Thoughts on the proposed Minnesota Guidelines for neuropsych training?

[erg923]

I mean, there is a small percentage in the field who do legitimately feel this way. But, these days, if you express any sort of disagreement or criticism against any policy or concept on the DEI front, regardless of the merit or empirical backing, there is no recourse but to lump you in with the extreme elements.

So, the Ralph Reitan issue, fixed vs flexible, and boarded vs non-boarded stuff has all pretty much settled by this point (I hope), right? Is it the DEI stuff that is getting people all in a tizzy here? Or is it something else?

There are probably very few on here who here on these "listservs" (that seems like a very mid 2000s term to me tbh) and very few who even know this debate is raging (which might tell how important it all is in the grand scheme of things, lol)

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[WisNeuro]

So, the Ralph Reitan issue, fixed vs flexible, boarded vs non-boarded stuff has all pretty much settled by this point (I hope), right? It is the DEI stuff that is getting people all in a tizzy here? Or is it something else?

There are probably very few on here who on these "listservs" (that seems like a very mid 2000s term to me) and very few who even know anything about all this issue (much might tell how important it all is in the grand scheme of things, lol)

Fixed vs. Flexible hasn't been a serious issue for a while aside from some geriatric holdouts near retirement. Boarded vs. non-boarded also not a big issue as far as I have experienced. This is pretty much about the new proposed guidelines having a lot of ill-defined, politically charged buzzwords, and not a lot on actual training guidelines. The crowd that is critical of the proposed guidelines almost universally agree that the document should contain references to cultural competency and increasing diversity within the field. They'd just rather focus more on actual training guidelines and taking the more politically charged language out. This has been both on the AACN boarded listserv, as well as the community listserv, which is open to any AACN member regardless of board cert status.

 

[WisNeuro]

Figured, that would be an indicator to me of which voices are being suppressed. And, why we will likely get a heavy DEI, politically strident activism laden set of guidelines.

Most likely. Well, there's always ABN

 

[erg923]

Fixed vs. Flexible hasn't been a serious issue for a while aside from some geriatric holdouts near retirement. Boarded vs. non-boarded also not a big issue as far as I have experienced. This is pretty much about the new proposed guidelines having a lot of ill-defined, politically charged buzzwords, and not a lot on actual training guidelines. The crowd that is critical of the proposed guidelines almost universally agree that the document should contain references to cultural competency and increasing diversity within the field. They'd just rather focus more on actual training guidelines and taking the more politically charged language out. This has been both on the AACN boarded listserv, as well as the community listserv, which is open to any AACN member regardless of board cert status.

I see. Thanks.

Is this something that has any kind of teeth though? Especially within neuropsych's existing work within the larger healthcare/medical systems? Or more like "training guidelines" for graduate schools, internship, and post-doc training programs?

 

[WisNeuro]

I see. Thanks.

Is this something that has any kind of teeth though? Especially within neuropsych's existing work within the larger healthcare system? Or more like training guidelines for gradate schools, internship, and post-doc training program's?

Most likely just the latter, to some extent.

 

[erg923]

Most likely just the latter, to some extent.

Thank you.

No one is going to argue that culturally informed practice and competencies are not important.... I hope.

But this big big revision/push is for....what, exactly? More diverse recruitment? Better outcomes? Better relationships with others? Has a legitimate hole or deficit been identified in neuropsychology/neuropsychology practice? Does this effect the rest of the psychology profession in any substantial way?

 

[WisNeuro]

Thank you.

No one is going to argue that culturally informed practice and competencies are not important.... I hope.

But this big big revision/push is for....what, exactly? More diverse recruitment? Better outcomes? Better relationships with others? Has a legitimate hole or deficit been identified in neuropsychology/neuropsychology practice? Does this effect the rest of the psychology profession in any substantial way?

There is one person who is pretty close, but no one is defending that person. The push is the result of prevailing forces at work, same thing is happening in state psych associations. We're moving away from being guild organizations and into political advocacy above and beyond guild specific issues.

 

[erg923]

It has teeth relative to board certification. Training guidelines relative to graduate school internship, and postdoc do matter in that regard. Meaning, if this becomes operationalizable in terms of board requirements, programs will adjust their training requirements to match. If our primary mission appears to be social activism, seems that would influence who goes into psychology. I imagine this would just continue to amplify the social activism elements we currently see (see earlier post relative to Rogers and billing), so we should see a long term uptick in apology demands. I see this trend as a slow suicide. But, we are going to be replaced by AI soon, anyways. So, whatever?

