UK Neuropsychologist: How to become one.

In the United kingdom clinical neuropsychologists must complete many years of training. Often early within education carefully selected A-levels and good grades provide an appropriate start point. The future clinical neuropsychologists will then complete a BPS accredited degree in psychology, this is normally a bachelor of science. Following the completion of the psychology degree with first of upper second grading, few will be lucky enough to secure  a number of years working within the field of psychology. Often this will be as an assistant psychologist or similarly responsible reseracher and clinician. In a competitive market the best  candidates at this stage will be selected to conduct their three-year doctoral degree in clinical psychology. This involves an integration of academic and clinical experiences and placements within the NHS. Once the trainee clinical psychologist completes their doctoral training they often begin a clinical career within the field of neuropsychology. Often potential clinical neuropsychologists will work a number of years as a clinical psychologist gaining further experience and knowledge and will then embark in a two-year postdoctoral diploma in clinical neuropsychology. This training is provided by only three institutions, including Bristol University, UCL and Glasgow University. Once the potential clinical neuropsychologist has satisfactorily completed this training day they then choose whether to enter the specialist register for clinical neuropsychologists by submitting payments, case studies and completing a viva.Those that do can use the title of clinical neuropsychologist.

CBT for TBI

A useful paper discussing the adaptions making CBT interventions efficacious for traumatic brain injury.
http://www.psychology.org.au/publications/inpsych/2012/april/wong/

Challenging Behaviour following headinjury

Headway have made publicly available a concise guide of challenging behaviour following acquired brain injury:
http://www.headway.ie/download/pdf/15_behaviour.pdf

Expert psychologist: Exploring quality

Research at the University of Central Lancashire has now been made available online detailing the wide variation in quality of expert psychologist reports. According to the research: "Results indicated wide variability in report quality with evidence of unqualified experts being instructed to provide psychological opinion. One fifth of instructed psychologists were not deemed qualified on the basis of their submitted Curriculum Vitae, even on the most basic of applied criteria. Only around one tenth of instructed experts maintained clinical practice external to the provision of expert witness work. Two thirds of the reports reviewed were rated as „poor‟ or „very poor‟, with one third between good and excellent (Ireland, Pinschoff and Trainor, 2012)". The full report, as a pdf, can be found at: http://www.uclan.ac.uk/news/files/FINALVERSIONFEB2012.pdf

The Bell Curve and Standarised Scores

In order to assert clinical opinion toward a patients raw data test results from varying sources should be assimilated into a common metric (standardisation). Percentiles tell us the rarity or abnormality of an individual's score. They are easily understandable and communicable but are not linear and so the difference between the 10-20th percentile in comparison to the 20-30th percentile is not necessarily the same. Z scores on the other hand, are linear transformations. They indicate with positive and negative values how many standard deviations a score is away from its mean. However, working in negative can present communication problems and z scores tend to get lost in translation when communicating with non-neuropsychologists. A common alternative is to use T scores (mean=50, SD=10) which offers a balanced level of incrementation. Others prefer index scales (mean 100, SD 15) which are often received with familiarity as they are used in the measurement if IQ. However, the fact that they are used in IQ can bring unwanted misconception when communicating interpretation and opinion.

Executive Function Brief Conceptualisation

Executive function is sometimes thought of as the functional equivalent of the frontal lobes. In 1982 Cummings proposed a fronto-straital circuits account of executive functioning and how it relates to structural circuits between the straitum located subcortically as part of the input to the basal ganglia, and the frontal lobes. In terms of executive function three specific areas are important within the fronto-straital circuits: the dorsolateral prefrontal cortex, which is typically concerned with tradional executive functions of planning, organisation and regulation. The orbitofrontal cortex (behind the orbits of the eye sockets) is more concenred with inhibition and decision making and social cogntion. Whilst the anterior cingulate is concerned with motivation. Dr Simon Gerhand of Bristol's Frenchay Brain Injury Rehabilitation Centre, practically summarises executive tests into the following: Executive function test types. Generativety: verbal fluency, design fluency. These are probably the only executive tests which lateralise. Planning: Tower test, zoo map test, Key search test, SET. Judgement: cognitive estimates, 20 questions, temporal judgement. Inhibition: Stroop, Hayling. Mental flexibility: Trails, Brixton, rule shift, WCST. Social-emotional: Baron Cohen E-Q and faux pas (not standardised) A way of remembering these dichotomies is: 'GP Jim's' model of executive function tests.