamed the Society for Clinical Neuropsychol-
ogy, Division 40 now has approximately 4,000 members and is the
largest division within APA. In 1981, the American Board of
Clinical Neuropsychology (ABCN) was formed to establish the
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
eligibility and examination procedures for board certification in
This document is copyrighted by the American Psychological Association or one of its allied publishers.
clinical neuropsychology (Meier, 1998). In 1983, ABCN began a
continuing relationship with the American Board of Professional
Psychology (ABPP) to conduct board examination procedures for
the specialty of clinical neuropsychology. To date, ABCN has
awarded more than 900 board certifications in clinical neuropsy-
chology (http://www.theabcn.org). In 1996, clinical neuropsychol-
ogy was recognized as a specialty by APA’s Commission for the
Recognition of Specialties and Proficiencies in Professional Psy-
chology (CRSPPP) (Meier, 1998). Thus, clinical neuropsychology
is recognized as a specialty by APA and ABPP. Clinical neuro-
psychology is part of the Council of Specialties in Professional
Psychology (CoS; http://cospp.org) and is represented at CoS by
the chair of the Clinical Neuropsychology Synarchy (CNS), a
specialty council composed of representatives from major organi-
zations within neuropsychology.
Training in Clinical Neuropsychology
Education and training in clinical neuropsychology before the
1970s was not well documented. Students often gained experi-
ences under either a mentorship model and/or by collaborating
with faculty to organize informal training opportunities. Because
of the lack of education and training guidelines in clinical neuro-
psychology, the INS formed a Task Force on Education, Accred-
itation, and Credentialing (TFEAC) in the 1970s to begin estab-
lishing educational and training guidelines for clinical
neuropsychology (Meier, 1998). As INS matured into more of a
scientific society, the management of TFEAC was gradually
shifted to APA Division 40. TFEAC produced a document that
outlined guidelines for specialty training in clinical neuropsychol-
ogy at the doctoral, internship, and postdoctoral levels (Report of
the INS-Division 40 Task Force on Education, Accreditation, &
Credentialing, 1987). Of note, the report indicated that completion
of a doctoral degree, including an internship with at least 50% of
experience in clinical neuropsychology, would meet the minimal
qualifications for practice as a clinical neuropsychologist. As such,
formal postdoctoral training was not required for entry into inde-
pendent practice. The report defined the goal of postdoctoral
training to “produce an advanced level of competence in the
specialty of clinical neuropsychology.” TFEAC specified that
postdoctoral programs in clinical neuropsychology be directed by
a board-certified clinical neuropsychologist and consist of 2 years
of clinical, research, and didactic training. Entry criteria were
defined as completing an accredited PhD graduate program in “one
of the health service delivery areas of psychology” and completion
of an Association of Psychology Internship Centers (APPIC) pre-
doctoral internship. The TFEAC guidelines further stated that
postdoctoral training in clinical neuropsychology occur at a hos-
pital setting with neurological and/or neurosurgical services. In
addition to clinical training, a significant research component was
specified and exit criteria included accomplishment in research.
Finally, the TFEAC guidelines defined postdoctoral exit criteria to
include eligibility for board certification by ABPP/ABCN.
The document produced by the TFEAC was an important step
toward outlining distinct criteria for training at each developmental
stage of becoming a clinical neuropsychologist. However, the
TFEAC document did not include a linkage between each stage. In
addition, the TFEAC document essentially created two tiers of
clinical neuropsychologists: (a) those who after a clinical neuro-
psychology internship met the minimal standards for independent
practice; and (b) those who completed 2 years of postdoctoral
training, met criteria for advanced practice, and were clearly
prepared to seek board certification.
After clinical neuropsychology was initially recognized by APA
as a specialty in 1996, members of the CNS discussed holding a
training conference to develop an integrated model of training in
clinical neuropsychology (Bieliauskas, 1998). This discussion ul-
timately culminated in the Houston Conference on Specialty Ed-
ucation and Training in Clinical Neuropsychology (Houston Con-
ference) held in September 1997 (Hannay et al., 1998). The goal of
the Houston Conference was to “advance an aspirational, inte-
grated model of specialty training in clinical neuropsychology”
across the doctoral, internship, and postdoctoral levels of training.
