Neuropsychology and

Neuropsychiatry
Dame Robinson
 What is the difference between a
Neuropsychologist and a Neuropsychiatrist?
A neuropsychologist
A neuropsychologist has a PHD in psychology with a
specialization neuropsychology.
According the Cleveland Clinic, the neuropsychologist “is an
expert in how brain injuries and conditions affect your behavior,
mood and thinking skills. They perform neuropsychological
evaluations to assess how your brain and mind are working and
suggest treatment plans”1
• A neuropsychologist assesses and evaluates “general
intellect, attention and concentration, processing speed,
language skills, learning and memory abilities, reasoning and
problem solving, visuospatial abilities, mood and personality.”1
• There are Two Types of Neuropsychologists:
1. Cognitive Neuropsychologists— do research in the field of
neuropsychology. 1
2. Clinical Neuropsychologists— work with patients and other
healthcare practitioners. They use tests and outcome
measures to evaluate cognitive function. They also create
interventions and assist in discharge planning. 1
A neuropsychiatrist
• A neuropsychiatrist is a medical doctor that specializes in
psychiatry and neurology. 2
• The neuropsychiatrist diagnoses and treats cognitive and
behavioral disorders from conditions of the nervous system.2
• A neuropsychiatrist performs neurological exams, patient
interviews and creates a treatment plan. 2
• What differs from the neuropsychologist is the
neuropsychiatrist prescribes medications and therapy. 2
• The neuropsychiatrists educates caregivers and families
• In addition, a neuropsychiatrist can “conduct research and
work with law enforcement or attorneys in providing witness
testimony, and collaborate with pharmaceutical companies in
conducting tests and trials for treating neurological patients”2
Educational Background of Neuropsychologist
and Neuropsychiatrist
A Neuropsychologist has PHD in Psychology with focus in the area of neuropsychology or
clinical neuroscience.3
• To become a licensed neuropsychologist, the individual pursues a degree in psychology
and specializes in neuropsychology during their doctoral degree and postdoctoral work.3
• Most universities do not have a specific neuropsychology degree, therefore an individual
who wishes to become a neuropsychologist will earn a doctorate in psychology with a
focus in neuropsychology or clinical neuroscience. 3
• A neuropsychologist needs to pass the Examination for Professional Practice in
Psychology (EPPP) for licensure of psychologists in the United States and Canada4
A Neuropsychiatrist has a medical degree with a focus in the area of neurology, psychiatry or
both2
• To become a neuropsychiatrist an individual must complete a residency in neurology,
psychiatry of both. Once the residency is finished, the individual may pursue a certification
of the American Board of Psychiatry and Neurology.2
• As a certified neuropsychiatrist, they may pursue a fellowship in neuropsychiatry. After this
they can take the certification exam to become board certified in behavioral neurology and
neuropsychiatry.2
 What does Neuropsychology contribute to the
Interdisciplinary team management of a complex
neurological patient?

• The neuropsychologist performs a comprehensive

neurological evaluation of the patient. 1,3
• In interdisciplinary settings, the neuropsychologist may help
with differential diagnosis, performing cognitive evaluations,
treatment and discharge planning.1,3
• The neuropsychologist can be a referral source for the
physical therapist
Settings in which you would find a neuropsychologist include:
• Clinics, laboratories, universities, hospitals, mental health facilities or
research offices at pharmaceutical companies3
• a neuropsychologist can work in a hospital setting as part of the
interdisciplinary team including occupational therapist, physical therapist,
nurse, physicians, and speech language pathologist
Systems and Impairments Neuropsychology
Specializes in
• Neuropsychology focuses on the nervous system. 1
• A Neuropsychologist focuses on how dysfunction in the brain can impact cognitive and
behavioral functions. 1
• According to the Cleveland Clinic, “The field of neuropsychology explores the connections
between thoughts and perceptions of the human mind and the brain structures and biological
processes that form them. Neuropsychology is a subspeciality of psychology, not neurology.”1
• Neuropsychology specializes in concussion and traumatic brain injury, epilepsy, brain cancer,
stroke, neurodegenerative disorders, like Alzheimer’s and movement disorders like
Parkinson’s disease.2
• According to John Hopkins website, a neuropsychology evaluation may be appropriate for
“any child who is experiencing changes in thinking, problem solving, attention, memory,
school performance, or emotional/behavioral functioning, as a result of a medical condition
that would impact the brain, may benefit from a neuropsychological evaluation.”5
• The pediatric neuropsychologist assesses the following conditions: “seizures/epilepsy, brain
injury, accident at birth, brain tumor, leukemia, chemotherapy/radiation, stroke or
prematurity/low birth weight.”5
What Tests, Measures and Procedures might a
Neuropsychologist do with the patient?
The Neuropsychologist uses many tests and measures with patients
According to Greene, the following tests would be used for initial evaluations
in rehabilitation centers:
• Patient history, chart review as well as interviewing family and caregivers6
• Tests of orientation: Mini Mental-State Examination, Benton Temporal
Orientation Test6
• Tests of attention: Wechsler Adult Intelligence Scale-IV Digit Span Subtest
and Brief Test of Attention6
• Tests of Receptive and Expressive Language: Hopkins Verbal Learning Test-
Revised, Multilingual Aphasia Examination—Tokens Test, Boston Naming
Test (15 item) and Wide Range Achievement Test-IV Reading Subtest6
• Test for Substance use: Alcohol Use Disorders Test6
• Test For pain: Numeric Pain Rating Scale6
• Tests for Depression: Geriatric Depression Scale and Beck Depression
Inventory—II6
What Patient/Family Education would a
Neuropsychologist be responsible for?

