THE PSYCHOLOGIST SPECIALISED IN CLINICAL NEUROPSYCHOLOGY: PROPOSAL FOR THE REGULATION OF PROFESSIONAL PRACTICE OF CLINICAL NEUROPSYCHOLOGY IN CATALONIA

CONFERENCES
TOPIC: MISCELANEOUS

---

Contents

• Introduction
• Objective of this document
• Description of the specialisation in Clinical Neuropsychology
• Definition of Clinical Neuropsychology
• Functions of the Psychologist specialised in Clinical Neuropsychology
• Areas of competence
• Training of the specialist in Clinical Neuropsychology
• Accreditation of training

1.- Introduction

 
Neuropsychology, understood as the study of brain-behaviour relationships, has a clinical and research tradition in Catalonia going back to the 1980s, in the Hospital de la Santa Creu i Sant Pau and the Hospital de la Nostra Senyora del Mar de Barcelona.

In 1987, the Universitat Autònoma de Barcelona launched its first postgraduate courses in the field, leading to the award of Diplomas and Master Degrees in Clinical Neuropsychology. In 1988, the Universitat de Barcelona first began to offer a doctoral programme in Neuropsychology.

Despite the existence of this postgraduate training, there was no official recognition of Neuropsychology as a specialised discipline in either Spain or Catalonia. As a result, there is at present no official recognised qualification for practising professionals in the field.

Since its beginnings, the practice of Neuropsychology has become consolidated in Catalonia. As a result of this and at the request of the Generalitat of Catalonia government for a specialist qualification, the Neuropsychology Working Group of the Col·legi Oficial de Psicòlegs de Catalunya was commissioned to prepare a document outlining, on one hand, the knowledge and training necessary for professional practice in the field, and on the other, the areas of competence of the specialist in Neuropsychology.

Neuropsychology Working Group
 

2. Objective of this document

 
The Neuropsychology Working Group, a subgroup of the Clinical and Health Psychology Committee of the Col·legi Oficial de Psicòlegs de Catalunya, at the request of the Committee of Mental Health and Related Specialities of the Catalan Council of Health Science Specialists, has prepared the following document which outlines the criteria which will regulate the training of the PSYCHOLOGIST SPECIALISED IN CLINICAL NEUROPSYCHOLOGY.
 

The specific objectives of the document are:

• To describe expertise in Clinical Neuropsychology, specifying the functions and areas of competence of the Psychologist specialised in Clinical Neuropsychology
• To outline the necessary training which will guarantee professional competence

Definition of Clinical Neuropsychology

Clinical Neuropsychology is a specialised area within Psychology the aim of which is to describe, diagnose and treat cognitive and behavioural disorders resulting from functional and / or structural dysfunctions of the Central Nervous System. This is reflected by the American Psychological Association in its definition of Clinical Neuropsychology as "an area within psychological intervention, the scientific basis of which lies in human Neuropsychology."

Practising as a specialised Clinical Neuropsychologist requires a specific set of skills, knowledge and instruments to assess and rehabilitate cognitive, behavioral and emotional disorders associated with Central Nervous System dysfunction. The basic areas of action of the Clinical Neuropsychologist are: language and communication, praxis and gnosis, attention, memory, visuospatial, visuoconstructional and visuoperceptual functions, executive functions and emotion and behavior.

Professionals specialised in Neuropsychology are psychologists with specific training in neurosciences. Therefore, they have been trained in the techniques and instruments of Clinical Psychology and Neuropsychology, and in the interpretation of neurological and psychiatric examination results, and of neuroimaging, neurophysiological and biochemical techniques. Integration of these areas of knowledge allows the specialist to design and guide neuropsychological assessment and treatment procedures.

Scientific literature in the field of Neuropsychology is extensive both in terms of journals exclusively devoted to neuropsychological research and of other psychological and medical publications which include neuropsychological investigations. Also of note are the numerous books published in the field, and the range of national and international Associations, Societies, Meetings and Conferences held in the area of Neuropsychology (Annex 1). Functions of the Psychologist specialised in Clinical Neuropsychology

The main functions of the Psychologist specialised in Clinical Neuropsychology fall into the areas of assessment, therapy and / or intervention, counselling, research, teaching and supervision.

