Collaborative Therapeutic Neuropsychological Assessment

Tad T. Gorske, Ph.D. is an assistant professor in the University of Pittsburgh School of Medicine, Department of Physical Medicine and Rehabilitation and is a licensed psychologist in Pittsburgh, Pennsylvania. His specialty areas include psychotherapy, psychological and neuropsychological testing with adults and older adults with mood, anxiety, and substance use disorders. Dr. Gorske completed his doctoral studies in Counseling Psychology at West Virginia University and postdoctoral training at Western Psychiatric Institute and Clinic in Clinical Neuropsychology and Addiction Medicine. From these experiences he developed Therapeutic Neuropsychological Assessment (TNA) with Dr. Christopher Ryan, an internationally renowned researcher in the field of neuropsychology and alcoholism. Dr. Gorske remains on faculty, studying the effects of TNA with clients. He has published in scholarly journals on topics related to addiction, neuropsychology, and counseling. Dr. Gorske is a member of the Motivational Interviewing Network of Trainers and is also active as Program and Education Board Chair for the Pennsylvania Psychological Association and the Board of Directors for the Greater Pittsburgh Psychological Association. He has presented his methods and results from a federally funded study in local and national conferences. Steven R. Smith, Ph.D. is an assistant professor in the Department of Counseling, Clinical, and School Psychology at the University of California, Santa Barbara. Dr. Smith conducts research on the integration of neuropsychology and personality assessment. He is the director of the Psychology Assessment Center at UCSB and is co-editor of two recent volumes on assessment: The Clinical Assessment of Children and Adolescents: A Clinicians Handbook (with Dr. Leonard Handler; LEA) and Personality Assessment: Evaluation, Application, and Integration (with Dr. Robert Archer; LEA). In 2005, he was presented the Beck Award by the Society for Personality Assessment for outstanding early career research. He completed his doctoral studies in clinical psychology at the University of Arkansas before internship and postdoctoral training at Massachusetts General Hospital and Harvard Medical School. After training, Dr. Smith remained on staff at MGH as a child psychotherapist and as Director of Consultation Neuropsychology before joining the faculty of UCSB in 2004.

Foreword by Stephen Finn, Center for Therapeutic Assessment I. Introduction: Overview and Background of CTNA a. This chapter will begin with brief case examples of feedback sessions conducted in a traditional manner and according to CTNA methods as a segue to an overview of CTNA as contrasted with standard practice in neuropsychological assessment, commonly referred to as the 'information gathering model.' b. The next section describes current challenges facing the field of Clinical Neuropsychology. Psychological and neuropsychological assessment have struggled in the era of managed care for a number of reasons, not the least of which include the advent of radiology methods for identifying brain lesions, consumer and provider misunderstanding of the rationale and usefulness of neuropsychological assessment, and the identity confusion many neuropsychologists face in the roles of treatment and rehabilitation planning. CTNA will be introduced as a method for meeting these challenges and helping to make neuropsychological assessment responsive to consumers, providers, and referral sources while enhancing collaboration between professions. An overview will be provided of a published survey, conducted by the editors, on neuropsychological assessment feedback practices. II. Conceptual Foundations: Brief history of neuropsychological assessment feedback a. Therapeutic Assessment Models: The historical background for using psychological testing as a collaborative and therapeutic intervention. First, a review of the early projective test studies will be described. Then the chapter will describe Constance Fischers Individualized Psychological Assessment and Stephen Finns Therapeutic Psychological Assessment. b. Lurias work: The chapter will begin with an analysis of Alexandr Rumanovich Lurias Neuropsychological Investigation and how his methodology provides aprecursor to contemporary client centered neuropsychological interventions and rehabilitation. c. Literature review: Second, a review of the empirical literature will be provided on recommendations for providing feedback from neuropsychological tests. d. Motivational Interviewing: The next generation of client centered feedback. The section will discuss the application of Motivational Interviewing methods for providing client centered feedback. This is relevant because CTNA feedback methods are based on the MI conceptual framework. e. Contemporary applications: In this section a review will be provided on the current work being conducted on CTNA methods. This will include a review of research conducted by the primary editors; the work of Dr. Diane Engelman from the Center for Collaborative Psychology and Psychiatry; Dr. John Strangs work with the Neuropsychology School Conference; and the study by Dr. Phillip Pegg on providing medical and neuropsychological information to traumatic brain injury patients. III. CTNA Model Basic Assumptions of CTNA . The patient/caregiver/referral source have noticed a change in the patients cognitive and/or behavioral functioning and would like a professional to tell them if there is a true change and to what degree, severity, and if possible potential causes. The patient/family are distressed because of the change in the patients cognitive/behavioral functioning. Part of the reason they are coming in for the evaluation is to receive help, direction, and guidance in order to feel less distressed. Patients would like to know of potential ameliorative strategies so that the patient performs better in school, work, social spheres, and begins to feel better about him/herself.