General Neuropsychology

icon_neuroHere are some answers to commonly-asked questions about neuropsychological assessment:

Neuropsychology is a branch of psychology that studies the relationships between the brain and behaviour. When we say behaviour we don’t mean only what people do, but also how they sense (that is, see, hear, smell, taste and feel) the world around them, how they attend to what they sense, learn and remember information, solve problems, understand and create language and so on.

These, taken together, are referred to as “cognitive functions.” The term behaviour also includes how the individual generates feelings or emotions, expresses those emotions, recognizes emotions in others and so on.

In short, neuropsychology is interested in how the brain makes us “who we are” and how who we are influences the brain’s functioning.

Like any other part of our body, the brain can be injured or affected by various diseases and disorders such as traumatic brain injury, strokes, tumors, epilepsy and so on. Clinical Neuropsychology is the applied branch of neuropsychology which assesses and treats behavioral changes resulting from changes in the human brain.
A Clinical Neuropsychologist is someone who practices clinical neuropsychology. However, this definition is misleading because unlike many specialty designations (e.g. neurologist, orthopaedic surgeon) there is no guarantee that someone saying they practice clinical neuropsychology is in fact qualified to do so.

Virtually every state and province in North America has laws preventing individuals from calling themselves psychologists if they have not demonstrated to a licensing body that they are qualified to do so. This is true in other fields as well, such as law, dentistry and medicine.

However, as is true in these other fields, subspecialties within psychology are not defined by law or statute but rather by the profession itself, typically at the national or international rather than state or provincial level. Because of this, although psychologists are required to practice only within areas in which they are trained there is little to prevent individuals from “self-declaring” a specialty.

This is further complicated by the fact that the current professional standards for training are of recent origin and only came into existence after many mid and late-career psychologists were already practicing.

There are, however, questions you can ask to establish whether an individual does in fact have adequate training in this field. If the psychologist is a mid or late-career psychologist you might ask the following:

• Did you receive your Ph.D. and do an internship at a program accredited by the American Psychological Association or Canadian Psychological Association? Did your internship include training and practice in providing neuropsychology services?
• Do you have a Diplomate in Clinical Neuropsychology from the American Board of Professional Psychology?
• If not, do you meet the eligibility requirements to become a diplomate?
• Have you ever worked in a hospital or other provincially-operated health care facility as a neuropsychologist?
• Have you ever been employed by a governmental agency as a neuropsychologist?
• What formal supervision have you had in neuropsychology? Was your supervisor a Diplomate?

Even if someone answers no to all of these questions it does not mean that they are not qualified to provide neuropsychological services. However, one must wonder whether their training is comprehensive and in depth.

For an early-career neuropsychologist you should ask the above questions as well as the following:
• Did you complete a two-year post-doctoral residency in clinical neuropsychology at a professionally-recognized training facility? Did your supervisors have Diplomates in Clinical Neuropsychology?

In recent years, a two-year post-doctoral residency program is viewed as an essential step in becoming qualified to provide neuropsychological services.

Division 40 (Clinical Neuropsychology) American Psychological Association Definition:

“The Clinical Neuropsychological is a professional psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The Clinical Neuropsychologist is a doctoral-level psychology provider or diagnostic and intervention services who has demonstrated competence in the application of such principles for human welfare following:

A. Successful completion of systematic didactic and experiential training in neuropsychology and neuroscience at a regionally accredited university;
B. Two or more years of appropriate supervised training applying neuropsychological services in a clinical setting.
C. Licensing and certification to provide psychological services to the public by the laws of the state or province in which he or she practices;
D. Review by one’s peers as a test of these competencies.

Attainment of the ABCN/ABPP Diploma in Clinical Neuropsychology is the clearest evidence of competence as a Clinical Neuropsychologist, assuring that all of these criteria have been met.”