What are the methods used in neuropsychological rehabilitation?
Sep 10, 2020 · New technologies can give cognitive treatment and specific rehab. These tools can be used on all kinds of populations, although some have been created for specific groups (children, the elderly, disabled people, etc.). Nowadays, two of the most used new technologies in neuropsychological rehab are computer software and virtual reality.
What is neuropsychological rehabilitation for brain damage?
The main objective outcome for rehabilitation is to assist in regaining physical abilities and improving performance. Three common neuropsychological problems treatable with rehabilitation are attention deficit/hyperactivity disorder (ADHD), concussion, and spinal cord injury.
When did neuropsychological rehabilitation begin?
Steps in cognitive neuropsychological rehabilitation. 1. Use a theoretical model of cognition made up of a number of distinct. processing components (see Figure 13.1) as a guide to assessment ...
What is the best book on neuropsychological rehabilitation after brain injury?
Rehabilitation psychologists provide clinical interventions and psychotherapy to assist patients and families in coping with physical, sensory, neurocognitive, behavioral, emotional, and/or developmental disabilities. These conditions may be acute or chronic, traumatic, progressive, or congenital in nature.
What are the methods used in neuropsychology?
We primarily use the following methods: Functional magnetic resonance imaging (fMRT) Electroencephalography (EEG) Transcranial magneto stimulation (TMS) Transcranial concurrent stimulation (tDCS)
How do neuropsychologists treat patients?
Neuropsychologists evaluate and treat people with various types of nervous system disorders. They work closely with doctors, including neurologists. Illnesses, injuries, and diseases of the brain and nervous system can affect the way a person feels, thinks, and behaves.
What are neuropsychological processes?
Neuropsychology is concerned with relationships between the brain and behavior. Neuropsychologists conduct evaluations to characterize behavioral and cognitive changes resulting from central nervous system disease or injury, like Parkinson's disease or another movement disorder.
What does cognitive rehabilitation therapy do?
Cognitive Rehabilitation Therapy is a collection of treatment strategies designed to address problems with memory, attention, perception, learning, planning and judgment brought about by brain injury, neurological disorders and other illnesses.
Do neuropsychologists use stethoscope?
Nonetheless, they are critical for sound practice. Tests and measurements of mental and neurological status and performance have long been a bailiwick of educational psychologists and neuropsychologists. Those with training in these specialties use them to garner data and obtain information about patients' functioning.
What is neuropsychology therapy?
Neuropsychology therapy is a therapeutic approach that helps an individual with thinking, memory, judgment, emotional functioning and behavior. Typically, neuropsychologists work with people who have chronic conditions involving the brain, e.g. stroke, TBI, ADHD, ADD, Autism and other disorders.
What is neuropsychology Verywell mind?
Clinical Neuropsychology is a specialty field within clinical psychology, dedicated to understanding the relationships between brain and behavior, particularly as these relationships can be applied to the diagnosis of brain disorder, assessment of cognitive and behavioral functioning and the design of effective ...
What does neuropsychology focus on?
Neuropsychology is a specialty field that joins the medical fields of neurology, psychology and psychiatry. Neuropsychology involves determining how well the brain is working when it is disrupted by a brain injury or psychological disorder.Oct 15, 2020
What is the goal of neuropsychology?
The goal of a neuropsychological evaluation is to carefully and comprehensively assess and identify strengths and weaknesses across multiple areas. Some children referred for an evaluation may already have a known learning disorder or other diagnosis.
How do you rehabilitate the brain?
HOW TO HELP YOUR BRAIN HEAL AFTER AN INJURYGet plenty of sleep at night, and rest during the day.Increase your activity slowly.Write down the things that may be harder than usual for you to remember.Avoid alcohol, drugs, and caffeine.Eat brain-healthy foods.Stay hydrated by drinking plenty of water.More items...•Jan 18, 2017
What is cognitive remediation therapy schizophrenia?
Cognitive remediation for schizophrenia has been recently defined as “a behavioural training based intervention that aims to improve cognitive processes (attention, memory, executive function, social cognition or metacognition) with the goal of durability and generalisation” (Cognitive Remediation Experts Workshop ( ...
What are two approaches to cognitive rehabilitation?
