The Adult Neuropsychology Program is a joint endeavor of the psychiatry and neurology departments. The interns are provided with experiential training in the neuropsychological examination and evaluation of
patients with a) actual and suspected neurological diseases and
disorders, b) psychiatric disorders, and c) general medical patients
with neurobehavioral disorders. Interns participate in clinical
activities with neurologists and neurosurgeons. They provide direct
consultation to patients involving neuropsychological issues, as well as to referring and treating professionals. Referrals to the program come primarily from the Memory Disorders Clinic and from the Neurology Service, in particular, the Behavioral Neurology Unit and the Arizona Comprehensive Epilepsy Program, but services are also provided to the Psychiatry Department, Neurosurgery Department, and other inpatient units and outpatient clinics throughout the medical center. In addition, the program accepts out side referrals.
During the rotation, the intern will attend the weekly staffing meeting for the Memory Disorders Clinic (Mondays, 8:00-9:30 am). Experience in the Memory Disorders Clinic offers in-depth exposure to diagnostic evaluation and treatment issues particularly relevant to the later stages of life. These encompass the need for awareness of the interplay between medical, neurologic, and psychiatric disorders and medications in the clinical presentation and management of elderly patients; the ability to identify and distinguish affective and organic disorders; an appreciation of the availability and limitations of biopsychosocial resources in the care of the elderly; approaches to legal, ethical, economic, and intergenerational issues in geriatric psychology; and the development of critical skills in reading and preparing clinical and research literature in this field.
The intern also attends and presents at the twice-monthly meeting of the Comprehensive Epilepsy Program. The intern attends the intracarotid amobarbital procedure and is encouraged to attend brain cuttings and watch a temporal lobectomy.
Requirements of the Rotation: The intern will be responsible for administration of two comprehensive batteries of neuropsychological tests weekly. The intern will begin assessing patients with tests chosen by the neuropsychologist. As the intern becomes more accomplished with the administration and interpretation of neuropsychological measures, he or she may choose alternate measures tailored to answer a specific referral question. It is expected that neuropsychological data will be evaluated both qualitatively and quantitatively. The intern will be responsible for the written Neuropsychological Evaluation report for each of the assessments performed. A draft of the report is submitted to the supervisor within one week following completion of testing.
Faculty:
Geoffrey L. Ahern, M.D., Ph.D.
Anne M. Herring, Ph.D., ABPP(CN)
Alfred W. Kaszniak, Ph.D., ABPP(CN)
This rotation consists of two primary activities: Organ Transplant Clinic and Insomnia Clinic
Organ Transplant Clinic
The psychological assessment/neuropsychological screening of the transplant candidate serves two primary functions. First, there is a limited number of donor organs available, and each transplantation consumes large amounts of human and financial resources. Transplant centers seek to select recipients with those psychological characteristics that will facilitate recovery and enhance postoperative quality of life. Second, the preoperative psychological assessment can reveal thoughts, feelings, and patterns of behavior that may not be sufficiently pathological to exclude the candidate from receiving an organ, but which could complicate the postoperative course. In addition, it is not uncommon for individuals needing liver or heart transplant to experience cognitive difficulties. Documentation of the presence of attention or memory difficulties is important so that interventions can be made to maximize the patient's post-transplant recovery. Findings from the assessment can suggest pre operative interventions or improve the efficacy of postoperative ones by providing the healthcare providers with an appreciation of the nuances of the transplant recipient's personality and cognitive functions.
Purpose: Familiarize psychology interns with the clinical assessment of the transplant candidate (heart, lung, kidney, liver). Interns are also involved in the evaluation of persons desiring to donate an organ (kidney and possibly liver).
The rotation is a four-month assignment. The intern attends the weekly patient selection meetings for the kidney and liver transplant services and the weekly staffing for the heart/lung transplant service. The intern evaluates patients referred by the transplant teams and reports these findings at the multidisciplinary team meetings. A draft report is submitted to the supervisor within three days following the evaluation. The intern provides short-term treatment to transplant candidate or family when indicated.
