The Society for Cognitive Rehabilitation, Inc th Ave NE, Bellevue, WA 98004, USA

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1 The Society for Cognitive Rehabilitation, Inc th Ave NE, Bellevue, WA 98004, USA Definition Application Process for Certification in the Practice of Cognitive Rehabilitation Therapy (Revised January 2010) Certification is a voluntary credentialing process for providers of Cognitive Rehabilitation Therapy (CRT). Certification is offered internationally by The Society for Cognitive Rehabilitation, Inc. (SCR) and is strongly encouraged. Certification: 1. Identifies those individuals who have met specific minimum professional standards, and promotes their visibility. 2. Recognizes those professional who are willing to uphold a professional Code of Ethics. 3. Entitles the individual to use the designation Certified in the Practice of Cognitive Rehabilitation Therapy (CPCRT). 4. Advances the professionalism of CRT within the field of rehabilitation, with the public and with third-party payers. 5. Has the potential to improve reimbursement from third-party payers. Levels of Certification SCR provides two levels of certification: 1. Level I Certification Applicants for Level I Certification must meet the criteria for designation as a Qualified Independent Practitioner as defined in the American Congress of Rehabilitation Medicine s Guidelines for Cognitive Rehabilitation. Such a practitioner is defined as a person who has acquired appropriate credentials for the independent practice in their discipline according to state licensing agencies appropriate to their profession; or in the absence of applicable state regulations, meet the appropriate national registration or certification requirements for the independent practice of their profession. 2. Level II Certification Applicants for Level II Certification are those who are unable to practice their profession independently, and require supervision by a Qualified Independent Practitioner. The Qualified Independent Practitioner is accountable for the design, implementation and ongoing quality and appropriateness of evaluation and treatment services delivered to clients.

2 Qualifications for Certification 1. Education For Level I Certification: Minimum of a master s degree in an allied rehabilitation field from a regionally accredited institution where the degree is a prerequisite for licensure or certification (e.g., Psychology, Speech), OR minimum of a bachelor s degree in an allied rehabilitation field from a regionally accredited institution where the degree is sufficient for licensure, certification or registration (e.g., Occupational Therapy). For Level II Certification: Bachelor s or master s degree in an allied rehabilitation field from a regionally accredited institution where the degree is insufficient for licensure, certification or registration, OR when such licensure, certification or registration is not available. Applicable allied rehabilitation degree programs include counseling, education, medicine, neuropsychology, occupational therapy, physical therapy, psychology, recreation therapy, social work, special education and speech-language pathology. Other disciplines will be considered on a case-by-case basis. 2. Credentials If credentials (licensure, certification, registration) are available in your discipline, you are expected to hold such. 3. Direct Work Experience Minimum of 2,000 hours of supervised post-master s experience (2,000 hours = 1 year of full time employment). If the applicant s graduate program included an internship or practicum of supervised clinical work, up to 1,000 of these hours may be substituted for post-master s work experience. Minimum of 4,000 hours post-bachelor s degree (i.e., 2 years of supervised experience). Applicable work experience must be in the direct provision of CRT and assessment of cognition for individuals. Work experience must be paid. Volunteer activities are not acceptable. Work must have been supervised. 4. Supervision Minimum of 50 hours of face-to-face supervision for those persons required to have 2,000 hours of work experience. Minimum of 100 hours of face-to-face supervision for those persons required to have 4,000 hours of work experience.

3 5. Temporary Waiver SCR recognizes the diversity of clinicians providing CRT. We wish to acknowledge those qualified clinicians who may not, for various reasons, meet all of the above requirements. Therefore, a temporary waiver is being considered for some of the above requirements: 1. Education While no waiver is offered for the minimum degrees listed, SCR will consider applicants from allied health fields not listed above. 2. Work Experience No waiver is offered for the minimum hours of direct work experience; however, the conditions under which persons obtain experience will vary and these will be considered. 3. Supervision You may qualify for waiver of supervised work experience if you meet all four of the following: Minimally hold a bachelor s degree in an allied health field and Graduated in or before 1986 and Have been an active CRT therapist since 1986 or before and Did not have access to direct, face-to-face supervision in your work experience. Waivers are granted on an individual basis. You must indicate your request for waiver on the application form, and provide information to support your request for waiver. Application Materials and Instructions 1. Application Form Please complete the application form, answering all questions. You may attach additional sheets of paper if necessary. Please label each additional sheet and attach to the application. All portions of the application must be completed, and information given on the form should match other materials you are submitting (vitae, credentials, education, experiences, etc.) 2. Diplomas Submit a copy of your graduate and undergraduate diplomas. 3. Vitae or Resume Submit an updated professional vitae. This should particularly include previous employment history and a listing of continuing education in the field of CRT. 4. Credentials Please submit copies of license, certificate or registration. For persons who are not credentialed, please indicate the reason on the application (e.g., none available in the field, etc.)

