Use of Psychometrists (updated 3/12/08)
"Testing assistants. ... Clinical neuropsychologists who use testing assistants invest significantly briefer evaluations, have greater incomes, charge higher hourly fees, have greater income satisfaction and greater job satisfaction, and spend fewer hours in clinical activities per week." (p 333) - (2006) The TCN/AACN 2005 "Salary Survey": Professional Practices, Beliefs, and Incomes of U.S. Neuropsychologists Jerry J. Sweet, et. al.
To link to this article: URL: http://dx.doi.org/10.1080/13854040600760488
Click here to download the file.
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NAN Policy Planning Committee. (2006). The use, education, training and supervision of neuropsychological test technicians (psychometrists) in clinical practice – Official Statement of the National Academy of Neuropsychology. Archives of Clinical Neuropsychology, 21, 837–839
Click here for the full article (10/18/06)
The Use of Psychometrists in Clinical Neuropsychology Practice
Official Statement of the National Association of Psychometrists (NAP)
The use of Psychometrists (also neuropsychological technicians, psychometricians, psychological assistants) to administer and score the full range of psychological and neuropsychological assessments has been the standard, accepted practice dating back to the late 1930's (DeLuca, 1989). Much like other medical professions, (e.g. EEG technologists, radiology technologists, and nurse practitioners), neuropsychologists rely upon trained non-doctoral personnel in their practices. According to the NAN position paper on technician use, this practice dates back for more than 3 decades and is an established standard of practice in neuropsychology.
Psychometrists administer and score psychological and neuropsychological assessments are beneficial for the following reasons:
> Psychometrists are highly trained professionals, usually with a Bachelor's degree or higher from a regionally accredited college or university, preferably in psychology or a related mental health field (as recommended by APA's Division 40). One example of competence is certification as a Certified Specialist in Psychometry (CSP), which requires educational training, clinical and/or research experience, a passing score on a Nationally Standardized exam, and ongoing continuing education. Extensive training is provided in standardized administration procedures to ensure that each client is assessed in the same way regardless of setting. Psychometrists work closely with and under the direct supervision of a licensed psychologist or neuropsychologist to ensure that quality care is delivered in a timely manner to as many clients as possible.
> The use of Psychometrists allows for objective data collection and additional behavioral observations from a second party, unbiased by clinical interview data, contributing to increased reliability and validity of test administration (DeLuca, 1989).
> It also allows the neuropsychologist/psychologist more time to devote to clinical interviewing, test selection, interpretation, and report writing. This permits a larger number of clients to receive needed services in a more timely manner.
> Standardized norms for such commonly used tests as the Wechsler scales (e.g. WAIS-III and WMS-III) and the Halstead-Reitan battery were based upon data collected by technicians.
> As of January 1, 2006, federal guidelines, such as CPT codes, establish and reimburse for technician-administered assessments.
> The use of Psychometrists to administer and score tests is recognized by APA Division 40, NAN, INS, the Standards for Educational, and Psychological Testing, and Medicare, and most state licensing boards in psychology.
> APA Division 40 guidelines detail the standards of practice in place for the selection, training, supervision, and utilization of psychometric support (Division 40 Task Force, 1989; 1991). Psychometrists' duties include the standardized administration and scoring of neuropsychological and psychological instruments and making behavioral observations regarding client behavior. Test selection, interpretation, report writing, and consultation remain the sole responsibility of the supervising neuropsychologist or psychologist (Division 40, 1989). Collection of fees for services remains the responsibility of the supervising psychologist/neuropsychologist (p.24, Division 40, 1989).
This official statement is endorsed and supported by the National Association of Psychometrists (NAP) and is consistent with previously published standards of practice as established by APA Division 40 and the National Academy of Neuropsychology (NAN Position Paper on The Use of Neuropsychology Test Technicians in Clinical Practice, 1999).
References:
DeLuca, J. W. (1989). Neuropsychology Technicians in Clinical Practice: Precedents, rational and current deployment.
Division 40 Task Force (1989). Report of the Division 40 Task Force on Education, Accreditation, and Credentialing (1989): Guidelines regarding the use of non-doctoral personnel in clinical neuropsychological assessment.
Division 40 Task Force (1991). Report of the Division 40 Task Force on Education, Accreditation, and Credentialing (1991): Recommendations for education and training of non-The Clinical Neuropsychologist, 3 (1), 3-21.The Clinical Neuropsychologist, 3 (1), 23-24.
