Clinical Neuropsychology Service for Stroke:

Information and guidelines for referrers

Who are Clinical Neuropsychologists?

Clinical Neuropsychologists are Clinical Psychologists who have specialised in Neuropsychology and are mainly concerned with how cognitive abilities (e.g. memory, executive functioning, attention etc.) influence a person’s everyday functioning and behaviour whilst considering the possible contributions of other psychological factors.

Clinical Neuropsychology Service for Stroke

The Neuropsychological Service for Stroke is provided by Dr Jackie Hamilton, Clinical Neuropsychologist (0.8 WTE) and Dr Roisin Jack, Clinical Neuropsychologist (0.2 WTE) for patients in Grampian (including Moray), Shetland and Orkney requiring specialist neuropsychological input following stroke. Often patients have complex cognitive presentations and referrals are usually requested in the following areas:-

  1. Cognitive Functioning
  • Quantifying cognitive deficits/strengths, identifying factors influencing cognitive functioning. This provides information on prognosis and informs decisions about treatment.
  • Intervention may include individual sessions or consultation with other professionals advising on strategies, and setting and reviewing goals for addressing cognitive problems. This may also involve advising other professionals on adapting approach or treatment that may be affected by cognitive difficulties.
  • Assessment of capacity

2. Emotional Problems

These may be as a result of neurological changes or adjustment issues following stroke. (NB a period of emotional upset or ‘adjustment’ can be part of a normal reaction to a life-changing event such as stroke.) Neuropsychological input may involve:

  • Assessment and formulation of the contribution of emotional problems/factors in those with cognitive deficits to functioning.
  • Recommendations e.g. environmental changes, input from other therapies, referral to psychiatry/ clinical psychology.
  • Therapy (e.g. cognitive behavioural therapy) with people who have cognitive deficits that would adversely affect their ability to participate in therapeutic intervention as offered by Dr Emma Hepburn, Clinical Psychologist (see below).
  1. Behavioural problems
  • Includes assessment, formulation and intervention of behaviour problems as a result of neurodisability. This work may involve ward staff or family.
  • This work may be undertaken as direct clinical contact with patients and/or families or may be in the form of advice and supervision to other professionals or input at MDT meetings/ case conferences.

NB: This service is provided for inpatients and outpatients within the acute and rehabilitation Stroke Services. Due to limited resources this service does not operate an in-patient waiting list. Therefore, please consult directly with the Neuropsychologist before making an inpatient referral.

Clinical Psychology Service for Stroke

As part of the Clinical Neuropsychology Service for stroke, a Clinical Psychology service for stroke is also provided by Dr EmmaHepburn, Clinical Psychologist. This service offers assessment and interventionfor psychological problems that have developed as a direct result of stroke, such as anxiety, depression and adjustment disorders. We can also offer limited input to families/ carers who are experiencing psychological difficulties directly related to adjusting to their family member’s stroke. Please call to discuss the suitability of any family referrals prior to making a written referral.

This service does not offer input to individuals whose psychological difficulties are longstanding, i.e. when psychological difficulties predate the stroke or longstanding difficulties are exacerbating or re-emerge following a stroke. Due to the time limited therapeutic service we offer, we also do not accept referrals for alcohol or drug use or when these exist co-morbidly with psychological difficulties. However advice can be provided on where such referrals can be directed.

NB: Due to limited resources (one day a week, 0.2 WTE) the Clinical Psychology service is provided for outpatients only.

How to refer

  • A written referral is required from a Medical Consultant, other Medical staff, GP or Medical Support Nurse
  • Information required in referral:-

-Referral question (try to be as specific as you can be in terms of referral question)

-Consultant

-Contact details of referrer (e.g. telephone/bleep number).

-CRN/Unit number

-Any other relevant information (e.g. relevant past medical and social history, specific areas of concern, concerns raised by relatives, behaviour in therapy, sensory difficulties, known language problems etc.)

  • Referrals will be accepted from other professionals (e.g. OT, Physio, SALT, CHSS nurses) but should be discussed with Neuropsychologist prior to referral being made.

If unsure about appropriateness of referral, please contact Neuropsychologist directly who will be happy to discuss.

Please direct all referrals/enquiries to:

Dr Jackie Hamilton

Clinical Neuropsychologist

Department of Clinical Neuropsychology

2nd Floor, Room 2.19 (Sec)

Ashgrove House

Aberdeen Royal Infirmary

Foresterhill

Aberdeen

AB25 2ZN

Secretary (01224) 559352 (Secretary, room 2.19)

Dr Jackie Hamilton & Dr Emma Hepburn, room 2.21 (01224) 553399

Email:

Revised 19 March 2010