Keynote address: Alex Troster

CHALLENGES AND OPPORTUNITIES FOR NEUROPSYCHOLOGY IN A WORLD OF NEW TECHNOLOGIES

Rapid neuroscience and technological advances herald a departure of some of neuropsychology’s traditional roles in health care but opens many new opportunities. Just as clinical neuropsychology has thrived decades after its use for determining the presence and location of a brain lesion faded with the advent of modern neuroimaging, so will neuropsychology thrive in an era when test administration is largely automated and its roles will likely increasingly involve early cognitive change detection, evaluation of therapies’ safety and efficacy, and selection of candidates for various treatments. Activities such as brain mapping for surgery and determination of language dominance are likely to remain neuropsychologist activities for some time. New roles will include participation in clinical trials design, behavioral medicine interventions for patients with cognitive compromise (e.g., medication adherence, exercise promotion to reduce risk of vascular disease), and incorporation of genetics and biomarkers into understanding of brain-behavior relationships and cognitive processes. Challenges facing clinical neuropsychology have traditionally centered around the availability and reimbursement for services and, in the US,  the assumption of testing roles by technicians/psychometrists and computers; neuropsychologists have become quite adept at dealing with these issues and examples of collaboration with payers and development of testing guidelines will be described. New challenges will be to train a new generation of neuropsychologists with technological, biological, and clinical expertise relevant to a new world technology and public health and health care cost reduction. The academician will have many new tools to test cognitive theories and to participate in translational research, adapting animal findings to bedside. To highlight some of these roles, examples of applications of neuropsychology to neurotherpeutic technology will be selected from studies in movement disorders.

Cognitive Impairments in Movement Disorders: Alex Troster

Alex Troster will be presenting the following 3-hour workshop at our conference in November.

COGNITIVE IMPAIRMENTS IN MOVEMENT DISORDERS

Much research continues to be devoted to the early diagnosis and treatment of the most common dementia, Alzheimer’s disease. In the last two decades, however, increasing attention has been paid to what were traditionally referred to as “subcortical dementias,” Parkinson’s disease (PD) dementia (PDD) and the rarer dementia associated with Huntington’s disease (HD). The first part of this workshop will deal with the rarer HD and atypical parkinsonian syndromes such as progressive supranuclear palsy, corticobasal degeneration, and multiple system atrophy. In the case of HD, particular emphasis will be placed on preclinical neuropsychological characteristics and recent questions about the implications of an “indeterminate” number of CAG repeats. Recent AAN treatment guidelines will also be summarized. For each atypical parkinsonian disorder recent advances in understanding the neural substrates of the disorder (including neuroimaging findings) and treatments are discussed. The neuropsychological differentiation of tauopathies from alpha synucleinopathies, and atypical from typical parkinsonian syndromes will be highlighted. Neuropsychological profiles of some clinical cases will be discussed. The second half of the workshop deals with PD and, consistent with recent research, emphasis is placed on mild cognitive impairment, potential imaging and biomarkers (e.g., beta amyloid and phosphorylated tau), and outcomes of treatments such as gene therapy and deep brain stimulation. The neuropsychological features associated with early dopaminergic deficits are described and differentiated from those probably related to other neurotransmitter abnormalities. Recent diagnostic criteria for PD MCI, and the special emphasis of neuropsychology in them, will be described.

Thankyou!!!

We are very excited by the diversity and number of submissions received for the conference! There are a large number of research papers and poster submissions, and also a pleasing number of workshops, symposia, lectures, and how to sessions, covering both practical and knowledge-based areas of neuropsychology. It was amusing that one of the last submissions we received last night was for a presentation on the neuropsychology of procrastination...

Due to a number of requests for extensions, the submissions portal will remain open until 5pm tomorrow, Australian Eastern Standard Time. So if you would like to submit something for our conference, it's not too late.

We are in the process of allocating submissions to reviewers for the review process, and hope to have the program finalised and open registrations before July 12th.

