Affiliations: Department of Psychiatry, Neuroscience Division, Jersey Shore University Medical Center, Rutgers–Robert Wood Johnson Medical School, Hackensack Meridian Seton Hall Medical School, Neuropsychological Rehabilitation Services-LifeSpan, 2100 State Route 33, Suits 9 and 10, Neptune, New Brunswick, NJ 07753, USA. E-mail: [email protected]
Abstract: BACKGROUND:Today, there exists a need for a practical counseling approach for patients with brain disorders based on an empirical measure that can be used to objectify procedural adequacy. Clinical neuropsychology, which focuses on developing knowledge about human brain-behavioral relationships and applying this information to clinical problems, is the ideal discipline to address this issue. Unlike other methods of appraisal and current counseling approaches, medical adjustment counseling (MAC) for patients with cognitive and behavioral changes due to brain disorders is based on the application of neuropsychological principles and evidence-based practices. OBJECTIVE:In this review, I discuss the neuropsychological principles underlying MAC, differentiation from conventional clinical psychology systems, and the specifics of the treatment stages. Transtheoretical analytic points of inclusion and a clinical case example are also discussed. METHODOLOGY:MAC involves an interactive exchange between the neuropsychologist and patient based on the neuropsychological examination (NPE). The resulting neuropsychological profile facilitates the conversion of empirical objective evidence into practical biopsychosocial adaptive strategies that can be modified according to each patient’s diagnosis and level of impairment. MAC is delivered in four stages (validation, education, accommodation, and reintegration) that require an understanding of the ecological applicability of the NPE to the real-life situation of the patient, a knowledge base of the neurobehavioral consequences of the medical diagnosis, integration of medical disciplines regarding additional diagnostics, psychological crisis systems and patient/family reactions. CONCLUSION:Without the objective neuropsychological evidence provided by the NPE and MAC, the clinical judgment of the psychologist is based on something more akin to witchcraft and magic than science.