[5] Studies have divided cognitive rehabilitation therapy into two components: Restorative and compensatory approach. [5] The restorative approach aims at reinforcing, strengthening, or restoring the impaired skills.
What is the frontal assessment battery?
The Frontal Assessment Battery (Oguro et al., 2006), Neuropsychological Assessment Battery (Stern & White, 2003), and Delis-Kaplan Executive Function System (Delis, Kramer, Kaplan, & Holdnack, 2004) are typical of cognitive neuropsychological case reports. Such assessments are widely recognized as important for planning cognitive rehabilitation (see Robinson & Weekes, 2013), because they adopt a bespoke diagnostic system consisting of statistically robust and clinically valid instruments that are tailored to the individual case. On the other hand, use of too many alternative tests makes comparison between different clinical groups difficult, and relies ultimately on choices of a neuropsychologist that can cause subjective biases. ...
What is the importance of anxiety and depression?
anxiety and depression) that will follow from changes in cognitive functioning. Of paramount importance, the patient is seen as an active partner during all. stages of the treatment process and therefore services provided must take. account of the individual’s preferences, needs, and resources.
What are the symptoms of neuropsychology?
Why would you need neuropsychology if you experience certain symptoms? 1 Memory loss 2 Difficulty communicating 3 Difficulty writing or reading 4 Attention or concentration problems 5 Difficulty organizing or planning 6 Difficulty multitasking 7 Changes in spatial skills or vision 8 Disturbed thinking or confusion 9 Behavior difficulties that have not improved through conventional treatment
What is rehabilitation psychology?
Rehabilitation psychology is the specialty of clinical psychology focused on achievement of optimal psychological, physical, and social functioning in patients and families impacted by a disability or medical condition.
What is neuropsychological evaluation?
Neuropsychological evaluations allow patients, family members and/or care providers, and treatment providers to better understand the thinking skills, emotional functioning, and behaviors of the individual undergoing the evaluation.
UH offers one of the few rehab programs in U.S. health systems
After a moderate to severe acquired brain injury (ABI), patients may go through a period of confusion and emotional distress. They may get frustrated more easily. They may have trouble paying attention. The words they’re thinking may come out jumbled.
WHAT IS NEUROPSYCHOLOGICAL REHABILITATON?
As Winegardner explains, neuropsychological rehabilitation starts with “the process of creating a sense of safety” for the patient and “equips them with the knowledge and information they need to understand that what they’re thinking and feeling is a normal response” after brain injury.
HOW NEUROPSYCHOLOGICAL REHAB WORKS
Neuropsychological rehabilitation combines elements of psychotherapy, occupational therapy and cognitive rehabilitation. The newly expanded neuropsychological rehabilitation service at UH includes Winegardner, occupational therapist Beth Norton, OTR/L, and neuropsychologists Cynthia Griggins, PhD, and James Mack, PhD.
WHO CAN BENEFIT
Patients with acquired brain injury, including TBI, brain tumor, encephalitis, and stroke, can benefit from neuropsychological rehabilitation. Winegardner says the practice is especially beneficial for patients who want to go back to work or school, improve family relationships and generally feel better about their condition and identity.
What is neuropsychology in rehabilitation?
Neuropsychologists have been an integral part of rehabilitation-oriented integrated care teams for some time and they provide care that is complimentary to other specialties, such as rehabilitation psychologists . Neuropsychologists are more likely than other specialties to offer objective cognitive data that includes consideration of emotional and behavioral features when assessing patients who have known or suspected brain injury or illness. Objective cognitive data is then often used for treatment and discharge planning as well as anticipating safety issues and impairment of functional skills. Unlike a consultative model, neuropsychologists in rehabilitation must work as part of a team of rehabilitation professionals and understand the contributions each specialty offers patients. This paper will highlight a number of issues pertaining to the practice of neuropsychology in rehabilitation settings including: (i) essential skills and duties, (ii) reimbursement, (iii) practice specifics, (iv) types of recommendations, (v) communication issues, (vi) impact of neuropsychological services, (vii) role satisfaction; (viii) advice for early career neuropsychologists, and (ix) a sample report.
What is rehabilitation psychology?
