Pepping Successful Private Practice in Neuropsychology and Neuro-Rehabilitation

A Scientist-Practitioner Model
2. Auflage 2014
ISBN: 978-0-12-800488-3
Verlag: Elsevier Science & Techn.
Format: EPUB
Kopierschutz: 6 - ePub Watermark

E-Book, Englisch, 320 Seiten

Reihe: Practical Resources for the Mental Health Professional

Thisÿsecond edition (of the original Successful Private Practice in Neuropsychology) provides an updated overview of key principles and processes for establishing, maintaining and developing neuropsychology practice and neuro-rehabilitation program (NRP) treatment in medical center and/or private practice settings. Essential elements of an entrepreneurial model that work well in the medical center context and the necessary role of variety and peer review in the private practice setting are also discussed. - How to gather and report NPE and other evaluation findings with a neuro- rehabilitation focus that lead to specific neuro-rehabilitation recommendations. Benefit: this will make your evaluations and reports more desirable and sought after in the setting and community where you work. - Updated billing/diagnostic code recommendations to accurately capture the actual time spent in evaluating and/or treating patients. Benefit: increased appropriate billing and collections for your time - Recommendations for clinical neuropsychology postdoctoral fellowship training of a Navy psychologist. Benefit: you may be able to obtain funding for an experienced Navy clinical psychologist who wants formal training in neuropsychology. This can expand your clinical services, increase variety and quality of your training program and ultimately support improved care for returning American military personnel.

Dr. Mary Pepping is a board certified neuropsychologist with 33 years of experience evaluating and treating working-age people and older adolescents with various forms of acquired brain injury. These include people with traumatic brain injury, brain tumor, stroke, multiple sclerosis, anoxic injuries, residual effects of neurological conditions such as meningitis, encephalitis, Huntington Disease, early-onset Parkinson disease, lupus, normal pressure hydrocephalus, and various forms of dementia. Dr. Pepping has long-standing involvement in neuro-rehabilitation of these populations of individuals. This includes an emphasis on detailed neuropsychological evaluations as a foundation for treatment, cognitive rehabilitation and psychotherapy in a milieu model context, and the role and functions of interdisciplinary teams to achieve good outcomes. With her PhD in Clinical Psychology completed 1981 from Washington State University she went on to a postdoctoral fellowship in Clinical Neuropsychology at the University of Washington School of Medicine. After fellowship she spent six years in the Section of Neuropsychology, Department of Neurosurgery, at HCA Presbyterian Hospital in Oklahoma City, OK, directing the milieu-based treatment program there in her final two years. This was followed by a return to Seattle to work for five years in the Physical Medicine and Rehabilitation Department at Virginia Mason Medical Center, continuing with evaluation, treatment and clinical research. After a subsequent six years in private practice, Dr. Pepping was recruited by the Department of Rehabilitation Medicine at the University of Washington Medical Center to serve for 14 years as Director of their Neuropsychology Service and outpatient interdisciplinary Neuro-Rehabilitation Program. Her years at the University of Washington School of Medicine gave her additional opportunities to provide teaching and training to interns, residents, fellows and practicum students from a range of disciplines, as well as shared research and scholarly writing projects with interdisciplinary colleagues. These fields included clinical psychology, neuropsychology, rehabilitation psychology, rehabilitation medicine, psychiatry, speech language pathology, occupational therapy, physical therapy, vocational rehabilitation and cognitive neurosciences. With retirement from direct clinical practice in July 2013, Dr. Pepping shifted to Professor Emeritus within her department to create more time for scholarly writing, research and a return to a private consultation practice.

Autoren/Hrsg.

