INS NYC 2024 Program

Poster	Poster Session 11 Program Schedule 02/17/2024 10:45 am - 12:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 11: Cultural Neuropsychology \| Education/Training \| Professional Practice Issues Final Abstract #48 Working Alliance in the Neuropsychological Evaluation: Implications for Patient Rated Outcomes Ellen Johnson, Baystate Health, Springfield, United States Beatrice Hadiwidjaja, University of Michigan, Ann Arbor, United States Elizabeth Kolias, University of Michigan, Ann Arbor, United States Kyler Mulhauser, Michigan Medicine, Ann Arbor, United States Kristen Votruba, Michigan Medicine, Ann Arbor, United States Category: Assessment/Psychometrics/Methods (Adult) Keyword 1: assessment Keyword 2: neuropsychological assessment Objective: Few empirical studies have examined patient’s perceptions of the utility of neuropsychological evaluations and feedback. Research is needed to better understand patient’s evaluation experiences and how they may impact implementation of recommendations. Working alliance is a multifaceted construct that measures aspects of the patient-provider relationship and has been consistently identified as an effective driver of change in psychotherapy, even within brief interventions. The present study examined the association between working alliance (of patient and neuropsychologist), patient perceptions of neuropsychological evaluation utility/helpfulness, and behavioral changes consistent with evaluation recommendations. Participants and Methods: Thirty-nine adult patients were referred for neuropsychological evaluations for a wide range of concerns (e.g., ADHD, age related changes, post-concussive symptoms, epilepsy, and other medical comorbidities). Participants were largely White (87.2%) and the majority identified as women (61.5%). Mean age was 48.4 (SD = 13.1). Patients with severe cognitive impairment or dementia were excluded from the study. Patients completed surveys at three time points; (1) within two weeks of their evaluation (N=39), (2) six weeks after their evaluation (N=25), and (3) four months after their evaluation (N=11). Patients completed the Working Alliance Inventory (WAI) at their initial assessment and six-week follow up. The WAI generates a total score as well as three subscales (goals, tasks, and bond). Participants also completed the Perceived Helpfulness Questionnaire (PH) at all time points, a 14-item measure that asked patients questions about their evaluation and feedback’s utility, clarity, and their intentions to make changes based on the results on a 0-100 scale. Patients also answered open-ended questions about the least and most helpful aspects of their evaluations. Correlations examining the association between WAI, PH, and confidence of enacting change were conducted. Results: All correlations were positive and statistically significant. At the initial visit, WAI total score was associated with PH (r =.67, p < .001) and confidence in making a change (r =.52, p =.003). At the six-week follow-up, WAI total score was related to PH (total: r =.86, p <.001) and confidence in making a change (r=.61, p=.003). Additionally, WAI total score at 6-weeks was associated with PH (r =.96, p <.001) and confidence in making a change (r = -.71, p =.049) at the 4-month follow-up. Patients cited validation, therapy referrals, psychoeducation, reassurance, and understanding of their condition as the most helpful aspects of their evaluations, whereas the length of their appointments, frustration with ongoing symptoms, feeling invalidated by findings, and not feeling their concerns were addressed/understood were the least helpful aspects. Conclusions: Working alliance was related to patients’ perceptions of the utility and clarity of neuropsychological evaluations, and their confidence in their ability to make changes consistent with evaluation results. Qualitative responses suggest that validation, feeling understood, and education were important aspects of evaluations. Data collection for this project is ongoing, and results are limited by a small heterogeneous sample. Additional research is needed to continue exploring these associations.

Poster

02/17/2024
10:45 am - 12:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 11: Cultural Neuropsychology | Education/Training | Professional Practice Issues

Final Abstract #48

Working Alliance in the Neuropsychological Evaluation: Implications for Patient Rated Outcomes

Ellen Johnson, Baystate Health, Springfield, United States
Beatrice Hadiwidjaja, University of Michigan, Ann Arbor, United States
Elizabeth Kolias, University of Michigan, Ann Arbor, United States
Kyler Mulhauser, Michigan Medicine, Ann Arbor, United States
Kristen Votruba, Michigan Medicine, Ann Arbor, United States

Category: Assessment/Psychometrics/Methods (Adult)

Keyword 1: assessment
Keyword 2: neuropsychological assessment

Objective:

Few empirical studies have examined patient’s perceptions of the utility of neuropsychological evaluations and feedback. Research is needed to better understand patient’s evaluation experiences and how they may impact implementation of recommendations. Working alliance is a multifaceted construct that measures aspects of the patient-provider relationship and has been consistently identified as an effective driver of change in psychotherapy, even within brief interventions. The present study examined the association between working alliance (of patient and neuropsychologist), patient perceptions of neuropsychological evaluation utility/helpfulness, and behavioral changes consistent with evaluation recommendations.

Participants and Methods:

Thirty-nine adult patients were referred for neuropsychological evaluations for a wide range of concerns (e.g., ADHD, age related changes, post-concussive symptoms, epilepsy, and other medical comorbidities). Participants were largely White (87.2%) and the majority identified as women (61.5%). Mean age was 48.4 (SD = 13.1). Patients with severe cognitive impairment or dementia were excluded from the study. Patients completed surveys at three time points; (1) within two weeks of their evaluation (N=39), (2) six weeks after their evaluation (N=25), and (3) four months after their evaluation (N=11). Patients completed the Working Alliance Inventory (WAI) at their initial assessment and six-week follow up. The WAI generates a total score as well as three subscales (goals, tasks, and bond). Participants also completed the Perceived Helpfulness Questionnaire (PH) at all time points, a 14-item measure that asked patients questions about their evaluation and feedback’s utility, clarity, and their intentions to make changes based on the results on a 0-100 scale. Patients also answered open-ended questions about the least and most helpful aspects of their evaluations. Correlations examining the association between WAI, PH, and confidence of enacting change were conducted.

Results:

All correlations were positive and statistically significant. At the initial visit, WAI total score was associated with PH (r =.67, p < .001) and confidence in making a change (r =.52, p =.003). At the six-week follow-up, WAI total score was related to PH (total: r =.86, p <.001) and confidence in making a change (r=.61, p=.003). Additionally, WAI total score at 6-weeks was associated with PH (r =.96, p <.001) and confidence in making a change (r = -.71, p =.049) at the 4-month follow-up.

Patients cited validation, therapy referrals, psychoeducation, reassurance, and understanding of their condition as the most helpful aspects of their evaluations, whereas the length of their appointments, frustration with ongoing symptoms, feeling invalidated by findings, and not feeling their concerns were addressed/understood were the least helpful aspects.

Conclusions:

Working alliance was related to patients’ perceptions of the utility and clarity of neuropsychological evaluations, and their confidence in their ability to make changes consistent with evaluation results. Qualitative responses suggest that validation, feeling understood, and education were important aspects of evaluations. Data collection for this project is ongoing, and results are limited by a small heterogeneous sample. Additional research is needed to continue exploring these associations.