I mean, I guess it depends on how the document is titled. And, it's actual purpose. I am certainly less, uh, "progressive" compared to many of my psychologists colleagues but this doesn't sound all that bad....I guess? No drafts of this document available for larger professional review/input, I take it?

Also, the IPad came out when I was in graduate school 15 years ago and people panicked and thought computerized testing was the way of future 10+years ago. But I don't know how much this has really changed a neuropsychologist's job, as I still see plenty of reports with WAISs, WMS, CVLTs (think that's like a modified list learning task from the 30s?), etc.

Any profession that has, for decades and decades now, relied on tests that were invented decades and decades before that has not too much to worry about in the short-term future, in my opinion.

 

[erg923]

Fixed vs. Flexible hasn't been a serious issue for a while aside from some geriatric holdouts near retirement. Boarded vs. non-boarded also not a big issue as far as I have experienced. This is pretty much about the new proposed guidelines having a lot of ill-defined, politically charged buzzwords, and not a lot on actual training guidelines. The crowd that is critical of the proposed guidelines almost universally agree that the document should contain references to cultural competency and increasing diversity within the field. They'd just rather focus more on actual training guidelines and taking the more politically charged language out. This has been both on the AACN boarded listserv, as well as the community listserv, which is open to any AACN member regardless of board cert status.

When is ageism ok and justified? I see "old man" stuff waaaay away to often in the mental heath profession.

 

[WisNeuro]

When is ageism ok and justified? I see "old man" stuff waaaay away to often in the mental heath profession.

When it's true. I have never met anyone under the age of 50 who is a strong fixed battery advocate. I'm thinking of two people in particular in my comment.

 

[erg923]

There is one person who is pretty close, but no one is defending that person. The push is the result of prevailing forces at work, same thing is happening in state psych associations. We're moving away from being guild organizations and into political advocacy above and beyond guild specific issues.

Yea. My state psych association CE offerings have been mild wing sauce for years and years now. 6 years since I have attended one.

 

[PsyDr]

When is ageism ok and justified? I see "old man" stuff waaaay away to often in the mental heath profession.

Cognition declines as we age. When the environmental requirements exceeds the normative ability, judgement should be encouraged.

 

[erg923]

Cognition declines as we age. When the environmental requirements exceeds the normative ability, judgement should be encouraged.

Wilma Rosen.... is how I would respond to this. Is she still alive?

 

[WisNeuro]

Wilma Rosen.... is how I would respond to this. Is she still alive?

I'll counter with Dianne Feinstein.

 

[erg923]

I'll counter with Dianne Feinstein.

Oh! That is indeed a shame then.

 

[PsyDWannabe]

The individual that was permanently banned was banned because of repeated infractions including repeated incendiary comments for the sake of being incendiary, personal accusations against listserv members, recurrent posts centered around sociopolitical debates, and lack of responsiveness to peer requests to self correct, vitriolic MNC debates being the latest in a series of bad behavior.

The ban was years in the making and not simply due to MNC opinions.

 

[WisNeuro]

The individual that was permanently banned was banned because of repeated infractions including repeated incendiary comments for the sake of being incendiary, personal accusations against listserv members, recurrent posts centered around sociopolitical debates, and lack of responsiveness to peer requests to self correct, vitriolic MNC debates being the latest in a series of bad behavior.

The ban was years in the making and not simply due to MNC opinions.

That one was somewhat justified, the disproportionate response to the other two was highly questionable. As in, the person who called a female POC not culturally competent and that she needed to do some personal exploration merely getting a verbal reprimand, was frankly, appalling.

 

[PsyDr]

Wilma Rosen.... is how I would respond to this. Is she still alive?

I don’t understand how bringing up someone who is slightly more important than you is a response.

 

[erg923]

I don’t understand how bringing up someone who is slightly more important than you is a response.

Like a mom that gives you a BIG hug...but also tells you that you are a "big dummy" at the same time. You kinda like both.

 

[Therapist4Chnge]

Yea. My state psych association CE offerings have been mild wing sauce for years and years now. 6 years since I have attended one.

