Neuropsychology Track (155213)

The Neuropsychology Track offers a variety of training experiences for interns specializing in neuropsychology. (Of course, interns with less neuropsychology experience are also welcome to complete any of these rotations.) Interns who match in the Neuropsychology Track will meet the didactic and experiential training requirements recommended by the Houston Conference and Minnesota Guidelines, including at least six months of clinical neuropsychology training. Interns also attend the monthly Neuropsychology Seminar Series, a forum for clinical case conferences, research presentations, professional issues, and other topics of interest. A monthly Neuropsychology Board Preparation Seminar helps trainees prepare for board certification in clinical neuropsychology in a relaxed setting. Research interests of neuropsychology faculty are listed listed here (PDF). The Charleston Consortium is a member of the Association for Internship Training in Clinical Neuropsychology.

Neuropsychology Clinic — VA HCS

The Neuropsychology Clinic provides neuropsychological evaluation services for patients throughout the Ralph H. Johnson VA Health Care System. Referrals come from various outpatient services, including Neurology, Mental Health, Primary Care, Physical Medicine and Rehabilitation, Geriatric Medicine, Infectious Diseases Clinic, and others. Adults with a range of diagnoses are seen for assessment, including neurodegenerative and other neurological diseases, cerebrovascular disease, traumatic brain injury, seizure disorders, chronic substance use, and other psychiatric conditions. The patient population includes younger and older Veterans with a broad range of backgrounds, presenting problems, and referral questions.

Outpatient evaluations utilize a hypothesis-testing approach, in which each evaluation is tailored to the specific needs of the patient and referral source. The clinical service and training model emphasizes interpretation and integration of historical, observational, and qualitative data, as well as quantitative test data. Emphasis is also placed on development of specific, concrete treatment recommendations, to maximize the benefit to each patient. Interns gain proficiency in all aspects of neuropsychological evaluation, including diagnostic interviewing, hypothesis generation, case conceptualization, integrative report-writing, and provision of feedback.

All training experiences in Neuropsychology Clinic are adapted to the needs of individual interns, so that the rotation can provide valuable learning experiences for those planning a career in neuropsychology, or for those with less experience in the field. After completing the VA HCS Neuropsychology Clinic rotation, interns will be able to:

• Conduct an efficient interview to aid in the differential diagnosis of neuropsychological syndromes.
• Correctly administer and score a wide variety of neuropsychological tests.
• Use a hypothesis-testing approach to select neuropsychological tests most appropriate to answering referral questions.
• Use the research literature to guide selection of assessment strategies, data interpretation, and recommendations based on patients' diagnoses, presenting complaints, and other factors.
• Modify assessment strategies, and interpret assessment data, in light of the unique needs of patients with various backgrounds.
• Write clear, concise, interpretive neuropsychological reports that integrate neuropsychological, neurological, and behavioral data, and that include specific recommendations for treatment or intervention.
• Orally present evaluation findings in a clear, effective manner to patients and their families, and consult effectively with referral sources as needed.

Location of Rotation

North Charleston VA Clinic, 6450 Rivers Ave.

Clinic Hours

VA hours are Monday through Friday, 8:00 a.m. to 4:30 p.m.

Neuropsychology Assessment Clinic — NP-MUSC

Housed in the Department of Neurology, this rotation is designed to help the intern develop clinical neuropsychological and psychopathology assessment skills useful in the practice of clinical neuropsychology in the medical center. This rotation provides interns with adult and pediatric experiences in medical neuropsychology, including experience with:

• An array of psychological, neurocognitive, and clinical interview techniques;
• Clinical assessment of primarily neurological-related diagnoses with specific diagnostic formulation and differential considerations; and
• Assessment/consultation of neurologic and neurosurgical patients.

Interns receive training in report writing and consulting with interdisciplinary patient care teams. Clinics served include a memory disorder clinic (Alzheimer and related dementia), movement disorder clinic (focusing on pre-post neurosurgical implantation of STM DBS), epilepsy movement disorder clinic (focusing on NES and pre-post neurosurgical treatment of seizures), and general neurological clinics (forensic, head injury, organ transplantation, multiple sclerosis, CNS tumors, etc.). Some pediatric experiences may be available in the areas of epilepsy and neuro-oncology.

