As a clinical psychologist, I get referrals from physicians, social workers, occupational and physical therapists, and other psychologists for psychological and neuropsychological assessments. Neuropsychology can be mysterious to those outside the field. So I’ve found that many providers are unsure how best to refer someone for neuropsych testing, and how to get the most out of it when they have a question about cognition. Here are a few tips.
Understanding The Value of Neuropsych Testing
Testing is expensive, time consuming, and requires a lot of effort from patients. So it’s easy to understand why it might seem like more trouble than it’s worth. Often, neuropsych testing can offer answers and insight that clinical interviews and physical labs simply cannot. Neuropsychological Testing can provide:
A differential diagnosis. Such as vascular dementia versus Alzheimer’s type dementia. This gives insight into the expected progression of the disease as well as areas of vulnerability and opportunities for additional support.
Rule-outs. For example, it can determine if cognitive deficits are the result of psychiatric or substance problems rather than mild traumatic brain injury as originally suspected.
Information on learning style and barriers. This is useful for academic accommodations or for recommendations on how to best support retention in physical rehabilitation programs.
Monitoring of cognitive change over time. In neurodegenerative diseases like MS, testing every few years can help us understand function and inform treatment planning.
Individualized recommendations. This is the greatest value of neuropsych testing. We can recommend strategies for managing problems with memory, organization, or functional decline. We can recommend evidence-based treatment for psychiatric needs. A Psychologist can comment on practical strategies to support carryover in rehabilitation, or strategies to support independent living for as long as possible. With appropriate testing, an experienced evaluator can offer tailored recommendations that can have a substantial impact on function and quality of life.
A Clear Referral Question for Neuropsych Testing
Neuropsych evaluation starts with a referral question. When the referral comes from another professional, I’ve often seen something like “Please test for dementia.” This doesn’t give much information. Instead, I recommend including as many of these elements as you can:
Brief summary of symptoms. “Patient has noticed problems with focus, attention, and slower thinking.”
Timeframe and/or precipitating event. “Patient began having these problems after infection with COVID in September of 2020.”
Any observations you or others have made related to the referral. “I’ve seen this patient for the past five years, and I’ve also noticed a change in ability to remember what we’ve talked about at appointments. Patient’s partner now comes to every appointment with them to help communicate and remember what is discussed.”
The desired outcome from testing. “Please offer a diagnosis.” Or “Please comment on the patient’s learning style and ways to improve carryover during rehab stay.” Or “Please provide an updated assessment of the patient’s cognitive function to inform treatment planning.” It could also be “Please recommend appropriate academic accommodations.”
Find a Neuropsychologist You Trust and Build That Relationship
Develop a relationship with a psychologist you trust to do thorough and competent neuropsych testing. This allows you to have a solid referral when you encounter patients who could benefit. If you work with older adults, this is crucial, but even if you work with kids or adults of any age, having a go-to neuropsych referral is helpful.
You never know when someone will report symptoms that sound a lot like undiagnosed ADHD, even in their 40s. Or when a patient will be in an accident and sustain a blow to the head with lingering symptoms. Having a relationship in place with a trusted psychologist ensures timely and quality neuropsych testing. This also fosters communication, as you become familiar with the release of information procedures for a given practice. As well as the type of information your psychologist wants about the patient. Good communication results in a thorough assessment and useful recommendations, both for patients and their providers.
Prepare Your Patients for neuropych testing
My final tip is that it’s helpful for referring professionals to prep their patients a bit for why they’re being referred for testing and what to expect. Even sending patients to my website testing pages or a blog post here to learn a little about neuropsych testing can help. People usually feel anxious about testing; but the more you prepare them by letting them know why they need testing and what to expect, the easier it will be for them to give their best effort. This results in the most accurate and useful results. You might say something like this:
“I’m referring you to Dr. Reger for neuropsychological testing. I’m concerned about your difficulty remembering things, episodes of getting lost lately, and new problems managing your medications on your own. Testing will give us some answers, and help us plan for the future. It is usually a long appointment, so be prepared for that. Dr. Reger will tell you more specifically what to expect on the day of testing. She will ask you questions and have you do some paper-and-pencil testing. Once you have the report, we can discuss Dr. Reger’s recommendations and where to go from there.”
Steps for Referring Someone for Neuropsych Testing in Los Angeles, CA
If you are looking for a Neuropsychologist you can refer someone to for neuropsych testing Dr. Reger can help. In order to start the process of a neuropsychological assessment follow these steps:
Have them schedule their appointment at one of our testing locations in Southern California
Get individualized recommendations and treatment suggestions for your client
Other Mental Health Services Available in Los Angeles, CA
Dr. Reger offers psychological and neuropsychological assessments for a variety of reasons. This includes cases of med-legal capacity, before operations or surgery, and for workers’ compensation psych claims. Beyond evaluations, she offers therapy for older adults.