Collaborative Therapeutic Neuropsychological Assessment

Hardcover | October 20, 2008

byTad T. Gorske, Steven R. Smith

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One of the challenges the field of clinical neuropsychology faces is to develop an assessment process that is relevant and responsive to the needs of patients. Indeed, it has been suggested that the survival of neuropsychology as a clinical discipline may be threatened due to an overemphasis on diagnosing cognitive deficits as opposed to developing methods that meet patients' needs. One way to meet this need is for psychologists to extend their services by developing clinical interventions that contribute to enhancing patients' cognitive and emotional well-being. Providing feedback from the results of neuropsychological tests is one method suggested as a way to enhance patient care and satisfaction with the assessment process while providing a link between clinical assessment and therapeutic interventions.In current practice, providing feedback to patients about the results of neuropsychological assessments has been considered an optional procedure by clinicians and thus received little attention in the literature. Yet there is evidence that when feedback is provided to patients the effects are overwhelmingly positive. Feedback provides a bridge between assessment and treatment by facilitating the development of applicable treatment plans. There is no agreed upon conceptual framework for providing feedback from neuropsychological assessment, although researchers have made recommendations. However, these recommendations have done little to affect clinical practice and training despite the fact that including patient-oriented feedback enhances the likelihood that neuropsychological assessment will remain a relevant and important component of patient care. The purpose of this proposed book is to first describe developments in methods of neuropsychological assessment feedback that involve active collaboration with patients in an open exchange of information and results. Second, we will present a comprehensive model for conducting neuropsychological assessment feedback. The authors of this book are expert clinical practitioners and academic researchers who are at the forefront of the development and implementation of Collaborative Therapeutic Neuropsychological Assessment methods. Table of contents follows.

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One of the challenges the field of clinical neuropsychology faces is to develop an assessment process that is relevant and responsive to the needs of patients. Indeed, it has been suggested that the survival of neuropsychology as a clinical discipline may be threatened due to an overemphasis on diagnosing cognitive deficits as opposed ...

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Collaborative Therapeutic Neuropsychological AssessmentEdited by Tad T. Gorske, University of Pittsburgh, School of MedicineSteven R. Smith, University of California at Santa Barbara Perhaps the greatest challenge faced by neuropsychological assessment is its image as a bearer of bad news, i.e., the diagnosis of cognitive impairment. T...

Tad T. Gorske, Ph.D. is an assistant professor in the University of Pittsburgh School of Medicine, Department of Physical Medicine and Rehabilitation and is a licensed psychologist in Pittsburgh, Pennsylvania. His specialty areas include psychotherapy, psychological and neuropsychological testing with adults and older adults with mood,...

other books by Tad T. Gorske

Format:HardcoverDimensions:166 pages, 9.25 × 6.1 × 0.27 inPublished:October 20, 2008Publisher:Springer New YorkLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0387754253

