Board Certification in Clinical Psychology: Demystifying the ABPP Process

1. Board Certification in Clinical Psychology: Demystifying the ABPP Process M. Victoria Ingram, Psy.D., ABPP President, American Board of Clinical Psychology ABCP Director, Mideast Region and Uniformed Members ABPP Board of Trustees Dr_ingram@yahoo.com

2. ??? If your primary care doc said “You need to see a Cardiologist,” would you want to see a Board Certified Cardiologist or a Non-Board Certified Cardiologist? Answer: X Board Certified Cardiologist ____ Non-Board Certified Cardiologist

3. ??? If your primary care doc said “You need to see a Psychologist,” would you want to see a Board Certified Psychologist or a Non-Board Certified Psychologist? Answer: ? Board Certified Psychologist __?_ Non-Board Certified Psychologist

4. The General Public • Knows that Board Certified is better than Non-Board Certified • Does not know the difference between psychologists and physicians

5. Hallmarks of a Profession Practitioners provide services perceived by the public as valuable and necessary Services are based on a body of knowledge The methods, techniques, and procedures used by practitioners derive from the knowledge base Society recognizes the profession through legislative action and enactment of licensing or certification statutes The profession voluntarily develops self-regulatory mechanisms (accreditation of training programs, ethical codes, board certification of specialists)

6. Accredited Doctoral Program Accredited Internship Post-doctoral Residency (optional) Licensed by State or Province Identified as Health Service Provider ? Board Certified in Area of Specialty Practice The Credentialing Continuum

7. Professional Certification To certify something as true, accurate, or genuine connotes that a standard has been met and that evidence exists supporting this conclusion “Board certified” connotes practitioners with documented competence skills in defined areas of professional practice This certification is voluntary and presumes that basic skills have already been recognized via statutory licensing

8. Examples of Board Certification in Related Professions Medicine has a history of board certification dating from the early 20th Century and the American Board of Medical Specialties has 24 affiliated specialty examining boards In 1999, the ABMS reported that 89% of licensed physicians were certified in one or more medical specialties (compared to less than 5% of psychologists in 2007)

9. Examples of Board Certification in Related Professions The National Board for Certified Counselors offers certification in mental health counseling, school counseling, and addictions counseling In 1998, Social Work board certification was established through the Office of Quality Assurance of NASW with certificates in case management; alcohol, tobacco, and other drugs; school social work; and advanced clinical practice

10. Specialty Certification in Psychology The American Board of Examiners in Professional Psychology was established in 1947 with the support of the American Psychological Association Three “fields of certification” were identified initially: Clinical Psychology Personnel–Industrial Psychology (no longer a board – but there is Organization and Business) Personnel–Educational Psychology (no longer a board – but there is School)

11. Specialty Certification in Psychology In 1968 the name was shortened to the American Board of Professional Psychology (ABPP), and School Psychology was recognized as a fourth specialty In 1984 and 1985, the American Boards of Clinical Neuropsychology and Forensic Psychology were accepted under an enlarging ABPP umbrella

12. Specialty Certification in Psychology ABPP expanded rapidly during the 1990s and into the 21st Century with the recognition and affiliation of a number of different boards

13. Specialty Certification in Psychology ABPP Exists through its Board of Trustees as a unitary governing body coordinating the efforts of 13 affiliated specialty examining boards Assures the establishment, implementation, and maintenance of specialty standards and examinations by its member boards Serves the public needs by providing oversight certifying psychologists competent to deliver high quality services in various specialty areas of psychology

14. Clinical Child and Adolescent Clinical Clinical Health Clinical Neuropsychology Cognitive and Behavioral Counseling Couples and Family Forensic Group Organization and Business Psychoanalysis Rehabilitation School 13 Recognized Specialties in ABPP, 2010

15. Specialty Certification in Psychology A Specialty is a defined area in the practice of psychology that connotes specialty competency acquired through an organized sequence of formal education, training, and experience The practice activities in any specialty seldom are exclusive to the specialty and most practice activities are shared with the general practice of professional psychology The pattern of practice activities, including limiting the scope of practice, and focusing upon more complex or unique problems or technologies is more relevant in defining a specialty together with advanced education, training, and experience

