Neuropsychology Q's?

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Well. This thread went places.

Not places it should be proud of.

But it went there.


There is some useful information in here for those wanting good info. Chief among them is that this field requires sacrifice. And humility.

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Applying for grad schools is a shake of the Yahtzee cup full of dice no matter where one applies from. I have no scientific data to back this up, but my best guess is that people from the western region probably want to go to schools in the east (e. g...Yale, Harvard, Penn State, John Hopkins, West Point Military Academy..) just as badly as folks from the east and mid-west want to come here to the west to study.

In my experience, successful grad school applicants have targeted their programs pretty carefully to fit their training goals and often sacrifice geographical preference to do so. Of course chance plays a role, but I know plenty of folks who moved to "flyover" states for grad school and were thrilled to work with a specific advisor.
 
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Calm down, you're completely misunderstanding what I wrote. As Erg alluded to, this isn't about where you're from, it's about basic probability and demand. You're applying to a region with very popular programs and whose demand is further increased by factors unrelated to the programs themselves, especially geography. The Pacific coast states are really popular, as are the adjacent states, because they are so close to the coastal states.

The same goes for internship placement and post-doc fellowships, the more desirable and populous the area, the more competition and demand there will be for those placements. A program listing a high match rate isn't a guarantee of an APA-approved placement simply because you attended the program. It's based on the individual, and geographically restricting your applications will hamstring your chances, regardless of the quality of your program.



See, this is what I was talking about. No one is saying that you can't apply to popular or highly selective programs in a given region, but only applying to them is going to make your very slim chances of admission (look up the stats, funded, APA-approved programs max out at admitting less than about 16% of applicants, most are less than 10%) even worse and will likely result in you not receiving any offers and having to reapply. And if time is such a factor, as you've already implied, do you really want to wait another year to start grad school, especially if the reason you didn't get admitted the first time was that you geographically restricted yourself?

You seem to be mainly focused on location and speed to licensure, which might not be the best strategy. For example, you spent so much time here inquiring about neuropsych and boarding, but dropped it fairly quickly once you deemed it to be too much of a "gamble." If you're this quick to drop something in which you're ostensibly so interested, maybe you need to take some time to think about your overall life goals and plans.

@psych.meout Thank you for your response, I appreciate that you took the time to clarify. I may have been out of line in my responses to you, and I didn't mean to come off as rude if I did. Please understand, I don't know where people in an online thread are in their studies of psychology, whether I'm talking to someone who read a yahoo article, whether the writer has actually conducted academic research on this topic, whether they are on some sort of regional committee from the APA who has studied the topic, or whether they are from the US, Sweden, Australia, GB, Mars.. etc. It's hard for me to blindly accept statements from anyone without any sort of survey, research data, or personal credibility to back up the claims.

All I saw from an unknown person was: "I understand the logic and empathize with your desire to not uproot your wife too much, but..." and that's where you kinda lost me at the time. I don't know if you are married, but there is a lot of compromise involved. My wife has the "I go where you go" philosophy, but she also has an aging father who is very important to her and he lives in our town here on the west coast of the US. At the same time, I have this once-in-a lifetime shot at finally finishing my bachelors (free-ride), and as an added bonus, it's all research-oriented and geared for students who plan to go to grad school in clinical psych. My wife knows this and she is willing to leave her career and her father behind for this. In other words, if I can make it less painful for her stay in my hometown alma mater or a state close by and matriculate for a PhD in clinical psychology without having to uproot my wife, why would I apply to Rhode Island?

So let's start over. Let me clarify what I am asking, so that hopefully we are on the same page. For the time being, my primary interest is in clinical psychology, not so much neuropsychology anymore. My question regards your assertion that I should be wary of regionally restricting my applications as this is a frequent kiss of death for applicants, and their regional restrictions are often in highly sought after areas.

I get that if a potential grad student limits his or her applications to say...three grad programs, they are less likely to attain acceptance than someone who applies for 10 grad programs and they are less likely if they are in highly desirable areas...and that this is basic stats and probability. My biggest issue about your statement is how you say this kiss of death is specifically tied to students applying to schools in their regional areas. Where are you getting this information? Please, please, please, don't say basic stats and probability. Thank you!
 