4 5. Verification of Supervised Work Experience Form This form must be completed by the qualified professional(s) who supervised the work experience(s) you are submitting to meet certification requirements. You may use persons listed as references (they complete both forms). Qualified supervisors are those who: 1) Preferably are certified by SCR, but minimally possess licensure, certification or registration in their field of study and are considered Qualified Independent Practitioners. 2) Minimally have five years of clinical work experience in the field of Cognitive Rehabilitation. 3) For supervisors who do not meet the above criteria, SCR will consider a special review of the supervisor s credentials, upon submission of the vitae and a $10.00 processing fee. Please indicate on the application form (page 1, #5) any request for special review. 6. Reference Forms You must submit two references from professionals who are familiar with your work as a CRT Therapist. These persons may be supervisors, instructors or colleagues. References must be submitted on the SCR Professional Reference forms. Please ask individuals submitting reference forms to place forms in a sealed envelope, write their signature across the seal, and return forms to you for inclusion with other application materials. 7. Work Samples To enable SCR to evaluate your CRT skills, we are requesting that you choose one client for whom you are presently providing CRT, and submit the following samples of your work with the client: 1) Case Report Conceptualization and documentation skills are important parts of providing CRT. In order to evaluate these skills, we are asking that you write a report on a client you are presently seeing, and include the information requested on the Clinical Work Sample: Case Report form. The report should reflect what you consider to be representative of your best work as a CRT therapist, and you should closely follow the guidelines given. The report must cover a sufficient number of sessions to effectively address the client s progress and prognosis, and may be a maximum of 10 typed, double-spaced pages in length. 2) Video Clinical Work Sample Structure of the session, relationship with the client, and clinical skills are critical parts of CRT. To help SCR evaluate these areas, please submit a video sample of your work with the client discussed in your Case Report. The sample may be on CD-ROM or DVD -R, and must be clearly visible and audible. The video must be of an actual individual CRT session, a maximum of 35 minutes in length.* The client and the therapist should be easily discernible. The session should not be an intake (initial evaluation) or discharge session. * Please be aware that video content beyond the 35 minute mark will not be reviewed in consideration of your application.

5 3) Clinical Work Sample: Video Critique This form must be completed by the applicant, based on the video work sample. Feel free to use additional pages if necessary, but each page must be labeled and attached to the original form. Only answer the questions asked on the form. Additional information provided by applicants will not be reviewed. 4) Release of Information The applicant must obtain the signature of the client used in the Case Report and on the Video Clinical Work Sample and submit this form to SCR. The applicant must clearly describe the use of the report and video to the client and ascertain his or her understanding prior to initiating the video session. Client data (reports or videos) submitted without the Release of Information forms will not be reviewed. 5) Note: Work samples will not be returned to the applicant. 8. Application Fee A non-refundable application fee of $ (USD) must accompany the application. Review Process After SCR receives all application materials, the review process will take approximately weeks to be completed. The process will not begin until all application materials are received by SCR. It is the responsibility of the applicant to ensure that all materials are complete. The review process involves: 1. Review of application materials to determine that the applicant meets minimal requirements for education, credentials, work experience and supervision. 2. Review of the clinical work samples by a panel of judges. Work samples are rated for evidence of skills, competency, effectiveness and efficiency. Following review, the judges will issue their recommendations for certification or denial. 3. Notification to the applicant of acceptance or non-acceptance. If accepted, the applicant will be mailed certification materials. If not accepted, SCR will explain what steps the applicant may undertake so that the materials may be re-evaluated. If not accepted, the applicant may also appeal the decision in writing within 30 days of the denial. The appeals process provides an independent, complete review of the facts and ensures due process. The appeals process is not designed to give the applicant additional time to acquire necessary education, work experience or supervision.

6 Requirements of Certification Certification is in effect for a five-year period. To maintain certification in good standing with SCR, the applicant is required to: 1. Practice CRT in accordance with the SCR Code of Ethics. 2. Maintain current licensure, other certifications, or registration required to practice. 3. Remain in good standing with SCR, state regulation agencies and other professional organizations. 4. Apply for recertification. At the end of each five-year period, the applicant must become recertified. The requirements for recertification include: 1) Submission of the recertification fee. Fees are due yearly. Annual reminders will be sent out along with SCR membership renewal/application information. 2) Submission of proof of participation in 50 hours of continuing education during the five-year period. Continuing education may be in the form of seminars, conferences, workshops or individualized training. The applicant must submit continuing education credits to SCR at the end of the five-year period. Content of continuing education must be related directly to CRT services. Complete all application materials and submit to Elsa van Schouwen, MS, CPCRT SCR Credentialing Chair Postbus 108, 1600 AC Enkhuizen The Netherlands