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Below is information about the use of Psychometrists from various other sources:
www.APApractice.org
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Retrieved 2/9/06 - Source: APA - http://www.apapractice.org/apo/toolkit.BottomPar.0009.file.tmp/AACN%20Technician%20Policy.pdf
American Academy of Clinical Neuropsychology
Policy on the Use of Non-Doctoral-Level Personnel in Conducting Clinical Neuropsychological Evaluations
The use of psychometric technicians, psychometrists, and other psychologist-assistants, as
well as trainees enrolled in formal educational and training programs, is both acceptable and a widespread practice in clinical neuropsychology. These individuals, who typically have
baccalaureate (and often masters) degrees in psychology, as well as additional training in thestandardized administration and scoring of neuropsychological tests, work under the direct and close supervision of licensed psychologists. The licensed psychologist has responsibility for the entire assessment, but test administration and scoring may be performed by non-doctoral-level personnel. The technician, assistant, or trainee thus functions in a way analogous to the medical laboratory or radiology technician; he/she is responsible for the acquisition of data upon which the licensed doctoral-level professional bases his/her evaluation and opinions.
Approved February 6, 1998
The Clinical Neuropsychologist, Vol. 13, No. 4, p. 385 © Swets & Zeitlinger.1385-4046/99/1304-385
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Retrieved 2/9/06 - NAN - http://www.apapractice.org/apo/toolkit.BottomPar.0010.file.tmp/NAN%20Technician%20Policy.pdf
Official Statement of the National Academy of Neuropsychology
The Use of Neuropsychology Test Technicians in Clinical Practice
The use of neuropsychology technicians (also referred to as “technicians, psychometrists,
psychometricians and psychological assistants,” p. 23, Division 40 Task Force, 1989) in the
supervised administration and scoring of the full range of neuropsychological tests and allied
cognitive, psychological, and behavioral assessment procedures, can be traced to the late
1930s, and it has been an established standard of practice in the field of clinical neuropsychology for more than three decades (DeLuca, 1989). This practice is not unique to neuropsychology. Other doctoral level health care practitioners also routinely employ trained non-doctoral technical personnel (e.g., radiology and EEG technicians). The use of neuropsychology technicians helps maintain the objectivity of data collection and minimizes potential for bias associated with clinical judgment. This practice maintains reliability and validity of test administration (DeLuca, 1989).
Standards of practice exist for the selection, training, supervision and utilization of neuropsychology technicians (DeLuca, 1989; Division 40 Task Force, 1989, 1991). These standards clearly indicate that the neuropsychology technician is trained “only for the administration and scoring of psychological and neuropsychological tests” (p. 24, Division 40 Task Force, 1989) and observation/reporting of test behavior. Technician training and supervision, test selection, interpretation/analysis of test data, report-writing, and neuropsychological consultation are the sole responsibility of the neuropsychologist who is licensed to practice psychology or neuropsychology. “The professional relationship in clinical neuropsychology is between the patient and the . . . neuropsychologist” (p. 24, Division 40 Task Force, 1989). The neuropsychologist establishes and charges fees for services, and is “accountable for the quality of professional work” (p. 24, Division 40 Task Force, 1989).
This official statement of the National Academy of Neuropsychology is consistent with previously published APA-Division 40 standards for education, training and supervision of non-doctoral neuropsychology technicians (Division 40 Task Force, 1989, 1991). These standards are endorsed and supported by the National Academy of Neuropsychology.
The NAN Policy and Planning Committee
Bradley Axelrod, Ph.D.
Robert Heilbronner, Ph.D.
Jeffrey Barth, Ph.D., Chair
Glenn Larrabee, Ph.D.
David Faust, Ph.D.
Neil Pliskin, Ph.D., Vice Chair
Jerid Fisher, Ph.D.
Cheryl Silver, Ph.D.
Approved May 15, 1999
Archives of Clinical Neuropsychology
Copyright © 2000 National Academy of Neuropsychology
Printed in the USA. All rights reserved.
Vol. 15, No. 5, pp. 381–382, 2000
References:
DeLuca, J. W. (1989). Neuropsychology Technicians in Clinical Practice: Precedents, rational and current deployment.
Division 40 Task Force (1989). Report of the Division 40 Task Force on Education, Accreditation, and Credentialing (1989): Guidelines regarding the use of non-doctoral personnel in clinical neuropsychological assessment.
Division 40 Task Force (1991). Report of the Division 40 Task Force on Education, Accreditation, and Credentialing (1991): Recommendations for education and training of non-The Clinical Neuropsychologist, 3 (1), 3–21.The Clinical Neuropsychologist, 3 (1), 23–24.
