Working in clincal neuropsychology
By Wendy Longley
Looking back, the laboratory work required by my Masters degree in Neurobiology did not suit me at all - the research was interesting but I was far too extroverted for such confined and often solitary work. Fortunately I stumbled across a clinical neuropsychologist who allowed me to sit in on a few of his adult assessments. I was hooked! I finished off my Masters, took off to Melbourne and enrolled in another Masters, this time in clinical neuropsychology.
After graduating I worked as a research assistant in a clinical research trial, which I can definitely recommend. I enjoyed two years conducting assessments with elderly people to try to establish whether or not they met the criteria for Alzheimer's disease.
I then moved to more regular work as a clinical neuropsychologist, mostly involving more direct contact with patients and allied health colleagues on the neurology wards. I gained great pleasure from the challenge and intensity of working with patients who had dementia, head injury, neurological illnesses such as Parkinson's disease, psychiatric illnesses, and those with unexplained cognitive decline.
Fourteen years after I started work at the Multiple Sclerosis (MS) Society of New South Wales, I still love it. I work mainly within the rehabilitation team and particularly enjoy the close contact with our clients, finding out how their cognitive changes are impacting on the other aspects of their life, and whether my interventions have been helpful.
At one end of the spectrum I conduct assessments for people who are having a few mild cognitive problems at work and need help to manage these problems themselves. The other end involves people who have a type of MS-related dementia, which affects about 10 per cent of people with the disease.
When not conducting assessments and feedback sessions and writing reports, I attend rehabilitation team meetings, coordinate clinical research projects of my non-psychologist colleagues or conduct my own research. I also develop educational presentations for people with MS and healthcare workers or get involved with professional development workshops with neuro or clinical psychology colleagues.
A neuropsychologist can become involved in an infinite number of projects. At Concord Hospital, I set up a Neurology Interest Group for allied health professionals, to help improve cross-disciplinary communication and understanding of roles in patient care. Then in 2002 I established a Neuropsychology Rehabilitation Interest Group, with about 70 members. We discuss issues such as the ecological validity of neuropsychological testing, and plan to explore further best practices for memory management techniques.
I feel very strongly that our scientific evaluation skills set us apart from most non-psychology trained professional colleagues. We know how to go about answering clinical questions, and how to read scientific articles. We can evaluate ‘best practice' and work out whether the claims are justified by the data or (as is often the case!) not. Probably the most useful aspect of psychology that I learned was how to critically analyse the evidence for, or against, a theory about behaviour or brain functioning. These are fabulous skills to have.
I benefited enormously from working alongside some very competent clinical psychologists, who introduced me to the wonders of ‘learning theory', and cognitive behaviour therapy, and gave me an understanding of the biological basis of personality. This, along with my neuropsychology knowledge, has enabled me to understand some of the exceedingly odd behaviours I have witnessed over the years - and not just among my own colleagues and family members!
Different personalities suit different roles and life is too short to work in an area where you may be doing good, but at the cost of your own happiness. Explore all your options, especially in the first few years of ‘practice' as a psychologist until you find one that you are good at, and which makes you happy.
Psychologists are, on the whole, appalling self-promoters. Our modesty can let other professions (for example medical practitioners, psychiatrists, speech therapists and occupational therapists) take over aspects of our core work. We often bring more relevant, efficient skills, even if they sometimes come with a more expensive price tag, so this is better economics in the long run. We must show the world what we can do, and lead loudly, by example!