https://global.oup.com/academic/covers/pop-up/9780199765690

Feedback that Sticks

The Art of Effectively Communicating Neuropsychological Assessment Results

Karen Spangenberg Postal,, PhD., ABPP-CN and Kira Armstrong

· This is the first book devoted to art of providing feedback in the science of neuropsychology
· Feedback that Sticks is organized around "pearls": the quotes, metaphors, and user-friendly explanations that seasoned clinicians use to convey complicated information to their patients.
· Reading the best feedback training from 85 different, seasoned mentors, clinicians can learn most compelling, accessible ways of explaining complex neuropsychological concepts from a broad variety of practitioners.
· The book also addresses feedback to other professionals, as well as a brief overview of concepts and considerations for writing neuropsychological reports.

Feedback that Sticks

The Art of Effectively Communicating Neuropsychological Assessment Results

Karen Spangenberg Postal,, PhD., ABPP-CN and Kira Armstrong

Description

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.

Feedback that Sticks

The Art of Effectively Communicating Neuropsychological Assessment Results

Karen Spangenberg Postal,, PhD., ABPP-CN and Kira Armstrong

Table of Contents
Contributors

Prologue

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:

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
Driving
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: ADHD

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
Sexuality
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?
Accommodations
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
Aphasias
Explaining specific neurological, cognitive and behavioral sequelae of moderate and severe TBI
Mild traumatic brain injury
Athletes and MTBI

Chapter 13: Neurological Disorders
Cancer
Genetic Disorders
Sickle cell anemia
Neurofibromatosis
Seizures and epilepsy
Nonepileptic Seizures/Pseudoseizures
Epilepsy surgery
Prematurity
Hydrocephalus
Spina Bifida
Cerebral Palsy
Multiple Sclerosis
Hepatitis
HIV

Chapter 14: Addressing Effort

Timing of feedback regarding suboptimal effort
Addressing suboptimal effort with patients during the assessment
Learning disability populations

Part III:

Chapter 15: Communicating assessment results with other professionals

Chapter 16: Report writing and written communication

Epilogue

Feedback that Sticks

The Art of Effectively Communicating Neuropsychological Assessment Results

Karen Spangenberg Postal,, PhD., ABPP-CN and Kira Armstrong

Author Information

Dr. Postal is a board certified neuropsychologist. She is President-elect of the American Academy of Clinical Neuropsychology and past-president of the Massachusetts Neuropsychological Society, and the immediate past president of the Massachusetts Psychological Association. Dr. 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.

Contributors:

Mark T. Barisa, Ph.D., ABPP/CN
Director of Neuropsychology Services Baylor Institute for Rehabilitation, Dallas, Texas

William B. Barr, Ph.D., ABPP/CN
Departments of Neurology & Psychiatry
New York University School of Medicine

John T. Beetar, PhD, ABPP/CN
Kennedy Krieger Institute
Johns Hopkins University School of Medicine
Baltimore, Maryland

Erin D. Bigler, Ph.D., ABPP/CN
Professor of Psychology and Neuroscience
Brigham Young University

Robert M. Bilder, Ph.D., ABPP/CN

Michael E. Tennenbaum Family Professor of Psychiatry and Biobehavioral Sciences,
David Geffen School of Medicine at UCLA
Professor of Psychology,
UCLA College of Letters & Science
Chief of Medical Psychology-Neuropsychology,
Semel Institute for Neuroscience and Human Behavior, and
Stewart & Lynda Resnick Neuropsychiatric Hospital

Julie Bobholtz, Ph.D., ABPP/CN
Associate Clinical Professor
Department of Neurology
Medical College of Wisconsin

Thomas Boll, Ph.D., ABPP/CN
Director
Neuropsychology Institute
Birmingham, Alabama

Mark W. Bondi, Ph.D., ABPP/CN
Professor of Psychiatry
University of California San Diego School of Medicine
Director, Neuropsychological Assessment Unit
VA San Diego Healthcare System