16. Ongoing Growth & Development • Development of the Subspecialty - Child Neuropsychology • - Military Psychology?? • - Clinical Psychopharmacology • - ?? * YOU • Task Force on Special Considerations Regarding ABPP Exams for Psychologists in the Military or Recently Returned

17. Vanity Boards, Quasi Certification, and Separating theWheat from the Chaff All professions suffer from this problem, some more than others Psychology’s “frontier mentality” has facilitated the phenomenon There are nine principles for identifying legitimate and bona fide psychology specialty boards

18. Vanity Boards, Quasi Certification, and Separating the Wheat from the Chaff 1. The specialty is represented by an independently incorporated examining board that has a stable history, is national in scope, and reflects the current development of the specialty 2. The specialty examining board is affiliated with a multi-board credentialing organization that is national in scope and representative of the broader profession 3. The examining board has a history of association and interaction with recognized general and specialty-specific professional organizations relevant to the practice of the specialty

19. Vanity Boards, Quasi Certification, and Separating the Wheat from the Chaff 4. Several psychologists serve on the board who are licensed and credentialed in the specialty and whose credentials are open to inspection by the public 5. Professional peer review permeates all of the board’s procedures for evaluating applicants’ qualifications (e.g., reviews of applicant credentials, evaluation of professional work samples, conduct of competency examinations 6. The prerequisite education, training, and experience standards necessary for specialty practice are defined clearly and implemented consistently

20. Vanity Boards, Quasi Certification, and Separating the Wheat from the Chaff 7. Candidates are required to submit work products and samples of professional practice in the specialty that are evaluated by professional peers with documented expertise in the specialty 8. All candidates complete written and/or oral examinations of substance and credibility that are conducted by board certified professional peers where competence in the practice of the specialty is demonstrated 9. Bona fide specialty examination boards do not employ “grandparenting” procedures that allow waiver of examination or work sample evaluations, nor do they have histories of repeated extensions of grandparenting waivers

21. ABPP VALUE STATEMENT Board Certification through the American Board of Professional Psychology (ABPP) provides peer and public recognition of demonstrated competence in one of it's thirteen affiliated specialty areas. Additionally, Board Certification through ABPP provides the professional with increased opportunities for career growth, including employability, mobility, and financial compensation.

22. Why Get Board Certified in Psychology? Preparing for and participation in the board certification process provides people the opportunity to consolidate own learning and perspective the chance to articulate own views and perspectives in a more advanced and sophisticated way a structure to facilitate self-assessment an important continuing professional education opportunity (CE credits actually awarded) more mobility opportunities

23. Why is Certification Necessary and Essential in Psychology? The generic nature of psychology licensing in North America presumes additional professional self-regulation of specialty practice **** The exponential growth of psychological knowledge leaves no alternative but specialization Our work environments impel us to specialize

24. Why is Certification Necessary and Essential in Psychology? Our professional context reinforces the need for specialization Protecting the public from charlatans and the ill-prepared requires personal and professional self-regulation Credential is understood by other professionals and the public Support the profession

25. Why Get Board Certified in Psychology? Highest credential for a psychologist and denotes an advanced level of competence (knowledge, skills, attitudes) “Final examination" that gives our students, the profession, and the public that extra confidence one gets when being referred to as a board-certified specialist

26. American Board of Clinical Psychology (ABCP) Specialty board of ABPP Examination in Clinical Psychology, for Board Certification by ABCP certifies that the successful candidate has completed the educational, training, and experience requirements of the specialty, including an examination assessing the competencies required to provide quality service in clinical psychology

27. Standards for Award of Board Certification by ABCP ABCP expects that most clinical psychologists should qualify for board certification Requirements are reasonable and reachable with a modest amount of effort

28. Eligibility RequirementsDegree (Generic): A doctoral degree from a program in professional psychology which at the time the degree was granted, was accredited by the APA or the Canadian Psychological Association (CPA), OR A doctoral which at the time the degree was granted was from a program listed in the publication Doctoral Psychology Programs Meeting Designated Criteria

