Value of ABPP Certification

[bigdodge53]

I have done some reading recently about seeking ABPP certification for a specific specialty (in my case, counseling psychology). I am a long time from making this decision (starting doc program in fall 2008) but I am unsure as to how valuable this certification really is. I can see how it could be valuable for a specialty like clinical neuropsychology but I don't see how it is valuable for my specialty. My understanding is that it is very difficult for psychologists to attain this credential and it does speak to a certain level of expertise if it is attained. I was just wondering if anyone else had heard any of your mentors or faculty speak on this and if it was helpful their careers in any way. Thanks for your help.

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[Therapist4Chnge]

I was just talking to someone about this the other day. I've heard that there is a push to have a more established boarding process in psych (which I happen to agree with), and ABPP seems to be pretty well respected. The challenge is that there are some competing boards in various areas, some are purely 'vanity' boards, and others are legit. When I am able, I'll probably try and go through it, but by then they may have a more official process.

 

[Neuro-Dr]

There are two issues, difficulty and value. If the question is whether an ABPP diplomate is difficult to attain, I would say no. In forensics and neuro there is an additional 100 item MC exam, which is difficult. However, the other 11 member boards require credential review, practice samples and oral exam. These reflect your actual work and you have a fair amount of control over what you submit. The pass rates are quite high for those who persists and I would say it is about what you'd expect.

In terms of value, other than minimal prestige (though even those with ABPPs find way to caste the rest of the field) and license portability, which is pretty close to the National Register (39 states), I'm not sure what value it is. I make no more money, get no more respect in most cases than without board certification. Though if you are in court often, it clearly helps.

My feeling is that for many specialties in which competency is not routinely taught as part of a traditional doctorate program, these take on more meaning.

 

[BellaPsyD]

^ not sure I understand you, isn't clinical competency taught in all programs?

 

[Ollie123]

^ not sure I understand you, isn't clinical competency taught in all programs?

I'd hope so, though I really do wonder sometimes!

Though I think he meant for any given specialty.

For example, not every program provides extensive specialty training in neuro, or health.

At least I'd always heard being boarded mattered more for those areas (especially neuro for whatever reason) than it did for say...general clinical. In fact, we were expressly told its a waste of time/money/effort to get boarded in all but a select few areas (though that may change in the future). You can reasonably assume every graduate is competent for general clinical practice if the school is accredited. You can't assume that just because someone graduated from an APA program that they are necessarily trained in neuro, or health psych.

 

[erg923]

I was under the impression that ABPP certification allowed you take make more in a few select settings, particularly in VA settings? Is this just bad info?

 

[Neuro-Dr]

No, you are right it used to be 10% and there may be a few hospitals (Harvard affiliated ones are an example). As an interesting historical note, ABCN was formed by several VA docs who were told they would get a raise if they were board certified and rather than go though ABPP clinical, they started the neuro board which joined ABPP in the 1990's.

 

[Therapist4Chnge]

....ABCN was formed by several VA docs who were told they would get a raise if they were board certified and rather than go though ABPP clinical, they started the neuro board which joined ABPP in the 1990's.

Cool fact!

 

[PsyDr]

I would also like to add that ABPN is also long recognized neuro board with many distinguished members.

 

[erg923]

My impression, per the ramblings on the the n-psych listserve is that the ABCN seems to be stronger, or at least more respected than ABPN. What is the real difference between the 2 neuro boards?

 

[BellaPsyD]

for health psych- does it make much of a difference?

 

[PsyDr]

ABCN undoubtedly has more respect in the neuro field. ABCN was started in 1981 or 82(although you might need to check that date as I am workgin from emmory). Joined ABPP in 1990s (1994 i believe, but again i am working from memory here so i would take this with a grain of salt). If my suspicions are correct about the identity of Neuro-Dr, he is a member of this board.


ABPN was started in either 1979 or 1980 from a group that decided that a neuro board needed to be created. they got together, figured out what the knowledge base needed to be, tested each other, and got started.


there were some political differences in the beginning that prevented the two from merging, although you will always hear rumors about a merger (the last one i heard was this year). ABPN is decried as allowing one to take weekend workshops in order to gain neuro experience.