 

[Freud’sMommy]

That one was somewhat justified, the disproportionate response to the other two was highly questionable. As in, the person who called a female POC not culturally competent and that she needed to do some personal exploration merely getting a verbal reprimand, was frankly, appalling.

I've been that POC lol. Idk how aware faculty are of this dynamic across programs, but just a few of these kinds of students (the numbers increase with each cohort) are enough to harm group dynamics and cohesion. They're intellectual zombies more interested in dominance than competence and conflict resolution. They tend to have a BPD/NPD flair, and their preferred debate tactics are repetition and steam rolling. The end result is what we're seeing now with the MNC debate and I can guess it will only worsen as these types become the majority of boarded NPs.

I think programs should do better gatekeeping of admitted students, but the trend has been to relax and lower standards (e.g., no GRE). I've been surprised that, considering our expertise in psychometrics, faculty generally don't employ objective assessments when evaluating interviewees and instead rely on unstandardized interviews. To keep things in perspective, my software engineer friends go through several hours of technical screening that are highly relevant for the potential job. For our field, maybe we could ask interviewees to do a case conceptualization, develop a statistical analysis plan, design a study, etc.?

 

[borne_before]

The individual that was permanently banned was banned because of repeated infractions including repeated incendiary comments for the sake of being incendiary, personal accusations against listserv members, recurrent posts centered around sociopolitical debates, and lack of responsiveness to peer requests to self correct, vitriolic MNC debates being the latest in a series of bad behavior.

The ban was years in the making and not simply due to MNC opinions.

I can't get enough of this chisme.

 

[PsyDWannabe]

I can't get enough of this chisme.

lol whew the tea is too much, i’m just eating my popcorn and watching because, oh my, what a dumpster fire across the board

 

[WisNeuro]

One thing that I think everyone can agree on is that AACN looks like AB InBev in how they've handled this thing.

 

[cara susanna]

Man, the only listserv drama I ever witnessed was the EMDR debate on the ABCT listserv, and even that was pretty lukewarm. Although there are the occasional ones where people mean to send something spicy to an individual but email the whole listserv.

 

[PsyDr]

I think we can all agree that the only way to solve this professional debate is: TRIAL BY COMBAT!

*I will also accept pistols at dawn

 

[Pragma]

I think we can all agree that the only way to solve this professional debate is: TRIAL BY COMBAT!

*I will also accept pistols at dawn

That's only okay after beating like 100 people with guns on the stairway up to the dual site before sunrise

 

[AcronymAllergy]

That one was somewhat justified, the disproportionate response to the other two was highly questionable. As in, the person who called a female POC not culturally competent and that she needed to do some personal exploration merely getting a verbal reprimand, was frankly, appalling.

Yeah, it's farcical, which is disappointing.

 

[NeuroTrope]

Glad I dipped from the list serv long ago.

Who got permabannd? Would "JS" mean anything to anyone??? Wouldn't surprise me...

 

[WisNeuro]

Glad I dipped from the list serv long ago.

Who got permabannd? Would "JS" mean anything to anyone??? Wouldn't surprise me...

Nope, it wouldn't surprise me if he did given the hypocrisy from leadership in this issue. But if it had happened, it definitely would have hastened my exit from the organization.

 

[PsyDWannabe]

Glad I dipped from the list serv long ago.

Who got permabannd? Would "JS" mean anything to anyone??? Wouldn't surprise me...

are you sure your usual suspect was not already permabanned years before now?

 

[Pragma]

Yeah, it's farcical, which is disappointing.

It is just ridiculous enough that I can't help but waste time reading the posts.

 

[borne_before]

It is just ridiculous enough that I can't help but waste time reading the posts.

I wish I had them... Chisme is the best.

 

[WisNeuro]

I wish I had them... Chisme is the best.

Meh, these are getting redundant and old at this point. Mostly just a bunch of pearl clutching and deliberate mischaracterizations to try and shut down any productive discussion. There was a slight bit of headway today, but we'll see.

 

[futureapppsy2]

What's the matter, they couldn't find a better place to vacation? At least the Boulder and Vail folks had style. Minnesota can be nice in the summer as well.

Baltimore has JHU, which is a powerhouse in rehab. (Also, we are currently updating the guidelines but not, AFAIK, changing the name)

 

[Neuroskeptical]

Guidelines inherently are not enforceable, unlike APA's ethical standards, for example. It begs the question of what is the point of making guidelines or updating them aside from providing "guidance" to the field. My understanding is the guidelines are intentionally vague becuase there are many different types of nueropsychologists (e.g., board-certified, research-primary, etc.).

