RENOWNREGIONALMEDICALCENTER
DELINEATION of PRIVILEGES
PSYCHOLOGY SECTION
Basic Education: Ph.D., Psy.D. or Ed.D.
Minimal Formal Training: Two years of post-doctoral clinical experience in a recognized health setting and must be eligible for the National Register of Health Service Providers in Psychology.
Board Certification:
Those applicants who are not board certified at the time of application but who have completed their residency or fellowship training within the last five years shall be eligible for Medical Staff appointment. However, in order to remain eligible, those applicants must achieve board certification in their primary area of practice within five (5) years from the date of completion of their residency or fellowship training.
Required Previous Experience: Demonstration of active practice during the last 18 of 24 months.
____Core Privileges in Psychology
Psychological testing, consultations and group psychotherapy for patients over the age of 17, as may be designated by the attending physician.
SPECIAL REQUESTS:
For the following requests, the applicant is requested to document specific training and experience in the following categories. This may be accomplished by a recommendation from the school or individual responsible for the training, school transcripts, certification of completed workshops, seminars, case samples, etc.
____Child Psychology
Psychological testing, consultation and individual or group psychotherapy for patients under the age of 12 and/or patients between the ages of 12 and 18. In addition to documentation of training, must meet two out of the following three criteria:
A)Evidence of at least ten appointment hours per month with patients in one or both of these age categories.
B)Evidence of work with one inpatient in one of the above age categories in the past two years.
C)Six CEUs in Child Psychology.
____Chemical Dependence
Psychological testing, consultation and individual or group psychotherapy for patients who are chemically dependent. In addition to documentation of training, must meet criteria as follows:
A)Evidence of at least 10 appointment hours per month with patients having substance abuse problems,
Or
B)Evidence of work with one inpatient during the past two years,
And one of the following
B)Six CEUs in Substance Abuse treatment,
OR
D)Bureau of Alcohol and Drug Abuse certification.
The following privileges require documentation of training and experience:
____Biofeedback
____Hypnosis
____Eye Movement Desensitization
elevation to Active Staff
All newly elected Associate Staff members shall be in the Associate status until they have fulfilled the following criteria: (1) Demonstrated competence through work sample reviewed by the mentor. A mentor needs to be satisfied that he or she has adequately sampled the work of the Psychologist, and the Chief of the Psychology Section likewise has approved that adequate work has been sampled and competency approved; (2) Served a minimum of 12 months in the Associate status. Following completion of Associate term, a member may then advance to Active status, providing they have met the necessary requirements (see Bylaws).
Mentor must write a letter recommending psychologist be released from mentoring; Psychologist must write a letter requesting to be released from mentoring. Requires approval by the Section, Department, Credentials & Privileges Committee, Executive Committee and Board of Governors.
Reappointment/Current Clinical Competence:
All members of the Department are reappointed every two years in accordance with the Bylaws and Credentialing Policies of the Medical Staff. Since reappointment is an affirmation of good clinical practice, each applicant will provide evidence of activity sufficient to demonstrate current clinical competence for the privileges requested.
______
ApplicantDate
______
Section Chief, Psychology SectionDate
______
Chief, Department of PsychiatryDate
Date of Recommendation by the Credentials & Privileges Committee: ______
Date of Recommendation by the Executive Committee:______
Date of Approval by the Board of Governors: ______
Approved: 11/96
Revised:
Psychology Section Delineation of PrivilegesPage 1 of 2