Clinical Neuropsychology: Answers to Frequently asked Questions
What is Clinical Neuropsychology?
Clinical neuropsychology is a specialty field within clinical psychology, dedicated to understanding the relationships between brain and behavior, particularly as these relationships can be applied to the diagnosis of brain disorder, assessment of cognitive and behavioral functioning, and the design of effective treatment.
What is a Clinical Neuropsychologist?
A clinical neuropsychologist is an independent, professional, doctoral level psychologist who provides assessment and intervention services to people of all ages, based upon the scientific concepts of clinical neuropsychology. Training in clinical neuropsychology comprises a broad background in clinical psychology, as well as specialized training and experience in clinical neuropsychology.
Training and preparation in clinical neuropsychology specifically entails 1.) completion of a doctoral degree in psychology from an accredited university training program, 2.) internship in a clinically relevant area of professional psychology, 3.) the equivalent of two years of additional specialized training in clinical neuropsychology, and 4.) state or provincial licensure to practice psychology and/or clinical neuropsychology independently. Attainment of the ABCN/ABPP Diploma in Clinical Neuropsychology (i.e., board certification) is the clearest evidence of competence as a clinical neuropsychologist, assuring that all of these criteria have been met.
What happens during a neuropsychological evaluation?
The neuropsychological evaluation consists of gathering relevant historical information, a neuropsychological examination, analysis and integration of data and findings, and feedback to the referral source. History is obtained through reviewing medical and other records, and through interview with the patient. With the patient’s permission, family members or other knowledgeable persons may be interviewed and asked to share their perceptions and perspective on important aspects of the history and symptoms. The examination typically consists of the administration of standardized tests using oral questions, paper and pencil, computers, the manipulation of materials such as blocks and puzzles, and other procedures. Depending on the scope and intent of the evaluation, testing may focus on a wide range of cognitive functions including attention, memory, language, academic skills, reasoning and problem solving, visuospatial ability, and sensory-motor skills. The neuropsychologist may also administer tests and questionnaires concerning psychological aspects of mood, emotional style, behavior, and personality. Some or all of the testing may be administered by a neuropsychology technician, under the direct supervision of the clinical neuropsychologist. The amount of direct contact time required for the patient will depend on the scope of the specific evaluation; the evaluation might be a brief screening requiring as little as an hour or a comprehensive assessment spread requiring 8 hours or more, spread out over several appointments.
What will happen after the evaluation?
After the evaluation, the clinical neuropsychologist will analyze all of the data and information gathered by history and examination, integrating it into a comprehensive report. Again, depending upon the referral issue and scope of the evaluation, the report will provide a description of neuropsychological strengths and weaknesses, patterns of findings that have diagnostic significance, and recommendations for further evaluation and/or treatment. The clinical neuropsychologist may schedule a follow-up consultation with you to review the findings and recommendations, and address any questions of concerns you may have.
Depending on the situation, this type of follow-up can also be provided over the telephone or through other forms of communication. With your permission, the report can be shared with the doctor (or other professional) who initiated the referral and other health care providers involved in your care.
Examples of common referral issues
Learning and development: Does this patient have a developmental disorder affecting learning? If so, how can we help him to circumvent these weaknesses and provide the best learning environment for success? Traumatic brain injury: What are the enduring effects of an injury and what treatment might help? Memory and aging: Is this normal age-related change or a disease? Or is it something else?
Changes in personality and behavior: Are these symptoms of a psychiatric disorder or do they signify a brain-related syndrome?
For litigation purposes: whether a person’s cognitive problems are a consequence of some kind of accident?
How can I find a Clinical Neuropsychologist?
Clinical neuropsychologists practice in a wide range of settings including hospitals, outpatient clinics, private practice offices, schools, rehabilitation centers, nursing homes, and governmental agencies. Referral is usually requested by another physician or health care provider; teachers may request an evaluation for a student who may be having difficulty with learning in the school setting; insurance companies may refer in order to assess whether or not a person is disabled from working, or whether a person’s claimed deficits are a direct result of some kind of accident.
If you have a concern that you believe would be best addressed by consulting with a clinical neuropsychologist, you can discuss referral options with your physician. Because neuropsychologists frequently work closely with neurologists, neurosurgeons, psychiatrists, and rehabilitation clinicians, speaking with one of these professionals is another option for finding a neuropsychologist. Also, most large hospitals and academic medical centers include neuropsychologists on staff.
A listing of Clinical Neuropsychologists, certified by the American Board of Clinical Neuropsychology, can be found on the AACN website in the member directory. Most states have professional membership societies or associations dedicated to clinical neuropsychology. Although membership in a state association does not necessarily imply professional competence, many do provide a referral service for the public.