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

ISBN : 9780199765690

Karen Postal; Kira S. Armstrong
336 ページ
163 x 241 mm

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.


Table of Contents
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: Putting Feedback to Work
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
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: Attention Deficit Hyperactivity Disorder
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
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?
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
Explaining specific neurological, cognitive and behavioral sequelae of moderate and severe TBI
Mild traumatic brain injury
Athletes and MTBI
Chapter 13: Neurological Disorders
Genetic Disorders
Sickle cell anemia
Seizures and epilepsy
Nonepileptic Seizures/Pseudoseizures
Epilepsy surgery
Spina Bifida
Cerebral Palsy
Multiple Sclerosis
Chapter 14: Addressing Effort
Timing of feedback regarding suboptimal effort
Addressing suboptimal effort with patients during the assessment
Learning disability populations
Part III: Communcation Beyond the Feedback Session
Chapter 15: Communicating assessment results with other professionals
Chapter 16: Report writing and written communication
Author Index
Subject Index


Karen Postal is a board certified neuropsychologist. She is the president of the Massachusetts Neuropsychological Society, the immediate past president of the Massachusetts Psychological Association, and a member of the board of directors of the American Academy of Clinical Neuropsychology. Kira 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.