Pepping, Abpp

Pepping, Mary

Inhaltsverzeichnis

1;Front Cover;1
2;Successful Practice in Neuropsychology and Neuro-Rehabilitation;4
3;Copyright;5
4;Dedication;6
5;Contents;8
6;Foreword to the Second Edition;16
6.1;Reference;20
7;Preface;22
8;Chapter 1: The Challenges of Practice in Neuropsychology;24
8.1;Pros and Cons of the Institutional Setting;24
8.2;Maintaining High-Level Skills;25
8.3;The Interdisciplinary Network;27
8.4;Do Not Go Gently into That Research Decline;28
8.5;Creating Educational Opportunities;29
8.6;Productively Managing Anxiety: Income;29
8.7;Protectively Managing Anxiety: Malpractice;30
8.8;Personality Factors in Private Practice;31
8.9;Ego Needs and Decreased Prestige;32
8.10;Ongoing Consultation: Are You Willing to Seek It? The Buck Stops Here;33
9;Chapter 2: Other Potential Indignities;36
9.1;No Paid Sick Leave or Holidays;36
9.2;No Additional Reimbursement for Professional Fees;37
9.3;No Guaranteed Salary or Health-Care Benefits;37
9.4;Overhead Expenses;37
9.5;Billing, Collections, and Taxes;37
10;Chapter 3: The Good News;40
10.1;Integrating Skills and Interests in Patient Selection;40
10.2;Creating the Optimal Schedule;41
10.2.1;Flexible Hours and Days;42
10.2.2;First Choice on Vacation Slots;43
10.3;Design Your Own Contracts;43
10.4;Setting Your Own Fees;45
10.4.1;Brief Comment on Fees and the Institutional Setting;45
10.5;Determining Salary;46
10.6;Choosing Your Own Support Services;47
10.7;Office Location, Space, and Atmosphere;48
10.8;Developing Your Own Letterhead and Brochures;49
10.9;Personalized Report Formats;49
10.10;Test Selection;49
10.11;Tax Advantages;50
11;Chapter 4: Getting Started: Practical Preliminary Questions;52
11.1;Are You Experienced Enough to Be on Your Own?;52
11.2;Individual or Group Practice;53
11.3;Interdisciplinary Practices;54
11.4;Full-Time or Part-Time Private Practice;55
11.4.1;Income Factors;55
11.4.2;Related Scheduling, Dictation, and Billing Factors;56
11.5;Consultation or Supervision Practices;57
11.6;Teaching;58
11.6.1;Classroom Teaching;58
11.6.2;Workshops;58
11.6.3;In-Service Training;58
11.6.4;Developing and Running Your Own Continuing Education Course;59
11.7;Medical-Legal Work;59
11.8;Neuropsychological Evaluations and Expert Witness Work;59
11.9;Hospital and Clinic Affiliations;61
11.10;University or Medical School Positions;62
11.11;Adjunct Appointments;63
11.12;Part-Time Clinical Faculty;63
12;Chapter 5: A Practical Guide for Opening Your Business;66
12.1;Dont Burn Bridges;66
12.2;Clinician, Know Thyself;66
12.3;A Moveable Feast: The Menu of Practice Options;67
12.4;Maintain a Part-Time Practice with Your Previous Employer;67
12.5;Developing a Safety Net: Starting with a Group;67
12.6;Offering Contract Services to Inpatient Rehabilitation Units;68
12.7;Offering Contract Services to Private Clinics;68
12.8;Membership in Managed Care Panels;69
12.9;Obtaining Adjunct or Clinical Teaching Appointments;70
12.10;How to Determine Fair Fees;71
12.11;How to Find Good Help;72
12.12;Developing a Business Plan and Practice Management Statistics;73
13;Chapter 6: Marketing and Other Matters;76
13.1;First: The Other Matters;76
13.2;Next: The Marketing Piece: The Introductory Letter;76
13.3;Develop Seminars and Workshops;77
13.4;Give Guest Lectures;77
13.5;Offer a Memory Course to the Public;78
13.6;Contact Local Physicians and Fellow Neuropsychologists;78
13.7;Contact Independent Nurse Case Managers;79
13.8;Contact Private Vocational Firms;79
13.9;Attend Weekly Hospital Teaching Rounds;80
13.10;Supervise Residents, Interns, and Postdoctoral Fellows;80
13.11;Obtain Graduate Student Help for Research;80
13.12;Conference Participation: Yours and Other Related Professions;81
13.13;Publish;81
13.14;Final Comment;82
14;Chapter 7: Creative Approaches to Financial Issues;84
14.1;Next Steps;85
14.2;Trading Consultation Time for Office Space;86
14.3;Sharing Testing Materials;86
14.4;Advice on Billing and Collections;87
14.5;Obtaining Basic Data from Your Patients;88
14.6;Obtaining Insurance Authorization;89
14.7;Contract and 50% Down for Private NPE;90
14.8;ICD-9 and CPT Codes;90
14.9;How to Bill and Collect for Legal Work;92
14.10;Reduced Cost Malpractice Insurance;93
14.11;Contract Assistants;93
14.11.1;One Final Insurance Note on Using Contract Neuropsychologists;95