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I get that if a potential grad student limits his or her applications to say...three grad programs, they are less likely to attain acceptance than someone who applies for 10 grad programs and that this is basic stats, but my biggest red flag about this is how this is specifically tied to regional areas. Where are you getting this information? Please, please, please, don't say basic stats and probability. Thank you!

http://psychology.berkeley.edu/sites/default/files/Research/2015-16 APA OUTCOMES PAGES.pdf

Now compare the app numbers here to programs in teh middle of the country and the mid-south. If you dont get it after that, then i dont know what to tell you.
 
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In my experience, successful grad school applicants have targeted their programs pretty carefully to fit their training goals and often sacrifice geographical preference to do so. Of course chance plays a role, but I know plenty of folks who moved to "flyover" states for grad school and were thrilled to work with a specific advisor.
 
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@Riggs82 people are trying to give you constructive feedback on your questions and clarify any misconceptions you may have. The tone of your last few responses comes off as snarky, inflexible, and unappreciative. That is not a good habit to have if you plan to apply to clinical psychology programs, where faculty are likely to give you constructive feedback you may not like. No one here said you would never get in to a West Coast program, just warned you to not restrict yourself geographically. There are many factors at play. Lots of people want to become clinical psychologists but it doesn't always mean they will reach their goal, or that their goal is appropriate. For the record, APA only accredits clinical, counseling and school psychology programs. Experimental programs such as Brain and Cognitive Sciences, Developmental, or Applied would not get accredited by APA.

So, me not buying into the whole "applying to grad schools in the same region is a frequent kiss of death," because they are usually in highly sought after areas (when I'm not applying to these areas) along with no research stats or facts to back it up other than just saying "it's basic stats" is snarky, inflexible, and unappreciative? I'm aware that people are attempting to help, but that doesn't necessarily mean their feedback is constructive, but rather the opposite in the case of this topic. Additionally I'm not allowed to completely disagree? My response to a rude interruption may have been a little more colorful and comical for your comfort level, but that doesn't mean I can't respond "snarky" to a snarky comment to me. An anonymous online forum is not grad school interview and comparing the two was just....horrible. I like how I've been asking and asking with no clear, concise response and the moment I disagree with someone, suddenly everyone is out of the woodwork with their two cents.

I gotta call it quits guys. I know. I know. You're all probably saying: "FINALLY...Good riddance Riggs. You're an idiot and you can't even see it in the non-existent math staring you in the face because we can't prove any of this." This online forum thing is starting to create friction in my family and is becoming an additional stressor and is not healthy at all.

Aside from Wisneuro and mamaPhD, who were very helpful, these responses here have been mostly just "doom and gloom" answers like it's going to be just impossible to get into grad school and there are all these stipulations to worry about like "what region I'm in" and vague answers like "it's in the write up" or "it's basic stats." What do those mean? Where are these basic stats that prove these points? That's like saying "well studies show..." What studies? No one can tell me where any of this is documented nor what their academic pathway was to get where they are. This adds to an already stressful experience and it gets to the point where it is flat out counter-productive. Person A asks Person B a direct question and/or the two disagree and everybody except for Person B responds with snooty comments...Then all people see is Person B's equally snooty reply to the original snooty comments, so everyone in the thread starts sending snootiness to the guy defending himself. It's like arresting the guy for a return punch after not seeing who threw the first punch. Then it becomes a snooty thread full of snooty mental health professionals.

In my opinion, a lot of this really is people hyping up grad school waaaay more than it needs to be. Everyone has their own unique situation when they apply, so really, all a person can do is attain the highest GPA/GREs he or she can, obtain shining letters of recs and research experience, and the rest is up to the program committee. It is a roll of the dice. It's either a yes or no and you move on accordingly. On that note, thanks, but no thanks.

Good luck with your goals, SDN. Love, peace and hair grease.
 
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So, me not buying into the whole "applying to grad schools in the same region is a frequent kiss of death," because they are usually in highly sought after areas (when I'm not applying to these areas) along with no research stats or facts to back it up other than just saying "it's basic stats" is snarky, inflexible, and unappreciative? I'm aware that people are attempting to help, but that doesn't necessarily mean their feedback is constructive, but rather the opposite in the case of this topic. Additionally I'm not allowed to completely disagree? My response to a rude interruption may have been a little more colorful and comical for your comfort level, but that doesn't mean I can't respond "snarky" to a snarky comment to me. An anonymous online forum is not grad school interview and comparing the two was just....horrible. I like how I've been asking and asking with no clear, concise response and the moment I disagree with someone, suddenly everyone is out of the woodwork with their two cents.