The primary training sites for this rotation include our outpatient clinic, the neurology service of MUSC’s outpatient hospital, and to a lesser extent, the inpatient neurology service. The training focus is medical psychology and often includes the multidisciplinary model of patient care. Educational opportunities include abundant patient contact with extensive daily individual case supervision using the medical model case teaching approach, weekly neurophysiology and neuron-radiology conferences, and monthly neuropsychology seminars. Opportunities exist to watch neurological exams, Wada studies, and/or neurosurgical procedure(s) on patients being followed by this service to gain a multidisciplinary perspective. Numerous research opportunities are available and active participation by interns is strongly encouraged.

After completing rotation, psychology interns will be able to:

• Accurately administer, score, and interpret a broad array of neuropsychological tests.
• Accurately identify syndrome signs and symptoms, and integrate complementary data (such as CT/MRI/PET/EEG), to formulate a list of differential diagnoses for common neuropsychological disorders with patients presenting to an outpatient neurological clinical setting.
• Use neuropsychological tests to effectively hone the diagnostic differential to the most parsimonious diagnosis that can be confirmed or refuted with time and/or complementary studies.
• Communicate patient findings concisely and effectively in verbal and written format.
• Effectively provide neuropsychological services to poorly served populations of all types.

Location of Rotation

Medical University of South Carolina Department of Neurology

Clinic Hours

Hours are Monday, Tuesday, and Wednesday from 8:30 a.m. to 5 p.m.

Traumatic Brain Injury Services — VA HCS

Interns on this rotation will participate in three primary clinical experiences:

TBI Clinic

All Veterans of more recent military operations are screened for a variety of health conditions on their initial visit to the VA HCS. Those who screen positive for possible TBI are referred for “second level” evaluation by a physiatrist, who then refers to Neuropsychology when further assessment is needed. Common reasons for referral include subjective cognitive complaints, evidence of cognitive impairment, psychiatric symptoms, or complex differential diagnosis. Patients in TBI Clinic are seen for a single session, which typically includes a diagnostic interview, immediate feedback, psychoeducation, and recommendations for treatment. The session aims to delineate TBI severity and possible sequelae, and to differentiate the possible effects of TBI from those of other comorbid conditions, such as mood and anxiety disorders, PTSD, substance use, and chronic pain. Patients may be seen either face-to-face, or remotely by video conference.

Neuropsychological Intervention Services

Education and skills-based intervention groups, based broadly on the AgeWISE model (O’Connor, et al. 2018), are offered to individuals who either have mild cognitive impairment or who are concerned about worsening cognition with age. Interns will begin by co-leading intervention groups, and will progress until they are leading groups relatively independently. Occasionally, skills-based cognitive remediation groups, based on the evidence-supported CogSMART model, are provided for veterans with memory difficulties and other cognitive complaints arising from TBI, severe mental illness, and other conditions. Opportunities are also available for interested interns to provide highly individualized cognitive rehabilitation and/or psychotherapy to neurologically impaired patients.

Neuropsychological assessment of patients with TBI

Interns conduct neuropsychological evaluations of outpatients with histories of TBI, ranging from mild to more severe. Patients typically present with cognitive complaints, and with other co-morbid conditions that can affect cognition. A hypothesis-testing approach is utilized, in which each evaluation is tailored to the specific needs of the patient and referral source. Emphasis is placed on a comprehensive record review and synthesis of clinical data to generate conclusions and recommendations.

After completing this rotation, interns will be able to:

• Conduct efficient diagnostic interviews of patients presenting with concerns related to TBI.
• Conduct hypothesis-driven neuropsychological evaluations of patients with TBI and related conditions, including writing integrative reports with specific recommendations for treatment or intervention.
• Provide empirically supported interventions, in group or individual settings, to address cognitive and other comorbid difficulties.
• Use the available scientific literature to guide assessment, data interpretation, treatment planning, educational feedback, and interventions.
• Accurately evaluate progress over the course of individual- or group-based treatment, and adjust treatment accordingly.
• Modify assessment strategies, interpret assessment data, and implement treatment interventions in light of the unique needs of patients with various backgrounds.
• Consult effectively with Physical Medicine and Rehabilitation, Mental Health, Social Work, and other disciplines regarding assessment results and treatment planning for patients with a history of TBI.

Location of Rotation

North Charleston VA Clinic, 6450 Rivers Ave.

Clinic Hours

VA hours are Monday through Friday, 8:00 a.m. to 4:30 p.m.