Most people are probably aware that Rehabilitation Psychology and Neuropsychology are two psychology specialties recognized by the Commission on Recognition of Specialties and Proficiencies in Professional Psychology (CRSPPP). Neuropsychologists have been entrenched in rehabilitation settings for quite some time, and authoritative papers have been written about their role and contribution to patients with rehabilitation needs ( Novack, Sherer, & Penna, 2010 ). As a starting point it is worth trying to compare and contrast the two specialties.
How is the number of cases seen per week determined?
The number of cases seen per week is often determined by the productivity benchmarks that are negotiated between the provider and their employer. In academic institutions this becomes a difficult issue because in addition to accounting for one’s salary and fringe benefits you may be paying for your share of a medical practice as well as other academic costs, such an exorbitant Dean’s tax. The average neuropsychologist in a rehabilitation setting is assigned to a specific unit (e.g., the brain injury unit) and is responsible for providing services to 15–18 patients at a point in time. Depending on productivity benchmarks the neuropsychologist may also have to see a certain number of outpatients per week. On a positive note, patients in the hospital never fail to show up for their appointments and so there is a 0% no-show rate. Depending on the average length of stay providers may be expected to do an initial brief assessment for all new patients in time for the first rehabilitation team meeting (usually within the first few days they are on the unit), and then to provide periodic interventional and consultative services while the patient remains on the inpatient unit. This is often intermixed with seeing outpatients who are discharged from the inpatient unit as well as covering for colleagues during absences on other units. Family meetings, support groups, and educational events are commonplace and may need to occur at off hours to accommodate schedules.
What is the goal of a rehabilitation evaluation?
The goals of an initial evaluation in a rehabilitation setting are 5-fold: (i) identification of barriers to therapy and discharge, (ii) assess for the presence of significant mental health or other emotional issues that require intervention , (iii) identify current cognitive and behavioral strengths and weaknesses, (iv) provide recommendations for optimal strategies for participating in rehabilitation therapies; and (v) provide information regarding safety and supervision needs relating to major life domains, such as capacity to make decisions. The evaluation should not be exhaustive or lengthy because it is only meant to obtain a glimpse of how the patient is doing at a moment in time. Patients almost always improve over time, and so an assessment has a time-limited shelf life and can easily be outdated within a matter of weeks or months. It is also important to remember that patients may have a number of sensory, perceptual, and motor impairments that constrain their ability to do some neuropsychology measures and/or questionnaires. As an example, the persons with hemispatial neglect may not be able to see half of a visual stimulus that is presented. Modification of measures when it will not compromise validity can be appropriate as well as testing the limits to determine the reasons for item failure ( Caplan & Shechter, 2008 ). Other therapies will also likely assess aspects of cognition and report on cognitive functioning within the team meeting, including speech-language pathology, occupational therapy, and physical therapy.
What is communication in rehabilitation?
Communication in rehabilitation settings occurs primary in team meetings, and to a lesser extent in “curbside” consults when the neuropsychologist is on the unit and is asked by a member of the team to help with an issue of importance. During team meetings there will be medical providers as well as therapists who discuss current functioning, rehabilitative treatments, barriers to care, and statements regarding discharge planning. Many treatment teams rely heavily on the functional independence measure (FIM), and so will describe functioning in terms of numbers representing varying levels of independence for this measure ( Furlan, Noonan, Singh, & Fehlings, 2009 ). Cognition on the FIM is made up of several domains including memory, problem solving, social interaction, expression, and cognitive comprehension. The cognitive FIM may be reported by the neuropsychologist or may be assigned to a speech-language pathologist assigned to the rehabilitation team.
Do rehabilitation teams use psychometricians?
When it comes to reimbursement one important factor to consider is that those who work in rehabilitation settings seldom use psychometricians for completion of testing. There is a belief that familiarity with the patient requires first-hand knowledge, which means spending time with the patient. The rehabilitation team will work directly with the patient, and there is a lack of credibility given to those who do not operate within this mindset. With the absence of psychometricians comes a higher reimbursement, though fewer patients are ultimately seen.
How long does a neuropsychological test last?
This testing can last a few hours to a full day.
What is the role of a neuropsychologist?