A group of 40 delegates was chosen by the planning committee,
including representatives from five sponsoring organizations:
NAN, APA Division 40, ABPP/ABCN, the Association of Post-
doctoral Programs in Clinical Neuropsychology (APPCN), and the
American Academy of Clinical Neuropsychology (AACN). The
Houston Conference defined a set of knowledge-based and skill-
based competencies that are addressed across the three levels of
training. The extent to which each of these competencies is ad-
dressed at a specific level is determined by the individual needs of
the trainee. For example, some individuals may acquire extensive
knowledge-based competencies during graduate education
whereas others may acquire these competencies primarily during
internship and postdoctoral training. The Houston Conference
specified that the postdoctoral residency in clinical neuropsychol-
ogy consist of 2 years of full-time education and training (Hannay
et al., 1998). Other aspects of postdoctoral training under the
Houston Conference included faculty consisting of at least one
board-certified clinical neuropsychologist; training at a fixed site
with on-site supervision; access to clinical services within medical
specialties; interactions with other medical specialties and allied
health professions; and a significant amount of time spent in
clinical, educational, and research activities. Entry criteria for
postdoctoral training were specified as completion of an APA or
Canadian Psychological Association (CPA) accredited graduate
program and predoctoral internship. The Houston Conference
identified exit criteria for postdoctoral training to include advanced
skill in neuropsychological evaluation, treatment, and consulta-
tion; advanced understanding of brain-behavior relationships;
scholarly activity (e.g., submission of a publication, presentation,
grant proposal, or outcome assessment); formal evaluation of
 POSTDOCTORAL TRAINING IN NEUROPSYCHOLOGY
competency; eligibility for licensure; and eligibility for board
certification by ABPP/ABCN (Hannay et al., 1998).
Houston Conference guidelines also clearly specified that com-
pletion of a 2-year, formal postdoctoral training experience is
required for independent practice in clinical neuropsychology. In
requiring postdoctoral training as the capstone experience for all
trainees, Houston Conference guidelines represented an important
change from the previous TFEAC document. Also in contrast to
the TFEAC document, Houston Conference guidelines implicitly
indicated that there would no longer be two de facto levels of
expertise or competence for practicing neuropsychologists, with
only those completing a postdoctoral program meeting the stan-
dard of “advanced” practice. Whereas the TFEAC document al-
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
lowed for flexibility of the training levels required for specializa-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
tion (i.e., doctoral, internship, postdoctoral), Houston Conference
guidelines fix the endpoint of formal training and specify that
specialty training occurs within all levels. However, the guidelines
explicitly allow for variation across individuals in the relative
proportions of knowledge and skills obtained at each training level.
At the doctoral level, knowledge regarding the foundations of
brain-behavior relationships is developed at least “to a consider-
able degree.” During the internship, training in general profes-
sional psychology practice is completed, and the percentage of
training in clinical neuropsychology is determined based on the
training needs of the intern. Finally, the postdoctoral residency
provides training in advanced competencies in clinical neuropsy-
chology and serves as the final step to independent practice.
The training and education guidelines that resulted from the
Houston Conference have, in general, been widely accepted over
the past 15 years. However, this acceptance has not come without
some criticism. For example, the results of the Houston Confer-
ence have been criticized for not including broader input from the
field and consisting of a potentially biased selection of delegates
(Reitan, Hom, Van De Voorde, Stanczak, & Wolfson, 2004).
Reitan et al. (2004) presented results of an informal survey of 92
neuropsychologists, the majority of whom did not respond favor-
ably regarding the Houston Conference procedures and findings.
However, more recent surveys have provided broad support for the
Houston Conference. In a broad practice survey conducted in
2010, 1,576 clinical neuropsychologists and 90 postdoctoral resi-
dents were asked whether their training followed the recommen-
dations of Houston Conference guidelines. Fully 66% of clinical
neuropsychologists and 88% of postdoctoral residents indicated
that their training conformed to the Houston Conference guidelines
(Sweet, Meyer, Nelson, & Moberg, 2011). These recent findings
suggest that Houston Conference guidelines have been widely
adopted. In 2006, representatives from NAN, APA Division 40,
and APPCN met to discuss the need for an Inter-Organizational
Summit on Education and Training (ISET) to consider whether the
Houston Conference guidelines needed to be reexamined. This
group concluded that an ISET steering committee be formed, the
goal of which would be to commission a survey to determine the
outcomes of the Houston Conference guidelines. The steering
committee included broad representation of neuropsychology or-
ganizations with an interest in practice. The ISET steering com-
mittee created a survey of postdoctoral residents and practitioners
in clinical neuropsychology (Sweet, Perry, Ruff, Shear, & Guidotti
Breting, 2012). Overall, the survey found wide adoption of the
Houston Conference guidelines among training programs. Further-
3
more, respondents who had completed training consistent with the
Houston Conference believed themselves to be better prepared for
practice than those whose training was not consistent with the
guidelines. Acceptance of Houston Conference guidelines has also
extended to board certification because the ABCN has endorsed
the Houston Conference. Specifically, to meet the specialty-
specific requirements for the ABCN certification, applicants who
received their graduate degree on or after January 1, 2005 are
required to demonstrate that their training met the Houston Con-
ference guidelines, including completion of 2 years of postdoctoral
training.
