Neuropsychology as a Profession

Neuropsychology as a Profession

  • Types of Neuropsychologists

    • There are two basic types of neuropsychologists:

    • Experimental Neuropsychologists

    • Clinical Neuropsychologists

  • Educational Requirements

    • Both types require a Ph.D. in psychology.

Experimental Neuropsychology

  • Formal Requirements

    • Does not have any formal requirements beyond a Ph.D.

    • Most experimental psychologists work at universities, requiring additional post-doctoral experience of 2 to 5 years, although not strictly required.

Clinical Neuropsychology

  • Additional Requirements

    • Clinical neuropsychologists have several additional requirements beyond a Ph.D. in psychology, including:

    • A state license is required to call oneself a clinical neuropsychologist and to charge for services.

  • Licensing in California

    • In California, to be a licensed Clinical Psychologist of any kind, the following must be met:

    • Pass a test by the licensing board.

    • Accumulate a minimum number of supervision hours by a licensed psychologist.

    • Note: These requirements may vary from state to state.

Clinical Psychologists

  • Functions and Roles

    • Clinical Psychologists diagnose and treat patients with psychological disorders.

    • Most such disorders are those discussed previously in the course.

    • Most treatments involve some type of psychotherapy, with only a few states allowing psychologists to prescribe drugs.

Role of a Clinical Neuropsychologist

  • Work Environments

    • Approximately half of clinical neuropsychologists work in private practice.

    • 24% work in medical schools.

    • 11% in rehabilitation hospitals.

    • 5% in university settings.

    • 5% in Veterans Affairs (VA) medical centers.

  • Focus Area

    • Clinical neuropsychology is focused on the diagnosis and treatment of brain disorders, which can include psychopathologies

    • Similarities with psychiatry, but most patients are referred from neurology.

  • Role Specialization

    • Many clinical neuropsychologists specialize in diagnosis using neuropsychological assessments.

Neuropsychological Assessment

  • Overview

    • The neuropsychological assessment is typically comprised of an objective, comprehensive battery of tests measuring cognitive and behavioral functioning.

    • This information is integrated with additional data such as medical history and brain scans, culminating in a neuropsychological report.

  • Purpose

    • Neuropsychological assessments contribute to diagnostic decisions and are integral for understanding cognitive integrity of the brain.

    • Focus on identifying, quantifying, and describing changes from typical functioning.

  • Referral

    • Many patients are referred by neurologists and neuropsychologists provide valuable insights into functional strengths and weaknesses, assisting in the design of treatment strategies.

Psychometrics in Neuropsychology

  • Definition

    • Psychometrics is the science of measuring human traits and abilities, and it focuses on the standardization of neuropsychological tests.

  • Standardization

    • Standardized tests are administered under specific conditions to assess aspects of a person’s knowledge or skill.

    • These tests yield quantitatively obtained scores which allow systematic comparisons among different groups or individuals.

Important Concepts in Psychometrics

  • Reliability

    • Defined as the stability or dependability of a test score; a reliable test produces consistent results upon repeated administrations.

  • Validity

    • Refers to the meaningfulness of inferences made from test scores; it evaluates whether the test measures what it was intended to assess.

Different Types of Assessments

  • Structured Interviews

    • Patients verbally answer a set of standardized questions regarding basic personal information (e.g., age, gender, education).

  • Paper and Pencil Tests

    • Tests requiring the patient to answer questions or perform tasks on standardized forms.

  • Laboratory Tests Using Stimuli

    • Assessment methods that measure reaction times and patterns of errors, with various tasks adapted by neuropsychologists, including lexical decision tasks and Continuous Performance Tests (CPT).

Neuropsychologists Assessing Multiple Skills/Domains

  • Assessment Scope

    • If referred for specific reasons, fewer assessments may be used; for more general reasons, a comprehensive set of assessments is often employed.

Full Neuropsychological Workup

  • Components

    • Administering a battery of tests, each assessing different mental abilities.

    • Scoring tests and comparing patient performance with a reference group.

    • Writing detailed reports showing the pattern of strengths and weaknesses.

  • Diagnosis & Recommendations

    • Involves making a diagnosis, recommending treatment, and possibly helping devise rehabilitation programs.

    • Example for memory problems: potential recommendations may include using a diary or journal to document important events.

  • Assessment Areas

    • Detailed assessment areas may include:

    • Orientation: Alertness and awareness of self and surroundings.

    • Memory: Immediate, short-term, long-term recognition, retrieval, etc.

    • Language Skills: Including types of aphasias and speech regulation.

    • Attention, problem-solving, emotional distress, and activities of daily living.

Orientation Assessment

  • Mini-Mental State Examination (MMSE)

    • A structured assessment tool that helps evaluate a patient's orientation and cognitive ability. Includes instructions for scoring responses to questions about time, location, object identification, counting, reading, writing, and drawing tasks.

    • Total score reflects the patient's cognitive functioning level, with specific attention to their awareness and interaction with the environment.