14.12;Tax Deductions, a Good Accountant, and Type of Business;96
15;Chapter 8: Medical-Legal Work;98
15.1;The Problems with Legal Work;98
15.2;True Believer Polemics in the Absence of Strong Scientific Data;99
15.3;Integrity and Reputation-Are You a Plaintiff or a Defense Expert?;100
15.4;Potential War of the Clinical and Legal Worlds;101
15.5;Subtle Influence and Examiner Drift;102
15.6;Inadvertent Promotion of a Litigious Zeitgeist;102
15.7;The Benefits of Forensic Work;103
15.8;Reference;106
16;Chapter 9: Consultation and Supervision Practice;108
16.1;Clinical Psychologists, Primary Care Physicians, Nurse Practitioners, Physician Assistants, and Neurology or Rehabilitation...;108
16.2;Neuropsychologists Who Wish to Augment Their Training;110
16.3;Therapists in Social Work, Counseling, or Pastoral Counselors;111
16.4;Rehabilitation Therapists, Occupational Therapists, Physical Therapists, Speech Pathologists, Vocational Counselors, Rehabi...;112
16.5;Consultation with Psychologists Preparing for Licensure;113
17;Chapter 10: Psychometric Concerns;114
17.1;The Interview: Who Should Be Present and Why?;114
17.2;The Collateral Interviews: When, Why, and with Whom?;115
17.3;Preparing the Patient to Be Tested;116
17.4;Test Selection;117
17.4.1;Core Batteries: Key Areas of Function That Must Be Assessed;117
17.4.2;My Typical Comprehensive Battery;117
17.4.3;Brief Batteries: Screening or Pre-Postprocedure Testing;118
17.4.4;Core Battery;119
17.4.5;Supplemental Tests;119
17.5;Selective Additional Testing: Divided by Specific Areas of Concern;120
17.5.1;Effort;120
17.5.2;Premorbid IQ Estimates;121
17.5.3;Significant Memory Impairment;121
17.5.4;Mild but Real Neuropsychological Impairments;122
17.5.5;Modified Batteries Secondary to Physical or Sensory Limitations;122
17.6;Evaluating Personality in Neuropsychological Assessment;123
17.7;Cross-Cultural Issues;124
17.8;Use of Psychometrists;125
17.9;Report Formats;127
17.10;Review of Test Results;128
17.11;Dictation Versus Typing it Yourself;129
17.12;Dissemination of Reports;130
17.13;Preservation of Testing Files and Raw Data;130
18;Chapter 11: Treatment Practices for Neuropsychologists;132
18.1;Your Training Background and Future Training Needs;132
18.2;What Kind of Practice do you Want?;133
18.3;Other Parts of Good Clinical Practice Development: Outpatient Psychotherapy;133
18.4;Establishing Short-Term and Long-Term Groups;134
18.5;Individual Treatment in a Neuropsychology Practice;135
18.5.1;Psychotherapy;135
18.5.2;Cognitive Rehabilitation;135
18.6;Billing and Reimbursement Issues;136
18.7;Other Practice Options: Employee Assistance Program Contracts;136
18.8;Other Practice Options: Case Management Services;137
18.9;References;137
19;Chapter 12: Nuts and Bolts of Your Evaluation Practice;138
19.1;Referrals;138
19.1.1;Referral Etiquette;138
19.2;Educating Referral Sources;139
19.3;Purpose of Testing;140
19.3.1;Working Diagnosis;141
19.3.2;Scheduling of Patients for Interview and Testing;141
19.3.3;Time Frame for Report;142
19.4;Mechanisms of Feedback to Referral Sources and Patients;143
19.4.1;Clinician Feedback;143
19.4.2;Feedback to Patients;144
19.4.3;Estimated Costs of Evaluation;144
19.4.4;Patient Information Handouts and Registration Forms;144
19.4.5;Obtaining Records;146
19.4.5.1;What Are Pertinent Records;146
19.4.6;Release of Information for Additional Information;146
19.5;Insurance Preauthorization of Services;147
19.5.1;Private Insurance;147
19.5.2;Contract Services and Legal Work;149
19.6;Timely Billing and Collections;150
19.6.1;Billing;150
19.6.2;Collections;150
20;Chapter 13: Neuro-Rehabilitation Program Treatment: Principles and Process;152
20.1;Introduction;152
20.2;What Is Milieu-Based Treatment?;152
20.3;The Value of Work in the Lives of Humans;153
20.4;Why Is the Traditional Versus the Milieu-Based Rehabilitation Distinction Important;154
20.5;What Is Traditional Outpatient Rehabilitation?;155
20.6;Why Is Milieu-Based Treatment Needed for the ``Medium-Severe?´´;156
20.7;Guiding Philosophy and Principles of the Milieu Model;161
20.8;Some Implications of Psychological Factors in Evaluation and Treatment;162
20.8.1;Unwitting Misinterpretation of Evaluation Findings;162
20.8.2;Clinicians are Not Blank Slates;163
20.9;Practical Considerations for Neuro-Rehabilitation;164