I gotta call it quits guys. I know. I know. You're all probably saying: "FINALLY...Good riddance Riggs. You're an idiot and you can't even see it in the non-existent math staring you in the face because we can't prove any of this." This online forum thing is starting to create friction in my family and is becoming an additional stressor and is not healthy at all.

Aside from Wisneuro and mamaPhD, who were very helpful, these responses here have been mostly just "doom and gloom" answers like it's going to be just impossible to get into grad school and there are all these stipulations to worry about like "what region I'm in" and vague answers like "it's in the write up" or "it's basic stats." What do those mean? Where are these basic stats that prove these points? That's like saying "well studies show..." What studies? No one can tell me where any of this is documented nor what their academic pathway was to get where they are. This adds to an already stressful experience and it gets to the point where it is flat out counter-productive. Person A asks Person B a direct question and/or the two disagree and everybody except for Person B responds with snooty comments...Then all people see is Person B's equally snooty reply to the original snooty comments, so everyone in the thread starts sending snootiness to the guy defending himself. It's like arresting the guy for a return punch after not seeing who threw the first punch. Then it becomes a snooty thread full of snooty mental health professionals.

In my opinion, a lot of this really is people hyping up grad school waaaay more than it needs to be. Everyone has their own unique situation when they apply, so really, all a person can do is attain the highest GPA/GREs he or she can, obtain shining letters of recs and research experience, and the rest is up to the program committee. It is a roll of the dice. It's either a yes or no and you move on accordingly. On that note, thanks, but no thanks.

Good luck with your goals, SDN. Love, peace and hair grease.

Are you psychotic?
 
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This online forum thing is starting to create friction in my family and is becoming an additional stressor and is not healthy at all.

Oh please do tell me how this part happened. Not that it's pertinent, I'm just feeling nosy.
 
Good programs in popular areas often have a 2-3% acceptance rate. As evidenced by the student admissions and outcomes data published by every accredited program. You're just being encouraged to not put all of your eggs in one basket if you want to increase your odds of getting in somewhere. Too often people who want to stay in California end up just going to a for profit program and accumulating 200-300k in debt. That's super helpful for a marriage too.

I get compromise and geographic restrictions. Your odds of being able to remain there and get in and complete a program are just really low. Another field may offer more stability as far as location is concerned. Can it be done in this field? Sure if you are the cream of the crop, network like a boss, and get lucky. Have many tried and failed? Yes.
 
Report writing question

When determining years of education for scoring/report purposes, if someone says I have 15 years of education, but only a high school degree.

How do you interpret that? My training (past supers) taught me that gets categorized as 13 years for scoring purposes.
 
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Report writing question

When determining years of education for scoring/report purposes, if someone says I have 15 years of education, but only a high school degree.

How do you interpret that? My training (past supers) taught me that gets categorized as 13 years for scoring purposes.

I say 12 years.

What the rationale fir the arbitrary assignment of 13 years?
 
I say 12 years.

What the rationale fir the arbitrary assignment of 13 years?

The rationale is they have completed some units of post-secondary education and could not obtain their degree for whatever reason.

To compare them to individuals who have only completed 12 formal years of education, not sure if it would be the most accurate.
 
The rationale is they have completed some units of post-secondary education and could not obtain their degree for whatever reason.

To compare them to individuals who have only completed 12 formal years of education, not sure if it would be the most accurate.

Ok. So why not 15 then by that rationale?

I would keep it simple. He has not earned a degree beyond high school-12 years.
 
Ok. So why not 15 then by that rationale?

I would keep it simple. He has not earned a degree beyond high school-12 years.

The reasoning to not give 15 (when brought up with my supers), I've had a few patient's say I been in school studying for 18+ years and have no advanced degree to show for it. So do we use normative data for those with 18+ years of education? I think they have kept it degree based when it comes to determining which normative data to use.

But to keep it simple makes sense, I do agree with that and make note of it in my education section.
 