ISBN - 13:9780387754253

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Table of Contents

Foreword by Stephen Finn, Center for Therapeutic AssessmentI. Introduction: Overview and Background of CTNAa. This chapter will begin with brief case examples of feedback sessions conducted in a traditional manner and according to CTNA methods as a segue to an overview of CTNA as contrasted with standard practice in neuropsychological assessment, commonly referred to as the "information gathering model." b. The next section describes current challenges facing the field of Clinical Neuropsychology. Psychological and neuropsychological assessment have struggled in the era of managed care for a number of reasons, not the least of which include the advent of radiology methods for identifying brain lesions, consumer and provider misunderstanding of the rationale and usefulness of neuropsychological assessment, and the identity confusion many neuropsychologists face in the roles of treatment and rehabilitation planning. CTNA will be introduced as a method for meeting these challenges and helping to make neuropsychological assessment responsive to consumers, providers, and referral sources while enhancing collaboration between professions. An overview will be provided of a published survey, conducted by the editors, on neuropsychological assessment feedback practices.II. Conceptual Foundations: Brief history of neuropsychological assessment feedback a. Therapeutic Assessment Models: The historical background for using psychological testing as a collaborative and therapeutic intervention. First, a review of the early projective test studies will be described. Then the chapter will describe Constance Fischer's Individualized Psychological Assessment and Stephen Finn's Therapeutic Psychological Assessment. b. Luria's work: The chapter will begin with an analysis of Alexandr Rumanovich Luria's Neuropsychological Investigation and how his methodology provides a precursor to contemporary client centered neuropsychological interventions and rehabilitation. c. Literature review: Second, a review of the empirical literature will be provided on recommendations for providing feedback from neuropsychological tests. d. Motivational Interviewing: The next generation of client centered feedback. The section will discuss the application of Motivational Interviewing methods for providing client centered feedback. This is relevant because CTNA feedback methods are based on the MI conceptual framework. e. Contemporary applications: In this section a review will be provided on the current work being conducted on CTNA methods. This will include a review of research conducted by the primary editors; the work of Dr. Diane Engelman from the Center for Collaborative Psychology and Psychiatry; Dr. John Strang's work with the Neuropsychology School Conference; and the study by Dr. Phillip Pegg on providing medical and neuropsychological information to traumatic brain injury patients. III. CTNA Model Basic Assumptions of CTNA. The patient/caregiver/referral source have noticed a change in the patients cognitive and/or behavioral functioning and would like a professional to tell them if there is a true change and to what degree, severity, and if possible potential causes.The patient/family are distressed because of the change in the patient's cognitive/behavioral functioning. Part of the reason they are coming in for the evaluation is to receive help, direction, and guidance in order to feel less distressed. Patients would like to know of potential ameliorative strategies so that the patient performs better in school, work, social spheres, and begins to feel better about him/herself. While patients seek guidance and direction from the psychologist, they also want their individuality and autonomy respected and to be empowered to be active participants in treatment and decision making processes. Neuropsychological tests provide objective, concrete information about patient's cognitive and behavioral functioning that applies to their daily life and problems they may be experiencing. Feedback to patients, from neuropsychological tests can help answer questions regarding changes in cognitive and behavioral functioning, provide hypotheses as to the causes of these changes, and provide direction for treatment planning or rehabilitation. Feedback presented in a client centered manner can elicit the patient as an active collaborator, empower them in the treatment and decision making process, and lower resistance to hearing difficult or discrepant information while motivating them to work closely with professionals to alleviate their problems and distress. The Initial Interview: Collaborative Information GatheringThis section provides guidelines for a collaborative interview and assessment as setting the stage for a CTNA feedback sessions. The emphasis is not on specific interviewing techniques but rather a set of guidelines for conducting interviews in a collaborative and client centered manner. Understanding the problem, when it occurs, and for how long. Overview: Balancing developing rapport and a collaborative relationship versus gathering important assessment informationDeveloping a collaborative agendaDeveloping Rapport and UnderstandingBalancing questions and self disclosureUnderstanding the patient's emotional experience of the problem by developing the Central Cognitive Emotional Complaint (CCEC)Understanding the patient's expectations for the assessment, results, and eventual outcome. Developing patient questions they hope the test results can answer. Understanding Neuropsychology and neuropsychological assessment. Schedule and conduct the assessment session.The Feedback Session This chapter will provide the steps for conducting a CTNA feedback session. It will include detailed explanations with case examples to illustrate the methods. IntroductionIntroduce the feedback session as a collaborative endeavor.Assess patient status since the initial assessment, changes, new developments, setbacks, successes, etc. Review the CCEC and modify if needed. Review patient questions previously developed and modify if needed. Provide a copy of the feedback reportUnderstanding neuropsychology and neuropsychological assessmentSkills assessedReviewing strengths and weaknesses, how determinedReviewing personal strengthsElicit - Provide - Elicit: OARSReviewing challenges or weaknessesElicit - Provide - Elicit: OARSSummarizing results and main findings: Making recommendationsProviding a summary in a collaborative mannerAsking the key question to elicit patients ideas about how to use the informationMaking recommendationsPractical Issues and Future DirectionsThis chapter will provide suggestions on ways CTNA can be useful in clinical work, research, and teaching. Suggestions will be provided on ways to incorporate CTNA methods in various disciplines, including clinical practice, rehabilitation psychology, school psychology, and others. Suggestions will be provided on ways to include CTNA in graduate level curriculums, internships, and postdoctoral experiences. In addition, the chapter will provide information on the applicability of CTNA with special groups such as those of different cultures, children and adolescents, the elderly, and families.  Clinical, Research, Teaching, directions for neuropsychologyCTNA and cultural issuesCTNA with Children and Adolescents.CTNA with elderly and their families. Discussion and future directions.