Katrina Boyer, Ph.D.
Director, Neuropsychology of Epilepsy Program
Division of Epilepsy and Clinical Neurophysiology
Children's hospital Boston

Anne Bradley, Ph.D.
Roger C. Peace Rehabilitation Hospital

Dominic A. Carone, Ph.D., ABPP/CN
SUNY Upstate Medical University

Gordon J. Chelune, Ph.D., ABPP/CN
Head, Section of Clinical Neuropsychology
Professor, Department of Neurology
Center for Alzheimer Care, Imaging & Research
University of Utah

Roger Cohen, Ph.D.
Independent Practice
Boston, Massachusetts

Jeff Cory, Ph.D.
Independent Practice,
Bozeman, Montana
Adjunct Professor, WWAMI Medical Program, Montana State University and
University of Washington School of Medicine

Paul L. Craig, Ph.D., ABPP/CN
Independent Practice Anchorage, Alaska
Clinical Professor WWAMI Program
Department of Psychiatry and Behavioral Sciences
University of Washington School of Medicine

C. Munro Cullum, Ph.D., ABPP/CN
Professor of Psychiatry
Professor of Neurology and Neurotherapeutics
Pam Blumenthal Distinguished Professor of Clinical Psychology
Director, Neuropsychology
The University of Texas Southwestern Medical Center at Dallas

Robert L. Denney, Psy.D., ABPP/CN, ABFP
School of Professional Psychology at the Forrest Institute and
The U.S. Medical Center for Federal Prisoners

Jacobus Donders, Ph.D., ABPP/CN
Chief Psychologist
Mary Free Bed Rehabilitation Hospital
Grand Rapids, MI

Deborah Fein, Ph.D.
University of Connecticut Board of Trustees Distinguished Professor
Department of Psychology
Department of Pediatrics
University of Connecticut

Tanis J. Ferman, Ph.D., ABPP/CN
The University of Texas Southwestern Medical Center at Dallas

Judith M. Glasser, Ph.D.
Independent Practice Silver Spring, Maryland

Ketty Patiño González, Ph.D.
Independent Practice
Coral Gables, Florida

Gail M. Grodzinsky, Ph.D., ABPP/CN
Staff Neuropsychologist, Department of Psychiatry
Children's Hospital Boston
Independent Practice, Lexington, MA

Christopher Grote, Ph.D., ABPP/CN
Professor, Associate Chair, Director of Neuropsychology
Department of Behavioral Sciences
Rush University Medical Center

Steven C. Guy, Ph.D.
Pediatric Neuropsychologist
Columbus, Ohio

James B. Hale, Ph.D., ABPdN
Associate Professor of Clinical Neuropsychology
University of Victoria

Robin Hanks, Ph.D., ABPP-CN
Chief of Rehabilitation Psychology and Neuropsychology
Director of Training in Clinical Neuropsychology
Wayne State University Physician Group and Rehabilitation Institute of Michigan
Associate Professor, Wayne State University School of Medicine

Robert L. Heilbronner
Independent Practice
The Chicago Neuropsychology Group
Chicago, Illinois

Winifred Hentschel, Ed.D.
Independent Practice
Cambridge, Massachusetts

Robin C. Hilsabeck, Ph.D., ABPP/CN Associate Professor Department of Psychiatry
University of Texas Health Science Center at San Antonio

Steve Hughes, Ph.D., ABPdN
Independent Practice St. Paul, Minnesota

James W. Irby, Jr., Ph.D., ABPP/CN
Clinical Neuropsychologist
Methodist Rehabilitation Center Jackson, Mississippi

Jennifer Janusz, Psy.D., ABPP/CN
Children's Hospital Colorado Assistant Professor of Pediatrics
University of Colorado Denver School of Medicine

Laura Janzen, Ph.D., ABPP/CN
The Hospital for Sick Children
Toronto, Ontario
Canada