The reasoning to not give 15 (when brought up with my supers), I've had a few patient's say I been in school studying for 18+ years and have no advanced degree to show for it. So do we use normative data for those with 18+ years of education? I think they have kept it degree based when it comes to determining which normative data to use.

But to keep it simple makes sense, I do agree with that and make note of it in my education section.

Arbitrary assignment of some number of compromise (i.e., 13) when they have been taking college class for god knows how long without earning a degree introduces more error variance than keeping simple it simple and just basing on the most objective metric we have, which is successfully completed education.
 
Arbitrary assignment of some number of compromise (i.e., 13) when they have been taking college class for god knows how long without earning a degree introduces more error variance than keeping simple it simple and just basing on the most objective metric we have, which is successfully completed education.

Interesting!

I'll check Heaton norms and see what it says when I get to work on Tuesday.
 
If they have some college, at least a year of credits, but no degree, they get 13. If they actually have an associates, 14. 16 if they have an actual bachelors, and so on. Don't think it matters much for Heaton as much as 13-15 is a category.

You don't get more years for just endlessly taking classes. E.g., 2 bachelors degrees wouldn't give you 20 years of ed, it's still just 16.
 
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Dang here I thought some more beautiful drama was going to unfold (the other thread got hit by the mods :() and I find its an old thread that someone bumped.
 
I'm going to hop on here for a neuropsych question. In short, I'd like to know if it would be possible to incorporate part-time, neuropsych testing into my career. Specifically, I'd like to work primarily doing inpatient/residential work while also renting an office to do my own assessment work on the side. Given that I will not be eligible for board certification due to my lack of formal training in neuropsych, would this be possible?

So far, I've had exposure to neuropsych testing at three of my year-long practica, although in each case it was less than half of what I was doing. The most intensive was at a prestigious teaching hospital where my supervisor was the chief of neuropsychology (obviously board certified), although I primarily did psychotherapy there. The second was on an inpatient unit where the assessments were primarily focused on projective/personality testing, but I also administered neuropsych assessments as part of the batteries. The least intensive was my first-year practicum at a school for kids with ASD where I got a basic introduction to neuropsych work (and became familiarized with a good number of assessments) but didn't do any direct testing (again, my supervisor was a board certified neuropsychologist). In total, I've completed a moderate number of batteries and feel well-versed in the more basic neuropsych assessments. I've also taken neuropsych testing coursework at school and I participated in seminars at two of my practica. So, I clearly don't have sufficient knowledge to be looking at things like brain damage or other organic disorders, but I definitely feel confident in using neuropsych testing for more general purposes (learning disorders, general cognitive assessment, etc.).

I've just matched for an APA predoc, and it's at a place where I won't be doing any neuropsych testing whatsoever. As such, I won't be able to do a neuropsych postdoc (and nor would I want to, since it's not my main focus). So, clearly I won't ever satisfy the criteria for board certification. However, do I need this certification to do what I want to do? Again, what I'm interested in doing is taking maybe one testing case per week in a private practice setting, and not advertising myself as a neuropsychologist, but simply including neuropsych tools in my assessments.

Thanks!
 
The vast majority of knowledge gained in NP occurs at the internship and postdoc level. I wouldn't recommend doing any neuropsychological assessment. Stick to psychological assessment and avoid ethical violations.
 
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So...you want to dabble in neuropsych eval without completing the requisite training? Would you want a general surgeon doing your neuro-surgery on the weekend? S/He admits that they aren't actually trained in the area, but they are just going to take the easy cases and limit their patients to a few a month, so that's good enough...right?

Seeing one case a week is actually harder than doing it full time because you need to stay sharp and considering you will only have a fraction of the actual training to do it right, that's a horrible idea. You also can't assume you can cherry-pick cases, so then you are stuck in the deep end and then what?

Lastly, no one wants to end up in front of a psych board or a judge bc you botched a case, but it definitely can happen when you don't know what you don't know. You'd be hung out to dry bc you have no defense for your lack of training.
 
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The vast majority of knowledge gained in NP occurs at the internship and postdoc level. I wouldn't recommend doing any neuropsychological assessment. Stick to psychological assessment and avoid ethical violations.

So...you want to dabble in neuropsych eval without completing the requisite training?