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Retrieved 2/9/06 - http://www.apapractice.org/apo/toolkit.BottomPar.0008.file.tmp/APA%20Division%2040%20Technician%20Policy.pdf
Report of the Division 40 Task Force on Education, Accreditation and Credentialing
Guidelines Regarding the Use of Nondoctoral Personnel in Clinical Neuropsychological Assessment
Introduction
The guidelines regarding the use of nondoctoral personnel in clinical neuropsychological
assessment represent a continuation of previous documents from the Task Force (Task Force, 1987, 1988). The document below represents a general position regarding the use of nondoctoral personnel, and delineates the role of such personnel in the general context of clinical neuropsychological assessment. The committee members who participated in the development of this document included R.A. Bornstein (Chair), Linas Bieliauskas, Lloyd Cripe, James Hom, Edith Kaplan, Roberta White, Alan Yozawitz.
Use of Nondoctoral Personnel in Neuropsychological Assessment
The practice of Clinical Neuropsychology involves the integration of data derived from a variety of sources which may include clinical or diagnostic patient interviews, clinical histories, and interpretation of data from various neuropsychological measures. There is a broad range of practice in regard to the use of neuropsychological measures in the assessment of behavioral consequences of impaired brain function. In the use of neuropsychological assessment techniques, individual psychologists may elect to perform their own assessment (in whole or in part) in order to directly observe specific aspects of behavior. However, there is no obligation for all psychologists to perform their own assessments in this manner. One practice in Clinical Neuropsychology includes the supervised participation of nondoctoral personnel (technicians, psychometrists, psychometricians, psychological assistants, etc. depending on the venue). The use of such technicians is a common and accepted practice when the supervising psychologist maintains and monitors high standards of quality assurance as suggested for such work in the General Guidelines for Providers of Psychological Services, (American Psychological Association, 1987); Specialty Guidelines for the Delivery of Psychological Services by Clinical Psychologists, (American Psychological Association, 1981); and Ethical Principles of Psychologists, (American Psychological Association, 1981).
Roles for Technicians in Clinical Neuropsychological Assessment
The neuropsychological technician occupies a critical role in the assessment process (for those psychologists who elect to use technicians). No neuropsychologist can interpret improperly obtained data, and it has been suggested that “excellent examination technique is the sine qua non of neuropsychological evaluation” (Boll, 1981). However, technicians have a very narrowly defined and highly specific role in the overall process. These technicians are responsible only for the administration and scoring of neuropsychological tests under the supervision of a neuropsychologist who must be a licensed psychologist in that state or province. The selection of tests, interpretation of those tests, clinical interviewing of patients or family members, and communication of test results and their implications is the sole and exclusive responsibility of the licensed (neuro)psychologist. Experienced or “senior” technicians may be involved in the training of new technicians or in the monitoring of testing procedures; however, the ultimate responsibility for testing procedures and training remains with the licensed supervising (neuro)psychologist. The professional relationship in clinical neuropsychology is between the patient and the licensed (neuro)psychologist. Fees for service and accountability for the quality of professional work are exclusively the purview of the licensed (neuro)psychologist.
References
American Psychological Association. (1981). Ethical guidelines of psychologists, American
Psychologist, 36, 633-638.
American Psychological Association. (1981). Specialty guidelines for the delivery of services
clinical psychologists. American Psychologist, 36, 640-651.
American Psychological Association. (1987). General guidelines for providers of psychological services. American Psychologist, 42, 712-723.
Boll, T.J. (1981). The Halstead Reitan Neuropsychology Battery. In T.J. Boll & S.B. Filskov (Eds.).
Handbook of clinical neuropsychology (pp. 577-607). New York: John Wiley & Sons.
Reports of the INS-Division 40 Task Force on Education, Accreditation, and Credentialing.
(1987). The Clinical Neuropsychologist, 1, 29-34.
Reports of the Division 40 Task Force on Education, Accreditation and Credentialing. (1988).
The Clinical Neuropsychologist, 2, 25-29.
This statement reflects the official position of the Division of Clinical Neuropsychology and should not be constructed as either contrary to or supraordinate to the policies of the APA at large.