 

a) Assessment

• The objective of neuropsychological assessment is to identify, describe and quantify the cognitive deficits and behavioural disorders resulting from cerebral lesions and dysfunctions.
• It therefore involves assembly of information and preparation of the neuropsychological clinical history, selection of appropriate tests and measurement instruments, administration, interpretation and diagnosis, treatment planning, preparation of written reports and return of information to source.
• The specific objectives of assessment are:

 
• Contribution to differential diagnosis (for example, Alzheimerís disease as opposed to normal deterioration due to aging or depression).
• Delimitation and quantification of impaired and preserved functions following focal or diffused lesions to the Central Nervous System (for example, cerebrovascular disease, traumatic brain injury, infection).
• Establishment of baseline measures to monitor progressive brain damage or recovery processes (for example, tumors, demyelinizating conditions, traumatic brain injury).
• Assessment of the efficacy of medical, surgical or psychological interventions (for example, drug assays, tissue resection, cerebrospinal fluid derivation valves, treatment of aphasia or behavioural-cognitive therapy).
• Determination of the cognitive, social, educational and professional implications of Central Nervous System disorders for courts of law.
• Assessment of cognitive and emotional functions to formulate rehabilitation strategies and to design treatment.


b) Treatment and / or intervention

• Neuropsychological intervention consists of the application of specific assessment and treatment techniques for the different cognitive and behavioural disorders, including clinical activities at both the individual and the social level.
• Treatment involves identification of objectives and needs, formulation of the intervention programme, implementation, supervision and adaptation of the programme to the specific needs in question, and assessment of treatment efficacy.
• Specific treatment and intervention actions:

 
• Neuropsychological rehabilitation. Therapeutic intervention to optimise recovery of impaired cognitive functions (attention, language, memory, etc.) and to facilitate the development of compensatory strategies. It also includes treatment of emotional and behavioural disorders associated with the actual lesion in order to facilitate the patient's adaptation process.
• Neuropsychological stimulation. Intervention aimed at stimulating the preserved functions so as to maintain patientís autonomy for as long as possible.


c) Counselling

• Provision of counselling and advice to patients and their families, health professionals and organisations (schools, courts of law, insurance companies, rehabilitation units, etc.).
• Counselling includes:
• Communication of results of neuropsychological diagnosis, prognosis and therapeutic orientation
• To provide information on neuropsychology services and their functions
• Raising public awareness of neuropsychological disorders


d) Research

• Research functions include selection and design of lines and areas of research, review of relevant literature, supervision of the development and evolution of research, and interpretation and publication of results.

 

 

e) Teaching and supervision

• This involves planning and design of courses and syllabuses and use of effective teaching techniques and methodologies.

 

 

Areas of competence

• The activities described above are carried out in the following areas:
• The neurological and neuro-surgical population, which includes cerebrovascular disorders, infectious or inflammatory diseases, epilepsy, degenerative disorders, traumatic brain injury, demyelinizating conditions and movement disorders, among others.
• Psychiatric population, which includes mood disorders both in terms of differential diagnosis with degenerative processes and of the cognitive consequences of the illness itself. Also included are psychotic, obsessive-compulsive, conversion disorders and certain personality disorders.
• Geriatric population, including the study of normal and pathological aging and the design of compensatory and preventive intervention strategies.
• Paediatric population, includes children with learning disabilities and with attention and hyperactivity disorders, among others.
• The general medical and surgical population, which includes those awaiting kidney transplant or dialysis, open heart surgery, etc.

4. Training of the specialist in Clinical Neuropsychology

The training of the Clinical Neuropsychologist requires a Degree in Psychology and a specialised Postgraduate Course.

The Degree in Psychology equips the professional with the necessary knowledge and skills in Basic Psychology, Behavioural Methodology, Personality, Assessment, and Treatment, Psychobiology and Developmental Psychology. In addition, the Clinical Neuropsychologist receives special training in all the disciplines concerned with brain-behaviour relationships (Annex 2).

The theoretical base is combined with clinical practice which provides skills in test administration, assessment, report writing, therapeutic guidance and rehabilitation. This training is aimed to equip the Neuropsychologist with a mastery of neuropsychological examination and rehabilitation techniques, and also with the capacity to use a flexible approach to choose the appropriate tests for a given need and to assess cognitive and behavioral functions both quantitatively and qualitatively.

All Clinical Neuropsychologists must also receive continuing education on an annual basis. The aim of this ongoing training is to maintain the professional's competence in Clinical Neuropsychology, by updating previous skills and knowledge. This continuing education should not be considered as sufficient in itself to provide training or professional qualifications in Clinical Neuropsychology. Neither can it be considered as sufficient to permit transfer from another field within Psychology to that of Clinical Neuropsychology.

