WRNNMC, Bethesda, Md.  –   Walter Reed National Military Medical Center celebrates the recent reaccreditation of its Clinical Neuropsychology Fellowship Program after the COVID-19 pandemic caused a two-year delay in onsite inspections by the American Psychological Association (APA).

Clinical Neuropsychology

According to the APA, clinical neuropsychology is a specialty field within clinical psychology dedicated to understanding the relationships between the brain and behavior, mainly as these relationships can be applied to diagnosing brain disorders, assessing cognitive and behavioral functioning, and designing effective treatment.

“The specialty of clinical neuropsychology largely involves examining patients’ cognitive abilities and psychological symptoms to understand how a brain disease or injury is impacting someone’s functioning,” shared Adam Minniear, PsyD, ABPP, the director of Walter Reed’s Neuropsychology Postdoctoral Training Program.

Based on the findings of a neuropsychological exam, the neuropsychologist can make recommendations for follow-up care, diagnose complicated conditions, determine how independently someone can function, track disease progression, or address a range of other clinical questions, explained Minniear.

Walter Reed’s Postdoctoral Fellowship in Clinical Neuropsychology

Walter Reed’s postdoctoral fellowship in clinical neuropsychology began its training mission in 1991 at Walter Reed Army Medical Center in Washington, D.C. It was first accredited by the APA in 2002.

Unlike private sector programs accredited by the APA, only U.S. Army officers are eligible to apply, and the Army’s National Psychology Training Coordinator, rather than the program director, determines which applicants to select. According to Minniear, Walter Reed and Brooke Army Medical Center in San Antonio are currently the only two approved options for Army psychologists seeking a fellowship in neuropsychology.

Walter Reed Leads the Way: Exceptional People, Protocols and Preparation

“We provide Army psychologists with training in a military setting, giving them experience with the kinds of issues they are going to see as neuropsychologists working in military facilities, such as traumatic brain injury and combat trauma,” Minniear outlined. “Since most military psychologists go on to civilian practices after retiring, the program trains them in a diverse range of neuropsychology activities, including clinical supervision, clinic administration, and scholarly research.”

Minniear believes Walter Reed’s program is exceptional because of its diverse faculty, which outnumbers the trainees 5-to-1 ratio and the diversity of training activities offered.

In particular, “the leadership in the Behavioral Health Directorate places a priority on its training missions, which allows us to ensure the neuropsychology fellows have time to focus on learning rather than productivity quotas,” Minniear emphasized.

Promoting the Defense Health Agency’s Ethos of Readiness and Resilience

Walter Reed provides Army psychologists with training in a military setting, preparing them to experience the kinds of issues they are going to see as neuropsychologists working in military facilities, such as traumatic brain injury and combat trauma.

Because of the long history of Walter Reed’s neuropsychologists collaborating with epileptologists and neurosurgeons in highly specialized and hard-to-find neuropsychological procedures, the neuropsychology fellows at Walter Reed can gain a competitive edge by learning cutting-edge procedures.

Wada Testing

Wada testing is a preoperative procedure for patients with epilepsy or brain tumors, in which cognitive tests are administered to partially anesthetized patients, yielding results that help to inform the likelihood that surgical removal of damaged brain tissue or a brain tumor would drastically impair critical cognitive functions like speech, language comprehension, and memory.

Intraoperative Speech-Language Mapping

The second highly specialized procedure fellows learn is intraoperative speech/language mapping, in which a patient is awake and has their language functions tested by a neuropsychologist. At the same time, the neurosurgeon administers tiny electrical currents to deactivate small areas of the brain, one at a time, around the epileptogenic zone or brain tumor. Finding the areas of the brain that, when deactivated, correspond with errors on simultaneous language testing identifies the boundaries of the language processing region of the brain with the greatest possible precision, which significantly reduces the risk that the surgeon would cut into it and permanently impair the patient’s ability to speak or comprehend.

Victory Loves Preparation: The Keys to Successful APA Reaccreditation

“I’d like to express my appreciation for the support provided by the program’s administrative specialist, Arlene Alphonse, and by Pamela Porter, who volunteered her time amidst her busy patient care schedule,” shared Minniear, who also credits Neuropsychology Assessment Service’s chief Paul Newman for providing space for the site visit and his flexibility in balancing the department’s resources.

Minniear said the most time-consuming aspect was preparing the voluminous 1,128-page self-study electronic submittal. “I worked on this for eight months, gathering documents, contacting recent graduates, analyzing outcome data, compiling data tables, and writing answers to dozens of questions about how the program’s training activities adhere to the APA’s Standards of Accreditation,” recounted Minniear.

After submitting the self-study, Minniear and his team waited for nine months before receiving feedback from the APA. Preparations for the site visit involved coordinating logistics with APA site visitors and assembling a schedule of 15 individual and group interviews between the APA visitors and Walter Reed’s team.

Minniear said he’s relieved that Walter Reed’s next reaccreditation will occur in 2033, when the program may have expanded to include Navy and civilian psychologists.

To learn more, visit this link:

https://walterreed.tricare.mil/Academics/Graduate-Medical-Education/Graduate-Medical-Education-Programs/Postdoctoral-Fellowship-Training-Program-in-Clinical-Neuropsychology