Clinical Neuropsychology: Open Access
Open Access

Neuropsychologists are good at explaining the relationship between brain and behavior, including understanding behavioral, cognitive, and emotional problems associated with brain damage and illness. Understanding the limitations of functional neuroanatomy and radiography is important for the group of neuropsychologists servicing in the field of rehabilitation [1]. The obvious reason for hospitalization may be stroke or traumatic brain injury, as some patients may have preillness and associated neurological disorders, but diagnostic confusion can occur. I have. To understand the specific needs of a particular patient, it is important to understand the neuropathy and how they manifest. Indeed, it is not uncommon for patients with recurrent stroke to suffer from premorbid dementia, which results in non-compliance with his antihypertensive drugs and is currently rehabilitation with memory impairment far greater than the expected severity of stroke [2]. I'm in the unit. Such findings have important implications for the patient's future efforts to maintain medication adherence and adhere to stroke prevention strategies.

Knowledge of psychometrics and test validity is important because it relates to many areas of life that neuropsychologists are required to enter. For example, treatment teams and families may see neuropsychologists as a key factor in deciding whether a patient should return to driving or be able to manage their own finances [3].These are important life-changing recommendations for the people we study and therefore need to be well supported by objective data. It is important to understand how the rehabilitation team works and the unique contributions of other rehabilitation disciplines such as physiotherapy, speech therapy and occupational therapy. Experienced neuropsychologists spend their time routinely with these other disciplines in team meetings and therapy sessions and enjoy excellent collaboration with other providers. It is important to understand their approach to assessment and treatment in order to advise them on how best to work with a particular patient [4]. Finally, the rehabilitation environment can be a stressful workplace that can be misleading among professionals. Effective communication within the rehabilitation team and between the team and family and the ability to resolve conflicts are repetitive skills that are effectively utilized. It is amazing how often controversial interactions occur, which are often used to resolve conflicts and mediate communication between team members and between teams and families. Family confusion that may have always existed can be much more problematic after a medical event, and team members are unoptimal communication or active interpersonal styles in this fast-paced environment [5]. Through it, it can unknowingly contribute to misunderstandings.

An important factor to consider when it comes to reimbursement is that people working in rehabilitation facilities rarely consult with a psychologist to perform the test. There is beliefs that direct knowledge is needed to get to know the patient. This means spending time with the patient. The rehabilitation team works directly with the patient and lacks the credibility of those who are not working within this mindset. Due to the shortage of psychometrics, fewer patients will eventually be treated, but higher reimbursement will occur [6]. Many of the above roles and activities of neuropsychologists in rehabilitation are non-refundable, so it is advisable to develop a hands-on model that adequately compensates for the non-refundable time desired by the hospital. As already explained, there is a clear need for a neuropsychologist in rehabilitation.

If neuropsychologists are expected to spend hours on team meetings, bedside visits, and staff training, it is important to ensure that these activities are well paid. When hired directly in a hospital, this means understanding these activities in terms of productivity impact and setting appropriate Relative Value Unit (RVU) benchmarks. Neuropsychologists with incentive plans often find that their RVU goals are too high to realistically achieve incentive rewards, especially along with the various non-reimbursement activities expected of neuropsychologists. Other factors that may affect productivity and redemption include the availability of internal support staff available to obtain pre-approval and invoice . The most prolific neuropsychologists cannot be compensated if the hospital does not obtain pre-approval or properly invoice. Psychology tends to be a small niche in most rehabilitation programs, so it is not uncommon for psychologists to have infrastructure issues that prevent them from receiving payment for services. At some hospitals I've been to, there was a routine practice of not getting pre-approval of psychological services and, in some cases, not submitting any kind of invoice on behalf of psychology. When budgets are tight, educational institutions may consider neuropsychology to be a consumable and non-essential service because it is not run on a revenue-neutral basis.

When a neuropsychologist contracts, it is important to negotiate a specific fixed agreement for unpaid work. The key to this negotiation is whether to see patients with uninsured services or whether neuropsychologists see patients who are not participating providers in the patient insurance plan. In my past position, I provided care for more than 100,000 patients annually, but estimated that they were not repaid, and only a small portion of that amount was repaid. Neuropsychologists can easily find themselves without the specific parameters that are part of an omnibus collaboration agreement that includes multiple providers and services. Two points to address when negotiating these agreements with hospital managers are: (i) Patients in the hospital do not have the opportunity to meet the desired psychologist as they do in the church. Audience of prisoners of war; (ii) All patients in the hospital should receive the same level of care, regardless of their insurance status. 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. As with the test limits for determining the reason for an item's failure, it may be appropriate to change the measure if this does not affect its effectiveness. Other therapies may evaluate cognitive aspects such as verbal pathology, occupational therapy, and physiotherapy and report on cognitive function within team meetings.

In addition to interviews with patients and their families (or others who can provide supplementary information), initial assessments include cognition, depression and anxiety, substance abuse, disability awareness, pain, and others, depending on the type. A simple measurement of the measurement may be included for the person being evaluated for the patient. Initial assessments in inpatient rehabilitation units often limit cognitive assessments to areas that have the greatest impact on inpatient treatment, such as: basic measures of attention, verbal learning and memory, and receptive and expressive language.

1. Barry P, O’Leary J (1989) Roles of the psychologist on a traumatic brain injury team. Rehabil Psychol 34:83-90.

Google Scholar, Crossref

2. Babor TF, de la Fuente JR, Saunders J, Grant M (1992) The alcohol use disorders identification test. Guidelines for use in primary health care. Geneva, Switzerland: World Health Organization.

Google Scholar

3. Bayley MT, Tate R, Douglas JC, Turkstra LS, Ponsford J, et al. (2014) INCOG Guidelines for cognitive rehabilitation following trauamtic brain injury: Methods and overview. J Head Trauma Rehabil 29:290-306.

Indexed at, Google Scholar, Crossref

4. Beck AT, Steer RA, Brown GK (1996) BDI-II: Beck depression inventory manual (2nd ed). San Antonio: Psychological Corporation.

Google Scholar

5. Benton AL (1983) Contributions to neuropsychological assessment. New York: Oxford University Press.

Google Scholar

6. Benton AL, Hamsher KD, Sivan AB (1994) Multilingual aphasia examination. Lutz, FL: Psychological Assessment Resources, Inc.

Google Scholar