Why would someone recommend therapy with a neuropsychologist?
September 7, 2017 2:39 PM
My psychiatrist recommended going in for an assessment for possible adult ADHD, as well as talk therapy.
At the end of the assessment appointment (no results yet), I asked the testing psychologist if she had any recommendations for talk therapists at their facility.
She recommended a colleague, a neuropsychologist, and emphasized that it would be the best fit. I'm not sure what to think, thinking of finding someone else. Any experiences?
On one hand, I feel rather cynical about it - the facility is in a very wealthy area and from what I know about neuropsychology, there is a lot of testing and such that they run (and charge me/my insurance for). It also seems like a short appointment for talk therapy - they schedule people every 40 minutes.
On the other hand, it's taken me years, decades even, to get treated at all, and I don't want to derail the progress I've already made on depression issues. I suck at setting up and keeping appointments (part of the reasons this test was recommended), and this appointment is in a week, which is good. There is also the chance that the testing psychologist is sincere, obviously.
So anyone with experience with neuropsychologists and/or possible adult ADHD/confirmed depression, is it worth going at all or should I muster the motivation to find someone else?
On one hand, I feel rather cynical about it - the facility is in a very wealthy area and from what I know about neuropsychology, there is a lot of testing and such that they run (and charge me/my insurance for). It also seems like a short appointment for talk therapy - they schedule people every 40 minutes.
On the other hand, it's taken me years, decades even, to get treated at all, and I don't want to derail the progress I've already made on depression issues. I suck at setting up and keeping appointments (part of the reasons this test was recommended), and this appointment is in a week, which is good. There is also the chance that the testing psychologist is sincere, obviously.
So anyone with experience with neuropsychologists and/or possible adult ADHD/confirmed depression, is it worth going at all or should I muster the motivation to find someone else?
40 minutes is the standard length of time for talk therapy. My wife is a therapist, and she only thinks in 40-minute increments. You might be able to find someone who goes longer, but the vast majority of therapists will only offer 40 minute sessions unless you're in crisis.
The reason for this is because you're not expected to do everything in one session. Each session is a small chunk, and then you work on what you talked about in between sessions. Baby steps, if you've ever seen "What About Bob?". Especially if you're working on ADHD, you'll probably run into diminishing returns with longer sessions.
I don't know much about neuropsychology, but as long as they're covered by insurance, why not give it a shot? If it's not a fit, you can always request a new therapist.
posted by kevinbelt at 2:53 PM on September 7, 2017
The reason for this is because you're not expected to do everything in one session. Each session is a small chunk, and then you work on what you talked about in between sessions. Baby steps, if you've ever seen "What About Bob?". Especially if you're working on ADHD, you'll probably run into diminishing returns with longer sessions.
I don't know much about neuropsychology, but as long as they're covered by insurance, why not give it a shot? If it's not a fit, you can always request a new therapist.
posted by kevinbelt at 2:53 PM on September 7, 2017
I'm a neuropsychologist. We are trained in providing counseling services as part of our graduate training, and many people choose to continue to provide counseling in addition to assessment services. The therapy you would receive would be very equivalent to any other therapist in the community and more directed at the brain behavior relationship. I personally do not do therapy, but a number of my colleagues here do, and many specialize in working with folks with ADHD. If you are interested in pursuing therapy I would recommend meeting with the provider and seeing if you feel like you could work well together, just as I would with any other therapist. If you book an appointment for therapy, you will not be doing assessment.
posted by goggie at 4:04 PM on September 7, 2017
posted by goggie at 4:04 PM on September 7, 2017
I am in a clinical psychology program right now, and several of the people in the program are training to be neuropsychologists. They get exactly the same amount of therapy training that I do, they just specialize in neuropsychology as well. As goggie said, many neuropsychologists simply do both assessment and therapy. That does not mean they will start running tests if you come in for therapy. They may suggest them as helpful, but you will be able to say no to them. It will never be sprung on you without booking well in advance and clearing it with you first.
The reason neuropsychology is associated with a lot of testing is because it focuses on the brain, and it's easier to test for a lot of brain-based conditions than, say, mood or personality disorders (not that there aren't tests for those, but they aren't as clear cut as some neuropsychological conditions). I actually think a neuropsychologist may be more helpful to you than a general talk therapist, because ADHD is a brain-based condition (not that depression isn't in the brain, but therapy for it involves less focus on how the brain works) that regular talk therapy might not help. If your only issue were depression, then sure, you might be fine with a talk therapist, but if ADHD is added to that, you really want someone familiar with both brain and mood disorders. Unfortunately, many therapists aren't equipped to treat ADHD. It's a current problem in psychology that many clinicians prefer to treat mild cases of anxiety, depression, and sometimes personality disorders, while leaving other conditions and more severe cases of those conditions for someone else. It's not guaranteed that a neuropsychologist will have specialized training in ADHD treatment, but it's probably more likely.
As for it being 40 minutes, that's pretty normal for talk therapy. A lot of therapy sessions are only for half an hour, even. There's only so long either of you can try and process, and going over 40 minutes is pushing your mental and emotional capacity. So don't be put off by that.
posted by brook horse at 4:44 PM on September 7, 2017
The reason neuropsychology is associated with a lot of testing is because it focuses on the brain, and it's easier to test for a lot of brain-based conditions than, say, mood or personality disorders (not that there aren't tests for those, but they aren't as clear cut as some neuropsychological conditions). I actually think a neuropsychologist may be more helpful to you than a general talk therapist, because ADHD is a brain-based condition (not that depression isn't in the brain, but therapy for it involves less focus on how the brain works) that regular talk therapy might not help. If your only issue were depression, then sure, you might be fine with a talk therapist, but if ADHD is added to that, you really want someone familiar with both brain and mood disorders. Unfortunately, many therapists aren't equipped to treat ADHD. It's a current problem in psychology that many clinicians prefer to treat mild cases of anxiety, depression, and sometimes personality disorders, while leaving other conditions and more severe cases of those conditions for someone else. It's not guaranteed that a neuropsychologist will have specialized training in ADHD treatment, but it's probably more likely.
As for it being 40 minutes, that's pretty normal for talk therapy. A lot of therapy sessions are only for half an hour, even. There's only so long either of you can try and process, and going over 40 minutes is pushing your mental and emotional capacity. So don't be put off by that.
posted by brook horse at 4:44 PM on September 7, 2017
Thank you all for answering! This was very reassuring. Now I know the lay of the land much better.
It seems I was too pessimistic/cynical about the choice of neuropsychologist - it actually looks like the perfect fit, from what goggie and brook horse have mentioned (I apologize brook horse, for my suspicion of your profession, thank you for informing me).
I've struggled mightily to explain to people, including another therapist, why I can't seem to get things done, and I didn't think about specialties very much.
I'll keep the appointment and see how it goes, I even feel a bit hopeful now!
posted by sockbladder at 1:52 PM on September 8, 2017
It seems I was too pessimistic/cynical about the choice of neuropsychologist - it actually looks like the perfect fit, from what goggie and brook horse have mentioned (I apologize brook horse, for my suspicion of your profession, thank you for informing me).
I've struggled mightily to explain to people, including another therapist, why I can't seem to get things done, and I didn't think about specialties very much.
I'll keep the appointment and see how it goes, I even feel a bit hopeful now!
posted by sockbladder at 1:52 PM on September 8, 2017
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I see a psychopharmacologist, because I was at the end of my rope with my previous doc and his insistence in treating me a certain way - which wasn't working.
I'm happy to elaborate more in memail.
posted by ApathyGirl at 2:51 PM on September 7, 2017