Neuropsychology Rotations

Neuropsychology Track

Megan Spencer, PhD, Track Coordinator

The Neuropsychology Track provides a full year of clinical neuropsychology experience and is designed to adhere to the guidelines for internship training set forth by the Houston Conference on Specialty Education and Training in Clinical Neuropsychology. Clinical rotations provide training in inpatient and outpatient adult neuropsychology in psychiatric (Butler Hospital), and general medical settings (Rhode Island Hospital, VA Medical Center).  The Butler Hospital rotation includes a minor experience in pediatric neuropsychology. Training experiences focus on diagnosis, consultation, and treatment planning. Neuropsychology clinical psychology residents participate in a yearlong supplemental psychotherapy experience in settings such as outpatient mental health services and primary care mental health services.  A weekly Neuropsychology Seminar is held September through May.  Seminars are taught by track faculty and provides didactic instruction on such topics as neuropathology, neuroimaging, neurology, neurosurgery, psychiatry, and specific neuropsychological disorders. Neuropsychology Grand Rounds occur approximately eight times per year.  These provide a forum for trainee research presentations and guest lecturers on topics pertinent to the field. 

The Neuropsychology Track is composed of the following rotations:

General Medical Neuropsychology Rotation - Rhode Island Hospital
Faculty Supervisor(s): Geoffrey Tremont, PhD, ABPP-CN, Jennifer Davis, PhD, ABPP-CN, & Seth Margolis, PhD
Rhode Island Hospital (RIH) is a private, non-profit hospital located in Providence, RI.   It is the largest general acute hospital in the state with over 700 acute-care hospital beds.  RIH is the Level-1 Trauma Center for southeastern New England.  RIH provides comprehensive health services for adult with pediatric care provided at Hasbro Children’s Hospital located on the campus.  RIH is the principal teaching hospital for Brown’s Alpert Medical School.

The Neuropsychology Program is housed in the Physicians Office Building on the RIH campus about 100 feet from the main hospital building.   The program provides outpatient and inpatient consultation services.  The program receives referrals from Alzheimer’s and Memory Disorders Center, Comprehensive Epilepsy Program, Stroke Center, Neuro-oncology, Movement Disorders Program, Transplant, and the Multiple Sclerosis Program as well as from community medical providers. This rotation emphasizes the role of the neuropsychologist in a general medical setting. The rotation involves outpatient assessment of patients with a broad range of presenting problems, including dementia, epilepsy, multiple sclerosis, traumatic brain injury, movement disorders, stroke, psychiatric conditions, and other medical disorders. The resident will also cover the inpatient consultation service one day per week. This service includes bedside clinical interviewing, assessments, and report writing for patients with acute mental status changes, including delirium, stroke, brain injury, or complicated general medical conditions. The resident will present cases at interdisciplinary Alzheimer’s disease and movement disorders (Deep Brain Stimulation Program) conferences. Opportunities within our Comprehensive Epilepsy Program include pre- and post-surgical evaluations, Wada testing, and interdisciplinary case conference presentations.  Participation in intraoperative cortical language mapping procedures with patients undergoing brain tumor resection may also be available. 

Neuropsychological Assessment Rotation - Providence VA Medical Center 
Faculty Supervisor (s): Megan Spencer, PhD & Donald Labbe, PhD
The Providence VA Medical Center (PVAMC) serves as one of the major teaching hospitals for Psychiatry and Psychology at Brown. The PVAMC is dedicated to providing high quality comprehensive outpatient and inpatient healthcare to veterans residing in Rhode Island and southeastern Massachusetts. Patients are male and female veterans of the U.S. Armed Forces of varied ethnic and socioeconomic backgrounds. The PVAMC has one of the highest ratios of ambulatory to inpatient services of all VAs nationally. The MHBSS has a 20-bed inpatient unit with 700 admissions per year. MHBSS outpatient services have over 40,000 visits annually. The PVAMC serves as a primary site for Brown residents in Psychiatry, Surgery, and Primary Care Medicine. 

This rotation is housed within PVAMC’s Mental Health and Behavioral Sciences Service (MHBSS). Experiences are provided in adult neuropsychology in outpatient and inpatient hospital settings. Referrals arise from various services in the medical center, particularly MHBSS and the Neurology and Primary Care services. The neuropsychology training experience emphasizes the impact of psychiatric, neurological, and general medical conditions on cognitive functioning.  

Consultation requests are varied and include outpatient assessment of neurodegenerative disorders of aging (e.g., mild cognitive impairment, Alzheimer’s disease, vascular dementia, etc.), neurologic conditions (e.g., multiple sclerosis, movement disorders, chronic sequelae of stroke or traumatic brain injury), decision making capacity, psychiatric disorder (especially depression, posttraumatic stress disorder, substance abuse disorders), as well as attention disorders and learning disabilities.  Inpatient referrals are typically for characterization of current cognitive status and differential diagnosis to guide treatment and discharge planning.  Clinical psychology residents may have the opportunity to conduct assessments of military deployment-related traumatic brain injury in the Polytrauma/TBI Clinic. Clinical psychology residents may also have the opportunity to participate empirically validated psychoeducational cognitive rehabilitation protocols with patients who do not have dementia.

The VA neuropsychology rotation is designed to emphasize the role of the neuropsychologist as an independent consultant to both outpatient and inpatient services. Clinical psychology residents will be provided with time for report writing and to fulfill their commitments to their year-long research and supplemental treatment placements. 

Clinical psychology residents have full access to test manuals and other resources needed for efficient test administration, scoring, and interpretation.  Computer word-processing templates are provided to aid in report writing and computerized scoring programs are available for many tests. All report writing is finalized within the VA's electronic medical record system. Directed readings are provided as need to supplement the training experience. 

Psychiatric Neuropsychology - Butler Hospital
Faculty Supervisor(s): Nicole McLaughlin, PhD, Karen Holler, PhD, Athene Lee, PhD

This rotation provides training in clinical neuropsychology in a psychiatric setting.  Founded in 1844, Butler Hospital is Rhode Island’s only private, non-profit psychiatric hospital for adolescents, adults, and seniors. Butler is affiliated with Alpert Medical School of Brown University and is the flagship for its Department of Psychiatry and Human Behavior. Butler has specialty inpatient units in geriatrics, substance abuse, adolescents, and mood disorders, as well as partial hospital programs focusing on young adults, women and substance abuse. Butler houses a multidisciplinary Memory and Aging Program directed by Drs. Stephen Salloway and Steve Correia, a Normal-Pressure Hydrocephalus Clinic, and a Movement Disorders clinic directed by Dr. Joseph Friedman.

Clinical psychology residents work as a member of a team that includes neuropsychology fellows, practicum students, technicians and supervisors. Consultations range from differential diagnosis of primary psychiatric disorders to evaluation of dementia patients with and without behavioral disturbance. Consults also frequently involve substance abuse, traumatic brain injury, and mixed psychological/physical trauma. Residents interact with attending psychiatrists and their teams on the inpatient and partial units to provide feedback on their consults. Computerized scoring programs are available to transform raw scores to standardized scores, and templates are available to facilitate report writing, Trainees gather background information and enter their consult reports via an electronic medical record.

Clinical psychology residents have the opportunity to participate in weekly Diagnosis Consensus Conference for the Memory Clinic, during which laboratory, neuroimaging, neurologic, and genetic findings are integrated in an interactive format. Residents also participate in biweekly case conferences with other neuropsychology trainees, using a “discovery” format to help prepare students for boards.