• For a caregiver/parent with a child that

is receiving a neuropsychological
evaluation, the neuropsychologist
would explain what to expect and what
the evaluation entails so that the
caregiver could share this information
with their child.5
• The neuropsychologist would be
responsible for education of family and
caregiver for the patient who is
experiencing cognitive and behavioral
deficits.
 What Advocacy Programs/Issues is Neuropsychology
involved in?

One Advocacy issue from the American Academy of Clinical

Neuropsychology is the “Relevance 2050 Initiative”
• It purports that “By the year 2050, a full 60% of the American
population will be “untestable” with our current toolkit of largely
mono-lingual, mono-cultural neuropsychological assessment
strategies.”7
• This initiative seeks “to support assessment methods, training
models, mid career supervision models, and clinical strategies that
every Academy member can access in order to begin to substantially
increase the percentage of patients we, and the generation of
neuropsychologists who follow us, are able to completely serve.” 7
 How Physical Therapy can support
Neuropsychology

• Physical therapists can make referrals to neuropsychologists for more

comprehensive cognitive and behavioral testing
• In rehabilitation, there are team meetings in which the physical therapist,
neuropsychologist and other healthcare team members interact and share
information to enhance patient care8
• Are there areas that physical therapy overlaps with neuropsychology
overlap?
• The PT and SLP may perform baseline cognitive assessments, but will
need to refer to the neuropsychologist for more thorough cognitive,
emotional and behavioral testing
• Would co-treatment be appropriate and what might it look like?
• In interprofessional settings the physical therapist and
neuropsychologist would work collaboratively on discharge planning8
Review of Journal Article 1: Neuropsychology in the Times of COVID-19. The Role
of the Psychologist in Taking Charge of Patients With Alterations of Cognitive Functions
• This article explored the role of the neuropsychologist for patients who experience
cognitive symptoms from a Covid-19 infection as well as the increase in the number of
referrals for evaluation of patients with cognitive symptoms as a result of a Covid-19
infection.6
• The article proposed that individuals who experience moderate, severe or critical
Covid-19 may experience many symptoms including cognitive impairments 6
• The article shared that the assessment of a neuropsychologist offers a baseline for
implementation of “individualized rehabilitation programs”6
• The article identified the main neuropsychological and neuropsychiatric symptoms in
individuals with Covid-19. The neuropsychological symptoms include memory
impairment, executive function deficits, and affective deficits. The neuropsychiatric
symptoms include delirium, loss of control, dysphoria, mood tone deflection and social
isolation. The overlapping neuropsychological and neuropsychiatric symptoms include
confusion and changes in state of consciousness.6
• The article emphasized the importance of “vis-à-vis” or face to face interaction of the
patient with neuropsychologist over a telehealth interaction. 6
• The article highlighted the importance of the neuropsychologist for evaluating and
treating patients with cognitive symptoms from a Covid-19 infection. 6
Review of Journal Article 1: Neuropsychology in the Times of COVID-19. The Role
of the Psychologist in Taking Charge of Patients With Alterations of Cognitive Functions