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The following exerpt is from the Summer/Fall 2005 edition of the Division 40 (Division of Neuropsychology - APA) Newsletter: Volume 23, Number 2
 For full newsletter article click here - the article is on pg 25 -
"Practice Advisory Committee Report: Dr. Neil Pliskin reported on the activities of the PAC. Technician Issue:
The issue of legislation to limit the use of technicians in assessment continues to be a primary focus in the PAC. Dr. Pliskin reported that the APA Practice Organization has been
strongly supportive of this practice concern and has recently completed a review of technician-related laws in all 50 states.
Particular emphasis during the EC discussion was placed on current activity in New York (where Dr. Pliskin has been working closely with the Practice Directorate and with NYSPA), Arkansas (where use of technicians was recently reaffirmed, due in part to strong support of the Practice Organization which included a grant to offset legal costs), Oregon (where an amendment was passed that permits the use of technicians), and Tennessee (where regulations have been drafted that would prohibit the use of technicians). The Executive Committee discussed ways that the Division can be effective in working toward ensuring that it is permissible to utilize appropriately trained and supervised technicians. The PAC will plan, among other strategies, to continue to work closely with ASPPB in order to educate licensing boards about the importance of this issue and to provide accurate information about the competent use of technicians.
The Executive Committee considered a request that Dr. Pliskin received for Division 40 to support a national movement towards certification or registration for technicians. It was decided that it would be outside the charge of the Division to be actively involved in developing guidelines for professionals who are not clinical neuropsychologists, although the PAC is willing to provide any information that is requested relevant to the appropriate supervision of technicians by neuropsychologists.
The PAC has drafted a fact sheet describing the proper and improper uses of test technicians, re-emphasizing the established findings of Division 40’s 1989 Taskforce on Education, Accreditation and Credentialing and offering specific examples of ethical practice. It is anticipated that this document will be ready for EC review in the fall.
At the urging of the PAC, APA has been working actively with CMS to request that they expand the diagnostic testing rule to allow psychologists to supervise others. At the request of the APA Practice Organization, the PAC sent a detailed memo to Diane Pedulla that outlined the Division 40 perspective on this matter. Dr. Randy Phelps reported at the EC meeting that CMS has now decided in favor of a rule, effective January 2005, that will allow psychologists to serve as supervisors. Dr. Phelps thanked Dr. Pliskin and the Division for assistance in negotiating this important ruling change, and Dr. Haaland expressed her thanks to the Practice Organization for its outstanding efforts in support of technician issues."
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http://div40.org/Resources_Pages/d40_tf_technicians.htm - retrieved 12/9/05
Division 40 Task Force on Technicians at this time does not have a definition of "technicians" (Psychometrists) listed on their website.
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http://div40.org/Committee_Activities_Pages/Advisory_Committee/practice.htm - retrieved 12/9/05
(1) Technician Issue
There have been an increasing number of challenges by different states (Arkansas, New York, Oregon and previously in North Carolina) to the use of testing technicians. The assumption by these groups has been that only psychologists can do their own testing. The Practice Directorate of APA has been instrumental in taking the lead on this critical practice issue on behalf of neuropsychologists, and has been working closely with state psychological associations to address these issues as they have arisen state by state. The APA’s position is that the safety net that assures the protection of the consumer is ultimately the responsibility of the licensed doctoral level provider and that use of technicians for routine aspects of neuropsychological test administration does not place the public at risk. Thanks in large part to their efforts, there have been positive results in meeting these challenges in North Carolina, Oregon and, most recently, Arkansas.
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The Professional/Technician Model in Clinical Neuropsychology:
Deployment Characteristics and Practice Issues
John W. DeLuca and Steven H. Putnam
The use of professional/technician model or, more specifically, the laboratory method in clinical psychology and clinical neuropsychology, dates back to the 1940s. The advantages of this method are thought to include objective data collection, more efficient use of the psychologist’s time, and cost-effectiveness. This article investigates some of the characteristics of technicians versus those who do not, along with a demonstration of the efficiency and cost-effectiveness of the professional/technician model. The results indicate that the use of technicians by neuropsychologists continues to be widespread, and differences between neuropsychologists using technical personnel and those who do not are limited to the number of patients assessed per month and the amount of time allotted for assessments. Increased efficiency and cost-effectiveness is also associated with use of neuropsychology technicians. The implications of these results are discussed within the context of suggestions supporting further proliferation of this practice model.
Click here to download full article.
DeLuca, J. W. & Putnam, S. H. (1993). The Professional/Technician Model in Clinical Neuropsychology: Deployment Characteristics and Practice Issues. Professional Psychology: Research and Practice; American Psychological Association; Vol. 24, No. 1; 100-106.
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