INSNET, Fall 1997
to address these challenges. In fact, these challenges have prompted neuropsychologists to appreciate the usefulness of Luria's "qualitative approach" in assessing cognitive dysfunction. On the other hand, the limitations of Luria's approach have also highlighted the need for a more psychometric analysis of cognitive deficits. It is envisioned that the model of a clinical neuropsychological tool that will prove useful for the local population may possibly evolve in the likeness of the "Boston Approach" as propagated by Edith Kaplan's WAIS-RNI. The combination of the qualitative and psychometric approaches though attractive, is not without difficulties.
It is hoped that with the collaboration of other professionals interested in establishing clinically useful neuropsychological instruments that are sensitive to local social mores, we will then be able to extend our contribution to the international clinical neuropsychological research community. Some progress is being attained in this direction, but much work lies ahead.
NEUROPSYCHOLOGY IN SPAIN
By Katia Verger-Maestre, Lie Department of Psychiatry and Clinical Psychobiology
University of Barcelona
Passeig de la Vall d'Hebron, 171
08035 Barcelona, Spain
The field of Neuropsychology is relatively new in Spain. The first attempt at formalising Clinical Neuropsychology was hosted by the Neurology Service of the Hospital de Santa Creu i Sant Pau, Barcelona, in 1982. The professional group consisted of neurologists, psychologists, and speech therapists. The activities were neuropsychological assessment and rehabilitation of in and out-patients. Before the establishment of the Clinical Neuropsychology unit, there was some private practice activity in assessment and rehabilitation of aphasic patients at the same hospital.
A few years later, also in Barcelona, a similar unit was created in the Neurology Service of the Hospital de Nuestra Senora del Mar. Other hospitals in Barcelona, Madrid, and Sevilla incorporated psychologists for clinical neuropsychologicw activities. Nowadays, there are about eleven hospitals in Barcelona (a city around 3 million population) that offer neuropsychological services. Although we have no reliable quantitative data, the proportion in the rest of Spain appears to be lower. At this moment, the Psychological Association from Madrid and the Catalonian Psychological Association are collecting information in order to create a database.
From an academic point of view, interest in Neuropsychology is growing day by day. An increasing number of Spanish universities include Neuropsychology as a subject in the curricula of Psychology, Medicine, and Speech Therapy. The evolution emerged from the 1992-1993 university curriculum reforms. Neuropsychology is a requirement for those wishing to obtain a degree in Psychology in seven Spanish universities and optional in nine. Courses offered are mainly in basic neuropsychology , with some special courses in child and developmental neuropsychology. In almost all cases the courses are offered by Departments of Psychobiology.
Although in Spain Clinical Neuropsychology is not recognised as a speciality, and in consequence there is no official accreditation, some universities offer postgraduate studies in Neuropsychology.
Since 1988, the University of Barcelona has offered a two-year doctoral program in Neuropsychology. Currently, there are thirteen doctors from this program. A similar program is offered at the University of La Laguna (Canary Islands) and three students have obtained doctoral degrees.
At the Autonomous University of Barcelona, postgraduate studies in Neuropsychology have been in existence since 1987. Masters degrees (in Clinical Neuropsychology) are obtained after two years of course work. At this time there are about sixty professionals with this tittle. In 1996, the University of Sevilla started a masters program in Neuropsychology. In Spain, there is only one professorship of Neuropsychology at the University of Barcelona.
Traditionally, the field of neuropsychology has been more of a scientific rather than clinical activity in our country. In 1958, A. Subirana published "The prognosis in Aphasia in relation to the factor of cerebral dominance and handedness" in the Journal Brain. In 1969, the same neurologist wrote the chapter about handedness and cerebral dominance in the Handbook of Clinical Neurology. J.L. Barraquer-Bordas published several case studies in French and Spanish journals, and wrote a book on apraxias, aphasias, and agnosias.
In Spain, systematic and continuous research in Neuropsychology started in the 80's. International articles were published by researchers ftom the Hospital de Santa Creu i Sant Pau, Hospital de Nuestra Senora del Mar, the Autonomous University of Barcelona, and the University of Barcelona. Currently, only one group i n Spain, the group of Neuropsychology from the department of Psychiatry and Clinical Psychobiology of the University of Barcelona, is a "Consolidated Group". This group is now composed of nineteen members (professors, clinical neuropsychologists, psychiatrists, and post-graduate fellows).
A Medline literature search crossing the terms "Neuropsychology" and the address of "Spain", we found eighty- two research articles published since 1987. Previous quantitative information is not possible because Medline did not include addresses of articles published before that date.
Three manuals of General Neuropsychology and fourteen monographs on specific topics have been written by Spanish authors.
Funding for research at the University is chiefly through the Ministry of Education and Culture (MEC), the General Direction of Scientific and Technological Researches (DGYCIT), the Social Insurance Research Funds