Seeing one case a week is actually harder than doing it full time because you need to stay sharp and considering you will only have a fraction of the actual training to do it right, that's a horrible idea. You also can't assume you can cherry-pick cases, so then you are stuck in the deep end and then what?

Lastly, no one wants to end up in front of a psych board or a judge bc you botched a case, but it definitely can happen when you don't know what you don't know. You'd be hung out to dry bc you have no defense for your lack of training.

What about for beginning graduate students? Would good neuropsych practica and graduate courses in psychopharmacology, neuropsychology, clinical neuroscience, psychobiology, behavioral genetics, etc. be sufficient to make them competitive for that more advanced training at the internship and post-doc level? Is research related to neuropsych during grad school necessary or just adds to competitiveness?
 
What about for beginning graduate students? Would good neuropsych practica and graduate courses in psychopharmacology, neuropsychology, clinical neuroscience, psychobiology, behavioral genetics, etc. be sufficient to make them competitive for that more advanced training at the internship and post-doc level?

Yes. Although I am not sure something like a formal course in behavioral genetics is required. Or else I'm a stowaway. Functional neuroanatomy should be on the list.

Is research related to neuropsych during grad school necessary or just adds to competitiveness?

Getting more and more necessary, given the competitiveness. I know of only a handful of contemporary folks who have gone on to neuropsych careers without a neuropsych research background.
 
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So...you want to dabble in neuropsych eval without completing the requisite training? Would you want a general surgeon doing your neuro-surgery on the weekend? S/He admits that they aren't actually trained in the area, but they are just going to take the easy cases and limit their patients to a few a month, so that's good enough...right?

Seeing one case a week is actually harder than doing it full time because you need to stay sharp and considering you will only have a fraction of the actual training to do it right, that's a horrible idea. You also can't assume you can cherry-pick cases, so then you are stuck in the deep end and then what?

Lastly, no one wants to end up in front of a psych board or a judge bc you botched a case, but it definitely can happen when you don't know what you don't know. You'd be hung out to dry bc you have no defense for your lack of training.

First, there's no need to be so sarcastic. I'm asking this question earnestly and with the best of intentions. I certainly don't want to be doing anything that I'm not qualified to do.

Second, maybe I didn't adequately explain what I meant by wanting to do neuropsych testing. I'm talking about adding neuropsych assessments like Wisconsin Card Sort, CVLT, D-KEFS, etc. into my testing batteries. These are tools that I'm familiar and comfortable with. Should I really not use them when I'm doing assessments?
 
I'm talking about adding neuropsych assessments like Wisconsin Card Sort, CVLT, D-KEFS, etc. into my testing batteries. These are tools that I'm familiar and comfortable with. Should I really not use them when I'm doing assessments?

But why? What types of assessments are these? Chances are that if a person needs a WCST, CVLT, D-KEFS, etc., they need a formal neuropsychological evaluation.
 
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Yes. Although I am not sure something like a formal course in behavioral genetics is required. Or else I'm a stowaway. Functional neuroanatomy should be on the list.



Getting more and more necessary, given the competitiveness. I know of only a handful of contemporary folks who have gone on to neuropsych careers without a neuropsych research background.

Would neuroimaging research fall under the umbrella of neuropsych research (or at least in the ball park)? Or are most sites specifically looking for research involving testing?
 
Would neuroimaging research fall under the umbrella of neuropsych research (or at least in the ball park)? Or are most sites specifically looking for research involving testing?

Yes, neuroimaging is a relevant tool and at least falls under the sphere of neuroscience methods. Ideally the link should also be conceptual, and you might want to think about asking some cognitive questions. But I think being neuroscientifically aligned is a good place to start.
 
First, there's no need to be so sarcastic. I'm asking this question earnestly and with the best of intentions. I certainly don't want to be doing anything that I'm not qualified to do.

Second, maybe I didn't adequately explain what I meant by wanting to do neuropsych testing. I'm talking about adding neuropsych assessments like Wisconsin Card Sort, CVLT, D-KEFS, etc. into my testing batteries. These are tools that I'm familiar and comfortable with. Should I really not use them when I'm doing assessments?
Here is a nice summary of the topic (cognitive assessment vs. neuropsychological assessment).

http://www.scn40.org/scn-neuroblog/...l-assessment-different-from-cognitive-testing

If you haven't gotten Houston Conference guideline training, then you shouldn't be doing neuropsychological assessment.
 