To summarise, professional training in Clinical Neuropsychology is structured as follows:

• Degree in Psychology with a clinical emphasis in the second cycle.
• Postgraduate theoretical training in Neuropsychology made up of a minimum of 32 credits.
• Clinical practice of a minimum of 2,400 hours parallel to the theoretical training. This takes place in a hospital in which there is a professional specialised in Neuropsychology.
• Continuing education

5. Accreditation of training

The Neuropsychology Working Group of the Col.legi Oficial de Psicòlegs de Catalunya will propose a committee made up of recognised experts in the field of Neuropsychology, which will have the task of accrediting by consensus the qualification of SPECIALIST IN CLINICAL NEUROPSYCHOLOGY.

Requirements

• Degree in Psychology or equivalent recognised qualification
• Specific postgraduate training in Neuropsychology, comprising a theoretical part worth a minimum of 32 credits and a practical part made up of a minimum of 2,400 hours running parallel to the theoretical training
• In cases where criterion no. 2 is not met, candidates must have practical experience to a total of 4,000 hours, corresponding to a minimum of five years of proven professional experience

Main specialised journals in Neuropsychology: FI (SCI)
 

Advances in Neuropsychology and Behavior Neurology
Aphasiology	0,396
Applied Neuropsychology
Archives of Clinical Neuropsychology
Brain and Cognition	1,500
Brain Injury
Brain and Language	1,197
Brain Topography
Cortex	1,147
Cognitive Neuropsychology
Developmental Neuropsychology
International Journal of Clinical Neuropsychology
Journal of Clinical and Experimental Neuropsychology	1,814
Journal of Neurolinguistics
Neuropsychiatry, Neuropsychology and Behavioral Neurology
Neuropsychologia	1,885
Neuropsicología Latina
Neuropsychological Rehabilitation
Neuropsychological Review
Neuropsychology
The Clinical Neuropsychologist
Journal of Clinical Neuropsychological Society

Neurology journals with neuropsychological content

Acta Neurologica Scandinavica	1,122
Annals of Neurology	6,320
Archives of Neurology	3,517
Brain	3,589
Clinical Neurology and Neurosurgery	0,353
Dementia
Developmental Medicine and Child Neurology	1,102
Epilepsia	2,707
European Neurology	1,351
Journal of Neurology	1,736
Movement Disorders	2,112
Neurología
Journal of Neurology, Neurosurgery and Psychiatry	2,696
Neurology	4,355
Revista Española de Neurología
Revue Neurologique	0,813
Seminars in Neurology	0,663
Stroke	3,513

Most frequently recommended Neuropsychology books:

• Boller F, Grafman J, (Eds.). (1990-1997). Handbook of Neuropsychology. Vols 1-11. Amsterdam: Elsevier.
• Ellis, A.W., & Young, A.W. (1988). Human cognitive neuropsychology. Hove: Lawrence Erlbaum Associates Ltd.
• Filskov, S. B., & Boll, T. J. (Eds.). (1981/1986). Handbook of clinical neuropsychology, Vol. I & II. New York: Wiley.
• Grant, I., & Adams, K. M. (1986). Neuropsychological assessment of neuropsychiatric disorders. New York: Oxford University Press.
• Heilman, K.M., & Valenstein, E. (Eds.). (1993). Clinical neuropsychology (3rd ed.). New York: Oxford University Press.
• Junqué, C., Barroso, J. (1994). Neuropsicología. Madrid: Editorial Síntesis.
• Kolb, B., & Whishaw, I. (1990). Fundamentals of human neuropsychology (3rd ed.). New York: Free-man.
• Levin, H. S., Eisenberg, H. M., & Benton, A. L. (Eds.). (1989). Mild head injury. New York: Oxford University Press.
• Lezak, M.D. (1995). Neuropsychological assessment (2nd ed.). New York: Oxford University Press.
• Luria, A. R. (1973). The working brain: An introduction to neuropsychology. New York: Basic Books.
• Luria, A. R. (1980). Higher cortical functions in man (2nd ed.). New York: Plenum Press.
• Spreen, O., & Strauss, E. (1998). A compendium of neuropsychological tests: Administration, norms and commentary. New York: Oxford University Press.
• Walsh, K. W. (1987). Neuropsychology: A clinical approach (2nd ed.). New York: Churchill-Livingston.