• Critique of article: The article did a nice job identifying the needs of
the neuropsychologist to assist in the care of patients with Covid-19
cognitive deficits as an essential part of identification, assessment
and rehabilitation.
• The clinical relevance of this article: With Covid-19 and long-Covid
being an ongoing health concern, incorporating thorough
evaluations for patients who experience long-term cognitive
deficits as a result of the infection may help to mitigate pervasive
cognitive symptoms and offer quicker interventions to assist
patients in return to function. In addition, exploring mechanisms in
which patients (especially those at risk) may utilize telehealth to
receive evaluation and treatment from a neuropsychologist may
allow for wider impact of the profession. Furthermore, this may be
important as we learn more about long Covid.
Review of Journal Article 2:
Clinical Neuropsychology in Integrated Rehabilitation Care Teams
• The article explored the roles, issues and challenges of a neuropsychologist in a rehabilitation setting including
“skills and duties, reimbursement, practice specifics, types of recommendations, communication issues, impact of
neuropsychological services, role satisfaction, advice for early career neuropsychologist as well as a sample case
report.”8 (P 310)
• The article explained the different roles of the neuropsychologist as part of the rehabilitation team and explored
the domains and activities of neuropsychologist
• The domains included assessment, treatment planning, intervention, education as well as discharge
planning8
• The activities of a neuropsychologist explored included behavioral, cognitive, and emotional assessment,
identification of treatment barriers, advising the rehabilitation team, behavioral interventions, cognitive
remediation, rehabilitation team consultation, patient education, caregiver and family education, treatment
team education as well as discharge planning. 8
• Discharge planning responsibilities of a neuropsychologist included “identifying barriers to discharge, address specific
areas of concern (supervision needs and ability to live independently, driving ability, employment considerations, ability
to manage finances) and vocational and educational needs.” 8(P 311)
• The article differentiated between a rehabilitation psychologist and a neuropsychologist. According to the article, a
rehabilitation psychologist works with patients with amputation, spinal cord injury, brain injuries and orthopedic
issues, whereas the neuropsychologist works with patients with degenerative neurological disorders.8
• The article looked at standard outcome measures a neuropsychologist would use in a rehabilitation setting8
• The article provided a case example that summarized the care and provided and example of recommendations
from the neuropsychologist.8
• Lastly, the article offered advice for novice neuropsychologist who are in the beginning of their career considering
working in a rehabilitation setting.8
Review of Journal Article 2:
Clinical Neuropsychology in Integrated Rehabilitation Care Teams

Critique of article:
The article provided a thorough description of the many roles of the neuropsychologist in
the rehabilitation setting. The article laid the foundation of what a neuropsychologist
would specifically do as well as some of the challenges they face such as reimbursement
of services and communication issues. The case scenario illuminated the role of the
neuropsychologist and highlighted how integral they are in aiding in discharge planning.

The clinical relevance of this article:

This article was not only relevant for a neuropsychologist to read, but also for other
members of the rehabilitation care team to understand the role and duties of the
neuropsychologist. Knowing where to appropriately refer patients as well as the details
about specific skills, duties, services and reimbursement for services performed by the
neuropsychologist may be helpful to facilitate care.
As an important member of the rehabilitation team, the neuropsychologist uses objective
outcome measures as well as experience that may help to identify the source of cognitive
deficits in order to offer more targeted care and interventions. In addition, the article
emphasized the importance of the rehabilitation team meetings in which all the members
come together to share findings for patient-centered care.
Review of Journal Article 3:
Integrating Neuropsychology into Interprofessional Geriatrics Clinics
• According to the article, “Despite the fact that older adults are at risk for cognitive difficulties, neuropsychologists are not routinely included on
Geriatrics consult teams”9(P545)
• The article emphasized the importance of interdisciplinary approach to care for complex elderly adults that may have comorbidities as well as
cognitive needs 9
• The article looked at the important role of the neuropsychologist in an interprofessional geriatrics consult clinic, namely with assistance in
differential diagnosis, emphasis on patient care and decrease in the barriers to care.9 However, the neuropsychologist may not be part of the core
team of providers in the geriatric interprofessional clinics.9
• The article argued that the neuropsychologist has distinctive skills that are a necessary part of the interprofessional team, namely their knowledge
in cognitive, behavioral and emotional disorders.9
• The article described the “4Ms” of the Age Friendly Health Systems Initiative: “mentation, mobility, medication and what matters most to the
patient” 9(P545-546) The neuropsychologist can impact directly and indirectly the 4M’s, directly assessing and treating mentation and indirectly
impacting what matters the most to the patient, medication compliance as well as mobility.
• The article emphasized that neuropsychologists are experts in differential diagnosis of psychiatric vs neurodegenerative conditions. In addition, they
may have more time than a doctor to screen for emotional and mood disorders.9
• The article provided an example of how neuropsychology was included within a Veterans health Administration (VA) interprofessional Geriatrics
team. 6 Specifically, it looked at the interprofessional geriatric care in the VA Boston Healthcare System which is an outpatient specialty clinic. The
neuropsychologist and a neuropsychology student (predoctoral intern or postdoctoral fellow are part of the interprofessional team. 9
• The authors of the article shared the VA model with the hope that it will influence other private sector geriatric specialty clinics to incorporate
neuropsychology as an important part of the interprofessional team.9
Review of Journal Article 3:
Integrating Neuropsychology into Interprofessional Geriatrics Clinics

