Need NP post-doc to do assessments?

[NP112]

Hey everyone,

I am currently having some second thoughts on a career trajectory. I am currently in my second neuropsych practicum placement (forth year student), and while I like assessments so far, I am not in love with it as much as I would have hoped. So far, I have gained extensive training in an AMC for various medical syndromes (epilepsy, TBI, suspected AD), as well as training in outpatient neurocognitive assessments (ADHD, psychoed, anxiety and depression). I am still processing what exactly I ultimately want in a career.

I enjoyed doing therapy in our first placement, and am considering doing a therapy-focused practicum next year at a VA. My question is, do I really need a 2 year NP post doc if I decide to go down the generalist route but still want to administer assessments on the side as part of an independent practice? I suspect I will still and try to get at least a NP rotation on internship.

Thanks!

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[AbnormalPsych]

You do not in independent practice. However, you would ethically be limited in providing assessments within your scope and competence.

Although they way the field is going, anywhere else, probably.

 

[WisNeuro]

I'll second what @AbnormalPsych said, with a caveat. There are a lot of "weekend warrior" types who do assessments on the side here and there, who are obviously not properly trained to do some of what they are doing. I see it a lot when I do re-evaluations. Sometimes this leads to fairly egregious errors. When I see those, I call out those errors in my own report for documentation. And, if someone wants to, they can use whatver they want to make a board complaint. If it's especially egregious, I'll make the board complaint myself. Luckily, only have had to do the latter twice.

Tl;dr, you can do assessment without a neuro postdoc, in some states. If you step into my area, and are not properly trained to do so, people like me will make it as easy as we can for people to complain about you and have it backed up empirically. So, make sure to stay within your scope.

 

[summerbabe]

If you enjoy AMC or VA environments, you could eventually consider positions where you would do a mix of therapy and assessment (e.g., inpatient, rehab) and refer out assessment cases to a NP when it's beyond your scope of practice.

And plenty of people change their career trajectory at this (and latter) stages so trust your gut and keep your options open. I like the idea of doing another therapy prac and using those experiences to help guide internship site selection.

Especially if you're a strong internship candidate, you can always keep your doors open and look for a site where you can get enough hours to be competitive for a NP postdoc but change course later. Good luck!

 

[PsychNLife]

What would the regulations be in states such as MA or NJ, for a licensed psychologist to do diagnostic assessment for ADHD/ASD? Would this require a specialized post doc, or just any ole post doc?

 

[Therapist4Chnge]

My question is, do I really need a 2 year NP post doc if I decide to go down the generalist route but still want to administer assessments on the side as part of an independent practice? I suspect I will still and try to get at least a NP rotation on internship.

Thanks!

Doing neuropsych "on the side" is not a viable plan. You don't know what you don't know, and you likely would do more harm than good. There are plenty of hacks already out there, don't be another.

 

[thebalmofhurtminds]

It sounds as though you might be more interested in a rehab psych career, have you considered this? You can look for internship and postdoc experiences specifically in this realm.

 

[WisNeuro]

What would the regulations be in states such as MA or NJ, for a licensed psychologist to do diagnostic assessment for ADHD/ASD? Would this require a specialized post doc, or just any ole post doc?

As far as ADHD, it's all clinical presentation and history taking. There is no testing that is necessary for a diagnosis. A little different in kids if the eval is to be used for accommodations and/or an IEP, but the diagnosis itself is based solely on symptoms and timeline. Any testing should not inform the diagnosis as it is not reliable. As for autism, as long as you get detailed supervision about doing such an assessment, you do not necessarily need a specialty postdoc solely focused on ASD. That being said, if you plan on doing this as a decent chunk of your clinical practice, please make sure you get a good deal of training here. This is a huge area of need in many communities, and unfortunately, it's lead to a lot of people attempting to do this work without adequate training. I see a TON of piss poor ASD evals.

 

[erg923]

What would the regulations be in states such as MA or NJ, for a licensed psychologist to do diagnostic assessment for ADHD/ASD? Would this require a specialized post doc, or just any ole post doc?

State boards would not have the time or authority for such practice micromanagement.

The DSM criteria for ADHD can be gathered by talking to the patient and parents, and maybe doing a BASC or Connors. If you think they might have depression or anxiety too, they probably do.

 

[WisNeuro]

State boards would not have the time or authority for such practice micromanagement.

The DSM criteria for ADHD can be gathered by tasking to the patient and parents, and maybe doing a BASC or Connors. If you think they might have depression or anxiety too, they probably do.

Some state boards do indeed look at your training and didactic experiences to determine if you have the scope to practice in a certain area. I'm only aware of a couple of these personally, but some do. I'm not sure how much they can actually limit what you do, but I imagine if you had a board complaint in an area of practice they deemed you not competent to practice in, it could be an issue.

 

[NP112]

Doing neuropsych "on the side" is not a viable plan. You don't know what you don't know, and you likely would do more harm than good. There are plenty of hacks already out there, don't be another.

I would certainly make sure that I was only practicing within my scope of practice and refer out liberally. I was just trying to garner more information as to keeping my options open down the line as opposed to continuing down a path right now I am not 100% sure I would enjoy.

Yes, rehab psychology is definitely on my radar. Thanks!

 

[cara susanna]

It's not uncommon for VA psychologists to have assessment clinics (I have one despite being mostly therapy). We don't do neuropsych stuff, though, since we have a neuropsych dept for that. Our assessment referrals are mostly things like ADHD testing, psychodiagnostic clarification, and pre-surgical evals.

 

[NP112]

It's not uncommon for VA psychologists to have assessment clinics (I have one despite being mostly therapy). We don't do neuropsych stuff, though, since we have a neuropsych dept for that. Our assessment referrals are mostly things like ADHD testing, psychodiagnostic clarification, and pre-surgical evals.

Yes, that is what I pictured doing in the future. Should have differentiated between assessments vs. neuropsych.

 

[WisNeuro]

Yes, that is what I pictured doing in the future. Should have differentiated between assessments vs. neuropsych.

Just remember that things are different in the VA as they do not have to worry about reimbursement from insurers. So, what is done there, is not done the same way in non-VA systems. For example. in many VAs, they will do neuropsych testing along with the ADHD eval. You will not be reimbursed by this by most insurers as they explicitly state that they will not reimburse those codes.