The guidelines are a direct pipeline to credentialing. It took about 7 years or so, but having training that met the Houston Conference guidelines were first a blueprint, and then an actual requirement for being permitted to sit for examination for board certification. Casting the MNC guidelines as purely aspirational and without a mechanism for assuring compliance is disingenuous. Whatever its eventual form, training that meets MNC guidelines will eventually become the standard for credentialing.

 

[AcronymAllergy]

The guidelines are a direct pipeline to credentialing. It took about 7 years or so, but having training that met the Houston Conference guidelines were first a blueprint, and then an actual requirement for being permitted to sit for examination for board certification. Casting the MNC guidelines as purely aspirational and without a mechanism for assuring compliance is disingenuous. Whatever its eventual form, training that meets MNC guidelines will eventually become the standard for credentialing.

Yep. Once the MNC are finalized, I don't know that anyone involved in training would seriously consider continuing to utilize the HC guidelines indefinitely, particularly if the board-certifying and other professional organizations all endorse the MNC. Training guidelines are also something that can be brought up in forensic work, such as when attempting to impugn an expert's training/qualifications or the work they've done.

 

[Neuroskeptical]

Token whippersnapper neuropsych trainee here. Can I (out of genuine curiosity, promise) ask what you make of the student activism/open letters/DEI focus bring pushed by trainees? I'm sensing a lot of similar attitudes in the faculty at my program, but they just smile and say "we're working on it!" and move on with their lives until something else happens. I am almost certain their responses to students are misleading, either intentionally or unintentionally, so it would be great to get an honest take on what the "adults" in the field think about all of this.

In part, confronting or addressing student/ trainee activism, open letters, protests and DEI focus is a distraction from what we are paid to do as training faculty, which is a combination of clinical care, teaching, training of students, interns, and fellows, and any of a number of administrative, reimbursement, and "other duties as assigned.". Your activism exhausts us, and further, takes time away from the "mission", which is to train you as clinical neuropsychologists.

The problem is, that training in DEI and advocacy may very well be part of the mission, and part of the tools you will need to navigate clinical and academic practice into the next decade or more. Some of my colleagues may appear to be kicking the can down the road because they don't have the mandate (or vigor) to take on this fight.

We were all trainees once, and genuinely appreciate your enthusiasm, commitment, and the adrenalin rush of advocating for what is important to you, and what you believe is important for the guild. Your older faculty put that level of effort and affect into the Fixed versus Flexible battery debate. Others into the Board Wars. Others, still, into fights over training standards, and HCG. The next into issues of medical staff privileges and parity. But in every generation, the next generation of neuropsychologists' fights have less meaning, hold less value for the folks who came immediately before. We are not necessarily equipped to help you in your fight, nor do we have the enthusiasm for the fight that we did when we were in your position.

If you want to think if it therapeutically, we are envious of your vigor, and are dealing with our own countertransference issues as we try to complete our task of teaching and honing your skills, towards getting you across the finish line and into our guild. Perhaps the best you can expect of us to provide you with requisite skills, support your growth, and get out of the way as you shape the profession in your own time

 

[Neuroskeptical]

Just out of curiosity, do the guidelines say anything about symptom or performance validity testing? If you can't comment on this, that's cool...I was just curious.

One of the more practical complaints regarding the MNC document is the exclusion of forensic issues from the lists of core competencies. This is an easy fix, and will likely be addressed in the drafts to come. While performance and symptom validity testing issues cut across practice areas, and most of the major NP organizations have position statements regarding their use, I suspect that they will be brushed against within a forensic competency requirement.

 

[Neuroskeptical]

Don't leave us hanging. What got ppl permabanned?

The permaban was for one member's repeated and seemingly extreme politicized statements. The temp suspension was for chronic surliness paired with a more recent assertion that the opinions of students, trainees, and those who had not educated, trained, or credentialed neuropsychologists might not warrant serious consideration with respect to a document purporting to establish standards for educating and training neuropsychologists.

 

[Fan_of_Meehl]

Just an interesting data point this morning. I entered the search terms into Google search 'Minnesota Guidelines Neuropsychology controversy.'