Insomnia Clinic
Purpose: Familiarize psychology interns with the diagnosis and treatment of sleep disorders and their relationship to psychiatric and physical disorders. Although the major focus will be on the diagnosis and treatment of insomnia, interns will learn to identify sleep disorders such as sleep apnea, periodic movements during sleep, REM behavior disorder, narcolepsy, and parasomnias for possible referral or treatment.
Description: The rotation will include a four-month, part-time assignment to the Insomnia Clinic (every other Friday at 12:30 pm in 7-OPC) which provides assessment, consultation, and treatment services. The intern will attend the weekly staffing and group supervision meetings, complete one to two new sleep disorder evaluations a week, and provide short-term treatment. The intern will also attend the twice-monthly Sleep Disorder Center case conferences (first and third Tuesdays at 5:00 pm) and attend one of Dr. Quan's and one of Dr. Bamford's sleep disorders clinics during the rotation.
As part of the initial intake process, all patients receive psychological assessment. A referral for a polysomnogram in the Sleep Lab is made for patients for whom physiological and psychological sleep disorders are suspected. Treatment modalities carried out as part of the Insomnia Clinic include stress coping techniques, cognitive-behavioral therapy, and educational and supportive treatments for families. Patients may require a medication review and referral for evaluation and treatment of psychiatric and physical disorders.
Faculty:
Richard R. Bootzin, Ph.D.
Anne M. Herring, Ph.D., ABPP(CN)
Psychopathology Treatment and Neuropsychology in the Community
Psychopathology Treatment
Purpose: Provide psychology interns with experience administering a manualized CBT group for patients with comorbid anxiety and depression. Interns will also have the opportunity to develop their diagnostic skills by administering semi-structured psychiatric interviews for depression and PTSD.
Description: The rotation will include a four-month, part-time assignment to provide assessment and intervention services for adults with severe mental illness. The intern will receive specialty training in CBT for comorbid anxiety and depression and serve as a co-therapist for a 12-week, 2-hour CBT group. As one of the therapists, the intern will participate in the group screening and outcome evaluation process, which will include administration of structured clinical interview assessments. The intern will attend weekly, individual supervision meetings and weekly CBT teaching seminars.
Neuropsychology in the Community
The intern will spend 1½ days at Southwest Neuropsychology Associates, a private group practice. The patient population includes children, adolescents and adults, inpatients and outpatients. The intern will administer neuropsychological tests, score and generate reports of neuropsychological evaluation. Sites include the offices at 2650 N. Wyatt Drive and 1921 W. Hospital Drive.
Weekly commitments for the Psychopathology and Neuropsychology in the Community rotation: Two half days per week with the Psychopathology Research Project (Dr. Haynes). These assignments are currently scheduled for Monday afternoons and Tuesday mornings.
A full day and a half day at Southwest Neuropsychology Associates. These are currently Thursday and Wednesday morning.
A half day in the Insomnia Clinic, currently Friday afternoons. This clinic will not be open from August 26 through October 24.
Faculty:
Shannah L. Biggan, Ph.D., ABPP(CN)
Jill T. Caffrey, Ph.D.
Patricia Haynes, Ph.D.
Lauri M. Yablick, Ph.D.
In addition to fulfilling responsibilities of their primary rotations
throughout the year, the intern serves as the primary therapist for
several outpatient psychotherapy cases. The cases will be assigned by the Director of the Psychiatry Outpatient Clinic in consultation with the Director of Psychology Training and the psychotherapy supervisors. Medication coverage will be provided by a psychiatry resident assigned to the case when indicated. Although some of the cases may be seen for the entire year, brief psychotherapy is also encouraged; therefore, the interns will most likely be exposed to more than four cases during the internship year. Patients present with complaints of mood, anxiety, or personality disorders.
Supervision by a clinical psychologist will occur on a weekly basis.
Faculty:
Patricia L. Haynes, Ph.D.
Barbara Pritchard, Ph.D.
Robert G. Rhode, Ph.D.
Meg St. John, Ph.D.
Daniel E. Shapiro, Ph.D.