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First, there's no need to be so sarcastic. I'm asking this question earnestly and with the best of intentions. I certainly don't want to be doing anything that I'm not qualified to do.

Second, maybe I didn't adequately explain what I meant by wanting to do neuropsych testing. I'm talking about adding neuropsych assessments like Wisconsin Card Sort, CVLT, D-KEFS, etc. into my testing batteries. These are tools that I'm familiar and comfortable with. Should I really not use them when I'm doing assessments?

Are these medically necessary for the clinical questions you are answering? If not, you're comitting insurance fraud. If it's cash only, your basically just milking your patients.
 
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Are these medically necessary for the clinical questions you are answering? If not, you're comitting insurance fraud. If it's cash only, your basically just milking your patients.

Honestly I don't see how someone could administer a sufficient cognitive battery without including a few tests that would be considered neuropsych tools. If I'm testing a kid with ADHD I'm going to want to use the CVLT, for example. So, I would of course not use things if they weren't necessary. Again, where I'm coming from with these questions is from a place of wanting to practice ethically; that's why I came here to get more information, because supervisors have been very elusive about giving me answers to these questions.
 
@Remembering

You might find it useful to refer to the Handbook of Rehabilitation Psychology. There is a strong history of Rehab Psych using cognitive measures. IIRC, Bigler had a chapter or paragraph or something in the 2nd edition about the different "depths" of neuropsych assessment. A short breakdown was the difference in training between using cognitive measures to describe abilities and using cognitive measures to diagnose specific neuropathologies. Makes sense if you are trying to explain and derive treatment based upon cognitive measures if a diagnosis is already made. IME, problems seem to arise when people without NP training use measures like this without using PVTs. It would seem that there is significant potential for iatrogenesis and being used.

@Therapist4Chnge might be a great resource for you as well.
 
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Yes... why?

Honestly I don't see how someone could administer a sufficient cognitive battery without including a few tests that would be considered neuropsych tools. If I'm testing a kid with ADHD I'm going to want to use the CVLT, for example. So, I would of course not use things if they weren't necessary. Again, where I'm coming from with these questions is from a place of wanting to practice ethically;

And people here are telling you- it is likely not ethical and best avoided. You can take or leave the advice. I do not think anyone here means to lambaste you, but there seems to be a misunderstanding of these tests and their uses, so you are providing your own evidence of why this is not OK. Again, if someone needs a "sufficient" cognitive battery, please send them for formal neuropsychological evaluation. Even if you think it is relatively benign to administer a few tests and then refer them, you are potentially introducing practice effects. So this can negatively impact patient care in multiple ways.
 
Yes... why?



And people here are telling you- it is likely not ethical and best avoided. You can take or leave the advice. I do not think anyone here means to lambaste you, but there seems to be a misunderstanding of these tests and their uses, so you are providing your own evidence of why this is not OK. Again, if someone needs a "sufficient" cognitive battery, please send them for formal neuropsychological evaluation. Even if you think it is relatively benign to administer a few tests and then refer them, you are potentially introducing practice effects. So this can negatively impact patient care in multiple ways.

Well, non-neuropsychologists can certainly assess general cognitive functioning if it is relevant to informing treatment/treatment planning or making a diagnosis, and in some cases it is/can be. But to casually mention that you might like to "throw in" some tests that you happen to already "feel comfortable with" suggests that this is being done for your (billing) benefit, and not because it needed or helpful to the patient. For example:

The results of a list learning task when assessing for possible AD/HD would not be needed to establish treatment plan/recommendations....and would certainly not be needed to establish or rule-out the diagnosis in the vast majority of cases.
 
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Honestly I don't see how someone could administer a sufficient cognitive battery without including a few tests that would be considered neuropsych tools. If I'm testing a kid with ADHD I'm going to want to use the CVLT, for example. So, I would of course not use things if they weren't necessary. Again, where I'm coming from with these questions is from a place of wanting to practice ethically; that's why I came here to get more information, because supervisors have been very elusive about giving me answers to these questions.