The discussion above outlined the structural evolution of post-
doctoral training in clinical neuropsychology. Concurrent with
these structural changes, there have also been important changes in
the content and philosophy of training in clinical neuropsychology.
In the early years of clinical neuropsychology, the focus of training
and practice was on utilizing neuropsychological test results to
make statements about lesion localization. However, with the
advent of advanced neuroimaging techniques (e.g., magnetic res-
onance imaging), the focus of training and clinical practice has
shifted to defining strengths and weaknesses and determining the
effect of the injury/disease on the patient’s life. In addition, the
earlier years of neuropsychology were dominated by so-called
fixed assessment batteries, whereas more flexible assessment bat-
teries have become more popular over time. This change in phil-
osophical focus has influenced training in clinical neuropsychol-
ogy at all stages. Finally, as the specialty has matured,
subspecializations have developed such that there are now post-
doctoral training programs focused on specific populations that are
based on age (i.e., pediatric vs. adult vs. geriatric) and diagnosis
(e.g., epilepsy).
APPCN
In 1988, a group of clinical neuropsychology postdoctoral pro-
grams formed a consortium (Midwest Neuropsychology Consor-
tium [MNC]) designed to promote the implementation of the
INS/Division 40 training guidelines (Hammeke, 1993). In 1991,
ABPP sponsored a conference on accreditation of postdoctoral
programs in professional psychology. That conference resulted in
a call for specific specialties to develop national organizations of
postdoctoral program directors. As a result, the MNC hosted a
meeting of clinical neuropsychology postdoctoral program direc-
tors in 1992. That meeting was attended by representatives from 27
different postdoctoral programs and led to the formation of the
APPCN (Hammeke, 1993). Since its inception, the defined mis-
sion of APPCN has been to “foster the development of advanced
postdoctoral education and training in clinical neuropsychology
and the establishment of residency program standards designed to
provide the competency necessary for specialized practice.” APPCN was
incorporated in 1994 as a nonprofit organization with a governance
structure of a board of directors and an executive committee
composed of a president, vice president, and secretary-treasurer
(Boake, Yeates, & Donders, 2002). More information about AP-
PCN can be found at the organization’s website (www.appcn.org).
Membership in APPCN is obtained by completion of a self-
study document that describes the program faculty, facilities, clinical
activities, didactic activities, and research opportunities. APPCN en-
dorses the Houston Conference guidelines and supports the
 4 BODIN, ROPER, O’TOOLE, AND HAINES
attainment of board certification through ABPP/ABCN as the
clearest indication of competency in clinical neuropsychology.
The main criteria for APPCN membership include a program
director who is board certified by ABCN; a minimum of 2 years
of full-time training; and the provision of at least 50% clinical
service, 10% didactic activities, and 10% research or other
scholarly activities.
In addition to promoting postdoctoral training standards in clin-
ical neuropsychology, APPCN also facilitates recruitment of post-
doctoral residency applicants (Boake et al., 2002). First, APPCN
encourages programs and applicants to interview at the North
American Meeting of INS. This meeting occurs in early to mid-
February, which coincides with the recruitment period. By inter-
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
viewing at INS, applicants save money and time because they do
This document is copyrighted by the American Psychological Association or one of its allied publishers.
not have to travel to multiple sites. APPCN has also been active in
developing coordinated recruitment procedures for postdoctoral
programs and applicants. For several years before 2001, APPCN
member programs agreed not to make offers before a uniform
notification date. In 2001, APPCN instituted a computerized match
administered by National Matching Services (NMS). In the second
year of the match, APPCN opened up the match to nonmember
programs that offer training consistent with Houston Conference
guidelines. APPCN has supported this process because the match
allows programs and applicants to designate their preferences
under an agreed-upon timeline and with agreed-upon rules. More
information about the APPCN match can be found at https://www
.natmatch.com/appcnmat/.
Despite the success of the APPCN match, concerns continue
regarding postdoctoral recruitment in neuropsychology (see
Belanger et al., 2013). For the 2013 match, there were 106 appli-
cants for 80 positions resulting in 31% of participants not obtain-
ing a match. Nine percent of available positions went unfilled after
the match. The most significant concern regarding postdoctoral
recruitment is that not all postdoctoral programs in clinical neu-
ropsychology participate in the APPCN match. Although APPCN
encourages nonmember programs to participate in the match,
many good quality programs continue to recruit outside of the
match system. The APPCN Board of Directors has made several
changes to the match over the years to reduce the number of offers
made outside of the match, but this remains a concern.