Main Spanish and international associations in the field of Neuropsychology

• Societat Catalana de Neuropsicologia (Spain)
• Sociedad Española de Neuropsicología (Spain)
• International Neuropsychological Society (INS) (USA)
• National Academy of Neuropsychology (USA)
• The American Board of Professional Neuropsychology (USA)
• The American Board of Clinical Neuropsychology (USA)
• Societé de Neuropsychologie en Langue Française (SNLF) (France)
• Nerderlander Vereniguing voor NPS (NVN) (Netherlands)
• German Society of Neuropsychology (GNP) (Germany)
• German Society of Neurotraumatology and Clinical Neuropsychology (DGNKN) (Germany)
• Association Suisse Des Neuropsychologues (ASNP) (Switzerland)

Foundations for the study of brain-behaviour relationships
 

• Functional neuroanatomy
• Neurological and related disorders, including their etiology, pathology, course and treatment
• Non-neurological disorders which affect the central nervous system
• Neuroimaging and other neurodiagnostic techniques
• Behavioural neurochemistry (for example, psychopharmacology)
• Behavioral neuropsychology
• Foundations for Clinical Neuropsychology practice
• Specialised neuropsychological assessment techniques
• Specialised neuropsychological intervention techniques
• Design and analysis of neuropsychological research
• Practical implications of neuropsychological disorders
• Professional ethics in Neuropsychology

NEUROPSYCHOLOGY WORKING GROUP (GtNPS)

Clinical Psychology Committee of the COPC
 

Members

Coordinator
Rosa Gené i Aguarod
Unitat de Neuropsicologia ? Servei de Neurocirugia. Centre Mèdic Teknon. Barcelona
Col. No. 3492

 
Carmen Arasanz i Latorre
Servei de Neurologia de líHospital de la Creu Roja. Barcelona
Col. No. 0098

 
Teresa Boget i Llucia
Senior Assistant, Servei de Psicologia Clínica de líHospital Clínic. Barcelona
Col. No. 953
Joan Deus i Yela
Col. No. 5644

 
Antonia Ensenyat i Cantallops
Senior Assistant, Neuropsicologia. Institut Guttmann. Barcelona
Col. No. 8014
Maite Garolera
Senior Assistant, Servei de Psiquiatria. Hospital de Terrassa
Col. No. 4919

 
Mercè Jodar i Vicente
Lecturer in Neuropsychology at UAB
Col. No. 5364
Montse Juncadella i Puig
Senior Assistant, Servei de Neurologia de líHospital Prínceps díEspanya. Barcelona
Col. No. 3139

 
Maria Mataró i Serrat
Member of the Neuropsychology Research Group at the Departament de Psiquiatria i Psicobiologia Clínica de la UB
Col. No. 7330

 
Ana Llorente i Vizcaino
Senior assistant to the ACE Foundation. Institut Català de Neurociències Aplicades. UFISS de demències. Barcelona
Col. No. 9319

 
Dunia Perdix i Solàs
Centre Socio-sanitari ìEl Carmeî. Hospital Municipal de Badalona. Associate lecturer at UAB
Col. No. 5166

 
Elsa Qiñonero i Prieto
Intern at the Servei díAnestesiologia i Reanimació de líHospital Universitari Germans Trías i Pujol, Badalona and at the Servei de Neurologia. Hospital Parc Taulí. Sabadell
Col. No. 5998

 
Teresa Roig i Rovira
Head of Neuropsychology. Institut Guttmann. Barcelona
Col. No. 1432

Teresa Arrufat
UFISS de Demències. Institut Pere Mata (Reus). Tarragona
Col. No. 8320

 
Olga Bruna i Rabassa
Lecturer at the Facultat de Psicologia i Ciències de líEducació Blanquerna. Universitat Ramon Llull. Barcelona
Col. No. 3918

 
Cynthia Càceres i Aguilar
Unitat de Demències Centre Albada. Corporació Sanitària del Parc Taulí
Col. No. 9987

 
Belén Garzón i Ruiz
Intern at the Facultat de Psicologia i Ciències de líEducació Blanquerna. Universitat Ramon Llull. Barcelona
Col. No. 9044

 
Carlos Jacas i Escarcelle
Senior Assistant to the Servei de Medicina Interna de líHospital de la Vall díHebron. Barcelona
Col. No.

 
Anna Maria Martí i Cuadros
Supervisor of Clinical Trials. Parke Davis Laboratory.
Col. No. 8802

 
Cristina Macias i Castellví
Unitat de Neurorehabilitació Clínica Stauros
Col. No. 7347
 

 
. Universidad de Barcelona. Carmen Junqué Plaja. Professor of Neuropsychology

. Universidad Autónoma de Barcelona. Mª Dolores Riba Lloret. Dean of the Faculty of Psychology

. Universidad Ramón Llull. Dr. Jordi Riera Romani. Dean of the Faculty of Psychology and Education Science, Blanquerna. Barcelona

. Universidad de Girona. Joaquín Pélach Busom. Dean of the Faculty of Education Science. Girona.

. Universidad Rovira i Virgili. Ángel-Pío González Soto. Dean of the Faculty of Education Science and Psychology. Tarragona

. Sociedad Catalana de Neuropsicología: Jordi Olivella Rius. President; Doménec Gil Saladié. Secretary

---