Exactly. Someone, please, correct me if I'm wrong, but neuropsych testing isn't a requirement to diagnose ADHD.
Well, non-neuropsychologists can certainly assess general cognitive functioning if it is relevant to informing treatment/treatment planning or making a diagnosis, and in some cases in is/can be. But to casually mention that you might like to "throw in" some tests that you happen to already "feel comfortable with" suggests that this is being done for your (billing) benefit, and not because it needed or helpful to the patient. For example:

The results of a list learning task when assessing for possible AD/HD would not be needed to establish treatment plan/recommendations....and certainly not be needed to establish or rule-out the diagnosis in the vast majority of cases.

That's what I was thinking, too. If cognitive testing is necessary for the purposes of differential diagnosis between ADHD, LD, vs other pathology, then the patient should be referred to a neuropsychologist, right?

Edit: Fixed autocorrect error from "neurologist" to "neuropsychologist."
 
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Exactly. Someone, please, correct me if I'm wrong, but neuropsych testing isn't a requirement to diagnose ADHD.


That's what I was thinking, too. If cognitive testing is necessary for the purposes of differential diagnosis between ADHD, LD, vs other pathology, then the patient should be referred to a neurologist, right?

No, this would be something a neuropsychologist might handle (although if it's "just" ADHD vs. LD, it wouldn't necessarily need to be a neuropsychologist). I wouldn't say the average neurologist is likely to have a whole lot of direct experience assessing or treating either ADHD or LD, and most neurologists don't typically administer much in the way of cognitive testing outside of screening measures such as the MMSE.

However, if by "other pathology" you're meaning there's suspicion of a neuropathological process, then a referral to neurology could be very appropriate. Again, they may not necessarily do much with ADHD vs. LD, but they could be of central importance if your differential also included, say, a seizure or perhaps neuroendocrine condition.
 
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No, this would be something a neuropsychologist might handle (although if it's "just" ADHD vs. LD, it wouldn't necessarily need to be a neuropsychologist). I wouldn't say the average neurologist is likely to have a whole lot of direct experience assessing or treating either ADHD or LD, and most neurologists don't typically administer much in the way of cognitive testing outside of screening measures such as the MMSE.

However, if by "other pathology" you're meaning there's suspicion of a neuropathological process, then a referral to neurology could be very appropriate. Again, they may not necessarily do much with ADHD vs. LD, but they could be of central importance if your differential also included, say, a seizure or perhaps neuroendocrine condition.
Whoops, I meant "neuropsychologist." I did not notice the autocorrect from Swype.
 
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No, this would be something a neuropsychologist might handle (although if it's "just" ADHD vs. LD, it wouldn't necessarily need to be a neuropsychologist). I wouldn't say the average neurologist is likely to have a whole lot of direct experience assessing or treating either ADHD or LD, and most neurologists don't typically administer much in the way of cognitive testing outside of screening measures such as the MMSE.

However, if by "other pathology" you're meaning there's suspicion of a neuropathological process, then a referral to neurology could be very appropriate. Again, they may not necessarily do much with ADHD vs. LD, but they could be of central importance if your differential also included, say, a seizure or perhaps neuroendocrine condition.
Differential for ADHD and LD? We do those all the time here. Kind of a standard testing referral for a psychologist and I don't know if we ever administer a CVLT for that. Used to use that as part of the memory testing during my neuropsych rotation and I would think that if a kid was suspected of having significant memory problems or I saw something unusual in the WISC that might necessitate a neuro referral. Along these lines, we do occasionally screen for dementia using something like the DRS2 or MMSE and my colleague will sometimes do a WAIS and if we see anything then we refer for further testing. I would rather send direct to a neuropsych but in rural area, don't want to send folks on five hour trips if they don't have to. What do you all think about that? Appropriate? Strategy for the screening?
 
Well, non-neuropsychologists can certainly assess general cognitive functioning if it is relevant to informing treatment/treatment planning or making a diagnosis, and in some cases it is/can be. But to casually mention that you might like to "throw in" some tests that you happen to already "feel comfortable with" suggests that this is being done for your (billing) benefit, and not because it needed or helpful to the patient.

I guess I've just had an odd experience then. In my program we've been taught very clearly that clinical psychologists can do cognitive assessment without being neuropsychologists. I know multiple graduates who have thriving practices doing this, and they didn't do dedicated neuropsychology training. They also don't advertise themselves as neuropsychologists, and I'd imagine that they pick referal questions that don't seem to be pointing in that direction.

