Feedback that Sticks: The Art of Effectively Communicating Neuropsychological Assessment Results

by Karen Spangenberg Postal , PhD., ABPP-CN, Kira Armstrong

Overview

This book is about how to give outstanding feedback to patients, their family members, and other professionals. Effective feedback sessions have the potential to help patients understand their neurocognitive syndromes in the larger context of their real world environments and in a manner that positively alters lives. As our profession has matured, feedback sessions with patients and family members have become the norm rather than the exception. Nonetheless, many senior and even mid-career neuropsychologists were never explicitly taught how to give feedback. And despite the burgeoning neuropsychological literature describing sophisticated assessment methods and neuropsychological syndromes, there has been almost no parallel literature describing techniques for communicating this information to patients and other professionals. This begs the question: how have we learned to do this extraordinary task well? And how do we effectively communicate intrinsically complex assessment results, to deliver the type of salient feedback that alters lives? It turns out, the answers are like feedback sessions themselves - varied and complex. Feedback that Sticks presents a compilation of the clinical feedback strategies of over 85 neuropsychologists from all over the country: training directors, members of tertiary medical teams, and private practitioners. It offers the reader the ability to be a fly on the wall as these seasoned neuropsychologists share feedback strategies they use with patients across the lifespan, and who present with a wide variety of neurological and developmental conditions. Like receiving the best feedback training from 85 different mentors, the book gathers the most compelling, accessible ways of explaining complex neuropsychological concepts from a broad variety of practitioners. Through this process, it offers a unique opportunity for practicing neuropsychologists to develop, broaden, and strengthen their own approaches to feedback.

Product Details

ISBN-13:	9780199395828
Publisher:	Oxford University Press
Publication date:	01/15/2013
Sold by:	Barnes & Noble
Format:	eBook
File size:	2 MB

About the Author

Dr. Postal is a board certified neuropsychologist. She is President-elect of the American Academy of Clinical Neuropsychology and past-president of the Massachusetts Neuropsychological Society, and the immediate past president of the Massachusetts Psychological Association. Dr. Postal is a lecturer at Harvard Medical school where she teachers postdoctoral fellows in neuropsychology. Her practice is dedicated to helping people think better in school, at work, and throughout later life. Dr. Armstrong is a board certified neuropsychologist currently working in private practice with an emphasis on pediatrics. Dr. Armstrong previously served as the secretary for the Massachusetts Neuropsychological Society and is currently a member of the board of directors of the American Academy of Clinical Neuropsychology.

