Neuropsychology and Rehabilitation Services in the United States: Brief Report from a Survey of Clinical Neuropsychologists

Archives of Clinical Neuropsychology 32 (2017) 369–374 Neuropsychology and Rehabilitation Services in the United States: Brief Report from a Survey of Clinical Neuropsychologists 1 Department of Psychiatry and Behavioral Health, Section of Neurobehavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA 2 Department of Psychology, University of Wisconsin at Milwaukee, Milwaukee, WI 53211, USA 3 Department of Psychology, National Institute of Psychiatry Ramón de la Fuente Muñiz, Distrito Federal, Mexico City, Mexico 4 Faculty of Psychology and Education, University of Deusto, Bilbao 48007, Spain 5 BioCruces Health Research Institute, Bizkaia 48903, Spain *Corresponding author at: Department of Psychiatry and Behavioral Health, Section of Neurobehavioral Health, The Ohio State University, 1670 Upham Drive, Columbus, OH 43210, USA. Tel.: 614-293-4539; E-mail address: (C. Block). Editorial decision 31 December 2016; Accepted 9 January 2017 Abstract Objective: To provide a brief presentation of preliminary data on rehabilitation services provided by clinical neuropsychologists within the United States. Method: This survey utilized data extracted from a larger international research study conducted in 39 countries including N = 173 professionals who reported to engage in neuropsychological rehabilitative services within the past year (63.6% female, 44.36 ± 11.83 years of age) took part in the study. Results: Neuropsychologists providing rehabilitation services in the United States in the past year were more likely to provide individual versus group therapy, likely to employ technology (e.g., personal computers, mobile phones/smartphones) as part of treatment services, see a range of diagnostic groups most prominently traumatic brain injury and stroke/vascular conditions, and work to address a range of both cognitive (e.g., memory, attention/concentration, and executive functioning) and psychological (e.g., emotional/behavioral adjustment and well-being, awareness of disability/disease) issues. Conclusions: Prior published surveys suggest that clinical neuropsychologists have a growing involvement in rehabilitation services within the United States but with little clarity as to the actual characteristics of actual professional activities and practices. The present study aimed to provide such information and hopefully will be helpful in promoting additional systematic studies in this area. Keywords: Rehabilitation; Professional issues Introduction A transdisciplinary collaborative approach to the conceptualization and treatment of disease and injury is integral to successful medical rehabilitation and, in many cases, eligibility for accreditation by national bodies, such as the Joint Commission and Commission on Accreditation of Rehabilitation Facilities (CARF). One of many important roles on these transdisciplinary teams is the clinical neuropsychologist (Caplan, 1982; Wilson, 2008). Neuropsychological expertise in the area of cognition is especially helpful in conceptualizing the patient’s abilities, facilitating goal-planning efforts through clinical input and comprehensive assessment findings, translating impairments into useful functional recommendations, modification of interventions, and provision of education to the patient/family and staff (Caplan, 1982; Tsaousides & Gordon, 2009; Wilson, 2008). Cognitive rehabilitation has long been a part of the array of services that clinical neuropsychologists offer (e.g., Hartlage, 1985; Seretny, Dean, Gray, & Hartlage, 1986), and nowadays rehabilitative efforts by neuropsychologists may © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: . doi:10.1093/arclin/acx002 Advance Access publication on 23 January 2017 Cady Block1,*, Octavio A. Santos2, Yvonne Flores-Medina3, Diego Fernando Rivera Camacho4, Juan Carlos Arango-Lasprilla5 370 C. Block et al. / Archives of Clinical Neuropsychology 32 (2017); 369–374 Methods Participants Participants in the present study are self-identified psychologists who worked in the field of neuropsychology from United States. This survey forms part of an international research study conducted in 39 countries from Latin America (ArangoLasprilla, Olabarrieta Landa, Rivera, Olivera Plaza, De los Reyes Aragón, & Quijano et al., 2015; Fonseca-Aguilar et al., 2015; Arango-Lasprilla, Stevens, Morlett-Paredes, Ardila, & Rivera, 2016; Fernandez, Ferreres, Morlett-Paredes, Rivera, & ArangoLasprilla, 2016), Spain (Olabarrieta-Landa et al., 2016), Nordic countries (Egeland et al., 2016), and South Africa (Truter, Mazabow, Morlett-Paredes, Rivera, & Arango-Lasprilla, Under Review). In this study participants’ data were included for analyses if they: reported living within the United States, reported having completed at least a bachelor’s degree, identified as a neuropsychologist, and reported being engaged in professional activities related to neuropsychology (i.e., assessment, diagnosis, treatment, teaching, or research) over the past year. All participants were required to complete the relevant sociodemographic questions included in this participant section below. A total of 456 individuals began the survey. Of these, two reported not considering themselves to be a neuropsychologist or not performing Table 1. Sociodemographic characteristics Frequency (%) General sample N = 418 Gender Male Female Maximum level of education Bachelor Master Doctorate Post-doctorate Age (Years) Rehabilitation sample n = 173a 168 (40.2%) 250 (59.8%) 63 (36.4%) 110 (63.6%) 2 (0.5%) 12 (2.9%) 145 (34.7%) 259 (62%) 44.67 (12.28) 0 (0.0%) 5 (2.9%) 57 (32.9%) 111 (64.2%) 44.36 (11.83) Note: aOnly 173 of 418 participants endorsed conducting neuropsychological rehabilitation within the past year. also be conducted outside of the typical inpatient setting, as smartphone and touchscreen technologies are increasingly utilized for treatment and compensation for cognitive impairments (Wilson, 2008). To the best knowledge of the authors, there are no published findings with a purpose limited to solely outlining rehabilitative practices specific to clinical neuropsychology in the United States. However, there are some American data available for comparison. A recent salary survey of N = 1,777 United States neuropsychologists (Sweet, Benson, Nelson, & Moberg, 2015) did include data from n = 151 respondents who identified as working within a rehabilitation setting, roughly 10% of the total sample. These individuals reported that they were more likely to work with adults only (13.6% reported working with adult-only vs. 6.4% pediatric-only), and make on average less than their doctoral-level professionals in neuroscience (in thousands, 140.3 vs. 122.8), or doctoral-level medical (i.e., neurosurgery = 161.1 and neurology = 127.9) settings. Another survey of N = 1,406 neuropsychologists in the United States (Sweet, Peck, Abramowitz, & Etzweiler, 20 (...truncated)