The APPCN continues to grow as an organization and work
toward ways to promote training standards. As of January 2014,
there were 66 member programs in APPCN. Member programs
have access to various training resources to prepare residents for
board certification through ABCN/ABPP, including a practice
written exam and mock oral exams that address the fact-finding
and ethics portions of the ABCN oral exam. APPCN has re-
cently developed competency-based training guidelines to help
member programs develop clinical, didactic, and scholarly activities.
APPCN program directors also have access to an electronic mailing
list and a social media page to discuss issues relevant to postdoc-
toral training. Finally, APPCN member programs are represented
by the organization in several national contexts. APPCN has
liaisons with the CNS and the Education Advisory Committee to
APA Division 40. APPCN is also a member of the Council of
Chairs of Training Councils (CCTC) and sends a representative to
APA’s annual Education Leadership Conference.
APA Accreditation
Postdoctoral training in clinical neuropsychology was a recog-
nized part of the training sequence long before the development of
Houston Conference guidelines. For example, in 1988, a published
listing included 41 postdoctoral programs (Cripe, 1989). However,
it was not until the late 1990s that accreditation as a mechanism to
maintain and promote training standards was available through the
APA (American Psychological Association, 1999). As such, early
in its history, APPCN planned to provide formal accreditation of
postdoctoral programs in clinical neuropsychology; however, in
the 1990s, the APA Council of Representatives tasked the Com-
mittee on Accreditation (CoA; currently known as the Commission
on Accreditation) to develop accreditation procedures at the post-
doctoral level. APPCN subsequently worked with the CoA to
develop a self-study procedure that was approved by the CoS and
the CoA in 1998 (Boake et al., 2002). The accreditation process
involves a comprehensive self-study and initial site visit with
periodic site visits required to maintain accreditation. The first
postdoctoral programs were accredited in clinical neuropsychol-
ogy as a specialty in 2002 (American Psychological Association,
2003; Boake, 2008). Currently, there are 21 postdoctoral programs
that maintain specialty accreditation in clinical neuropsychology
through the APA CoA (American Psychological Association,
2013).
Summary and Future Directions
Clinical neuropsychology is a specialty within professional psy-
chology that traces its roots to the 1940s. Neuropsychology is
defined as the scientific study of brain-behavior relationships.
Clinical neuropsychology combines principles of clinical psychol-
ogy and behavioral neurology to provide evaluation and treatment
for individuals with known or suspected central nervous system
impairment. Training guidelines for clinical neuropsychology be-
gan to be developed in the 1970s and were refined during a
national conference in the 1990s (i.e., the Houston Conference). At
the postdoctoral level, the APPCN was formed in the early 1990s
to promote and maintain training standards in clinical neuropsy-
chology. Specialty accreditation in clinical neuropsychology by
APA has been available since the late 1990s.
Despite the strong organizational structure of postdoctoral train-
ing in clinical neuropsychology, problems remain within the field,
and there is much work to be done. A major problem regards
recruitment of postdoctoral residents. Although there is a formal-
ized computer match process sponsored by APPCN to provide a
structured recruiting system, many programs decline to participate
in the match. As a result, clinical neuropsychology lacks consensus
regarding how to conduct postdoctoral recruitment. A solution to
this problem will involve broad organizational involvement that to
date has been lacking (Belanger et al., 2013).
As the defined capstone for independent practice, postdoctoral
training has a crucial role in the future practice of clinical neuro-
psychology. Accordingly, the maintenance and development of
standards within clinical neuropsychology practice are closely tied
to the standards found within postdoctoral training. Although
Houston Conference guidelines describe training as competency-
based, the guidelines were developed during a time that
competency-based education and training received little attention
relative to the present day. Indeed, during the past 15 years, the
 POSTDOCTORAL TRAINING IN NEUROPSYCHOLOGY
so-called “competencies movement” has contributed theoretical
models to our understanding of training and education (e.g.,
Kaslow et al., 2004; Rodolfa et al., 2005). Furthermore, over the
past several years, competencies have been developed in the gen-
eral practice of professional psychology (Fouad et al., 2009) and
specialty practice in clinical health psychology (France et al.,
2008) and professional geropsychology (Karel, Emery, & Moli-
nari, 2010; Karel et al., 2012; Knight, Karel, Hinrichsen, Qualls, &
Duffy, 2009;). When viewed in light of the competencies move-
ment, Houston Conference guidelines fall short in several ways.