Thanks to everyone who has contributed, and for your interest in this blog - we've had over 4000 views, with more than 1600 in the last month, resulting in a number of redirects from a "goneviral" website, and large numbers of views from pages around the world. If you're an international reader, we hope you might be able to join us in November.

This blog isn't over yet - look out for more information on Launceston, Tasmania, and the conference program as it develops. But for now, thanks. We have some abstracts to read....

Invited workshop: Motivational Interviewing in Neuropsychology Basic Principles and Methods

Motivational Interviewing in Neuropsychology

Basic Principles and Methods

By: Tad T. Gorske, Ph.D.

Neurological disorders constitute approximately 6% of the global burden of disease (WHO, 2006) requiring a need for rehabilitation strategies for restoration of functioning. Non-compliance with rehabilitation recommendations can compromise a successful recovery program. Non-compliance can be related to client motivational or disability factors in addition to family member’s difficulty coping and adapting to the responsibilities of a rehabilitation program (Suarez, 2011).  While the problem of poor compliance has been studied as a factor in managing patients with medical issues, physical disabilities, cognitive impairments, and other injuries; little has been written about teachable methods for enhancing motivation and increasing compliance with rehabilitation recommendations. The Health Behavioral Change (HBC) model which is based on Motivational Interviewing (MI) fills this important gap by giving healthcare professionals essential tools for discussing the importance of following rehabilitation recommendations in addition to other topics such as exercise, eating habits, medication compliance, smoking, and drinking (Rollnick, Mason, and Butler, 1999; Miller and Rollnick, 2002). The HBC model was originally designed for physicians and provides a concise framework that can be used for brief-time limited interventions. It has been used in various rehabilitation settings where a therapeutic and collaborative relationship is an essential component for enhancing patient participation and outcome attainment (Prigatano, 1999).

In this training participants will learn the background and principles of the HBC model and its application to rehabilitation.  The essential elements of the model will be reviewed in addition to the specific clinical skills necessary to conduct an HBC session.  Participants will receive practical skills to guide client(s) through the difficult task of change all the while maintaining an empathic and collaborative relationship, rolling with client resistance, and then gently guiding them through the process of collaborative goal development and attainment.

Learning Objectives

Participants will learn….

1. The background and conceptual foundations of the HBC model;
2. The core interpersonal skills for conducting an HBC session;
3. To identify a client’s stage of change and intervene appropriately;
4. To assess clients level of readiness for change and enhance change talk;
5. Collaborative ways to manage client resistance;
6. To explore and enhance levels of importance and confidence for making difficult behavior changes;
7. To give feedback and advice in a way that maintains collaboration and motivates change;
8. To enhance client readiness to transition to more active and directive treatment interventions.

Collaborative Therapeutic Neuropsychological Assessment

Invited workshop:

