by A.J. Finch, Jr., PhD and W.M. Nelson, III, PhD
History of Examination Development
In response to increasing interest in specialization and proficiencies in professional psychology, the Commission for the Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP) was established in 1996. CRSPPP developed procedures whereby organizations could petition for recognition of specialty areas or proficiencies by APA. In 1998 CRSPP recognized Clinical Child as a specialty area, and in 1999, Clinical Child Psychology became Division 53 of APA. Prior to this time it had been a Section of Division 12 (Clinical Psychology). In the 2000 winter meeting of Division 53, the executive committee invited the American Board of Professional Psychology (ABPP) to send a representative to discuss the affiliation process. As a result of this discussion, a committee was appointed to pursue recognition of clinical child psychology by ABPP. The committee consisted of Al Finch, Mary A. Fristad, James H. Johnson, Philip C. Kendall, John Lochman, W. M. Nelson, III, and John Piacentini.
In 2002 the initial application was presented and approved. As part of this application process, an exam had to be proposed, developed, and observed. During the spring of 2003, the initial examinations were conducted under the observation of ABPP and formal recognition of the Clinical Board was awarded that summer. The initial group of Board Certified Clinical Child and Adolescent Psychologists were recognized at the ABPP Convocation during the 2003 APA convention in Toronto, Canada.
The Examination for Board Certification in Clinical Child and Adolescent Psychology
ABPP has established standards that all specialty boards must follow for affiliation. Such standards were conceptualized and developed to identify those practitioners who have demonstrated higher than basic level competencies certified by jurisdictional licensure (typically state licensing boards), but within the reach of most experienced practitioners of professional psychology. The first phase of this examination process involves the determination of the educational requirements to be recognized as a specialist. Considerable work had already been done on the establishment of course work, internship, and post-doctoral requirements for specialty training in clinical child and adolescent psychology. For example, academic guidelines were developed by Roberts, Erickson, and Tuma (1985), Roberts, et. al (1998), Tuma (1985a), Tuma (1985b) and Johnson and Tuma (1986). Pre-doctoral internship guidelines were developed by Finch and Robbins (1985) and Elbert, Abidin, Finch, Sigman, and Walker (1988). Post-doctoral guidelines were published by Ollendick, Drotar, Friedman, and Hodges (1988). Drawing upon these works and following the ABPP standards, the basic educational requirements were established. The next task was the exam itself.
The decision was made that the examination would be entirely oral and conducted by a group of three psychologists who were board certified in the area. The rationale for this decision was that professional practice in clinical child and adolescent psychology can be conducted in a variety of different settings and from a variety of different perspectives. An oral examination allows the flexibility needed to examine candidates with an exam based on the nature of their practice. The examination process encompasses seven competency areas.
1. Professional Knowledge: Successful candidates understand patients/clients within their social context (family, school, peers, etc.) and their problems with conceptual breadth and depth. This involves having a definable set of constructs or a theoretical orientation of sufficient complexity to allow a rich discussion which can be justified from the research and/or clinical literature. Successful candidates critically evaluate research and professional literature and discuss implications for practice. They appreciate the limitations of their competence and appropriately seek consultation, supervision, and continuing education.
2. Assessment Competence: Successful candidates articulate a comprehensive assessment model and choose procedures appropriate for referral needs and characteristics of the patient/client. They interpret assessment data accurately, develop conclusions supported by their assessment procedures, and make appropriate recommendations. Successful candidates communicate results in ways that lead to useful outcomes for diagnosis and treatment while minimizing the likelihood of misuse.
3. Intervention Competence: Successful candidates effectively manage treatment contract issues (patient/client goals, boundaries of treatment, payment resources, etc.). They choose intervention procedures appropriate for the patient/client and the situation, based on an articulated theory. Interventions are applied and documented skillfully. Successful candidates assess intervention issues in a developmentally appropriate and contextually relevant manner.
4. Interpersonal Competence with Clients: Successful candidates relate in developmentally appropriate ways that enhance the effectiveness of services and minimize interference or disruption. They are aware of patient-therapist interpersonal issues, personal impact, strengths, weaknesses and limitations as professionals – and they skillfully manage these factors. Successful candidates are sensitive to the welfare, rights and dignity of their patients/clients, families, other professionals and society as a whole.
5. Ethical and Legal Standards and Behavior: Successful candidates demonstrate knowledge of ethical principles, professional practice standards, record keeping requirements, and legal standards. They effectively apply ethical principles, professional practice standards, record keeping requirements, and legal standards in clinical practice.
6. Commitment to the Specialty and Awareness of Current Issues: Successful candidates demonstrate active participation in the profession. They can thoroughly describe current issues facing the profession and their implications for patient/client welfare.
7. Competence in Supervision and Consultation: Successful candidates demonstrate awareness of the activities involved in and the complexities of the supervisory relationship. They also understand the parameters for consultation and the limitations of their training and competence.
The examination itself is based on a professional statement and a practice sample consisting of a video recording of both an assessment session and an intervention session, both submitted by the candidate. The professional statement describes training, experience, current work, and identity as a psychologist. This statement provides candidates with the opportunity to communicate about themselves as a clinical child and adolescent psychologist, and it serves as a basis for discussion in the opening portion of the oral examination. Candidates describe in detail the theoretical orientation that guides their professional work and should reflect actions congruent with this orientation throughout the examination process. The professional statement includes a description of the full scope of the candidate’s primary employment and professional activities. It is important that the statement include a thorough description of an ethical quandary that the candidate has faced professionally.
The practice sample includes an intervention video and an assessment video. Each video segment, approximately 50 minutes in length, must be accompanied by supporting file/case material. One segment should depict an unrehearsed psychological assessment while the other segment depicts an unrehearsed intervention; the video segments should be drawn from typical clinical practice within approximately six months prior to the submission. If the assessment segment includes test administration, the recording must be of the first hour of the assessment session since that is the portion during which rapport building and any interviewing takes place. Recordings solely depicting a test administration are not satisfactory. Both video segments must include copies of all source documents and contextual statements containing:
• The rationale for the procedures used.
• A reflective comment on the candidate’s own behavior in the sample.
• Any relevant events for candidate or client subsequent to the sample.
Candidates are encouraged to submit video samples that reflect their competence and expertise and which depict their interactive style drawn from their typical practice rather than exemplary situations. Consistent with their awareness of confidentiality issues, candidates are required to remove identifiers from all materials, including test protocols.
The oral examination is three hours long with a brief break in the middle. The first part of the exam is a brief review of the procedures of the day and a general introduction. This lasts about ten minutes. The committee then moves into the discussion of the professional statement and the practice samples. This is the longest portion of the exam. The next portion of the exam is spent on the ethical, legal and professional issues sections of the exam. During the ethical section, the candidate is given two ethical vignettes and asked to respond to them as if they occurred in his/her practice. Criteria for passing responses are provided to the examiners. Also, the candidate discusses one ethical issue that she/he has submitted with the professional statement. The final stage of the exam is a wrap-up discussion and any topics that need to be further addressed.
Immediately following the examination and after the candidate has left, each member of the committee independently completes a scoring grid that rates the candidate according to the seven competency areas previously described. Again, to aid in the standardization process, examples of passing and failing criteria are provided for each area. Examiner rating is done independently and without discussion to facilitate the objectivity of the examiner ratings. Following the rating, each examiner is asked to vote either pass or fail based on the candidate’s responses during the oral exam. Two pass votes are required for passing the examination.
Applying for Board Certification in Clinical Child and Adolescent Psychology
Application materials and requirements for board certification in any of the thirteen specialty areas recognized by ABPP can be obtained from the webpage: www.abpp.org.