A Neuropsychologist is licensed in that state of Virginia as a doctoral level provider through the Virginia Board of Psychology. A neuropsychologist has completed a doctoral program (either Ph.D or Psy.D.) in Clinical Psychology and was initially trained as a Clinical Psychologist, which included learning about mental illness and treatment for various disorders including psychotherapy. A Neuropsychologist obtained additional training through didactic experiences, coursework, specialized clinical training experiences, and the completion of at a least a two year postdoctoral residency in Clinical Neuropsychology. A Neuropsychologist has knowledge of “cognitive” abilities such as memory, attention and concentration, and multitasking and how these cognitive abilities change with age, or injury and disease.
A Neuropsychologist is a Clinical Psychologist with additional training in Neurology, Neuroanatomy, Rehabilitation, and Neuropsychology. A neuropsychologist also has an understanding of how various medical conditions, such as diabetes, vitamin deficiencies affect cognition.
Both are doctoral level providers. A Psychologist completed either a Doctorate in Philosophy (Ph.D.) or Doctorate in Psychology (Psy.D.) and a Psychiatrist completed a Doctorate in Medicine (M.D.). Both have advanced knowledge of mental illness and treatment modalities, but Psychiatrist are training in the use of medications to treat conditions. A Psychiatrist can prescribe medications to treat mental illness. Psychologist specialize in psychotherapy (talk therapy) to help alleviate symptoms of mental illness.
A Neuropsychological evaluation is a procedure composed of a variety of different types of assessments, such as paper and pencil tests, verbal, short-answer questions, solving puzzles, and drawing designed to assess functioning of specific parts of the brain. This allows us to how the brain is functioning in comparison to a peer group to determine if there is an injury or disease present that is having a negative impact on cognition.
This varies by insurance companies and insurance plans. It is recommended that you contact your insurance company and ask. Neuropsychological evaluations are medical producers and use medical procedural codes for insurance purposes. Common CPT codes utilized by your neuropsychologist will be: 96116, 96118, 96119, and 90837. Also, make sure that your neuropsychologist is a preferred provider for your insurance company.
There is a large variation in the amount of time required to complete a neuropsychological evaluation. This depends on the patient’s age, the nature of the problem, the extent of injury or disease to the brain, level of functioning before an injury or disease developed, frustration tolerance, etc. Generally, your neuropsychologist will meet with you and someone who knows you well who can comment on observations about your cognitive abilities. This may last 1-2 hours. A testing session can be 4-8 hours, but will be less for older individuals and possibly longer for younger individuals. The nature of the referral question also may have an impact on the amount of time needed to complete the evaluation. Once testing is complete, a feedback appointment will be arranged to discuss the results with you, which may take 1-2 hours.
Cognitions, such as memory, are complex processes, and difficulties in your day to day life in a specific cognitive ability may be due to a break down in the process at different stages. Quick screens just as a 5-minute MMSE, are not typical sensitive or specific to conditions of the brain, especially for individuals at the extreme ends of the normal spectrum. In addition, we learn a lot about what is causing your difficulties by observing the type of errors made on testing. In some cases, we need to see how the brain functions as fatigue sets in. Just like a cardiologist uses a cardiac stress test to see disease of the heart, we can see injury or disease when the brain is placed under stress and fatigue.
Benefits from completing the testing will be dependent on the nature of the evaluation. In general, we are able to see your individual profile of strengths and weakness, which help us clarify and underlying diagnosis, suggest rehabilitation and compensatory strategies, and to help inform treatment recommendations. Another benefit is that we compare your results to an appropriate peer group and can see how you compare to what is considered “normal” for your peer group. In some cases, we can help relieve anxiety if you are worried you have a problem, but our tests show that you are functioning at a level consistent for your age and education. We also develop a baseline of cognitive abilities that can be used to compare future results against if there is concern your cognition is changing.
Some risks of completing a neuropsychological evaluation include feeling fatigue, becoming frustrated, feeling like you are smart, becoming increasingly anxious or depressed, having an emotional reaction during the evaluation by some aspect of your past that is upsetting. In some cases, neuropsychological test results may be used to determine if you meet eligibility for disability, have the capacity to live independently, have the capacity to manage your medications or finances, or have problems that would predict you are not safe to drive.
Clinical evaluations (the standard and default type of evaluation unless otherwise identified as Forensic), will be used to help you and your doctor(s) understand how your brain is working and whether there are concerns about your cognitive abilities. This is used to inform treatment recommendations, offer compensatory strategies to work around areas of difficulty, and to help keep you physically and financially safe.
Neuropsychological evaluations and other sessions with your neuropsychologist are confidential and in most cases you hold the privilege of how the information is communicated with others. A Neuropsychologist is a mandated reporter under certain situations, such as if you are danger to others, or provide information that a child or elderly adult is being physically or sexually abused or neglected.
Your neuropsychologist will ask you to sign a release of information that will allow communication with your doctor(s), and will send your doctors a report summarizing the findings and recommendations. In some cases, your neuropsychologist may have direct communication with physicians involved in your care, but you do have the ability to limit this communication.
NO. Currently, in the State of Virginia, Psychologists, including Neuropsychologist do not have prescribing rights. In some states and in some federal programs, neuropsychologists have gained the right to prescribe a limit class of medications, but currently this is not available in the State of Virginia. Furthermore, the current Neuropsychologist has no intention on pursuing that possibility if it were to become legal for Neuropsychologists to prescribe medications in the State of Virginia.