1. What is Clinical Neuropsychology?
Neuropsychology and Clinical Neuropsychology are briefly defined by the EFPA Standing Committee on Clinical Neuropsychology: Neuropsychology is a specialised domain of psychology that is focused on the relationships between cognitive and affective functioning, the personality and behaviour of the individual, and brain functioning. Cognitive functions include e.g. attention, learning, memory, language, and reasoning. Affective functions include emotions and mood. Clinical Neuropsychology is the application of Neuropsychology in clinical situations across the life span to understand how these functions relate to either normal brain functioning or acquired or developmental brain injury. The practice of Clinical Neuropsychology involves a clinical interview and the use of neuropsychological assessment methods for diagnostic and prognostic purposes. This information can also be used for planning, implementation and evaluation of interventions.
2. Development of the Specialisation in Clinical Neuropsychology
During the last few decades, Clinical Neuropsychology has developed from a small clinical discipline to an advanced and well-respected specialty internationally and in Europe. In most countries, comprehensive academic and practical training in the field is required to practice as a specialist in Clinical Neuropsychology.
There are regional and national neuropsychological associations worldwide, providing evidence that neuropsychology and its clinical application is a specialised domain within psychology. In Europe, 23 neuropsychological associations with a total membership of more than 8200 are represented in the Federation of European Societies of Neuropsychology (FESN). The FESN was founded in 2008 and is an associate member of EFPA. In many countries a large proportion of the membership already has an advanced level specialization while in others the advanced training is still being developed.
The piloted Specialist Certificate builds upon the Basic Certificate and the training is targeted to professionals that are eligible for the basic EuroPsy. Several countries in Europe (for instance the Nordic countries, Austria, The Netherlands, UK, Italy) already recognize neuropsychology as a pathway for specialism and have programmes that provide training on the specialist level. The entry requirements include the license to practice within clinical health care settings. In many countries, completion of the specified training program ensures certification as a specialist. In others, candidates provide proof of the competencies they have acquired when applying for membership in a specialist registry or society.
3. Why is Clinical Neuropsychology important?
The prevalence, and health impact, of brain disorders are substantial. The European Brain Council has monitored the situation since 2003 when they reported that disorders of the brain are the largest contributor to the total morbidity burden in Europe, accounting for 35% of all disease burdens. More recently, the economic costs of brain disorders were found to be correspondingly large, constituting 24% of the total direct healthcare expenditure in Europe in 2010. Since 2010 the burden in absolute terms has still increased.
It is well recognised that Clinical Neuropsychology makes a significant contribution to the management of a host of neurological, neurodevelopmental, neurodegenerative, psychopathological, and neuroendocrine disorders from assessment to treatment. In many countries, a comprehensive neuropsychological assessment is considered standard for the management of a range of diseases and disorders affecting the nervous system and the brain. Clinical neuropsychologists are typically involved in integrated healthcare settings, participating in multidisciplinary collaborations, and contribute to the treatment and rehabilitation of patients.
Based on comprehensive clinical assessments of cognitive, affective and behavioural functioning, neuropsychological assessments provide information about the daily life functioning of children and adults. Schools and universities increasingly use this information for children and students with special needs, and other institutions use it for adults in planning vocational and neuropsychological rehabilitation. The objective data provided by neuropsychological assessment has shown high utility in follow up of patients, either to measure the efficacy of treatment or rehabilitation or by measuring decline in neurodegenerative disorders.
The demands for clinical neuropsychological services are both increasing and diversifying. Within health care and community settings, Clinical Neuropsychology can help analyse the cognitive, affective and behavioural consequences of all neurobiological-based diseases and disorders interfering with mental functioning. Clinical neuropsychologists today have a key role in the management of a range of psychological, psychiatric, neurological, and neurodevelopmental disorders.