Each board bases it's decision on a combination of clinical experience, and examination. ABCN uses the Houston conference guidelines (2000 hrs in 2 years)as the standard for clinical experience, although to some this is controversial. For example, the representatives at the HC did not allow Dr. Reitan to attend. ABCN uses multi choice and orals. They are also very much proponents of the flexible battery approach.

ABPN uses more lax definitions of its needed clinical experience (500hrs of neuro for 3 years for a miniumum of 1500hrs). Multi choice and orals for again No real preference for flexible vs fixed battery.

Each has notables in the field: Charles Golden, Ralph Reitan, Kaplan, etc. Each has members who are faculty members on big name universities.

Some say there is animosity between these two groups, and i suppose it depends on who you are talking to. I truly believe that each is a great way to prove that one has obtained a necessary degree of competence in neuropsyc, although i am sure many would disagree.

 

[Therapist4Chnge]

Good post Jon. I agree btw about having 1 standard and req. boards....though sadly people will fight it kicking and screaming because they don't want to get left out in the cold.

 

[Neuro-Dr]

So, if ABCN was told "no" by ABPP who said that neuro should just be a specialty within "Clinical" like the APA clearly has it delineated, then I guess there would be no ABCN? Doubtful, we can have arguments about which ABPP boards are really specialties. I, for one, do not believe Group, CBT, or Family should be considered "specialties" as opposed to proficiencies; but no one asked me. All boards started as independent entities that were at least partially entraperneurial (sp?) in nature before joining ABPP. When you go down the "one board to rule them all" path, you will not have any new boards and you will clearly not have any growth of the field except through ABPP, which has done a horrible job to date. One could argue that the efficiency, growth and evolution of the field on neuro is BECAUSE there is more than one board and thus there has been much more pointed discussion about the make up of board certification. My personal opinion is that Forensic and Neuro have move so far into pedigree as a marker of training that breadth has been lost. I had a recent conversation with a another board certified NP and was shocked to learn that they had no real foundation courses in neuroanatomy. They took a class alright and it was called neuroanatomy, but their working knowledge of even basic level understanding of neurocircuitry was horrible. They did point out that they trained with one of the biggest names in the field though. In 2005 I watched an applicant curl up in a fetal position in the bathroom in Tampa after a board oral examination and later found out that his crime was choice of not doing an APPCN fellowship rather than any real skill deficit. I've spoken to people who were "desired" by one of the boards who said they skated through with almost no questions on orals.

I can go on... My point is, none of them do the job of seeking to find out what it is we want our field to be in terms of inclusion, they developed their own standards based on their own membership and never asked what that meant, they then recruited from their own sites and never asked what that meant. I have seen questions from ABCN, ABPdN and ABPN and frankly there is no difference in difficulty on any of them, with the exception that an adult trained NP won't pass ABPdN. Marty Rholing has written extensively on this subject and consulted with all three at one point and has much the same conclusion.

See my OP for recommendations on boarding.

 

[PsyDr]

jon, i would agere with you except for a few reasons:

1) I believe that ABCN has done a poor job of defending the financial aspect of NP. Puente's CPT codes were a result of NAN, not ABCN. NAPP was the one who offerred legal action on that hospital thing recently, as opposed to APA. Also, the stipends for ABCN fellowships are almost a standard deviation below the average starting salary for regular psychologists, which seems to be bordering on exploitative to me. once ABCN are able to actually show a financial benefit to psychologists, i will readily support them. however, right now we are restricting the # of NPs we are producing and others outside the field are filling the void. same goes with forensics. the "mental health professional" who spoke as the witness in the recent Ives/anthrax case was a substance abuse counselor, which in many states does not even require a BA.

2) the assumption that there is a single way to come to understand a body of knowledge. the HCG offers a single route to education by creating admission criteria to simply sit for the exam. research does not support this form of education. if an individual demosntrates expertise in an area on objective measures (i.e., an exam), then i believe that he/she should be boarded.


btw jon snow: i fully support your cries for functional neuroanatomy.

