So you were referred for a neuropsychological evaluation and went to Wikipedia to find out what that was. Now you know that “Neuropsychology studies the structure and function of the brain as they relate to specific psychological processes (cognition) and behaviors”. You’ve also learned that neuropsychologists work in “clinical settings involved in assessing or treating patients with neuropsychological problems”. That’s nice but not necessarily helpful. You call your insurance company and find out that there are dozens of psychologists who do neuropsychological testing in your area. Your child is having difficulty in school and you find that the school also does psychological testing and it’s free. So now what do you do?
The truth is that any clinical psychologist who is licensed in the state or any school psychologist certified by the state, even if they are not licensed psychologists, can do psychological testing. They can also purchase tests that can be used for neuropsychological testing. “Testing,” however, is not the same as a neuropsychological evaluation. Dr. Edith Kaplan, a well-known neuropsychologist who was a former president of the International Neuropsychological Society, told a story during her presidential address. The story is that one of her mentors (who was a first generation neuropsychologist – although I don’t recall who) said to her that if she were stranded on a desert island with one of her colleagues and the only things on the island were a coconut tree, a coconut hanging from it, some sticks and sand, and while sitting under the tree the coconut fell and struck her colleague on the head, she would have all the instruments she needed to conduct an evaluation. Essentially this means that it’s not the test, it’s the tester. Anyone can give a test. Which tests you choose to give, what you need to look for, how you put the whole clinical picture together and how useful the information you give back as a result of the evaluation are what is important. That’s a lot more than a score on a test or a diagnosis you’d get from the DSM IV or V (or more commonly these days lists of diagnoses).
Neuropsychologists undergo rigorous specialized training to practice their craft. Whether in a medical setting, rehabilitation facility, clinic or private practice the work we do is “neuropsychological”. It is not a sideline to fill in empty slots in a psychotherapy schedule. It is not the administration of an IQ test, some educational tests and additional tests that sound “neuropsychological” or questionnaires. Most neuropsychologists have years of supervised experience before they begin to practice independently. Most are accustomed to working in an interdisciplinary way with physicians, therapists, schools and mental health providers.
So what’s the bottom line? While in some states the title “Clinical Neuropsychologist” is licensed and protected this is not the case in most states. It’s up to the consumer of a neuropsychological evaluation (or their parents) to ask questions so that they know the background, training and credentials of the person they’re entrusting to do an evaluation. Despite superficial appearances, not all zebras are alike. Be diligent, ask questions.