Critique of article: The article did a nice job emphasizing the importance
of the neuropsychologist as an important discipline to be included in the
interdisciplinary care team, however the article described the core group
as a physician (geriatrician) and/or a geriatrics trained nurse practitioner,
nurse, social worker and relevant specialists such as physical therapists,
pharmacists and/or psychologists. With another potential psychologist on
the team, it may be difficult to justify another staff member from the field
of psychology.
The clinical relevance of this article:
This article highlighted the important role of the neuropsychologist in the
interdisciplinary team in geriatric clinics. It stressed the skills of
neuropsychologists to add to the team which include performing baseline
cognitive assessments, differential diagnosis of psychiatric vs
neurodegenerative conditions, as well as increasing patient safety and
care. In addition, the neuropsychologist will look at patient’s barriers to
care and communicate findings to the healthcare team.
By highlighting the success of the interprofessional geriatric care in the VA
Boston Healthcare system it emphasizes the importance of the
neuropsychologist’s role as part of the interdisciplinary team.
 References:
1. Neuropsychologist, Cleveland Clinic website https://my.clevelandclinic.org/health/articles/24691-
neuropsychologist. Accessed June 4, 2023.
2. Neuropsychiatrist: Education and Career Information. Medical and healthcare website.
https://medicalandhealthcare.com/professions/psychiatry/neuropsychiatrist-education-and-career-
information.html. Accessed June 4, 2023.
3. Chamlou N. How to Become a Neuropsychologist. Psychology.org website. Updated Augst 15, 2022.
https://www.psychology.org/careers/neuropsychologist/#:~:text=Where%20do%20neuropsychologists%20
work%3F,research%20offices%20at%20pharmaceutical%20companies. Accessed June 4, 2023.
4. What is the EPPP? The AATBS website. Group Setting https://aatbs.com/what-is-the-
eppp#:~:text=The%20EPPP%20(Examination%20for%20Professional,Professional%20Examination%20Servic
e%20(PES). Accessed June 4, 2023.
5. Neuropsychological Evaluation FAQ. John Hopkins All Children’s Hospital website.
https://www.hopkinsallchildrens.org/Services/Institute-Brain-Protection-Sciences/Programs-and-
Services/Center-for-Behavioral-Health/Neuropsychology/Neuropsychological-Evaluation-FAQ. Accessed
June 4, 2023
6. Sozzi M, Algeri L, Corsano M, et al. Neuropsychology in the Times of COVID-19. The Role of the Psychologist
in Taking Charge of Patients With Alterations of Cognitive Functions. Front Neurol. 2020;11:573207.
Published 2020 Oct 15. doi:10.3389/fneur.2020.573207
7. Relevance 2050 Initiative. American Academy of Clinical Neuropsychology website.
https://theaacn.org/relevance-2050/relevance-2050-initiative/. Accessed June 4, 2023
8. Johnson-Greene D. Clinical Neuropsychology in Integrated Rehabilitation Care Teams. Arch Clin
Neuropsychol. 2018;33(3):310-318. doi:10.1093/arclin/acx126
9. Brunette AM, Rycroft SS, Colvin L, et al. Integrating Neuropsychology into Interprofessional Geriatrics
Clinics. Arch Clin Neuropsychol. 2022;37(3):545-552. doi:10.1093/arclin/acab084