29. OR THE (Generic) DEGREE REQUIREMENT CAN BE MET IF: The applicant is credentialed as a health service provider in the current Directory of the National Register of Health Service Providers in Psychology (NRHSPP), or the current Canadian Register of Health Service Providers in Psychology (CRHSPP), OR The applicant holds a current Certificate of Professional Qualifications in Psychology (CPQ) from the Association of State and Provincial Psychology Boards (ASPPB), OR The applicant holds a doctoral degree in psychology and has subsequently been certified as completing the requirements of a formal, doctoral level, professional program that meets the APA accreditation requirements in clinical, counseling, or school psychology (re-education-often referred to as re-specialization). The applicant qualifies for an individualized exception review. Individualized exception reviews are available for degrees granted outside the U.S. or Canada, doctoral degrees granted prior to 1983, or for applicants claiming equivalent doctoral degree and program requirements. Such exceptions are coordinated through the ABPP Executive Office and the appropriate specialty board.

30. Eligibility RequirementsDegree (Clinical Specialty): In addition to the generic foundation requirements delineated above, the Clinical Psychology specialty requires completion of an organized doctoral education and training program in Clinical Psychology, which includes an internship. The specialty also requires postdoctoral supervised practice and experience in the specialty. The specialty’s specific program requirements are met if: • The doctoral degree program was in Clinical Psychology from a program accredited by the APA or CPA. • The doctoral degree program qualifies as equivalent to an APA or CPA accredited program in clinical psychology as determined by the ABCP. • The doctoral degree is from a nonprofessional program in psychology, with an additional certification that the applicant has completed at least a two year doctoral level re-education program (including an internship) designed to meet APA or CPA accreditation requirements in Clinical Psychology. • The doctoral degree program was in a counseling or school psychology program accredited by the APA or CPA (see additional experience requirements – E.2.)

31. Eligibility RequirementsLicensure (Generic): • The Applicant must be licensed or certified as a psychologist at the independent practice level by the State, Province, or Territory of the U.S. or Canada in which the psychologist practices. • Exceptions for the above are recognized for: (a) active duty federal uniformed service psychologists when practicing in those roles, or (b) organizational and business consulting psychologists (I/O) if the specialty’s scope of practice is excluded from statutory licensure or certification.

32. Eligibility RequirementsInternship (Clinical Specialty): A one year full-time or two year half-time internship program is required. The internship requirement is met if: • Accredited by the APA or CPA • Listed in the Association of Psychology Postdoctoral and Internship Centers (APPIC) Directory for the year the internship was completed • The applicant is listed in the NRHSPP or CRHSPP Directory or holds the CPQ

33. Eligibility RequirementsPostdoctoral Experience and Supervision (Specialty) The postdoctoral requirements include the following for individuals whose degree is from an APA or CPA accredited program in Clinical Psychology: One year of post-doctoral supervision in Clinical Psychology in a successfully completed, post-doctoral training program in Professional Psychology that is accredited by the APA or CPA or from an APPIC member program OR Two years total of postdoctoral experience, one of which was supervised (minimum of one hour per week of supervision was conducted face-to-face by a licensed psychologist) Any variance from this requirement will be decided on a case-by-case basis.

34. Eligibility RequirementsPostdoctoral Experience and Supervision (Specialty) Individuals whose degree is from an APA or CPA accredited program in Counseling or School Psychology or a Combined Program or have a doctoral degree in professional psychology from a program listed as a designated doctoral program in psychology by ASPPB/NRSPP must: have had five years post-doctoral experience as a Clinical Psychologist. One of the five years must have been supervised by a Clinical Psychologist, AND demonstrate self-identification as a Clinical Psychologist and an expected continued identification with the specialty OR successful completion of an APA or CPA accredited or APPIC member postdoctoral residency/fellowship program in professional psychology

35. Eligibility Requirements: Senior Psychologist Option 15 years or more post-doctorate experience (years count from the receipt of the license) Complete Professional Statement and Practice Sample that discuss contribution to clinical psychology (clinical practice, publications, teaching, training, clinical research project) Submit additional written products that form the basis of an interesting discussion among peers Work samples (as described below) are NOT required

36. Application and Review Process Submit Application Form, application fee, and credentials to ABPP Central Office who verify credentials (Stage I – Credentials Review) ABCP Credentials Review Committee conducts evaluation for specialty requirements and may ask for additional information Notified of approval Begin preparing practice sample – 3 copies of which must be received within 12 months of credentials acceptance and must be accompanied by examination fee

37. Application and Review ProcessPractice Sample • Curriculum Vitae • Professional Statement (read requirements in the manual*) • Work samples Each provides the Candidate the opportunity to communicate about him/her self as a Clinical Psychologist and serves as the basis for discussion in the opening portion of the Oral Examination. Also is used to evaluate the performance in COMPENTENCIES.

