What do private practice referrers value about neuropsychology assessment?

ABSTRACT

Objective

For optimal clinical utility of neuropsychological assessment (NPA), we need to understand what aspects referrers value. We aimed to use quantitative and qualitative methods to evaluate the value of NPA for a diverse range of Australian private practice referrers.

Method

Forty-nine referrers to Australian private neuropsychology practices completed a 25-item online survey evaluating referrer satisfaction, report preferences, barriers to referral, and views on the most beneficial outcome(s) of NPA. Sixteen referrers participated in individual online semi-structured interviews to provide richer accounts of these issues.

Results

Referrers’ survey responses indicated high satisfaction, and that NPA was considered valuable for diagnostic clarification, management planning, and access to support. Participants valued individualised reports with user-friendly explanations of findings and tailored recommendations. Interview data revealed four themes: (1) neuropsychologists possess unique expertise which carries weight amongst referrers and services, (2) neuropsychology enhances understanding of the person and problem, (3) neuropsychology guides healthcare and support, (4) financial, structural, and geographical barriers occur in accessing NPA and implementing supports.

Conclusions

Referrers’ perspectives can inform neuropsychologists’ approach to their work and optimise clinical utility. Future clinical trials should measure the reported useful outcomes of NPA to demonstrate more rigorously the evidence for the value of NPA.

Key Point

What is already known about this topic:

1. There are barriers to accessing NPA services within Australian youth mental health settings.

2. Although multiple systematic reviews support the usefulness of NPA, some trials have not, which may relate to outcome measures not reflecting the most valuable outcomes of NPA.

3. Prior surveys evaluating referrers’ perspectives in the US and Australian youth mental health settings found referrers were satisfied and found NPA useful for treatment planning, diagnostic clarification, and service access.

What this topic adds:

1. Australian referrers from a diverse range of professional backgrounds are satisfied with NPA services, finding NPA valuable for diagnostic clarification, management planning, and access to support services and funding.

2. Referrers reported NPA benefited clients’ and families’ understanding of their condition and how to manage it, via comprehensive case formulation and individualised recommendations.

3. Referrers perceive that neuropsychologists’ unique expertise improves the understanding of the person and presenting problem, which guides healthcare and support. Logistical, financial, and systemic barriers to access of NPA and implementation of recommendations were identified.

KEYWORDS:

• Neuropsychology assessment
• clinical neuropsychology
• barriers
• accessibility
• referrers
• neuropsychological report

Acknowledgements

We are grateful for the neuropsychologists who shared this study with their referrers and for the participants, both those who completed the survey and those who took time out of their busy schedule to share their ideas and experiences with us in interviews. We would also like to thank Jessie Hill for her help with the coding of the qualitative data. This work was supported by a La Trobe University Tracey Banivanua Mar Fellowship awarded to KP.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available on request from the corresponding author, KP. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Additional information

Funding

The work was supported by the La Trobe University Tracey Banivanua Mar Fellowship.