Neuropsychologists guide the ongoing assessment of each patient's progress, making sure each team member keeps the whole person in mind. Pate neuropsychologists focus on the patient’s strengths, weaknesses, interests, occupation, hobbies and personality to design a customized treatment plan that takes the real person into account. Neuropsychologists fine tune and adjust the treatment plans as time goes on to maximize treatment so that the person can thrive in the real world.
What are the symptoms of neuropsychology?
Why would you need neuropsychology if you experience certain symptoms? 1 Memory loss 2 Difficulty communicating 3 Difficulty writing or reading 4 Attention or concentration problems 5 Difficulty organizing or planning 6 Difficulty multitasking 7 Changes in spatial skills or vision 8 Disturbed thinking or confusion 9 Behavior difficulties that have not improved through conventional treatment
What is rehabilitation psychology?
Rehabilitation psychology is the specialty of clinical psychology focused on achievement of optimal psychological, physical, and social functioning in patients and families impacted by a disability or medical condition.
What is neuropsychological evaluation?
Neuropsychological evaluations allow patients, family members and/or care providers, and treatment providers to better understand the thinking skills, emotional functioning, and behaviors of the individual undergoing the evaluation.
What is a clinical neuropsychologist?
A clinical neuropsychologist is a licensed psychologist who specializes in understanding brain-behavior relationships. They have expertise in how thinking skills, emotions, and behavior are related to brain structures and systems.
Rationale For Neuropsychologists Being Part of The Rehabilitation Team
Essential Skills and Specific Competencies
- As previously described, neuropsychologists excel at being able to describe brain-behavior relationships, which includes an understanding of behavioral, cognitive, and emotional difficulties associated with brain injury and illness. First, an understanding of functional neuroanatomy and the limitation of radiographic imaging is important for the populations served by neuropsycholo…
Roadmap to Integration/Reimbursement
- When it comes to reimbursement one important factor to consider is that those who work in rehabilitation settings seldom use psychometricians for completion of testing. There is a belief that familiarity with the patient requires first-hand knowledge, which means spending time with the patient. The rehabilitation team will work directly with the patient, and there is a lack of credi…
Practice Specifics: Setting and Cases Per Week
- The number of cases seen per week is often determined by the productivity benchmarks that are negotiated between the provider and their employer. In academic institutions this becomes a difficult issue because in addition to accounting for one’s salary and fringe benefits you may be paying for your share of a medical practice as well as other academic costs, such an exorbitant …
Focus of The Evaluation
- The goals of an initial evaluation in a rehabilitation setting are 5-fold: (i) identification of barriers to therapy and discharge, (ii) assess for the presence of significant mental health or other emotional issues that require intervention, (iii) identify current cognitive and behavioral strengths and weaknesses, (iv) provide recommendations for optimal strategies for participating in rehabil…
Recommendations
- Recommendations largely follow the goals of assessment previously outlined. There is an emphasis on the patient’s ability to make decisions and safety considerations. For example, would the patient be expected to be at greater risk for falls because of acute delirium, disorientation, spatial neglect, and anosognosia for a hemiparasis. If a patient is asked to make medical decisi…
Communication
- Communication in rehabilitation settings occurs primary in team meetings, and to a lesser extent in “curbside” consults when the neuropsychologist is on the unit and is asked by a member of the team to help with an issue of importance. During team meetings there will be medical providers as well as therapists who discuss current functioning, rehabilitative treatments, barriers to care, …
Impact
- The actual impact of the neuropsychologists’ role depends on the quality of their recommendations and whether it is perceived by the rehabilitation team as being meaningful vis-à-vis assisting them to work more easily with the patient (i.e., making their job easier) or facilitating a greater awareness and understanding of the patient. The return on the financial inv…
Role Satisfaction
- Being collaborative and not defensive about one’s turf will facilitate a sense of team membership in the rehabilitation setting and is essential to being valued by other specialties. Psychologists and physicians have traditionally been the only doctoral level providers in rehabilitation, though physical therapists have now adopted the doctoral level as the standard for new graduates. Reg…
Brief Case Example
- The following report (summary and recommendations only) is an example of a sample initial evaluation for a patient on a rehabilitation unit. Note that reports tend to be short and to the point, seldom exceeding 2–3 pages.