20.9.1;Team Constellation;165
20.9.2;A Commentary on the Critical Function and Role of Psychometrists;165
20.10;Key Practical Program Components;166
20.11;Fundamental Relationship Between NPE and NRP Treatments;170
20.11.1;Why Is It Useful for Neuropsychologists to Fully Understand Cognitive Rehabilitation?;171
20.11.2;Other Practical Examples of NPE-NRP Connections;173
20.11.3;NPE in Return to Work, School, and Community Independence;174
20.11.3.1;General Comments;174
20.11.3.2;NPE and Return to Work;175
20.11.3.3;NPE and Return to School;176
20.11.4;Some Problematic Challenges to the Confidentiality of Students NPE Data;177
20.11.4.1;Student Athletes;177
20.11.4.2;Medical School and Medical Residency Applicants;178
20.11.4.3;NPE Findings and Increased Independence in the Community;179
20.12;How Can the Milieu-Based Model Be Modified for Your Practice?;179
20.12.1;For Private Practitioners or Institution-Based NPs in Non-NRP Departments;179
20.12.2;A Brief Aside on Speed of Information Processing and Flexibility of Thinking;181
20.12.2.1;Implications for Return to School, Return to Work, and New Technologies;181
20.12.2.2;Closing Comments;182
20.13;References;183
20.14;Further reading;185
21;Chapter 14: How to Design and Implement a Cognitive Group;190
21.1;Introduction;190
21.2;Which Patients?;191
21.3;Basic Clinical Rules and Procedures;192
21.3.1;Patient Screening;192
21.3.2;Attendance, Participation, Confidentiality, Respect;193
21.3.3;Use of Co-Leaders;194
21.3.4;Individual Therapy as an Adjunct to Group Therapy;195
21.4;Basic Billing and Documentation;196
21.5;One Model for Cognitive Group Treatment;196
22;Chapter 15: The Value and Use of the MMP1 in Neuropsychological Practice;198
22.1;Introduction and Background;198
22.1.1;Why Use Personality Testing?;198
22.1.2;Why Has the MMPI Fallen into Disrepute in Some Circles?;199
22.2;Challenges to Providing Balance: Identifying Personality Strengths;200
22.2.1;Is an Emphasis upon Problem Areas Unique to the MMPI?;200
22.2.2;How Do We Protect Against Misuse?;201
22.2.3;How Can We Improve Our Use of the MMPI in Clinical Practice?;202
22.3;MMPI Profile Case Examples;203
22.3.1;Case1: ``Brooke´´ (Not Her Real Name)-Female Age 24-Severe (Glasgow Coma Scale Score=6) TBI in Horse-Back Riding Accident;204
22.3.1.1;Relevant MMPI Profile Features;204
22.3.1.2;The Ultimate Added Value of the MMPI for This Patient;205
22.3.1.3;What Did We Learn More Specifically about and from the Patient in the NRP to Augment MMPI Findings?;206
22.3.1.4;Some Practical Treatment Implications of Her MMPI Profile and History;208
22.3.1.5;Summary of Where the MMPI Profile Helped Lead Treatment;208
22.3.1.6;Outcome after Discharge from Treatment;209
22.3.2;Case2: "Andy" (Not His Real Name)-53-Year-Old Man-25+ Year History of RRMS, Now With Secondary Progressive MS;210
22.3.2.1;Relevant MMPI 3172 Profile Features;211
22.3.2.2;Some Practical Treatment Implications of His MMPI Profile and History;212
22.3.2.3;The Ultimate Added Value of the MMPI for This Patient;213
22.3.2.4;How Did the MMPI Findings Affect Choice and Delivery of Treatment?;213
22.3.2.5;Why Did This Approach Work?;215
22.3.2.6;Outcome with Treatment;216
22.3.2.7;Final Summary Comments;217
22.3.3;In Summary, Why Should We Use the MMPI?;218
22.3.4;A Brief Word on the MMPI, MMPI-2, and the MMPI-2-RF;218
22.4;References;218
22.5;Further reading;219
23;Chapter 16: Designing and Implementing a Clinical Neuropsychology Fellowship;220
23.1;Introduction;220
23.2;Design of the Fellowship: Three Key Components;222
23.3;Implementation of the Key Components;224
23.3.1;APA Division 40 Training Guidelines;224
23.4;Training Content to Meet General Knowledge Requirements for Our Fellow;225
23.5;Specific Skills to Master per Houston Guidelines;225
23.6;Our Practice and Training Components;226
23.6.1;Background of the Training Neuropsychologists;226
23.6.2;Patient Groups for Neuropsychological Evaluations;227
23.6.3;Exposure to Medical-Legal Work as Part of Fellowship Training;227
23.6.4;Quantity of Neuropsychological Evaluations;228
23.6.5;Additional Components of Neuropsychologist Training Available to the Fellow;228
23.6.6;An Emphasis upon Interpretation of NPE Results;228
23.6.7;Training in Neuro-Rehabilitation Program Principles, Process, and Practices;229
