Neuropsychology Track (155213)

The Neuropsychology Track offers a variety of training experiences for interns specializing in neuropsychology, though interns with no 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 Guidelines and the Society for Clinical Neuropsychology (APA Division 40), including six months of specific neuropsychology experiences, and multiple track-specific seminars and case conferences. Research interests of neuropsychology faculty are listed here (PDF).

Neuropsychology Clinic — VA Medical Center (NP-VA)

The Neuropsychology Clinic provides neuropsychological evaluation services throughout the VAMC. Referrals come primarily from various outpatient services, including Neurology, Mental Health, Primary Care, Physical Medicine and Rehabilitation, Geriatric Medicine, Infectious Diseases Clinic, and others. The clinic serves adults with a range of diagnoses, including traumatic brain injury, cerebrovascular illness, neurodegenerative and other neurological diseases, seizure disorders, chronic substance use disorders, other psychiatric conditions, and attention-deficit/hyperactivity disorder.

All interns in the Neuropsychology Clinic conduct outpatient neuropsychological evaluations. 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 (1) interpretation and integration of historical, observational, and qualitative data, as well as quantitative test data; and (2) development of specific, concrete treatment recommendations to maximize the benefit to each patient.

Interns on this rotation also participate in the Memory Disorders Clinic, a weekly, interdisciplinary clinic based in the Neurology Service for evaluation of older adults. Patients seen in this clinic include those with Alzheimer’s disease, vascular neurocognitive disorders, mild cognitive impairment, frontotemporal dementia, late-life depression, and other conditions. In addition to conducting brief evaluations, interns attend monthly, interdisciplinary team meetings in which the neurological, neuropsychological, and neuroimaging data are reviewed, consensus diagnoses are assigned, and recommendations are formulated. Interns also gain experience in providing feedback of examination results to patients and their families in an interdisciplinary team setting.

As the clinic has adapted to conditions imposed by the COVID-19 pandemic, patients may be seen for virtual visits, face-to-face visits, or both. For example, a patient might be seen remotely via videoconference for a clinical interview, and later for a face-to-face appointment for formal testing. For other patients, a limited amount of remote testing may be appropriate. These adaptations help to minimize patients’ risk of exposure to COVID-19, but also increase access to neuropsychological services for patients who live far away.

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 little or no prior experience in the field. Interns attend the monthly Neuropsychology Seminar Series, a forum for research presentations, clinical case conferences, and other topics of interest. There is also a monthly Neuropsychology Peer Consultation, for informal case presentations and discussion of professional issues in a relaxed setting. Finally, numerous research opportunities are available in the Neuropsychology Clinic. The Charleston Consortium is a member of the Association for Internship Training in Clinical Neuropsychology.

After completing the VAMC 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.
  • Write clear, concise, interpretive neuropsychological reports that integrate neuropsychological, neurological, and behavioral data, and that include specific intervention recommendations.
  • Orally present evaluation findings in a clear, effective manner to patients and their families, and consult effectively with referral sources and interdisciplinary treatment teams.
 

Location of Rotation

Ralph H. Johnson VA Medical Center

Clinic Hours

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

Faculty

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 underserved populations, including racial/ethnic/aged minorities and/or economic disadvantaged.

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.

Faculty

Mark T. Wagner, Ph.D.
Professor

Traumatic Brain Injury Services — VA Medical Center (TBI)

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

TBI Clinic

All veterans of recent military operations (e.g., OIF, OEF, OND) are screened for a variety of behavioral health problems on their initial visit to the VAMC. Those who screen positive for possible TBI are referred for “second level” evaluation in the TBI Clinic. Patients there are first examined by a physiatrist, who consults Neuropsychology when further evaluation is needed -- e.g., for cognitive complaints, evidence of cognitive impairment, psychiatric symptoms, or complex differential diagnosis. After consulting with the physiatrist, the neuropsychologist or intern sees the patient 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 effects of possible TBI from those of other conditions (e.g., mood or anxiety disorders, PTSD, substance use). In adapting to the conditions imposed by the COVID-19 pandemic, patients may be seen either remotely by videoconference, or face-to-face. The ability to see patients remotely also helps to improve access for patients who may have difficulty traveling to the VAMC.

Neuropsychological Intervention Services

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. More commonly education and skills-based intervention groups, based broadly on the AgeWISE (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. When possible, these groups are offered in face-to-face format. However, under current conditions imposed by the COVID-19 pandemic, groups are conducted virtually, via web-based tele-health platforms. The ability to conduct groups remotely provides interns with unique training experience and improves access for patients. 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 participate in all aspects of neuropsychological evaluations of outpatients with histories of TBI, 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.
  • Collaborate and consult effectively with Physical Medicine and Rehabilitation, Psychiatry, Social Work, and other disciplines, sharing assessment and treatment planning for patients with a history of TBI.
  • Effectively provide empirically supported interventions, in group and/or individual settings, to address cognitive and other comorbid difficulties.
  • Conduct hypothesis-driven neuropsychological evaluations of patients with TBI.
  • Recognize and sensitively address cultural, racial/ethnic, educational, and other factors in the provision of assessment and intervention services.
  • 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 and interdisciplinary treatment teams.

Location of Rotation

Ralph H. Johnson VA Medical Center

Clinic Hours

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

Faculty