1. The delegates, divided into four teams at the conference, brainstormed the original content. Teams were provided with the Houston Guidelines as a “jumping off point” but were not compelled to stick with them in drafting the new guidelines.  
2. Each evening a drafting team worked from 6:00 pm to typically past midnight to integrate the brainstormed content into a single document reflecting the day’s work. The resulting document was very rough, with many comments left in the margins for later discussion and resolution. There was a different drafting team each day, but it always included 1 steering committee member, at least 1 (and in some cases 2) delegates from each of the four delegate teams for a total of 4-6 delegates, and three content experts (1 expert each respectively from the technology, competency, and DEI expert panels). The work product of these drafting teams was saved to a Google Drive each morning for delegates at the conference to review and comment on.   
3. Post-conference, a team of the willing that included content experts and delegates continued trying to integrate the large number of ideas into a more manageable document, but they left unaddressed a large number of the concerns and comments that had been put in the margins by delegates at the conference when they reviewed the daily drafts. 
4. Then the Steering Committee and various content expert panel members did their best to resolve the numerous issues that had been left open and tried to produce a coherent document that was more than just a brain dump of ideas. We went through multiple iterations of the document, trying to find compromises on how much knowledge description should be included, how much redundancy to eliminate, the length of competency descriptions, etc. 
5. The final iteration of this process was then sent to the co-leaders of each of the delegate teams for their review and input. This led to further revision. 
6. Finally, the document was distributed to all of the organizations who sent delegates with a request for feedback and actionable amendments. However, the Steering Committee ultimately acted on the recommendation to halt voting on amendments in favor of further major redrafting in consultation with the Arredondo Group. That is where we currently are in the process.

Draft 1 of the Minnesota Guidelines was distributed broadly to neuropsychologist professionals and trainees in the second quarter of 2023 with a request for substantive amendments. Feedback from the MNC Delegates and from various organizations made it clear that Draft 1 would require more revision than could be accomplished through a process of amendment and that it was premature to vote on amendments at the delegate meeting held in July 2023. Therefore, voting on amendments was suspended and delegates instead held intensive discussions on all proposed revisions that were received. The results of this discussion and the text of all proposed revisions were summarized for delegates and for the consulting group hired to assist the Steering Committee in revising competency statements. Currently it is not possible to know which proposed revisions will be in the next draft of the Minnesota Guidelines, but it can be stated with certainty that all proposed revisions are being considered.

The CNC is not a membership organization. It is set up similar to the Clinical Neuropsychology Specialty Council (formerly Clinical Neuropsychology Synarchy) whereby each neuropsychological association has one representative that attends meetings and works to make decisions with their representative group in mind. The Planning Commission designed the structure of the Steering Committee to include the presidents of both boarding groups (ABCN and ABN), the president of the postdoctoral training group (APPCN) and president of internship training group (AITCN). For the other 3 positions, they sought the CNC given the mandate that was given to the Planning Commission. That group selected the representatives from AACN, ABCN (both of whom were already on the Planning Commission) and one of the planning chairs. The final position was given to the APPCN treasurer and made ex-officio member in order to manage funds. These are outlined in the Planning Commission minutes.

Delegate selection was also outlined on the MNC website. Members of the delegate selection subcommittee who were nominated or submitted at large applications, were recused from the selection process.

The Steering Committee has had several meetings with members of the AAG and have received feedback on the MNC documents. A meeting with the delegates will be held to review this feedback at the end of January 2024.

While clinical neuropsychology has only one subspecialty that the American Board of Professional Psychology recognizes (i.e., pediatric neuropsychology), neuropsychologists nonetheless have many areas in which they may elect to obtain advanced knowledge and expertise. For example, “rehabilitation neuropsychologists” acquire advanced knowledge in cognitive and behavioral rehabilitation, neuropsychologists working in Epilepsy Surgery Centers acquire skills in conducting Wada tests, cortical mapping, and functional MRI. While ABPP declined to officially recognize forensic neuropsychology as a subspecialty, neuropsychologists who elect to practice in this area acquire knowledge beyond that of the general entry level specialist. The Minnesota Guidelines will incorporate within existing competency areas, measurable elements related to forensic neuropsychological assessment that are important for all entry level neuropsychologists but will not include a separate competency in forensic neuropsychology that goes beyond this baseline level of knowledge and skill.

Individual specialists always have the option of seeking training during fellowship and after that will allow them to practice in a subspecialty area of choice such as forensic neuropsychology, but not all specialists will choose to do so. The Minnesota Guidelines are not intended to cover subspecialty level knowledge that reflects individual practitioner choice rather than what can reasonably be required of all entry level neuropsychologists based on available time and resources. It may be desirable for the field to develop training guidelines for forensic and other subspecialty areas in the future, but this is beyond the scope of the Minnesota Conference. Incorporation of forensic-related competencies within the Guidelines will be at an intensity that is appropriate for all beginning practitioners, including those who do not choose to do forensic work.

The growth in opportunity for forensic practitioners may lead to an increase in the number of trainees seeking more advanced competence in forensic neuropsychology, with a corresponding increase in the number of fellowship programs offering forensic experiences. These market forces, however, are not the sole determinant of what is required at entry level, nor do they remove the individual trainee’s ability to choose the area(s) in which they may seek more advanced competence. Not all training programs have the faculty and the populations to train forensic subspecialists and it is anticipated that trainees and programs will seek each other out based on the match between trainee interest and training program focus.

Why would a new field like epigenetics be mentioned in the Minnesota Guidelines when forensics is not included as a separate competency domain?

Some psychologists only encounter epigenetics in the context of research on what has been termed “intergenerational transmission of trauma.” In fact, this one area of research is on the periphery of epigenetics which more broadly is concerned with factors that affect gene expression in the absence of a modification in DNA sequence. It is an area of growing importance in understanding risk and prevention of a wide range of pediatric and adult neurological conditions to which genetic factors are a contributor. Ignoring the entire field of epigenetics because of a single area of research that has caught popular media attention is akin to ignoring all research on laterality of function because of popular media promotion of the right hemisphere as the source of creativity and the left hemisphere as the seat of logic. Regardless of whether trauma causes a heritable change in gene expression, epigenetics as a field of science is well-established, annually produces hundreds of peer-reviewed papers in highly respected journals of biology and medicine and is poised to have a significant impact on the understanding of gene expression and the modification of genetic disease risk. Neuropsychologists cannot ignore important areas of medical science that directly bear upon the diseases of patients seen in our clinics. Epigenetics (along with genetics) will likely receive limited mention within the Neuroscience and Brain and Behavior Relationships Foundational Competency, while forensic-related knowledge and skills will be covered in appropriate detail within several competency domains. There is room for both within the Training Guidelines proportionate to their relevance to entry level practice.