Michael Joschko, Ph.D.
Senior Psychologist ?
Queen Alexandra Centre for Children's Health ?
Victoria, British Columbia

Paul Kaufmann, JD, Ph.D., ABPP/CN
University of Oregon

Julie Keaveney, Psy.D.
Independent Practice
Pennsylvania and Delaware

John W. Kirk, Psy.D., ABPP/CN
Children's Hospital Colorado

Michael W. Kirkwood, Ph.D., ABPP/CN Department of Physical Medicine and Rehabilitation
Children's Hospital Colorado
University of Colorado School of Medicine

Cynthia S. Kubu, Ph.D., ABPP/CN
Center for Neurological Restoration
Cleveland Clinic

Greg J. Lamberty, Ph.D., ABPP/CN
Rehabilitation/ EC&R Psychology Supervisor
Clinical Neuropsychology Postdoctoral Fellowship
Minneapolis VA Health Care System

Gregory P. Lee, Ph.D., ABPP/CN
Department of Neurology
Medical College of Georgia
Georgia Health Sciences University

Cynthia Levinson, Ph.D.
Independent Practice, Braintree, Massachusetts

Muriel D. Lezak, Ph.D.
Emeritus Professor of Neurology
Oregon Health Sciences University

John A. Lucas, Ph.D., ABPP/CN
Professor of Psychology,
Chair Division of Psychology
Mayo Clinic

William S. MacAllister, Ph.D., ABPP/CN
New York University - School of Medicine
Department of Neurology
Comprehensive Epilepsy Center

Karin JM McCoy, Ph.D., ABPP/CN South Texas Veterans Health Care System and University of Texas Health Science Center at San Antonio.
E. Mark Mahone, Ph.D., ABPP/CN
Director of Neuropsychology,
Kennedy Krieger Institute
Associate Professor of Psychiatry and Behavioral Sciences
Johns Hopkins School of Medicine

Robb Mapou, Ph.D., ABPP/CN
Independent Practice
The Stixrud Group
Silver Spring, Maryland

Bernice A. Marcopulos, Ph.D., ABPP/CN
Associate Professor
Department of Graduate Psychology
James Madison University

Michael McCrea, Ph.D., ABPP/CN
Professor & Director of Brain Injury Research
Departments of Neurosurgery and Neurology
Medical College of Wisconsin

Susan McPherson, Ph.D., ABPP/CN, LP
Associate Professor of Neurology
University of Minnesota School of Medicine
Private Practice, Edina, Minnesota

Monica Rivera Mindt, Ph.D.
Associate Professor Department of Psychology
Fordham University

Joel E. Morgan, Ph.D., ABPP-CN
Independent Practice
Madison, NJ and
Department of Neurology
New Jersey Medical School

Richard Naugle, Ph.D., ABPP/CN
Head, Neuropsychology Section Neurological Institute
Cleveland Clinic

Aaron Nelson, Ph.D., ABPP/CN
Chief of Psychology and Behavioral Neurology
Brigham and Women's Hospital
Assistant Professor, Harvard Medical School

Christopher Nicholls, Ph.D.
Independent Practice,
Scottsdale, Arizona

Marc A. Norman, Ph.D., ABPP/CN
Professor, Department of Psychiatry
Director of the Neuropsychiatry/ Epilepsy Clinical Evaluation Program
University of California, San Diego

Margaret O'Connor, Ph.D., ABPP/CN Director of Neuropsychology, Dept of Neurology, Beth Israel Deaconess Medical Center
Associate Professor of Neurology
Harvard Medical School

Keith Owen Yeates, Ph.D., ABPP/CN
Department of Pediatrics, The Ohio State University
Department of Psychology, Nationwide Children's Hospital

Edward A. "Ted" Peck III, PhD., ABPP/CN
Independent Practice Richmond, Virginia

Jennifer Turek Queally, PhD
Children's Hospital
Boston, Massachusetts

Christopher Randolph, Ph.D., ABPP/CN Clinical Professor of Neurology,
Director Neuropsychology Service
Loyola University Medical Center