Nearly every search result had a line drawn through the term 'controversy' (meaning, the other terms matched but there don't appear to be matches out there reflective that there is any controversy/debate). Now, I understand that this process hasn't been made public at this point, so it's not exactly surprising that there don't appear to be any matches or associated discussions/articles/whatever out there on the fact that there IS controversy/debate among neuropsychologists about the proposals.

We'll see how it plays out in the coming years. It won't be boring (though it may be 'silent').

Without controversy/debate there is no 'science.'

 

[NeuroTrope]

The permaban was for one member's repeated and seemingly extreme politicized statements. The temp suspension was for chronic surliness paired with a more recent assertion that the opinions of students, trainees, and those who had not educated, trained, or credentialed neuropsychologists might not warrant serious consideration with respect to a document purporting to establish standards for educating and training neuropsychologists.

I for one welcome this new dark horse to the board!

 

[borne_before]

The permaban was for one member's repeated and seemingly extreme politicized statements. The temp suspension was for chronic surliness paired with a more recent assertion that the opinions of students, trainees, and those who had not educated, trained, or credentialed neuropsychologists might not warrant serious consideration with respect to a document purporting to establish standards for educating and training neuropsychologists.

Like super alt right or super post modern political statements?

 

[Neuroskeptical]

Like super alt right or super post modern political statements?

The perma-banned member's statements had a flavor of the alt-right/ libertarian right. The camel that broke the board's straw back was a post that was decidedly tone deaf to the tenor of the debate. Standing on its own, it probably merited a three month ban and and re-admission contingent upon apology, but the "traumatized" folks on the other side needed to be placated, and frankly, the offending party probably needed a penalty box vacay, or at very least, a nap.

 

[WisNeuro]

With the amount of vicarious tears that were apparently shed in those discussions, I think a lot of people could use a good nap.

 

[Sanman]

One could say that this is what you get when you start putting politics into professional matters that really do not necessitate politics.

 

[WisNeuro]

One could say that this is what you get when you start putting politics into professional matters that really do not necessitate politics.

One of the (several) issues is that most people agree in principle about the need for diversity in neuropsych, and multicultural competency, but disagree with some of the terms used that are somewhat ambiguous and carry a lot of political connotations. Again, just one of the issues, this a fairly multifaceted issue of which some people really want to boil it down to an oversimplified binary.

Not much happening at the moment, we're kind of in a holding pattern while another draft is being prepared behind the scenes. Haven't gotten much in the way of substantive updates in a while.

 

[Sanman]

One of the (several) issues is that most people agree in principle about the need for diversity in neuropsych, and multicultural competency, but disagree with some of the terms used that are somewhat ambiguous and carry a lot of political connotations. Again, just one of the issues, this a fairly multifaceted issue of which some people really want to boil it down to an oversimplified binary.

Not much happening at the moment, we're kind of in a holding pattern while another draft is being prepared behind the scenes. Haven't gotten much in the way of substantive updates in a while.

While I am not watching the blow by blow, this echoes what is going on in the profession and society at large. There are the relevant issues that need to be addressed regarding how research and clinical work is carried out in the future, such as the limitations on norming data. Then there are the other issues that are more politics than science where the people will continue to all do what they want anyway.

 

[WisNeuro]

While I am not watching the blow by blow, this echoes what is going on in the profession and society at large. There are the relevant issues that need to be addressed regarding how research and clinical work is carried out in the future, such as the limitations on norming data. Then there are the other issues that are more politics than science where the people will continue to all do what they want anyway.

And when it comes to issues such as improving norms, there is almost total, if not complete, agreement.

 

[PsyDWannabe]

The perma-banned member's statements had a flavor of the alt-right/ libertarian right. The camel that broke the board's straw back was a post that was decidedly tone deaf to the tenor of the debate. Standing on its own, it probably merited a three month ban and and re-admission contingent upon apology, but the "traumatized" folks on the other side needed to be placated, and frankly, the offending party probably needed a penalty box vacay, or at very least, a nap.

Why are we minimizing statements that by your own admission was “alt-right flavored” and serious and offensive enough to “merit a three month ban”, and simultaneously downplaying the seriousness of such statements to the offending party merely needing a nap? Why is traumatized in quotes? Would you have the same flippant attitude if the “traumatized” folks were on the other-other side? These are serious questions, related to why the “other side“ feel uncomfortable and “traumatized“ in the status quo.