Negative effects of neuropsychological assessment for dementia
Research type
Research Study
Full title
Clinician and client reports of the negative effects of neuropsychological assessment for dementia
IRAS ID
308215
Contact name
Nikki Duncan
Contact email
Sponsor organisation
NHS Lanarkshire
Duration of Study in the UK
0 years, 10 months, 29 days
Research summary
Research Summary
The study aims to understand clinician and clients experience of negative effects of neuropsychological assessment for dementia. Exploring negative experiences of therapy and neuropsychological assessment is an under researched area. No previous research has explored clinicians' understanding of the possible negative experiences their clients have when undergoing neuropsychological assessment for dementia. If clinicians are aware of possible negative effects experienced then they can inform their clients of these when doing prediagnostic counselling and this would ensure clients were fully informed about the risks involved before agreeing to complete the assessment. The study will be conducted in NHS Lanarkshire's Psychological Therapies for Older People Service. There will be two parts to this study. In the first part, qualified Clinical Psychologists who do neuropsychological assessments will be invited to be interviewed by the researcher for up to an hour to discuss their awareness of negative effects their clients have experienced during neuropsychological assessments. In the second part of the study clinicians and clients will be asked to complete a questionnaire, which should take no more than 30 minutes, identifying negative effects they have experienced during neuropsychological assessment. Clients will be identified by clinicians in the team and asked if they wish to participate. The study will recruit participants for both parts of the study for up to 6 months.
Summary of Results
Who participated in the study?
Eleven clinical psychologists working in PTOP took part in interviews. Clinicians answered questions about the process of neuropsychological assessment and what negative effects their clients had experienced.
Twenty-five clinical psychologists working across health boards in NHS Scotland completed a questionnaire. The questionnaire provided a list of possible negative effects and asked clinicians to report which ones they had seen their clients experience.
Twelve clients who had completed neuropsychological assessment in PTOP completed a questionnaire about their experience. The questionnaire provided a list of possible negative effects and clients reported which ones they had experienced.
What were the results of the study?
Clinician Interviews
Interviews with clinicians found that they were aware of their clients experiencing negative effects. They talked about feelings of anxiety being present during assessments and they said that this could be because of feeling anxious about being tested or anxious about what the outcome might be. They said that testing can lead to clients being critical of themselves when they do not feel they have performed well and this can impact their confidence. They also said that testing can sometimes highlight difficulties for clients that they weren’t aware they had and this can be upsetting. They explained that sometimes clients can be upset if the outcome of the assessment is not what they expected.Clinicians talked about other factors that can mean a client is more at risk of experiencing negative effects. They said that pressure from a clients’ family or medical clinician can affect their experience. They also said that if someone has had a bad experience of being tested before, for example when at school, or if they have a mental health condition such as anxiety that these can sometimes impact clients’ experiences.
Clinicians described what they do to try and reduce the risk of one of their clients experiencing negative effects. They said it was very important for them that their clients felt calm and they would spend time trying to create a relationship first before testing. They also said that they try and accommodate clients’ needs. For example, they will arrange to see them at home if their physical or mental health prevents them coming to clinic, or will include breaks during the appointments. They said it was important that their clients consented to taking part and would use their judgment of whether it was helpful for the client to continue with the assessment if they became aware that it was having a negative impact on them which might affect the results of the tests.
Clinician and client questionnaires
Both clinicians and clients responded to 28 questions which described possible negative effects. The top six most selected negative effects were the same for clinician and clients. These were: feeling disappointed in their performance on tasks, feeling frustrated, critical of themselves, worried about the outcome of the assessment, stressed and worried. The majority of clinicians and clients said that these negative effects were a direct cause of the neuropsychological assessment.REC name
West of Scotland REC 4
REC reference
22/WS/0064
Date of REC Opinion
27 Jun 2022
REC opinion
Further Information Favourable Opinion