Neuro Psychology

What is a Neuropsychologist?

A neuropsychologist is a clinical psychologist who specialises in neurological conditions. These include acquired brain injury, stroke, progressive conditions and dementia. To be on the specialist register for practitioners in neuropsychology, the person must first be registered within a core psychological profession, usually clinical but sometimes educational psychology. They then have a further training in neuropsychology that leads to an additional speciality neurological problems.

Medico Legal Reports

What can a Neuropsychologist do to assist the Legal System?

Neuropsychologists are most usually instructed in cases of acquired brain injury or clinical negligence. They have a number of skills to bring:

Firstly, a neuropsychologist can carry out a detailed psychometric examination to determine any possible loss of cognitive functioning. Medical doctors can carry out relatively simple tests to screen for cognitive impairment but most will defer to a neuropsychologist for a full objective assessment. Cognitive impairment is less visible than many other sorts of impairment, but it can have a devastating impact on a person’s life. Finding out, early, what the short and long-term cognitive impairment is likely to be is important both in establishing quantum and in prescribing rehabilitation.  

Any neuropsychological examination is assisted by the use of profile validity tests. These are formalised tests that measure whether a person is applying themselves fully to the assessment and, in brief, whether any impairments are likely to be organic. This is important as a non-organic impairment might be due to a treatable problem or might be due to a motivation to appear impaired. An organic impairment is more likely to be untreatable and permanent.  A neuropsychologist has more tools than any other professional to establish whether an impairment is organic, functional or motivational.

Secondly, a neuropsychologist can use their clinical psychological skills to determine the quality of a person’s adjustment to their injury. An injury, whether a traumatic brain injury or suspected clinical negligence, can have a significant emotional consequence. Typically, neuropsychologists have seen this many times and are able to provide an opinion on the emotional consequences of the injury and to recommend appropriate treatment.

Neuropsychologists who provide legal services through NPP are all on the specialist register for practitioners in neuropsychology. They work under the guidance of Dr Tim Hull, who has prepared several hundred reports for the civil and criminal courts, and who has been to court on a number of occasions. This ensures a standard and quality that will advise the courts correctly.

Relationship with Other Expert Specialities

In cases of significant or catastrophic injury neuropsychologists often work with neurologists, care experts and neuropsychiatrists. All reports can be complimentary.  As a rule of thumb, all experts can comment upon the severity of a brain injury. A neurologist can comment upon medical issues, seizure risk, the nature of any seizure-like episodes, and suitable medication. A neuropsychiatrist can comment upon the emotional consequences of a neurological issue, the coexistence of mental health problems, the psychiatric consequences of seizures or pseudoseizures and whether medication would be helpful. A neuropsychologist can comment upon a person’s cognitive impairment, on their premorbid and current personality, and are best placed to comment on psychological treatments.

Do you always need a neurologist first?

The answer, based on a great deal of research, is no. The neuropsychologist is frequently the first expert to assess a claimant and will refer on if appropriate. We would advise the neurologist first if the primary issues were seizure -related or medical, but a neuropsychologist first of the primary issues were cognitive.

Rehabilitation

When would you need a Neuropsychologist?

There are two main reasons why you might need neuropsychologist to assist with rehabilitation. One is to determine levels of cognitive impairment, more accurately and precisely than can be determined by a medical doctor or an occupational therapist. Psychologists have skills in teasing out the differences between an emotionally based and an organically based cognitive impairment. This is important for ensuring that the right rehabilitation is given.

The second reason for needing a neuropsychologist is to deal with emotional problems and challenging behaviour.  A psychologist can deal with these by means other than medication. Medication is often useful and sometimes entirely necessary as part of rehabilitation but it is not nearly so effective in dealing with the consequences of brain injury as it is with functional mental illness. Many nonspecialist services may not appreciate the subtleties of brain injury. A neuropsychologist will be able to formulate the emotional and behavioural difficulties psychologically. They will work with family and staff to produce a management plan.

How to Find a Neuropsychologist

In NPP we have a number of neuropsychologist with experience in different areas of clinical practice. Please contact us to make referral.