For example, the guidelines do not distinguish between founda-
tional and functional competencies, and the competency areas
enumerated lack specificity. Although initial entry-level compe-
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
tencies have been proposed within clinical neuropsychology (Rey-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
Casserly, Roper, & Bauer, 2012), and APPCN has developed
competency-based training guidelines for member programs, there
is no clear consensus on what set of competencies are required for
independent practice. Furthermore, although Houston Conference
guidelines explicitly allow for flexibility in training such that
training can vary considerably across individuals, such flexibility
undermines explication of entrance criteria for initial clinical
practicum, the internship, and the postdoctoral residency. Compe-
tency benchmarks have been developed within some areas of
psychology that include considerable detail regarding the appro-
priate developmental level at which various stages of training
should begin (e.g., Fouad et al., 2009). Continued efforts are
needed to better define the competencies required for specialty
practice in clinical neuropsychology, and the points during the
training sequence at which specified competency levels should be
in place.
To promote and strengthen interagency collaboration and
policy-making, it will be important to work closely with organi-
zations involved across all three stages of clinical neuropsychol-
ogy training (i.e., doctoral, internship, and postdoctoral). Involving
the Association for Doctoral Education in Clinical Neuropsychol-
ogy (ADECN) in the development of expectations, competencies,
and entry criteria for the two subsequent training experiences
(internship and postdoctoral residency) is consistent with its mis-
sion of advocating and promoting appropriate standards for edu-
cation, training, and research in clinical neuropsychology at the
doctoral level. Likewise, collaborating with the Association for
Internship Training in Clinical Neuropsychology (AITCN) in de-
lineating entry and exit criteria would help create a seamless
transition from one level of training to the next. Finally, across all
three levels of training, it is crucial to devise guidelines for
referring to training experiences that apply the Commission for the
Recognition of Specialties and Proficiencies in Professional Psy-
chology (CRSPPP) taxonomy to our specialty (American Psycho-
logical Association, 2012). CNS has been active in meeting with
the different specialties involved in CRSPPP to discuss models for
applying the taxonomy to their specialties. The CNS is now
preparing a “straw person” neuropsychology taxonomy grid to
prepare and finalize as a model. These efforts will grant our
specialty a greater level of cohesion and a stronger political voice.
Recent legislative changes will need to be addressed at all levels
of training in clinical neuropsychology. The acceptance of the
Patient Protection and Affordable Care Act (2010) will create
challenges for neuropsychologists now and in the future. The
Inter-Organizational Practice Committee (IOPC; a committee of
5
the practice chairs of the AACN/ABCN, NAN, APA Division 40,
and the American Board of Professional Neuropsychology) is
tasked with coordinating advocacy efforts and improving the prac-
tice climate for neuropsychology. Recently, the APA Practice
Organization joined the IOPC and has developed a website de-
voted to providing information to neuropsychologists about
changes and reforms in health care (http://neuropsychologytoolkit
.com). One area that the website emphasizes is that there will need
to be a fundamental shift in neuropsychologists’ approaches to
patient care, from “What’s the diagnosis?” to “How can my data be
used to improve the health of my patient and decrease medical
costs?” Education about this, and other professional issues that
clinical neuropsychologists face, will need to be addressed at the
postdoctoral level. This will require the faculty of postdoctoral
training programs in clinical neuropsychology to not only create
didactic opportunities to discuss health-care legislation and policy
but (also) to remain up to date on these rapidly developing changes
themselves.
With continued growth of the science that undergirds an area of
health-care practice, it is important that the professional practice of
that area should also evolve. In addition, those in practice must
attend to other influences within and outside of the profession. As
a specialty, clinical neuropsychology has an established history of
fostering clinical science, developing practice guidelines, and fur-
thering specialty practice through encouraging specialty recogni-
tion, advancing board certification, and developing training stan-
dards. For clinical neuropsychologists, postdoctoral training now
represents the culmination of formal training for independent
practice. Accordingly, those engaging in postdoctoral training
shoulder a heavy responsibility for the future of the specialty.
Although many challenges remain and new challenges will surely
surface, we are confident that the specialty in general, and post-
doctoral trainers in particular, will continue to meet these chal-
lenges.
References
American Psychological Association. (1999). Accredited internship and
postdoctoral programs for training in psychology: 1999. American Psy-
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Received November 14, 2013
Revision received January 31, 2014
Accepted April 4, 2014 䡲