Psychotherapy and Psychological and Neuropsychological Evaluations

Yes! Dr. Fine is able to conduct almost all evaluations and psychotherapy via telehealth, utilizing secure Zoom videoconference, to protect your confidentiality. Research has demonstrated neuropsychological evaluations produce comparable results whether conducted in person or via videoconferencing for many measures (Brearly et al., 2017). Additionally, therapy provided in person, over the phone, and via videoconferencing demonstrates similar outcomes and patient satisfaction (Turvey, 2012).

Neuropsychological evaluations can help to establish or confirm a diagnosis, assist with differential diagnosis, determine the presence and severity of an individual's cognitive-behavioral-emotional difficulties, assist with determination of limitations in daily functioning and decision-making capacity, assist in treatment planning, offer feedback and treatment recommendations to patients/caregivers and other providers, and provide a baseline from which recovery or deterioration can be tracked.

A typical neuropsychological evaluation assesses many of the following ability areas:

• General intellect

• Motor skills and sensation

• Attention and concentration

• Language

• Visual-spatial skills

• Learning and memory

• Executive functioning (e.g. planning, problem solving, decision making, insight, judgment)

• Mood and personality

Individuals needing evaluation may have general complaints of cognitive dysfunction in some or all of the areas listed above due to:

• Acquired brain dysfunction (e.g., stroke, tumor, CNS infection)

• Traumatic brain injury

• Seizure disorders/epilepsy

• Demyelinating diseases (e.g., multiple sclerosis, ALS)

• Neurodegenerative disease (e.g., dementia, movement disorders)

• Medical disorders impacting cognition (e.g., vascular, transplant, pain)

• Psychiatric conditions (e.g., anxiety, mood, PTSD, and substance abuse)

• Childhood issues (e.g., learning disabilities, ADHD, autism spectrum)

• If your primary language is English, you will meet with Dr. Fine, in her private office.

• If your primary language is not English, you and your interpreter will meet with Dr. Fine, in her private office.

• A clinical interview to obtain information about your history (e.g. psychosocial, educational, employment, mental health, medical) will be conducted by Dr. Fine.

• Paper and pencil questionnaires, in your preferred language, will be administered to assess for symptoms that are common in individuals who have sought asylum or are applying for domestic hardship or an N-648 exception. (Dr. Fine understands that some of these questions may be difficult, and you are not required to respond to any questions.  However, the more questions you are able to respond to, the greater likelihood Dr. Fine can obtain the information she needs for your case.)

• Paper and pencil – and in some cases computerized – neurocognitive testing to assess relevant domains, which may include memory, attention/processing speed, executive functioning, visuospatial skills, language, and intellectual functioning will be conducted. 

• Dr. Fine will prepare a report (or completion of the N-648 form) based on the results of the clinical interview, questionnaires, neurocognitive testing, and review of records, which will include all necessary components.

• Dr. Fine will consult with your attorney, with your written authorization, regarding your immigration case, including providing a report of your history, symptoms, diagnoses, conclusions, and recommendations.

• If your primary language is English, you will meet with Dr. Fine, in her private office.

• If your primary language is not English, you and your interpreter will meet with Dr. Fine, in her private office.

• A clinical interview to obtain information about your history (e.g. psychosocial, educational, employment, mental health, medical) will be conducted by Dr. Fine.

• Paper and pencil questionnaires, in your preferred language, will be administered to assess for symptoms that are common in individuals who have sought asylum or are applying for domestic hardship or an N-648 exception. (Dr. Fine understands that some of these questions may be difficult, and you are not required to respond to any questions.  However, the more questions you are able to respond to, the greater likelihood Dr. Fine can obtain the information she needs for your case.)

• Dr. Fine will prepare a report (or completion of the N-648 form) based on the results of the clinical interview, questionnaires, and review of records, which will include all necessary components.

• Dr. Fine will consult with your attorney, with your written authorization, regarding your immigration case, including providing a report of your history, symptoms, diagnoses, conclusions, and recommendations.