Neuro-Dr: was anyone left in tampa after that near hurricane miss? i didn't stay around long enough to see.

 

[PsyDr]

snow, i will try to address only those that are originally from myself.


1) puente was working under NAN's PAIC for the CPT code. his 2005 address at NAN made this very clear. he got a standing o too. i imagine some ABCN boarded individuals were part of this, but the organization as a whole was not.

2) depending on one's ability to negotiate, the stipend difference is considerable. i would estimate a 20K difference, minimum. in some cases much much more. to me, that is verging on exploiting students. i also see no reason to not pay the students what is fair.

3) i am unsure what you are referring to when you stated "this isn't a numbers problem".
a)if you are referring to a lack of individuals seeking NP boards, then i agree with you.
b)if you are referring to a lack of NP boarded individuals, then i disagree. Rohling's poster last year made this very clear.
c) if you are referring to training sites as the numbers then i disagree. last time i checked this year, at least 2 sites were removing their programs as CMS has stopped reimbursement for training. this would bring it below 50 sites nationwide.

4) in reagrds to talking to the powers that be, i am also unsure to what you are referring.
a) if you are referring to limiting NP practice to NPs, then i agree.
b) if you are referring to limiting NP practice to ABCN boarded NPs, then this battle has already been fought in several states. ABPN won a lawsuit in Texas, which resulted in ABPN being named as one of the boards OK'ed as designating NPs. They won this by demanding that the opposition prove that there was a difference in competence between the boards. which the ABCN side was unable to do.

 

[erg923]

I know neuro is gaining in popularity and appeal with new grad students. However, all my professors and prac supervisors (neuropsychologists included of course) have always stressed that there are NOT enough neuropsychologists, overall. And that neuro will become more in demand, partly due to the increased focus on aging and dementia research, cog rehab issues, Iraq war vets, and the aging baby boomer generation, etc etc.

For example, the entire state of Kansas only had 2 boarded neuropsychs when I left there in 2006. When I worked in Kansas City (a large city btw) there wasn't even a neuropsychologists at the VA hospital there. There was one at KU med (Where i worked) and one all the way in Wichita. Because of this, the waiting list at our npsych clinic at KU med was 4 months on average. it was 9 months at one point. Not something the neurologists liked btw. We had patients driving 4 and 5 hours to get to us, because there were no NPs anywhere even close to them. If there are "plenty" of NPs, then where the hell are they? The entire state of North Dakota doesn't even have 1 NP practicing there (at least boarded ones) last time I checked. Any opinions here?

 

[PsyDr]

snow:

#1: the law is really all that matters. professional orgs can state whatever they want, but in the end, government trumps professional disagreements. again, why i support any PAC for the profession. i know nothing of san antonio other than that is where the alamo is, so i will take your word on the MD conference thing. but even if this conference offers a board cert, it is still not recognized by law.

#2: i still find the practice of paying people less than they are worth in the free market exploitative. regardless of the payoff. ethics codes agree that the payoff never justifies exploitation.

#3: i disagree. everywhere i have lived the average wait for an NP is over a month. i have seen 6 months waiting lists before. the turn around times are ridiculous. a week turnaround is average according to a recent discussion on one of the list servs. when we are able to provide a service in a timely manner, then i would contend that we have enough.

as always: it is a pleasure having a professional discussion with you.

 

[Neuro-Dr]

Jon, I don't want several things to get lost in these discussions. I understand your position and I also understand that the multiple board issue is problematic. Having sat for two (and considering the third) I understand the waste of time at a level others may not. I am also privy to the history and the process in a way you may not be. ABCN and ABPN both grnadfather their initial membership. Then ABCN went on to grandfather (exempt from written exam) the next 180 members. ABPN did develop the written exam in response to criticism from ABCN. ABPdN came about because ABCN said there was no need for subspecialties despite the fact that those were recommendations from the original HCG group. To my knowledge, every ABCN who has tried to pass the ABPdN exam has failed (admittedly I only know of three).

