Neuropsych assessment in adult mental health

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captain artichoke
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Joined: Mon Feb 08, 2010 9:53 am

Neuropsych assessment in adult mental health

Post by captain artichoke » Sun Nov 04, 2012 6:52 pm

This feels like a really obvious question but one I want to ask anyway.

In adult mental health settings (CMHTs, inpatient, EIP - anything really) what kinds of reasons are people referred for neuropsych assessment? I imagine some are 'diagnostic' (Asperger's, ADHD) and others are more general (ascertaining cognitive strengths and weaknesses etc). In these settings do people receiving these referrals generally feel satisfied that there is a coherent, thought-out rationale for why the person has been referred for neuropsych assessment or is it sometimes less clear? My experience in adult mental health is somewhat limited to one placement (inpatient forensic) where all clients received a 'screening battery' which included the WAIS and I was always dubious about exactly how helpful they were. I was wondering whether this is something common across services?

Thanks
:)

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Toria
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Re: Neuropsych assessment in adult mental health

Post by Toria » Sun Nov 04, 2012 8:39 pm

From my experience working in 2 different general adult Step 4 psychology services, the use of neuropsych assessments really varies. In one service, no psychologists in the team offered neuropsych assessments at all - clients were either referred to the general hospital neuropsychology team or an older adult psychologist would see them for a less in-depth 'screening' neuropsych assessment. However, in the second adult team I worked in, people were referred for neuropsych assessments for a variety of reasons, e.g. financial capacity assessments, cognitive strengths/weaknesses, memory difficulties, and to assess for LD. I also did some neuropsych work for an EI team and, again, that was for an assessment of the client's strengths and weaknesses, although this referral was more vague than those I saw in the adult psychology service and was to add to the team's assessment.

I have heard of neuropsych tools being used as part of an initial assessment for a service, although I have some concerns about whether the client is fully aware of the implications of this and of the possible consequences following the assessment.

Hope that helps.
You can't stop the waves, but you can learn to surf - Jon Kabat-Zinn

urmaserendipity85
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Re: Neuropsych assessment in adult mental health

Post by urmaserendipity85 » Tue Nov 06, 2012 1:11 pm

Toria wrote:people were referred for neuropsych assessments for a variety of reasons, e.g. financial capacity assessments, cognitive strengths/weaknesses, memory difficulties, and to assess for LD.
Just to echo this, I worked in an acute neuropsych department for a year. My job was mostly to conduct a clinical assessment, followed by a full neuro battery and use both sets of information to try and determine whether any difficulties were functional or organic. People were referred for things like - memory problems, language difficulties (including word finding), following a stroke, head injury etc, problems with praxis, disorientation etc.

In the end, it hardly ever looked like an organic problem. Most of the time people were having really stressful times at home, were depressed/anxious, were coping with illness and so in pain, generally unwell, fatigued etc. Other times it might have been a further piece in a puzzle where nobody really knew what was going on. It might have been something psychosomatic, e.g. a headache that wouldn't go away, general feelings of disorientation for which there was no observable physical cause. Or in a select few cases, people may have received a diagnosis of Alzheimer's disease, MS, motor neurone disease etc. Neuropsych assessment in a lot of these cases either aided diagnosis, or provided further information about functioning when there was already a diagnosis.

We got a lot of referrals for adults under 65, or those who needed more than a memory clinic, so admittedly the people we saw were quite complex and not necessarily representative of those in AMH settings who require a neuropsych for whatever reason.

HTH

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