23.6.8;Involvement in Clinical Team Meetings;229
23.7;Organizing the Training Schedule;230
23.8;Feedback from the Fellow After Return to Active Military Service;232
23.8.1;Main Criticism of the Training Program;232
23.8.2;How Could We Incorporate Requested Changes in Future Training?;233
23.8.3;Main Strengths of the Training Program;233
23.9;A Final Word on Selection of Trainees;234
23.10;A Final Comment on How to Make This Happen in Your Locale;235
23.11;Supervisor Time Required for Fellowship Training;236
24;Chapter 17: Research as a Daily Reality;238
24.1;What Are Your Research Interests?;238
24.1.1;What Are Your Populations of Interest?;239
24.1.2;How to Arrange Research Access to Patient Populations;240
24.1.3;Setting Up Your Hypotheses;240
24.1.4;Setting Up Your Data Summary and Data Entry Sheets;241
24.1.5;Finding a Graduate Student Assistant;242
24.2;Grants;242
24.3;Conference Presentation;243
24.4;Journal Articles;243
24.5;Chapters;243
24.6;Journal Groups;244
24.7;Collaborations;244
25;Chapter 18: Summary and Conclusions;246
25.1;The Importance of Relationships and Mutual "Best Interest";246
25.2;What Sort of Work Do You Want to Do?;246
25.3;Where and How Do You Want to Begin?;247
25.4;What are the Best Ways for You to Minimize Costs and Maximize Income?;247
25.5;What Sort of Financial Floor Do You Need?;248
25.6;How Will You Monitor and Promote Growth of Your Practice?;248
25.7;What Do You Do If Plan A Isn't Working as You Expected?;248
25.8;What are Your Short-Term, Intermediate, and Long-Term Goals?;249
25.9;Practical Ways to Vary Your Practice;249
25.10;Periodic or Long-Term Contract Work;250
25.11;Clinical Faculty Appointments;250
25.12;Be Alert to Clinical, Teaching, and Research Opportunities;251
25.13;Enjoying Your Practice;251
26;Appendices;254
26.1;Appendix A;254
26.1.1;Expanded Neuropsychological Evaluation Report Format (for Training and Ease of Dictation);254
26.1.1.1;Neuropsychological evaluation report;254
26.1.1.2;Identifying information;254
26.1.1.3;Reason for referral and pertinent medical background;254
26.1.1.4;Evaluation procedures;255
26.1.1.5;Interview and relevant personal/social history;255
26.1.1.6;Current medications;256
26.1.1.7;Behavioral observations;257
26.1.1.8;Specific tests administered (*my typical battery);258
26.1.1.9;Summary of examination findings;258
26.1.1.10;Intellectual functions;258
26.1.1.11;Memory functions;259
26.1.1.12;Simple and complex attention;260
26.1.1.13;Language skills;260
26.1.1.14;Executive functions;260
26.1.1.15;Visual spatial and tactual spatial skills;260
26.1.1.16;Speed of thinking and performance;261
26.1.1.17;Emotional and personality factors;261
26.1.1.18;Diagnostic impression;261
26.1.1.19;Recommendations;261
26.2;Appendix B;262
26.2.1;What Is a Neuropsychological Evaluation Handout for Referral?;262
26.2.2;What Is a Neuropsychological Evaluation?;262
26.2.3;What Comprises the Formal Neuropsychological Evaluation?;262
26.2.4;What Tests Are Commonly Used as Part of a Testing Battery?;263
26.2.5;What Are General Referral Guidelines?;263
26.2.6;Additional Useful Information;264
26.3;Appendix C;266
26.3.1;Sample Disclosure Statement and Informed Consent for Evaluation Practice;266
26.3.1.1;Professional qualifications;266
26.3.1.2;Policy;266
26.3.1.2.1;Appointment Scheduling;266
26.3.1.2.2;Fees;266
26.3.1.2.3;Is7 Insurance;266
26.3.1.2.4;My Availability;267
26.3.1.2.5;Your Record;267
26.3.1.2.6;Confidentiality;267
26.3.1.2.7;Your Rights as a Psychology Patient;267
26.3.1.3;Patient's agreement;268
26.4;Appendix D;269
26.4.1;Intake Registration Information;269
26.5;Appendix E;270
26.5.1;Release of Information and Release to Obtain Information;270
26.6;Appendix F;271
26.6.1;Neuropsychology Fees for Service;271
26.6.1.1;Clinical work;271
26.6.1.2;Legal consultation;271
26.6.1.3;Cancellation policy;271
26.7;Appendix G;272
26.7.1;Billing Form (on Your Letterhead with Your Contact Information and License Numbers);272
26.8;Appendix H;273
26.8.1;Common International Statistical Classification of Diseases-9th Revision Codes (ICD-10 Will Be Implemented October 1, 2015);273
26.8.2;Brief Overview of Changes Coming with ICD-10;274
26.9;Appendix I;276
26.9.1;Current Procedural Terminology Codes;276
26.9.2;More on Health and Behavioral Assessment/Intervention Codes;276
