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Individual differences |
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Typically, a clinical neuropsychologist will hold an advanced degree in clinical psychology (in most countries, this requires a doctorate level qualification: Ph.D., Psy.D., or Ed.D.) and will have completed further studies in neuropsychology. This usually involves the completion of a one-year internship with substantial training in clinical neuropsychology, as well as a two-year post-doctoral fellowship in the same field.
What distinguishes a clinical neuropsychologist from other clinical psychologists is an extensive knowledge of the brain, including an understanding of areas such as neuroanatomy, neurobiology, psychopharmacology, neurological illness or injury, the use of neuropsychological tests to accurately assess cognitive deficits, and the management, treatment and rehabiliation of brain injured and neurocognitively impaired patients.
Clinical neuropsychologists perform a number of tasks, usually within a clinical setting. They are often involved in conducting neuropsychological assessments to assess a person's cognitive skills, usually after some sort of brain injury or neurological impairment. This may be for the purposes of planning treatments, to determine someone's neurocognitive functioning or mental capacity (often done for presentation as evidence in court cases or legal proceedings) or to detect changes over time.
A clinical neuropsychologist's typical caseload may include people with traumatic brain injury (TBI), cerebrovascular accidents (CVA) such as stroke and aneurysm ruptures, brain tumours, epilepsy/seizure disorders, dementias, mental illnesses (e.g. schizophrenia), and a wide range of developmental disorders, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, autism and Tourette's syndrome.
Clinical neuropsychologists' training has included methods of psychotherapy and counselling. They can also provide therapeutic services to patients in need of education and emotional support concerning their neurological injuries or illness.
Many clinical neuropsychologists are employed by medical schools and hospitals, especially neurology, psychiatry, and rehabilitation facilities, and some work in private practice. They are frequently active in teaching at the university level and conducting research into a wide range of issues concerning human brain-behavior relationships. Some clinical neuropsychologists are also employed by pharmaceutical companies to help develop and test neuropsychological assessment tools.
As the majority of clinical psychologists do not have the necessary training or experience to carry out clinical neuropsychology/neuro-rehabilitation assessment or treatment.It is a specialist role requiring further training.
As the Division of Neuropsychology of the BPS in the UK points out:
The clinical role of the neuropsychologist is built upon the findings of researchers in neuropsychology, which provide a growing scientific understanding of the relationship between brain and neuropsychological function. This knowledge forms the basis for highly specialist assessment and rehabilitation of people with brain injury, or other neurological disease.
- To qualify as a clinical neuropsychologist requires specific experience and training and the Division of Neuropsychology maintains that the fundamental qualification for clinical neuropsychology is not a qualification in clinical psychology or educational psychology alone, but the additional completion of one of the BPS/DON recognised training courses leading to the Division of Neuropsychology Practitioner Full Membership Qualification in Clinical Neuropsychology.
Neuropsychologists work with people of all ages with neurological problems, which might include traumatic brain injury, stroke, toxic and metabolic disorders, tumours and neuro-degenerative diseases.
Specialist skills are required in the assessment of neurological patients. This involves proficiency in the administration of a wide variety of neuropsychological tests
- Acute treatment
The importance of the contribution of clinical neuropsychologists has been recognised in recent UK Health Service guidance eg,
- NICE Guidelines on Epilepsy,
- NSF for long term conditions,
- NICE Guidelines on Paediatric Oncology,
- NSF exemplars for Acquired Brain Injury in Adults and Children
Here, clinical neuropsychologists are specifically recommended as team members, recognising their unique role in diagnosis and rehabilitation of serious and disabling neurological conditions.
Treatment and rehabilitation encompasses a broad range of specialist behavioural and cognitive interventions not only for the client, but also for their family and carers.
In acute settings neuropsychologists work alongside neurosurgeons and neurologists and allied disciplines, usually in a regional neurosciences centre. They are concerned with the early effects of trauma, neurosurgery and neurological disease.
In rehabilitation centres they provide post-acute assessment, training and support for people who have sustained brain injury, or who have other neurological problems. A limited number of neuropsychologists work in community supporting those who have returned home.
In all these settings the neuropsychologist will play a central role in the multidisciplinary team which aim to maximise recovery, minimise disability, and prepare the client for return to the community or to a residential placement.
*Consultation Neuropsychologists have an important role consulting to other memeers of the multidisciplinary team, providing them with important information from the psychological perspective Experienced neuropsychologists can also act as expert witnesses for the Courts,
Research is an important aspect of neuropsychological practice.
- Management resposibilities
Neuropsychologists are also to be commonly found in the management of rehabilitation facilities, and in individual case management. Leadership of multidisciplinary rehabilitation teams is frequently part of their clinical role.