Some clinical psychologists do not feel very
comfortable doing neuropsychological assessment,
nor are they qualified. Their training in such assess-
ment is often limited, as is their knowledge of brain–
behavior relationships. As Lezak and colleagues
(2004) point out, the success of any neuropsycholog-
ical assessment will depend on how well examiners
understand not only normal brain–behavior relation-
ships but also the psychological effects of brain
dysfunction. Therefore, experts are needed. Reitan
and Davison (1974) some time ago remarked on
the necessity for developing a new field of clinical
neuropsychology. Clinical neuropsychology is now
a specialty that is formally recognized by both the
American Psychological Association and the Cana-
dian Psychological Association (Boake, 2008).
The September 1997Houston Conference con-
vened leaders involved in the training of future clin-
ical neuropsychologists. Guidelines for the graduate
(doctoral) internship and postdoctoral training of
future clinical neuropsychologists were offered.
Briefly, these guidelines recommend a Ph.D. from
a graduate program with a specialty track in clinical
neuropsychology. As a required knowledge base,
the Houston Conference recommended (a) a ge-
neric psychology core (statistics, learning, social psy-
chology, physiological psychology, developmental
psychology, history); (b) a generic clinical core (psy-
chopathology, psychometrics, assessment, interven-
tion, ethics); (c) neurosciences and basic human and
animal neuropsychology (functional neuroanatomy,
neurodiagnostic techniques, neurochemistry, neuro-
psychology of behavior); and (d) specific clinical
neuropsychological training (research design in neu-
ropsychology, specialized neuropsychological assess-
ment techniques, specialized neuropsychological
intervention techniques). Further, the conference
recommended that skills be acquired in assessment,
treatment and interventions, consultation, research,
and teaching and supervision. Knowledge and skills
in these areas can be acquired and mastered through
coursework, supervised experience, internship expe-
rience, and a required 2-year residency/postdoctoral
training. Those completing such a rigorous training
experience in clinical neuropsychology should, at the
end of their training, be able to demonstrate
advanced skill in neuropsychological assessment,
treatment, and consultation and should be eligible
for board certification in clinical neuropsychology
by the American Board of Professional Psychology.The Future
In the future, neuropsychology may hope for the
development of increasingly more sophisticated indi-
vidual tests and batteries. Better assessment devices
and procedures, including enhanced provisions for
planning, therapy, and rehabilitation for patients
with brain dysfunction, are highly desirable. Assess-
ment obviously means more than pinning labels on
people; it is meant to enable clinicians to help the
patient adjust to the future. In particular, then, the
field must concern itself more with predicting and
facilitating recovery from brain injury. Fortunately,
this is exactly what is beginning to happen. Training
procedures that help foster rehabilitation, tests that
predict the extent and rate of recovery, and general
information on the course of debilitating injury can
offer hope and structure to patients and their fami-
lies. Even bad news, offered sensitively and construc-
tively, can facilitate adjustment.
Almost two decades ago, Johnstone and Frank
(1995) urged more neuropsychologists to shift their
focus to rehabilitation. Although the need for reha-
bilitation services has increased over the years, rela-
tively few neuropsychologists have received specific
training in rehabilitation. Moreover, traditional
neuropsychological tests have not generally been
used (or adapted) to provide information that is clin-
ically useful to rehabilitation specialists. Johnstone and
Frank argue, for example, that many important cog-
nitive abilities (e.g., attention, executive functions,
and memory) are poorly understood and poorly mea-
sured. In their view, neuropsychological test results
need to be clearly tied (via empirical research) to
real-world functions so that rehabilitation can address
deficits or impairments that, if improved, will lead to
positive outcomes. If heeded, these suggestions will
likely affect research, training, and clinical applications
in the field of neuropsychology.
Changes in the way that health care is delivered
and reimbursed will also have a great impact on the
field of neuropsychology. Neuropsychological assess-
ment may no longer be routinely conducted whenNEUROPSYCHOLOGY 533