26.9.2.1;Cognitive rehabilitation code;277
26.10;Appendix J;278
26.10.1;List of Team Members for Milieu-Based Program;278
26.11;Appendix K;280
26.11.1;Sample Cognitive Group Handouts;280
26.11.1.1;Cognitive group;280
26.11.1.1.1;Purpose;280
26.11.1.1.2;Goals;280
26.11.1.2;Cognitive group outline;280
26.11.2;Summary of Brain Areas (Figs 1 and 2) and Deficits Following Damage by Mary Pepping, Ph.D.;284
26.11.2.1;Frontal lobe damage (varies by left versus right hemisphere);284
26.11.2.2;Temporal lobe damage (varies by left versus right hemisphere);284
26.11.2.3;Parietal lobe damage (varies by left versus right hemisphere);284
26.11.2.4;Subcortical injuries: anoxia, tumors, stroke;284
26.11.3;Most Commonly Cited Cognitive Deficits After Traumatic Brain Injury: A 20-Year Review of the Literature;285
26.11.4;Topic: What Is Attention? What Is Memory? How Do They Work in Real Life?;285
26.11.4.1;Pay attention;285
26.11.4.2;We use different kinds of attention;285
26.11.4.3;Ways to aid attention in everyday life;285
26.11.4.4;Pleasurable activities to stimulate attention;286
26.11.4.5;We use different kinds of memory;286
26.11.4.6;Ways to aid memory in everyday life;286
26.11.5;Strategies for Memory Enhancement and Retention;287
26.11.5.1;Internal strategies;287
26.11.5.2;External strategies;288
26.11.5.3;Important principles to remember for improving memory!;288
26.11.5.4;Short-term memory strategies;288
26.11.6;General Rules of Good Communication;289
26.11.7;Time-Management Strategies;289
26.11.8;Planning and Organizing;291
26.11.8.1;Planning;291
26.12;Abodes;292
26.12.1;Organization;292
26.13;Note-Taking Strategies (Cognitive Group);293
26.14;Appendix L;295
26.14.1;Business Deductions to Track for Tax Purposes;295
26.14.2;Direct Expenses;295
26.14.3;Indirect or Other Expenses;295
26.15;Appendix M;296
26.15.1;Review of the Mental Status Exam-By Mary Pepping, Ph.D., ABPP-CN;296
26.16;Appendix N;297
26.16.1;Narrative Discussion of Interview Format;297
26.17;Appendix O;300
26.17.1;Sample Patient Questions;300
26.17.2;Sample Provider Questions;300
26.18;Appendix P;302
26.18.1;Marketing Letter Samples;302
26.18.1.1;The ``too general´´ letter:;302
26.19;Appendix Q;303
26.19.1;Marketing Letter Samples;303
26.19.1.1;The better letter;303
26.20;Appendix R;304
26.20.1;The Houston Conference on Specialty Education and Training in Clinical Neuropsychology;304
26.20.1.1;Policy statement;304
26.20.1.1.1;I. Preamble for Conference;304
26.20.1.1.2;II. Introduction;304
26.20.1.1.3;III. Who Is a Clinical Neuropsychologist?;305
26.20.1.1.4;IV. Who Should Have Education and Training in the Specialty of Clinical Neuropsychology?;305
26.20.1.1.5;V. Professional and Scientific Activity;305
26.20.1.1.6;VI. Knowledge Base;305
26.20.1.1.7;VII. Skills;306
26.20.1.1.8;VIII. Doctoral Education in Clinical Neuropsychology;307
26.20.1.1.9;IX. Internship Training in Clinical Neuropsychology;308
26.20.1.1.10;X. Residency Education and Training in Clinical Neuropsychology;308
26.20.1.1.11;XI. Nature and Place of Subspecialties Within Clinical Neuropsychology;309
26.20.1.1.12;XII. Continuing Education in Clinical Neuropsychology;309
26.20.1.1.13;XIII. Diversity in Education and Training;309
26.20.1.1.14;XIV. Application of the Model;309
26.20.1.1.15;XV. Model of integrated Education and Training in Clinical Neuropsychology;310
26.21;References;20
27;Index;312

Leseproben

The world of neuropsychology and the world at large have changed in many ways in the 11 years since the first edition of this book was published. Within neuropsychology, a wide range of topics continue to evolve from the newly understood chronic traumatic encephalopathy in some professional football players to the fuller explication of neuropsychological difficulties for people with multiple sclerosis or chemotherapy effects for people with cancer. As a specialty profession, we continue to update our core tests, refine brief screening instruments and work diligently to elucidate brain–behavior relationships as they uniquely affect each person yet are characteristic of human function. There have also been great strides in science and technology, including an impressive array of new capabilities in brain imaging techniques as well as the delineation of the human genome and such advances as targeted