John J. Randolph, Ph.D., ABPP/CN
Independent Practice, Lebanon, New Hampshire

Lisa Riemenschneider, Psy.D.
Delnor/ Central DuPage Hospital

Joseph H. Ricker, Ph.D., ABPP/CN, RP
Department of Physical Medicine and Rehabilitation
University of Pittsburgh School of Medicine

Joel Rosenbaum, Ph.D.
Independent Practice
Boston, Massachusetts

Beth Rush, Ph.D., ABPP/CN, RP
Mayo Clinic, Florida

Laurie M. Ryan, Ph.D.
National Institutes of Health*

Michael P. Santa Maria
DeGraff Hospital

Jim Scott, Ph.D., ABPP/CN
Professor, OUHSC College of Medicine Clinical Neuropsychologist, Department of Psychiatry and Behavioral Sciences

Marla B. Shapiro, Ph.D.
Independent Practice Rockville, Maryland

Barbara J. Schrock, Ph.D., ABPP/CN
Lead Clinical Neuropsychologist
Sharp HealthCare

Hillary Shurtleff, Ph.D., ABPP/CN
Department of Neurology Washington School of Medicine
Department of Psychiatry
Seattle Children's Hospital

Brenda J. Spiegler, Ph.D., ABPP/CN
Director, Department of Psychology
Hospital for Sick Children
Associate Professor,
Faculty of Medicine
University of Toronto

Janine Stasior, PhD., M.S., ABPdN
Child Development Network, Lexington Massachusetts

Yana Suchy, Ph.D.
Associate Professor Department of Psychology
University of Utah

Sara J. Swanson, Ph.D., ABPP/CN
Professor, Department of Neurology
Medical Center of Wisconsin

H. Gerry Taylor, Ph.D., ABPP/CN
Professor of Pediatrics
Case Western Reserve University, Rainbow Babies & Children's Hospital, University Hospitals Medical Center

David E. Tupper, Ph.D.
Director, Neuropsychology Section
Hennepin County Medical Center

Linda Vincent, Ph.D.
Independent Practice
Northampton, Massachusetts

Deborah P. Waber, Ph.D.
Senior Associate
Department of Psychiatry
Children's Hospital Boston
Director, Learning Disabilities Program
Department of Neurology
Children's Hospital Boston
Associate Professor
Department of Psychiatry
Harvard Medical School

Mary (Molly) Warner, Ph.D., ABPP/CN
Epilepsy & Epilepsy Surgery Program
Seattle Children's Hospital

Cheryl Weinstein Ph.D., ABPP/CN
Assistant Professor of Clinical Psychology
Harvard Medical School
Beth Israel Deaconess Medical Center Longwood Neuropsychology
Training Program

Michael Westerveld, Ph.D., ABPP/CN
Medical Director, Pediatric Neuropsychology
Walt Disney Pavilion, Florida Hospital for Children

Desirée A. White, Ph.D.
Associate Professor
Department of Psychology
Washington University in St. Louis

Roberta F. White, Ph.D.
Professor and Chair, Department of Environmental Health
Associate Dean for Research Boston University School of Public Health

Karen E. Wills, Ph.D., LP., ABPP/CN
Children's Hospitals and Clinics of Minnesota

Rebecca Wilson, Psy.D.
Lead Psychologist
Child Development Unit
Assistant Professor
Neurodevelopmental - Behavioral Pediatrics and Psychiatry

Tony Wong

T. Andrew Zabel, Ph.D., ABPP/CN
Department of neuropsychology, Kennedy Krieger Institute
Department of Psychiatry and behavioral Science
Johns Hopkins University School of Medicine

Andrea L. Zartman, Ph.D., ABPP/CN
VA North Texas Health Care System Dallas, Texas

*Dr. Ryan contributed to this book in her personal capacity. The views expressed are her own and do not necessarily represent the views of the National Institutes of Health or the United States Government.