38. Application and Review Process Practice sample is reviewed for completeness and then forwarded to Regional Board Member Regional Board Member guided by the Professional Statement, selects a Chair and together they select 2 committee members and inform the candidate The 3 committee members review the practice samples (Practice Sample – Stage II). If the Practice Sample Stage is passed (2 independent passes) – Oral examination is held with same 3 member committee (Oral Examination -Stage III)

39. Application and Review Process Notification of outcome by ABPP Central Office Successful Candidates receive a congratulatory letter from ABPP and the President of ABCP ABPP Convocation at APA annual convention

40. Application and Review Process Notification of outcome by ABPP Central Office Candidates who fail receive a report from the Examination Committee that documents the outcome and rationale, identifies specific areas of weakness and suggestions for improvement, and identifies specific areas of strength and competence

41. Why do some “Fail?” • Failure rates – ABCP vs. other Specialty Boards • Recent reasons for failure at Practice Sample stage • #1 reason – Not reading and following the current exam manual directions; sloppy attention to detail • Insufficient material in submission to assess • Senior sample • Breach of confidentiality/Violation of HIPPA • Electronic Medical Records • Sending in the signed tape release • Oral Exam stage • A special note on professional appearance of work sample

42. COMPETENCIES: 1) Science Base and Application – Provide evidence for ways you use or contribute to the current science base by either: (a) evidence base that informs your practice, or (b) own clinical-research 2) Assessment 3) Intervention 4) Consultation 5) Supervision/Teaching/Management (If Applicable – NOT REQUIRED FOR ALL CANDIDATES)

43. COMPETENCIES: 6. Interpersonal Interactions 7. Individual and Cultural Diversity 8. Ethical and Legal Foundations 9. Professional Identification * Guidelines for professional statement and scoring Form are both in the manual!

44. Work Sample: Videotape Samples 2 taped samples of professional work – recorded in a continuous, unedited 50 minute run at standard 2 hour speed; both individuals visible! 3 copies of a single cassette/DVD with both topics Each sample ~ 50 minutes in length Good audio and video quality is essential Typed verbal transcripts (3 copies) if taping problems

45. Work Sample: Videotape Samples Choose two of the following four: Unrehearsed assessment (1st 50 minutes including rapport building, not just administration of tests) Unrehearsed intervention Unrehearsed consultation Unrehearsed supervision or management May not use same client/patient or specific setting/context for both samples Each written sample should be 1000-1500 words

46. Practice Sample: Videotape Samples Do not need to provide exemplary work or gold standard session, just your usual good work Use work samples that reflect the work you actually do Work conducted no more than 6 months prior to submission

47. Practice Sample: Videotapes Must obtain Client/Patient Consent Forms as part of the videotape process Remove all identifiers from all materials!!!

48. Practice Sample: Assessment Contextual statement - Date of contacts, descriptive information, presenting problem, brief history Rationale for procedures used Copies of raw data, protocols, and computer printouts (if applicable) Formulation and discussion of problem Diagnoses Recommendations Discussion of diversity and ethical and legal issues Self-reflective commentary Copy of report

49. Practice Sample: Intervention Contextual statement - Dates of contacts, session #, non-identifying description and history, presenting problem, course of treatment, diagnoses Rationale for interventions used and intervention goals Formulation and discussion of intervention Discussion of diversity and ethical and legal issues Self-reflective commentary Copy of report (if applicable)

50. Practice Sample: Consultation Contextual statement - Dates of consultation contacts, non-identifying description of consultation context, purpose and goals of consultation, brief history of consultation Rationale for consultation activities used Formulation and discussion of consultation Discussion of diversity and ethical and legal issues Self-reflective commentary Copy of report (if applicable)