Guest Post by Elizabeth Wallace, Ph.D.
Elizabeth Wallace received her master’s degree and Ph.D. in clinical psychology, with a specialization in neuropsychology, from the University of Kentucky. She is currently completing a postdoctoral fellowship in clinical neuropsychology at the Kentucky Neuroscience Institute, where she works primarily with older adults with cognitive concerns.
In my seven years of neuropsychology training, I usually asked patients at the start of their appointments, “What do you know about today’s appointment?” The typical answer: “Nothing.” This answer is unsurprising given how poorly explained neuropsychology is compared to other fields you might encounter in your medical care. I hope the following information is helpful in preparing you for an upcoming appointment with a neuropsychologist and for decreasing the mystery around these providers.
Before your appointment:
Some background is important to understand what neuropsychologists do and what a referral to one might mean. Neuropsychologists hold a PhD or PsyD in clinical psychology with a focus on how the brain works. They receive many years of training working with patients and researching the brain and how it functions. Neuropsychologists are different from medical doctors (MDs, DOs) since their training also incorporates psychology – and unlike medical doctors, neuropsychologists don’t prescribe medications (unless they live in the few states that allow licensed psychologists to prescribe).
Instead, someone may be referred to a neuropsychologist when there’s a question about the person’s thinking and what could be causing problems. Neuropsychologists commonly see people who have had an injury to the brain (such as a stroke or a car accident with head injury), or disease (such as a suspected dementia like Alzheimer’s disease), or emotional stress (such as significant depression in older age). Neuropsychologists examine how your brain is working now and how they expect it to work in the coming years. Neuropsychologists are like extra detectives working on a case with your doctors, trying to solve a problem for you.
So you’ve been referred to a neuropsychologist from another medical provider, perhaps a neurologist or psychiatrist. Your appointment is probably going to be different from any other medical appointment you’ve experienced. The appointment is noninvasive, meaning they won’t do physical tests or treatments like take your blood or give you a shot. Instead, you will be completing cognitive tests of your thinking.
Tests might include paper-and-pencil or just spoken tests of your memory, language, problem-solving, and more. And the good news about these tests is that they’re not like tests in school – you don’t get a “grade” on them, and you can’t “fail” them. Thousands of other people have taken them before, and the neuropsychologist looks at how you did compared to people similar to you in important ways like age and education.
During your appointment:
If you can, bring someone with you who knows you well. The neuropsychologist will spend time talking with you and your loved one about a timeline of issues you’ve noticed in your thinking. They are trained to put together the pieces of the puzzle that is you and your life to make a coherent picture. They need your help doing that.
Be prepared for your appointment to be longer than other doctor’s appointments. The neuropsychologist may spend 30 minutes to one hour speaking with you and your loved one, and then you will spend one to six hours doing one-on-one testing with the neuropsychologist or a testing assistant. Your appointment may even span multiple days to get all of the testing that’s needed!
It can be helpful to ask before your appointment how long to expect to be there. For appointments that last most of the day, the testing assistant you’re working with will usually factor in a lunch break. Take your usual medications, try to sleep well the night before, and eat a meal before your appointment. Bring snacks and water, and ask for breaks as often as you need. Lastly, bring hearing aids or glasses if you use them.
Most importantly, just do your best! Neuropsychologists are trying to get an accurate picture of who you are and what concerns you have. It’s not in your best interest to try to do poorly on the tests. But these appointments are long and deal with thinking changes that might make you feel frustrated, sad, or worried. It’s normal for these emotions to come up during the appointment, so take breaks when you feel them.
After your appointment:
Most often, you will see a neuropsychologist for one appointment only. After your appointment, the neuropsychologist will write a report putting together your history, testing results, what they think is going on, and what they think would be helpful for you.
This report will be visible to your other doctors as part of your medical record or chart, and you have the right to get a copy of the report. However, know that you may need help understanding some technical terms used in the report. Sometimes you will meet with the neuropsychologist again for a feedback session to explain the report, or you might not; regardless, the doctor who referred you will use the report to inform their treatment plans.
Remember to take an active role in your health care as much as you can. Some ways to do this include contacting the neuropsychologist for additional explanation, or asking the provider who referred you to explain the report, what will happen next, and why. You have the final say in your medical care.
The neuropsychologist is another member of your health care team. Together with your other doctors, they try to provide you with answers and advice about your brain health. Knowledge of a provider’s specialty is power and can help you get the most out of the appointment.
Thanks so much to Dr. Wallace for this helpful information. If you would like to know more about neuropsychologists, please leave a comment or question. Also, please subscribe to my blog and feel free to follow me on X (formerly Twitter) or Instagram, “like” my Facebook page, or connect on LinkedIn. Finally, if you enjoyed this post, please share it with a friend.