Also, as I said before, two of my supervisors during my past half-time practicums were board certified neuropsychologists, and one was the chief of neuropsychology at a very large and well-known teaching hospital in a major city. Both of them gave me the same impression (that I could do cognitive assessment without pursuing dedicated neuropsych training. It's not that I'm blowing you guys off or anything or that I'm trying to find a loophole in order to make extra money, this is just all a surprise to me and frankly it's pretty disappointing. I've really enjoyed the assessment that I've done over the past four years, and it sucks to think that I won't get to do it again after I finish my internship.
 
Differential for ADHD and LD? We do those all the time here. Kind of a standard testing referral for a psychologist and I don't know if we ever administer a CVLT for that. Used to use that as part of the memory testing during my neuropsych rotation and I would think that if a kid was suspected of having significant memory problems or I saw something unusual in the WISC that might necessitate a neuro referral. Along these lines, we do occasionally screen for dementia using something like the DRS2 or MMSE and my colleague will sometimes do a WAIS and if we see anything then we refer for further testing. I would rather send direct to a neuropsych but in rural area, don't want to send folks on five hour trips if they don't have to. What do you all think about that? Appropriate? Strategy for the screening?

See this is what confuses me (refer to my post directly above this one). I see loads and loads of people saying that they do this kind of testing and then here people are saying it's unethical.
 
See this is what confuses me (refer to my post directly above this one). I see loads and loads of people saying that they do this kind of testing and then here people are saying it's unethical.

I wrote the following:
Well, non-neuropsychologists can certainly assess general cognitive functioning if it is relevant to informing treatment/treatment planning or making a diagnosis, and in some cases it is/can be.

So, what exactly is your confusion?

One doesn't just "throw in" a DKEFS to a psychological assessment (for example) unless its needed to answer the clinical question at hand.

Cognitive assessment of any kind (not to mention something as nonspecific as a list learning task) is not really necessary for standard/uncomplicated AD/HD evaluations, so I'm not sure where you have come up with that idea.
 
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See this is what confuses me (refer to my post directly above this one). I see loads and loads of people saying that they do this kind of testing and then here people are saying it's unethical.

I would also venture to say that there are indeed "loads" of people out there doing poor psychological assessment due to abusing psychometrics or poor training in psychometrics...which often leads to ridiculous interpretations (usually over interpretations or "textbook interpretations" lacking real complexity or truth). I review lots of testing reports in some of my side work.

Proper psychological assessment using psychometric data is difficult, and I really dont think the average clinical psychologist is very good at it. Hence, most of us urge a great deal of caution in this area unless one has formal training in brain-behavior relationships and neuropsychology as a whole.
 
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See this is what confuses me (refer to my post directly above this one). I see loads and loads of people saying that they do this kind of testing and then here people are saying it's unethical.
What are you confused about? No one said that differential between ADHD and LD would require specialized training in neuropsychology. Any psychologist should be able to administer and interpret a WISC and compare it to a measure of academic achievement such as the WIAT or WJ. I don't assess for and especially don't diagnose neurological disorders and if I see evidence of one, then I refer to someone with specialized training such as a neuropsychologist. I have not administered any of the neuropsych tests that I administered during my clinical rotation since I did my clinical rotation. For example: Boston Naming, Peg Board, Wisconsin Card Sort, Trails A or B, and CVLT are some of the tests that I recall having administered then but have not done since.
 
Cognitive assessment of any kind (not to mention something as nonspecific as a list learning task) is not really necessary for standard/uncomplicated AD/HD evaluations, so I'm not sure where you have come up with that idea.

I came up with that idea because those evaluations are done all the time where I'm from (Boston). The testing is done for IEPs and in order to get accommodations like extended time for testing. Many colleges and high school (and the SAT board) require psych testing in order to grant these things. I know psychologists (who are not neuropsychologists) who have 4+ month wait lists just to do these assessments.

Proper psychological assessment using psychometric data is difficult, and I really dont think the average clinical psychologist is very good at it. Hence, most of us urge a great deal of caution in this area unless one has formal training in brain-behavior relationships and neuropsychology as a whole.

Yeah I totally get that. I guess I've just gotten poor information. I had really hoped to be able to incorporate cognitive assessment into my practice but it sounds like that's not realistic. Thanks for the information.
 
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