ABPP is not ABMS, none of the ABPP boards have to conform to similar standards, ABMS has 147 subspecialties and it is relevant to practice. Why I/O, which is not a license eligible degree should be a member board in a professional group is beyond me. I can continue. If ABPP is not relevant to the field for general practice, how could we possible make it a requirement?

 

[Neuro-Dr]

Far points all around. Just know that, while I was not part of the discussions with ABPN at the time they were trying to merge with ABCN, I am privy to the archives on the ABPP discussions. The final straw seemed to be that ABCN wanted all members boarded after mid 1990's to take the written exam. ABPN said something to the effect that since most of those people had graduated at the same time as the 180 ABCN members who did not have to take it, they should not have to either. I see both sides of the argument and wish someone would have told everyone how long this would drag on if they can't play nice for the good of the field. Oh well....

 

[ther rocker]

I am currently a board certified neuropsychologist and an active member of the medical staff at several hospitals. My board certification is through the American Board of Professional Neuropsychology. I had to pass a written examination, an oral examination and a review of my actual test protocols. Additionally, my credentials (including training) were assessed before I was allowed to sit for the examinations. I can assure you that "weekend workshops" are not allowed. Rather, I completed a specialized residency and post doctoral fellowship at the University of Oklahoma Health Sciences Center in neuropsychology. I completed formal course work in neuroanatomy and neuropathology through the University of Oklahoma Medical School. The American Board of Professional Neuropsychology is one of two boards recognized in Louisiana (one has to be boarded in this state to be called a "neuropsychologist"). The American Board of Professional Neuropsychology may have fewer members than the American Board of Clinical Psychology but it is no less prestigious. We do offer additional sub specialties which I found attractive (i.e. forensic, geriatric, and pediatric). These subspecialties require that one be boarded for at least 2 years prior to making application. By the way, my fellowship is a member of the illustrious group mentioned above and my director was and is ABPP. Casting stones and making erroneous comments is childish and certainly unproductive. I have never been challenge in the court room about my credentials. It seem rather ludicrous to be challenged in this forum.

 

[Existenz]

So is ABCN the better certification to get?

 

[Therapist4Chnge]

So is ABCN the better certification to get?

Boarding from the ABPP is the gold standard.

*edited to fix*

 

[Therapist4Chnge]

Just for a clarity.. . .

ABPP-Cn = ABCN. It is the same thing.

Yeah, I had a typo. That's what I get for posting in the early morning.

 

[DrGero]

Don't have much to say about the inside baseball being discussed re. ABCN and neuropsych, but I would say that the main reason I'm interested in getting boarded (ABPP) is b/c I've now been w/ the VA for three years and my raises are now slowing down to once every two years (as opposed to yearly for my first three). ABPP is pretty much the only sure-fire way to get around that.

Aside from that, given the number of capacity declarations I've done in the past I anticipate (and look forward to) doing courtroom work at some point in the future, and ABPP certainly appears to be a reasonable way to enhance one's credibility.

The part for me that's a little hazy is the fact that I've been solely specialized in geriatrics for the past 6 years, and gero is on the cusp of being awarded ABPP status. Do I wait, or do I go for rehab or clinical (both of which I could be reasonable contenders for)? Anyways.

 

[Therapist4Chnge]

I think the rehab ABPP will be a very useful credential, though I'm not sure how much work you'd need to do to make it feasible. I'm looking at double boarding in rehab and neuro, which may or may not happen.

 

[deleted176373]

I was under the impression that ABPP certification allowed you take make more in a few select settings, particularly in VA settings? Is this just bad info?

+$6k/year in the military.

 

[DrGero]

I think the rehab ABPP will be a very useful credential, though I'm not sure how much work you'd need to do to make it feasible.

I haven't researched it that much yet. I figure that since much of the work I currently do is essentially behavioral medicine in a hospital setting (with a subacute / short-stay patient population no less), and that much of my training was so-called "primary care psychology," I could swing it.

I'm looking at double boarding in rehab and neuro, which may or may not happen.

Hmmm. How often do people get double boarded?