genetically related treatments for some cancers. We are also in many ways a more closely connected global community than was true even 11 years ago, with events in one country or economy having far greater impact on other countries and economies than was appreciated in 2003. This closer connection is complex. It includes exposure on a daily basis though graphic news accounts to the details of terrorism, genocide, famine, disease, mass murders, environmental degradation, and the many other forms of human suffering, most of it at the hands of other humans. Some of this occurs in our own countries, some in the countries of friends and colleagues throughout the world. It all forms a steady thrum of underlying stress present in all of us, if we take the time to pay attention, rolling like a deep river under the surface of our daily lives. Yet it is this higher degree of interconnection, interdependence, and awareness that has allowed each of us to be reminded of the importance of each single life, to identify with people of every race, ethnic group, country, and condition, as they seek to survive, and if possible, find a better life for themselves and their children. On a scientific and academic professional level, the greater interconnections of this smaller world yield much better appreciation of, and involvement with, the work of our peers in the many countries of the world. This includes the people and places where neuropsychology and neuro-rehabilitation are employed. On a clinical level, this awareness of each individual's potential contribution can lead to a redoubling of our efforts to fully understand and assist each person referred to us for care. For me personally, it comes down to this: I can’t singlehandedly stop famine or murder or the melting of the polar ice cap in the service of a better world. However, I can provide the kind of thorough analysis of a given person's neuropsychological evaluation results that can lead to an improved life for that person in the world, in the larger context of effective treatment. It is this purpose and rationale that has led to this Second Edition of my 2003 book on private practice in neuropsychology. This time, there is an expanded focus, first upon neuropsychology in the private practice and the institutional work domains and second upon neuro-rehabilitation as it may be best carried out in each of those settings by a team of interdisciplinary clinicians. This Second Edition contains three new chapters: on Neuro-Rehabilitation, on the MMPI in clinical practice, and on the design and delivery of a clinical neuropsychology fellowship. By way of relevant historical review: In 1993, after many years of work in institutional settings, I decided to enter private practice and to become fully self-employed. Although I had a general sense of what would be required, it was only in the day-to-day implementation of myriad clinical and business details (as well as in trying to maintain some teaching and research interests) that I learned first-hand what might constitute a good practice model. At the end of 1999, an unexpected opportunity arose to direct a neuropsychology service and an outpatient neuro-rehabilitation program in an academic medical center. Part of the reason I was recruited was my history as a private practitioner who knew how to build and operate a successful neuropsychology practice. The teaching and clinical research I continued during those private practice years were also a good fit for the Clinician-Educator faculty position the university was seeking to fill. Prior interdisciplinary neuro-rehabilitation experience rounded out the fit. I have recently returned to private practice in a consulting role, both for clinical consultation and for medical-legal cases, while shifting to Professor Emeritus in my academic life. With a well-developed appreciation for both practice settings, it is my intention for this 2nd Edition to fulfill four specific roles for the reader: (1) Continue as an updated practical guide for understanding and meeting the requirements of effective self-employment as a neuropsychologist in the scientist-practitioner framework. (2) Examine features of private practice design and application that can be brought to bear on institution-based practices and