Collaborative Therapeutic Neuropsychological Assessment - Tad Gorske

One of the challenges Clinical Neuropsychology faces is to develop an assessment process that is relevant and responsive to patient’s needs. Neuropsychology has typically followed an “Information Gathering/Medical Model” of assessment guided by the premise that tests are used to isolate a disease process and initiate treatment. More recently, neuropsychologists have taken a holistic perspective of practice.  A holistic neuropsychological perspective reflects patient-centered care models which emphasize empowering patients and families to improve their health and well being. Patient centered care views illness from a biopsychosocial perspective and emphasizes an egalitarian relationship with a strong working alliance between patient and practitioner (Mead and Bower, 2000). Collaborative Therapeutic Neuropsychological Assessment (CTNA) is a patient centered method for conducting a neuropsychological assessment feedback session that enlists patients and family members as collaborators and empowers them to take charge of their cognitive health (Gorske and Smith, 2009).  Evidence suggests neuropsychologists are frequently providing feedback and that the process is viewed as a positive experience by practitioners, patients, and family members (Bennett-Levy, et al., 1994; Donofrio, Piatt, and DiCarlo, 1999; Smith, Wiggins, and Gorske, 2007). Furthermore, patient centered interventions can potentially enhance the working alliance between practitioner and client which has been shown to enhance neuropsychological rehabilitation outcomes (Shonberger, Humle, Zeeman, and Teasdale, 2006). While authors have stated the importance and provided recommendations for providing neuropsychological test feedback, no agreed upon model exists (Gass & Brown, 1992; Malla et al., 1997).  CTNA hopes to fill this gap by providing a framework and methods for giving feedback from neuropsychological test results in a way that is understandable, patient centered, and empowers patients to take an active role in treatment. This workshop will provide the following: a) conceptual foundations of the CTNA approach; b) methods for providing neuropsychological test feedback based on CTNA principles; c) case examples of CTNA sessions; and d) suggestions for further work and research on CTNA applications.  This workshop will not discuss basic methods of neuropsychological interviewing, assessment, and interpretation as it is assumed attendees will be well versed in these procedures.

Learning Objectives:

1.    Participants will understand the value of a holistic CTNA approach for enhancing patient care.

2.    Participants will learn principles and methods of CTNA and be able to incorporate them into practice.

3.    Participants will understand the applications of CTNA in the rehabilitation of different patient populations. 

Registration enquiries and student volunteers

Enquiries have started to come in about registration fees and the conference programme.

CCN Conferences have always aimed to provide a strong conference that is good value for money, and  members of the CCN pay a discounted rate. It is planned that the registration fee for the 3.5 day conference this year will include morning and afternoon teas, lunch on the first 3 days, welcome drinks, attendance to all sessions, and a practical 'Neuropsychology in Action' conference backpack and drink bottle (to facilitate your brain-enhancing walks around Launceston and Tasmania). There may be a small charge for attendance at workshops, but this will be decided when the programme composition is known.

We will not be able to set the registration fees until we have finalised the conference program. However, for the 3.5 days of this year's program, we are confident that the early bird rate for CCN members will be less than the member rates for the APS2011 and College of Clinical Psychology conferences,  (early bird $695 plus >$100 for workshops at APS 2011, and $780 for CClin members at their conference in 2012).

We hope the early-bird  registration fee for CCN student members will be no more than $200 for the whole conference. This compares to $395 for student members of the College of Clinical Psychologists to attend their conference this year, and $310 for APS student members to attend the APS 2011 conference. The CCN student registration fee is heavily discounted, to encourage student participation and presentations which enrich the conference programme with contemporary research and developments in our field, and to facilitate broader student learning from engaging with the wider professional community.

Student volunteers
Students are very important to the CCN - you are the future of our profession! We want you to be involved with our professional community, and the annual conference is one forum where we value your input, through formal presentations and also as volunteers to help make the conference run smoothly.

Student volunteers will be needed at this year's conference, but unlike previous years, the conference is being held in a state without a postgrad neuropsychology program, which have usually supplied resident student volunteers. I've already received several email queries from interested students, which is fantastic! However, to be fair to everyone, we will need to have a formal volunteer selection process.

Before we can call for volunteers, our conference committee will need to consider how many volunteers we need, what we need them to do, and if we will offer them free registration at the conference, or a subsidised registration fee. We will also need to consider the selection criteria - e.g., should we set a cap on the number of students from each course, so that students from each course can have an opportunity to help out and to meet each other and develop a sense of camaraderie?

School holidays are about to start in Tasmania, so we will not be meeting as a committee to discuss these issues until after June 18th. Rest assured that we will be calling for student volunteers in July or August.

Launceston and the Tamar Valley

Two videos about Launceston, one contemporary, one from the National Film and Television Archive in 1966.

http://www.youtube.com/watch?v=g3Y1RauJmZU&feature=related

http://www.youtube.com/watch?v=mlklnP25_2A

The visitor can decide what has changed in 47 years...