Medical Professionals and Other Referrers
Welcome to the Health Professionals page. Follow the links below for more information about our services.
Neuropsychological Assessment
Full Neuropsychological Assessment
A full neuropsychological assessment involves:
- A detailed clinical interview for history (with patient and an informant)
- A review of recent medical test results (e.g. imaging, cognitive screening tests)
- A thorough assessment of major cognitive domains (attention, processing speed, language, spatial abilities, memory and executive functioning)
- Screening assessment for reversible causes of cognitive difficulties: e.g. fatigue, anxiety, depression, pain
- A detailed medical report with test results and an opinion regarding the referral question
- An in-person feedback session with the patient regarding cognitive test results and any strategies or recommendations
- A short, written feedback document for the patient.
Neuropsychological assessment is recommended for the following referral questions:
Diagnostic
Can the person’s cognitive symptoms be explained by a condition or disease?
Does this person meet criteria for a dementia / neurodegenerative disorder?
Is the person’s cognitive profile suggestive of a specific dementia?
Are the person’s cognitive difficulties more consistent with depression or dementia?
Return to Work or Study
Does this person have cognitive difficulties which may affect their ability to return to work or study following a stroke / brain injury?
Are this person’s work difficulties caused by cognitive impairment?
What strategies or recommendations can be provided to minimise the effects of cognitive dysfunction on work/study performance?
Capacity Assessment
Is this person’s cognitive performance affecting their ability to make decisions about accommodation/treatment/services/finances?
Could a person’s cognitive deficits affect their ability to understand the implications of making an enduring power of attorney, advanced health directive or will?
Cognitive Strengths and Weaknesses
Is there evidence of cognitive impairment?
What strategies or recommendations can be given to this patient to help with everyday functioning?
Will this person require increased support in the home or a driving assessment? (note an occupational therapist would be the best person to address these issues directly, however a cognitive assessment can address these as a secondary concern)
Please assess this patient’s baseline of cognitive functioning prior to surgery/treatment
Is there evidence of decline or improvement since the previous assessment?
Thinking and Memory Screen
Bryden Neuropsychology can also provide a short, standard screening assessment which uses population normed instruments (i.e. not just screening tests) to briefly assess all main areas of cognitive performance. This assessment also screens for other common causes of reversible cognitive difficulties including sleep difficulties, anxiety and depression, and pain.
This assessment is not suitable for people who have language, culture or sensory/motor limitations as it is a standard assessment. It is also unlikely to detect very mild changes in people with above average intelligence, although it may be useful to track changes over time.
The brief neuropsychological assessment is a time-effective and inexpensive way for your patients to receive a slightly more detailed account of their cognitive functioning. Example recommendations following an assessment may be:
- Re-assessment in 12 months following treatment of pain, sleep difficulties, or anxiety and depression
- Full neuropsychological assessment (available at a reduced rate if conducted within 6 months)
- Review in 24-months’ time
We are also able to administer screening assessments such as the ADAS-Cog, ACE, RUDAS or MOCA upon request.
Referral for Neuropsychological Assessment
A patient does not need a doctor’s referral for neuropsychological assessment. However, communication with their treating medical team is invaluable to the assessment process. It is most helpful to provide us with the following information regarding your patient if you would like them to undergo a neuropsychological assessment:
- A specific referral question
- Demographic data (e.g. age, gender)
- Information about whether English is a second language and whether an interpreter may be required (thorough assessment may require an interpreter even if a person has a conversational level of English)
- Sensory or motor issues which may affect assessment (vision difficulties, hearing difficulties, motor limitations)
- Current known issues with pain, fatigue, anxiety, depression or substance misuse
- Relevant medical and psychiatric history
- Current medications
- Any previous assessment about cognitive or brain function (e.g. imaging results, cognitive screening tests, sleep assessments, anxiety/depression test, previous neuropsychological assessment). Note that it is more helpful to receive the full results of cognitive screening tests and imaging rather than a summary score or brief report.
Counselling
Kelly Bryden is a psychologist registered with AHPRA and Medicare. Her specialisations include therapeutic support for people experiencing cognitive difficulties, caregiver stress support, and therapy for older people. She also provides counselling support to other groups.
Kelly’s therapeutic approaches are tailored to the individual and the specific issue. They include Cognitive Behavioural Therapy, Acceptance and Commitment Therapy, Motivational Interviewing, Compassion-Focussed Therapy, Interpersonal Therapy, Dialectical Behaviour Therapy, and Schema Therapy.
Therapeutic Support for People with Cognitive Difficulties
Anxiety and depression are common for people with dementia as they adjust to diagnosis. There is early research that suggests therapeutic interventions can be helpful for people in the early stages of dementia who have depression and anxiety. These interventions have mainly involved adapted versions of CBT and Mindfulness therapy.
Therapeutic Support for Caregivers
Family caregivers experience a higher reported rate of psychological symptoms including depression, anxiety, stress, isolation and grief. This is not surprising, considering the changes in relationships and life-roles which occur when a family member becomes a caregiver.
One of the main issues faced by family and friends of a person with a neurodegenerative disease is a state of bereavement or loss. This may be present from early in the disease process and may fluctuate at different stages of progression. A key issue with this type of grief is that it is not publicly acknowledged or routinely addressed.
Practical Support for People with Thinking and Memory Difficulties
Kelly Bryden has experience in the management of Behavioural and Psychological Symptoms of Dementia in an acute inpatient setting. In her work more generally, it is demonstrated that people with dementia and their family have little knowledge about the progression of the disease.
Therefore, it is not surprising that when responsive behaviours occur, families are unprepared for how to cope.
Bryden Neuropsychology aims to form longstanding relationships with people with dementia and their families to provide support through progression of symptoms. Services include:
- Post-diagnostic psychoeducation regarding disease progression and advanced planning
- Strategies to maintain engagement in work, study or leisure activities
- Strategies to support instrumental and personal activities of daily living
- Psychoeducation and support about responding to hallucinations and delusions
- Management of anxiety, agitation and aggression in a person with moderate to severe dementia
- Management of socially inappropriate behaviours
- Transition to substitute decision maker and difficult decisions about ability to care for someone with complex needs
Please feel free to refer any patients or caregivers that you feel may benefit from this type of support.
You can also arrange a time to directly discuss a patient’s needs with Kelly (deidentified or with patient consent), to identify what might be the best intervention to help them.