Table of Contents

Table of Contents Contributors Prologue Part I: What is feedback, and what makes it stick? Chapter 1: Feedback that Sticks: The art of communicating neuropsychological assessment results Chapter 2: Why some feedback sticks Chapter 3: Feedback protocols and theoretical considerations Chapter 4: How is feedback presented? Part II: Chapter 5: Putting feedback to work with patients from multiple populations Developing relationships with patients and families Connecting with the patient family Creating a therapeutic atmosphere for parents and caretakers Setting the stage for feedback Explaining the testing process and goals Explaining the normal curve Acknowledging the limitations of testing Offering hope and normalizing findings Explaining memory Pearls to explain slowed/inefficient processing Explaining executive function and frontal impairment Offering recommendations and compensatory strategies Introducing compensatory strategies for memory Recommending psychotherapy Pearls to facilitate connecting with other cultures Introducing religious ideas Offering feedback to pilots General pearls for the pediatric population Parting words Chapter 6: Dementia Discussing dementia and memory loss with families and patients Mild cognitive impairment Using the "A" word - Alzheimer disease Caregiver issues Helping caregivers to understand and manage their loved one's deficits Encouraging caregivers to take care of themselves - and to share the burden among family members Addressing unawareness with patients Caregiver unawareness/denial Driving Securing services in the home and transitioning to assisted living or nursing home placement Helping patients and caregivers accept and implement compensatory strategies Visual hallucinations and Capgrass Legal issues Chapter 7: ADHD Defining attention problems Explaining the difference between can't vs. won't Executive functions Treatment issues Anxiety and ADHD Behavioral interventions / compensatory strategies Accepting the Diagnosis Explaining the diagnostic process Chapter 8: Somatoform Disorders Developing empathy as a provider Acknowledging the patient's symptoms Introducing other factors, such as role strain, that affect cognitive efficiency Discussing the meaning of normal test results while maintaining a therapeutic relationship Introducing the role of stress and emotions Introducing interventions Framing an unknowable medical issue Normalizing somatization Creating an "out" Chapter 9: Psychiatric Illness Explaining schizophrenia and other psychiatric disease Addressing resistance to feedback Coping with delusions and hallucinations Discussing treatment interventions Substance abuse Uncertain psychiatric diagnosis Chapter 10: Learning Disorders and Developmental Disability Disclosing IQ Intellectual disability (MR) Discussing the meaning of MR or Intellectual Disability Correcting misunderstandings about a child's ability level Sexuality Long term planning for severely impaired children Learning Disabilities Explaining Dyslexia and Language Disorders Using specific test performances to explain daily difficulties Using Labels Will my child be able to go to college? Accommodations Securing special education services (IEP's) The comorbidity of anxiety disorders, ADHD, and learning disorders Chapter 11: Autistic Spectrum Disorders Explaining Autism Spectrum Disorders and associated difficulties Sharing an Autism diagnosis with parents Discussing long-term expectations and prognosis Recommendations and Interventions Alternative treatments Long term planning for autistic children Issues specific to adults with Autistic spectrum disorders Chapter 12: Acquired Brain Injury: Traumatic Brain Injury and CVA Discussing prognosis and expectations for recovery Creating realistic expectations for treatment and longer-term goals Offering Hope Unawareness following acquired brain injury Return to work/ School How to encourage compensatory strategies and active rehabilitation Emotional issues with acquired brain injury recovery Explaining specific neurological, cognitive and behavioral sequelae of CVA Aphasias Explaining specific neurological, cognitive and behavioral sequelae of moderate and severe TBI Mild traumatic brain injury Athletes and MTBI Chapter 13: Neurological Disorders Cancer Genetic Disorders Sickle cell anemia Neurofibromatosis Seizures and epilepsy Nonepileptic Seizures/Pseudoseizures Epilepsy surgery Prematurity Hydrocephalus Spina Bifida Cerebral Palsy Multiple Sclerosis Hepatitis HIV Chapter 14: Addressing Effort Timing of feedback regarding suboptimal effort Addressing suboptimal effort with patients during the assessment Learning disability populations Part III: Chapter 15: Communicating assessment results with other professionals Chapter 16: Report writing and written communication Epilogue

Editorial Reviews

"How would you like to be a fly on the wall in the office of a respected neuropsychologist as he or she gives neuropsychological feedback to patients? Addressing adult and child patients with neuropsychological disorders including dementia, somatoform disorder, autism, and traumatic brain injury, among many others, Feedback that Sticks provides simulated quotes obtained from neuropsychologists during interviews about they how they would actually give feedback to their patients... This is a must-read resource for clinical neuropsychologists. It has the potential to change the way you practice."
Russell L. Adams, Ph.D., ABPP-CN, Professor, Director of Psychology Internship and Postdoctoral Programs, University of Oklahoma Health Science Center

"This very readable and interesting book is unlike any other neuropsychological assessment volume you are likely to read. I expect that most neuropsychologists give some kind of feedback to their patients: for example most will go through test findings with them; fewer, I suspect, will give information to the families; and even fewer are likely to think about the significance of providing feedback. This book should change all that. Before reading it, I had always assumed that the feedback I provided was reasonably inclusive, but the authors have taught me that there are many aspects to providing feedback that I had never considered. I learned a fair amount and will change some aspects of my professional behavior in the future." — Barbara A Wilson, The Oliver Zangwill Centre, Ely, UK, Neuropsychological Rehabilitation

From the Publisher