What does a neuropsychologist do?

[sunshine008]

After grad school and internship, what does a neuropsychologist do? On post-doc? As a job? I do not like research. What are my options in a career as a neuropsychologist? Thank you. 🙂

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[erg923]

After grad school and internship, what does a neuropsychologist do? On post-doc? As a job? I do not like research. What are my options in a career as a neuropsychologist? Thank you. 🙂

In the clinical realm, the primary role will be using advanced knowledge of functional neuroanatomy and psychometrics to conduct assessment of cognitive and personality functioning in a wide range of patients. Full reports are written that provide differentiatial diagnosis and treatment recommendations. Of all the subdiciplines of clinical psych, npsych is def NOT the one to try to do if you don't like research. Stats, research and research applciations are integral in training of clinical neuropsychology.

PS: Didn't we already do this once before with you?
http://forums.studentdoctor.net/showthread.php?p=13867647#post13867647

 

[sunshine008]

In the clinical realm, the primary role will be using advanced knowledge of functional neuroanatomy and psychometrics to conduct assessment of cognitive and personality functioning in a wide range of patients. Full reports are written that provide differentiatial diagnosis and treatment recommendations. Of all the subdiciplines of clinical psych, npsych is def NOT the one to try to do if you don't like research. Stats, research and research applciations are integral in training of clinical neuropsychology.

PS: Didn't we already do this once before with you?
http://forums.studentdoctor.net/showthread.php?p=13867647#post13867647

Sorry, I felt that thread was taken over and wanted to receive more information, and figured maybe posting a new thread would help. Evidently, it did not.

Can you maybe explain why stats are so integral career-wise in npsych? I feel as though doing assessments wouldn't require an abundant amount of stats. Also, I don't hate research. I just do not love the pressure to publish, as I feel I am not very creative in coming up with research ideas. Does that help? Thank you for your help.

 

[Pragma]

Sorry, I felt that thread was taken over and wanted to receive more information, and figured maybe posting a new thread would help. Evidently, it did not.

Can you maybe explain why stats are so integral career-wise in npsych? I feel as though doing assessments wouldn't require an abundant amount of stats. Also, I don't hate research. I just do not love the pressure to publish, as I feel I am not very creative in coming up with research ideas. Does that help? Thank you for your help.

A lot of neuropsychologists don't publish. But you do have to have a really strong background in assessment, sampling, statistics, etc. in order to be a competent consumer of the literature and in order to competently interpret assessment scores. If you don't like reading research journals and aren't comfortable with statistics in general, it isn't a good specialty to be in, because we talk a lot about statistics and how our instruments are predictive of outcomes. That is a huge part of the field.

I know several neuropsychologists who basically just do clinical work and don't publish anymore (although they usually did in grad school). But they work at hospitals outside of academia and still are heavy consumers of the research literature. But MOST of the neuropsychologists I know are in academic settings or VAs, as well as private practice, and do actively engage in some research based on their clinical populations.

 

[erg923]

Sorry, I felt that thread was taken over and wanted to receive more information, and figured maybe posting a new thread would help. Evidently, it did not.

Can you maybe explain why stats are so integral career-wise in npsych? I feel as though doing assessments wouldn't require an abundant amount of stats. Also, I don't hate research. I just do not love the pressure to publish, as I feel I am not very creative in coming up with research ideas. Does that help? Thank you for your help.

Understanding what you are measuring and how you are attempting to do so (psychometrics/ psychometric theory) is pretty much all stats. I dont think producing original empirical research is necessary to practice competently, but fi you dont like it, never have done much of it, I would argue it hinders you significantly in that subfield.

 

[AcronymAllergy]

Understanding what you are measuring and how you are attempting to do so (psychometrics/ psychometric theory) is pretty much all stats. I dont think producing original empirical research is necessary to practice competently, but fi you dont like it, never have done much of it, I would argue it hinders you significantly in that subfield.

+1

Some of the strongest statistically-minded folks I know are nearly 100% clinicians who apply that knowledge to their understand and interpretation of neuropsychological assessment.

As I mentioned in another thread, our clinical assessment instruments aren't nearly as "out out of the box" ready-to-go as some may like to believe. Correctly interpreting the clinical data you get from an assessment requires both a strong knowledge of functional neuroanatomy and a solid understanding of statistics and psychometric principles. As one of my supervisors used to say [paraphrased], "as a neuropsychologist, when you walk into a room, you should know more about testing than any other person in there."

 

[cara susanna]

Remember that all of the tests that you use as a neuropsychologist were developed and tested with research. So understanding that research is critical, as is understanding the statistical principles behind said tests and their development.

 

[Sancho Panza]

I'm asking this because I honestly know very little about clinical neuropsychology not because I'm trying to challenge anyone, but what are nueropsychological assessments able to assess for that couldn't be examined in a regular psychological assessment? Is the emphasis primarily on cognitive deficits, or do you assess for mood or anxiety or psychotic disorders as well? Is neuroscience in its current state able to reliably test for those things? One of you mentioned personality functioning as something neuropsychology tests for, and I'm curious what these tests are able to determine about personality functioning.

Sorry if these questions sound ignorant, I just really haven't had much exposure to neuropsychological assessment, and it seems like a lot of people on this board are in the field so I'm curious.

 

[erg923]

I'm asking this because I honestly know very little about clinical neuropsychology not because I'm trying to challenge anyone, but what are nueropsychological assessments able to assess for that couldn't be examined in a regular psychological assessment? Is the emphasis primarily on cognitive deficits, or do you assess for mood or anxiety or psychotic disorders as well? Is neuroscience in its current state able to reliably test for those things? One of you mentioned personality functioning as something neuropsychology tests for, and I'm curious what these tests are able to determine about personality functioning.

