The evolution of clinical neuropsychology in Puerto Rico: A survey of education, training, barriers, and opportunities for a bilingual population.

Objective: To examine neuropsychology education and training in Puerto Rico (PR) and identify areas of growth within neuropsychology curricula in graduate programs. Method: A survey was conducted among 44 psychology graduate students, 21 psychologists, and 17 neuropsychologists in PR to assess interest in neuropsychology, education and training experiences, training barriers, professional affiliations, awareness of the Houston Conference Guidelines (HCG), knowledge of competitive neuropsychology internships in the United States (US), and attitudes toward neuropsychology training in PR. Comparisons were made to evaluate PR's alignment with the US HCG standards. Results: Participants were primarily Spanish-English bilinguals completing or with doctoral degrees in clinical psychology. While APA-approved programs in PR offer foundational neuropsychology courses, clinical training opportunities are limited, resulting in few individuals acquiring HCG competencies. Most neuropsychology training occurs in private practice settings. Barriers to HCG training standards include the scarcity of neuropsychology practicums, with students often seeking education and training outside their institutions. The top professional affiliation was with the National Academy of Neuropsychology. Strengths included the number of psychotherapy hours, while research skills and consultation need improvement. Most participants reported inadequate guidance on postdoctoral training and agreed with the recognition of clinical neuropsychology as a sub-specialty in PR, alongside the development of local training guidelines. Conclusions: PR is advancing neuropsychology for a bilingual and bicultural population, but addressing barriers in education and training is essential. Coordinated efforts among educational institutions, the government, and professionals are crucial to enhance neuropsychological practice on the island and contribute to the global neuropsychology community.