vice versa. This 2nd Edition will speak more specifically to ways in which a greater degree of creativity, flexibility, and individual practice freedom can be possible, even within the institutional setting. (3) Expand exploration of career options for psychology graduate students, interns, and postdoctoral fellows who might find it helpful to learn more details about private practice as well as clinical practice in interdisciplinary medical settings than may be available to them within the walls of their graduate programs. (4) Psychologists of all stripes, whether neuropsychologists or clinical psychologists, as well as other treating therapists and rehabilitation clinicians, are likely to find portions of this book that could be implemented to maximize quality of work life and patient care options. This book reflects my beliefs and approaches to the topics of neuropsychological practice and neuro-rehabilitation, in both private and institution-based settings. I have tried to make those beliefs explicit and reference some of the information upon which they are based. There are many additional valuable viewpoints. I encourage you to find and consider them in your reading, conference attendance, and work. Three caveats are the following: 1. This book is not intended as a primer on how to become a neuropsychologist. Those criteria are well documented in the National Academy of Neuropsychology (NAN) definition of neuropsychologist; in the requirements for candidacy for neuropsychology diplomates via ABPP (American Board of Professional Psychology: Clinical Neuropsychology) and ABCN (American Board of Clinical Neuropsychology); and in the APA (American Psychological Association) Div. 40 (Neuropsychology) and Houston Guidelines regarding necessary training to become a neuropsychologist. 2. Neither is this book intended as a primer on how to create or conduct a forensic practice. While the medical-legal work described here can be an interesting, challenging and satisfying source of work, the skills, training, and experience required go beyond the intent of this book. 3. While I include such topics as billing processes, procedural coding advice, diagnoses useful for neuropsychology, and potential tax deductions and other business matters, these represent my opinions and are never to be construed as legal advice. You need to determine what is appropriate for your practice and assure yourself it conforms to local, state, provincial requirements, and national requirements that govern your business. One of the most important things I have learned over the past 33 years in both institutional life and private practice is that regardless of our work setting, we have more freedom to craft a practice that works well for us than we may think we do. Although some jobs do not lend themselves to the flexibility I advocate, it is also true that those of us with a particular kind of work ethic may find it difficult to consider the kinds of modifications that would make our lives better. This may be for fear of being perceived as less than productive, as not carrying our weight, or as somehow not being fully up to the task of chronic overwork. There is a funny (and I don't mean humorous) unspoken competition in many institutions about who is toughest when it comes to bearing unreasonable demands and a subtle pecking order based on those principles. So, you may have some decisions to make about your own quality of life and career. To borrow a phrase from Winnicott, you can be “the good enough” neuropsychologist and find that a sufficiently meaningful, satisfying, and remunerative goal. You can also play a satisfying role in evaluation, treatment, teaching, training, and research projects, in both the private and institutional setting. You can maximize what is positive about each, and reduce what is negative about each form of employment. It is the intent of this book to assist you in that process. Finally, while this book necessarily reflects my US-based training and practice, it remains instructive for all of us as neuropsychologists and neuro-rehabilitation clinicians to explore the work of our international colleagues. It may be a journal article regarding a study in Bolivia (Chestnut et al., 2012) looking globally at the comparative use of...