The Clinical Neuropsychological Experience
By Matt Facciani
The general public frequently holds the view that students study psychology only to become therapists someday. Many psychology students do wish to become therapists, but there are many different paths one can choose in the field of psychology. I did not know what I wanted to do when I started my undergraduate career; however, after taking an introductory psychology course my first semester, I decided I wanted to become a clinical psychologist and practice psychotherapy. Now, after two knowledge-packed years of undergraduate education, my passion for psychology is strong as ever but is much more specialized than just a passion for therapy.
Many psychological theories and experiments fascinated me when I learned about them in various classes. I loved reading about Zimbardo’s Stanford Prison Experiment and Asch?s Conformity Study?I even replicated this study for my research methods class?but neurological psychology did not attract me at first. This changed when I took Learning and Memory, a course taught by my school?s neuroscience professor. The experiments discussed ranged from habituation and sensitization in the neural networks of sea snails to an fMRI showing activation of a human?s left hippocampus during a recollection task (Eichenbaum, 2008). I found these experiments to be nothing short of amazing. Learning about how I could study behavior through studying the brain took my fascination with psychology to a whole new level. Yet how could I study neuroscience and psychology without losing any substance in either subject? This is when I discovered the great synthesis of neuroscience and psychology: neuropsychology.
Neuropsychology is a relatively new field that aims to study the relationship between the brain and behavior (Swiercinsky, 2001). The typical path of becoming a clinical neuropsychologist involves a bachelor?s degree, followed by a PhD or Psy.D in clinical psychology, and then ultimately a two-year post-doctoral fellowship specializing in clinical neuropsychology. To be accepted into these competitive post-doctoral programs, you must take basic neuroscience classes in graduate school such as functional neuroanatomy (Hannay, et al. 1998). Post-doctoral programs vary significantly, depending on whether or not the neuropsychologist to be wants to do more clinical work or research. Clinical work consists of assessing many kinds of cognitive functioning, including intelligence, memory, and attention. Complete neuropsychological batteries can be very detailed and provide great insight on treatment planning. For example, if a person is injured in an automobile accident and suffers brain damage, he or she might undergo a neuropsychological examination, and the neuropsychologist would interpret the results to determine whether the person has the cognitive ability to return to work. The neuropsychologist can also suggest ways the person can maximize their cognitive strengths and compensate for their weaknesses. An immense amount of knowledge in neuroscience and psychology is required to provide the patient with proper treatment planning. Treatment may include cognitive rehabilitation, behavior management, psychotherapy, or teaching coping strategies. The neuropsychologist may provide some of this treatment themselves, depending on his or her specialization (Swiercinsky, 2001). Clinical neuropsychologists can work in a variety of settings depending on what they choose to do. Some of these may be a university if they are more interested in teaching and research, a hospital if they are interested in clinical work, or they may open up a private practice (Swiercinsky, 2001). Neuropsychology is truly fascinating, and the work neuropsychologists do can have a large impact on people?s lives.
After learning about the basics of neuropsychology I was definitely interested but how could I know if it was for me? This past summer, I was fortunate enough to find a clinical neuropsychology internship at a hospital close to where I live. This was a great opportunity to strengthen my risumi and learn if clinical neuropsychology was the path I wanted to take. The internship was nothing short of spectacular. My job consisted of learning, administering, and scoring tests of neuropsychological function. I would test cognitive functioning of patients suffering from all sorts of brain injuries, from motor vehicle accidents to strokes. The test results were interpreted by the clinical neuropsychologists on staff. Interacting with patients was great clinical experience, and I enjoyed it a lot. However, I was truly fascinated by learning how the tests measured cognitive dysfunction. For example, the Wisconsin Card Sorting Task (WCST) is like a matching game that measures problem-solving and cognitive flexibility, which are part of executive functioning. Research has shown that the frontal lobes are involved in executive function. Thus, a patient who suffered damage to his or her frontal lobes would struggle in the WCST due to executive dysfunction (Lie et al, 2005).
I was also fortunate enough to be involved in several research projects at my internship. One such project investigated the utility of subjective and objective neuropsychological tests on patients with depression, traumatic brain injury, and both depression and traumatic brain injury. This allowed me to get a great first experience in professional research on a topic that greatly interested me. This internship allowed me to explore neuropsychology and develop a new passion; I recommend such an experience to anyone interested in furthering their psychology career.
Eichenbaum, H. (2008). Learning and memory. New York, NY: W.W. Norton Company.
Hannay, H. J., Bieliauskas, L. A., Crosson, B. A., Hammeke, T. A., Hamsher, K. deS., & Koffler, S. P. (1998). Proceedings: The Houston conference on specialty education and training in clinical neuropsychology. Archives of Clinical Neuropsychology, 13(2), 157-249.
Lie, C. H., Specht, K., Marshall, J. C., & Fink, G. R. (2005). Using fMRI to decompose the neural processes underlying the Wisconsin Card Sorting Test. NeuroImage, 30(3), 1038-1049.
Swiercinsky, D. P. (2001). Intro to neuropsych. Retrieved August 7, 2009, from Brain Source Website.
Future Reading and Online Resources:
One of the best journals for neuropsychological research.
The official website of the division 40, APA?s clinical neuropsychology division.
A great source for neuropsychology information online. Provides an online forum as well.
Matt Facciani is a junior psychology major at Westminster College. He aspires to become a clinical neuropsychologist.