4. Why a EuroPsy Specialist Certificate in Clinical Neuropsychology?
Clinical Neuropsychology: (1) is a field with its own scientific knowledge base and tradition; (2) is a fast growing field in Europe and world-wide; (3) requires a standardization in training and practice, given the huge diversity in training and level/quality of services across Europe; (4) requires a high level of specific knowledge and competent skills from clinical neuropsychologists to meet the expectations of society and health care systems; and (5) fits naturally into the EuroPsy specialisation model.
Findings from surveys conducted by the EFPA Standing Committee on Clinical Neuropsychology have revealed that the level of training and the quality of service provided by Clinical Neuropsychologists throughout Europe varies considerably (link to the infographic here). In the European countries that already offer advanced training and a specialisation track, the profession of Clinical Neuropsychology has been developed into an important discipline for the neurocognitive and affective health care of children and adults. In some other countries in Europe this training and professional development hardly exists. The Specialist Certificate, the proposed training model leading to it, and the advanced competencies to be delineated, will provide an aspirational goal for countries that are still developing the training.
The profession of Clinical Neuropsychology is built on a unique scientific knowledge base, well-established training, unique methodology and clinical practice. A range of competencies has been identified that are specific to its practice, in line with the EuroPsy. An earlier European survey conducted by the Standing Committee on Clinical Neuropsychology demonstrated a high level of agreement among experienced senior professionals on the core competencies needed for the practice of Clinical Neuropsychology in the advanced level.
A universal minimum standard of training and practice is necessary to ensure an acceptable level of quality across Europe and to protect from malpractice. Common high-level standards for education, practical training and clinical practice in Clinical Neuropsychology within Europe will aid in the strengthening of clinical neuropsychological services. This has already been achieved in the countries with high standards in Clinical Neuropsychology. The piloted certificate will complement but not override national regulations and will not jeopardize the existing high standards.
Establishing a specialisation will help build a common ground for quality clinical neuropsychological services across Europe. Providing a specialist register of qualified neuropsychologists who have met the agreed minimum standards will protect the public by helping society identify who is trained to a particular standard endorsed by EFPA. To have a common definition of specialisation in Clinical Neuropsychology will also facilitate the free movement of neuropsychologists across Europe. This is important, as free movement of labour is an important EU foundation.
5. For further information about…
1. The work of clinical neuropsychologists across Europe, see Kasten, E.; Barbosa, F.; Kosmidis, M.H.; Persson, B.A.; Constantinou, M.; Baker, G.A.; Lettner, S.; Hokkanen, L.; Ponchel, A.; Mondini, S.; et al. European Clinical Neuropsychology: Role in Healthcare and Access to Neuropsychological Services. Healthcare 2021, 9, 734. https://doi.org/10.3390/healthcare9060734
2. Core Competencies in Clinical Neuropsychology as a Training Model in Europe, see Kosmidis MH, Lettner S, Hokkanen L, Barbosa F, Persson BA, Baker G, Kasten E, Ponchel A,
Mondini S, Varako N, Nikolai T, Jónsdóttir MK, Pranckeviciene A, Hessen E and Constantinou M (2022). Core Competencies in Clinical Neuropsychology as a Training Model in Europe. Front. Psychol. 13:849151. doi: 10.3389/fpsyg.2022.849151
3. Neuropsychology as a Specialist Profession in European Health Care and the Europsy model, see Hokkanen L, Barbosa F, Ponchel A, Constantinou M, Kosmidis MH, Varako N, Kasten E, Mondini S, Lettner S, Baker G, Persson BA and Hessen E (2020). Clinical Neuropsychology as a Specialist Profession in European Health Care: Developing a Benchmark for Training Standards and Competencies Using the Europsy Model? Front. Psychol. 11:559134. doi: 10.3389/fpsyg.2020.559134
P-SEAC acknowledges the hard work of the EFPA SC members who completed all the background work and provided the content of this website page https://www.efpa.eu/working-groups/clinical-neuropsychology