Please contact Dr. Fine for a consultation to decide on a course of action together that makes the most sense based on your presenting history, symptoms, and diagnoses; and a plan that, most importantly, meets your level of comfort.

The cost of the evaluation varies based on the purpose and includes face-to-face time spent with the client, time spent scoring questionnaires and tests from the assessment, review of your records, consultation with your attorney and others (when appropriate), and report writing.  Please contact Dr. Fine for an hourly rate (if not covered by insurance) for the type of evaluation you are requesting.  Regardless, an agreed upon retainer is due when scheduling your appointment (if not covered by insurance).  The remainder or refund (if applicable) for evaluations will be payable each month.  Dr. Fine accepts payment in the form of cash, check, money order, credit card, and PayPal.  

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If you cancel or reschedule your appointment within less than two business days (48 hours) of your appointment, a fee will apply, due to the decreased likelihood of being able to schedule another patient with such short notice.  The cancellation fee varies based on the type of evaluation, and Dr. Fine will discuss this amount with you prior to scheduling the appointment.

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Dr. Fine is a Medicare, Anthem Blue Cross, Cigna, Molina Healthcare, and ComPsych provider and is an out-of-network provider for other insurance.   People often falsely believe that they have to see an in-network provider in order to have services covered and decide not to see an out-of-network provider for this reason, but this is is not the case.  PPO insurance plans typically reimburse between 50-70% of the allowed cost of services for out-of-network providers, if you choose to use your insurance.  All this usually requires is completing a one page form provided by your insurance company and attaching the detailed superbill that Dr. Fine will provide you.  Please check with your individual insurance plan.  

“Clinical neuropsychologists are professional clinical psychologists who undergo additional specialty training in cognitive psychology, neuroanatomy and neuropathology, neuroscience, behavioral neurology, and pharmacology. Clinical neuropsychologists are primarily involved in the evaluation of a person's cognitive abilities.” – American Psychological Association (APA) Division 40

In 2001, the National Academy of Neuropsychology (NAN) expanded on the criteria put forth by APA Division 40 to define the role and duties of a clinical neuropsychologist:

"A clinical neuropsychologist is a professional within the field of psychology with special expertise in the applied science of brain-behavior relationships. Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and/or rehabilitation of patients across the lifespan with neurological, medical, neurodevelopmental and psychiatric conditions, as well as other cognitive and learning disorders.

The clinical neuropsychologist uses psychological, neurological, cognitive, behavioral, and physiological principles, techniques and tests to evaluate patients’ neurocognitive, behavioral, and emotional strengths and weaknesses and their relationship to normal and abnormal central nervous system functioning.

The clinical neuropsychologist uses this information and information provided by other medical/healthcare providers to identify and diagnose neurobehavioral disorders, and plan and implement intervention strategies. 

The specialty of clinical neuropsychology is recognized by the American Psychological Association and the Canadian Psychological Association. They are often board certified akin to medical specialties. Clinical neuropsychologists are considered to be independent practitioners (healthcare providers) of both clinical neuropsychology and psychology." – NAN Definition of a Clinical Neuropsychologist (2001) 

Several training criteria, referred to as the Houston Conference Guidelines, must be met for practice as a clinical neuropsychologist:

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1. A doctoral degree (Ph.D. or Psy.D.) in psychology from an  accredited university with  core psychology, clinical psychology, brain-behavior, and clinical neuropsychology coursework in addition to obtaining in-depth training in assessment,  treatment, consultation, research, and teaching/supervision.

2. An internship, or its equivalent, in a clinically relevant area of professional psychology that is also approved by the American or Canadian psychological associations.

3. The equivalent of two (full time) years of experience and specialized training, at least one of which is at the post-doctoral level, in the study and practice of clinical neuropsychology and related neurosciences. These two years include supervision by a clinical neuropsychologist.

4. A license in the home state or province to independently practice psychology and/or clinical neuropsychology.

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Please verify these criteria with any mental health provider you are considering for neuropsychological assessment.