Sorry if these questions sound ignorant, I just really haven't had much exposure to neuropsychological assessment, and it seems like a lot of people on this board are in the field so I'm curious.

Psychological assessment will usually not delve in to cognitive functioning any deeper than IQ and its associated domains. Npsych will look at attention (sustained, divided, visual and verbal), language (receptive and expressive), executive functioning, memory and learning (visual and verbal), fine and gross motor functioning, as well as others.

Some npsych tests localize pretty well in certain brain regions (thus we can infer damage or pathology if extremely discrepant), other taps into general domains of cogntive functioning.

Any good psychological assessment would assess for mood, anxiety, and psychotic symptoms, as would any good neuropsych too.

Common tests that assess for overall personality and pathological aspects pf personality are the MMPI and PAI.

 

[MBellows]

Common tests that assess for overall personality and pathological aspects pf personality are the MMPI and PAI.

Offtopic, but thanks for not mentioning the Millons. I actually had someone tell me the other day that they like to give them with the PAI because it's harder to invalidate the Millon and sometimes they can get "useful data" when the PAI is invalid. I think the facepalm from that caused occipital lobe damage.

 

[cara susanna]

Aww, I like the MCMI for my therapy clients. Gives you some idea of their coping style and what will best motivate them in therapy.

 

[MBellows]

Aww, I like the MCMI for my therapy clients. Gives you some idea of their coping style and what will best motivate them in therapy.

Have you tried asking them what motivates them? Nah, really, it's probably great for that. I just run into a lot of times when they'll come out invalid on everything from a DAPS, VIP, TOMM, and PAI, but that good ole Millon will come out fine.

 

[Member6523]

The competent neuropsychologist is trained in psychometrics, psychology, and behavioral neurology and is able to adroitly assess a number of neurodevelopmental, neurological, and psychiatric disorders through brain-behavior methods that include qualitative observations of pathognomonic expressions and quantitative population and intra-individual normative techniques to clarify diagnosis, assess functional capacity, and ascertain prognosis for treatment planning. This is often accomplished by throwing colorful blocks at patients, sticking them in front of a computer screen that flashes random letters, and waving your hands majestically in the air while a tape recorder plays nonsensical syllables. Efforts to tie such endeavors to clinically based science that includes both downstream and upstream correlates are currently underway and a growing body of literature is emerging.

 

[MBellows]

The competent neuropsychologist is trained in psychometrics, psychology, and behavioral neurology and is able to adroitly assess a number of neurodevelopment, neurological, and psychiatric disorders through brain-behavior methods that include qualitative observations of pathognomonic expressions and quantitative population and intra-individual normative techniques to clarify diagnosis, assess functional capacity, and ascertain prognosis for treatment planning. This is often accomplished by throwing colorful blocks at patients, sticking them in front of a computer screen that flashes random letters, and waving your hands majestically in the air while mumbling random syllables. Efforts to tie such endeavors to clinically based science that ties with downstream and upstream correlates are currently underway and a growing body of literature supports the field.

The BLS should use this text in the description for psychologists.

 

[Insomniac99]

As a neuropsychologist, do you test the pts yourself? What is the difference between a neuropsychologist doing testing and a psychometrist doing testing?

 

[Therapist4Chnge]

As a neuropsychologist, do you test the pts yourself? What is the difference between a neuropsychologist doing testing and a psychometrist doing testing?

Some do their own testing, but I'd guess more than half have a psychometrician do it. A psychometrician is akin to a radiology tech. They gather the data through a set protocol of how to do it. The Neuropsychologist has to interpret the data within the context of the case. Administration of the tests can be taught far easier than interpretation et al.

 

[psych.meout]

Some do their own testing, but I'd guess more than half have a psychometrician do it.

From the most recent Sweet survey, slightly more than half (~53% IIRC) use psychometrists, prac students, interns, and/or post docs to do testing for them.

 

[Insomniac99]

So does the interaction between the dr and the pt only come from treatment plans, or collection of medical history?

 

[WisNeuro]

I do all of my own testing. But, in a psychometrist situation, the npsych would do the clinical interview, collateral interview if applicable, choose a test battery, (hopefully) check in with the tester partway through to see if changes need to be made to the testing, check over the scoring (hopefully), integrate information from all available sources, report and deliver feedback to patient.

 

[AcronymAllergy]

I do all of my own testing. But, in a psychometrist situation, the npsych would do the clinical interview, collateral interview if applicable, choose a test battery, (hopefully) check in with the tester partway through to see if changes need to be made to the testing, check over the scoring (hopefully), integrate information from all available sources, report and deliver feedback to patient.

This. The neuropsychologist may also opt to do a bit of their own testing, such as administering a test or two at the beginning or end of the appointment.

Some neuropsychologists may opt to follow-up with the patient afterward for therapy or cognitive rehabilitation if indicated, but many/most refer out to other providers for this.

 

[Therapist4Chnge]

I use a tech and they handle administering and scoring of the battery I choose. I will do my own testing for some non-neuro cases, but usually I just leave that up to the tech so I can focus on reports and managing the ongoing patients. I end up following maybe 60% of my neuropsych cases (a decent portion are legal w/o follow-up and some patients decline f/u). My in-house counselor takes all of the therapy cases for follow-up. I keep a small caseload (not typical of neuropsych, but some of us do brief f/u) and provide education about the diagnosis (typically some type of acquired brain injury)and I provide some basic behavioral interventions and education to the family/spouse of the patient.