© 2018 Emily B. Fine, Ph.D.

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For any questions you have, you can reach Dr. Fine here:

Contact

Emily B. Fine, Ph.D., QME

Clinical Neuropsychologist

Licensed Clinical Psychologist

Qualified Medical Evaluator

CA PSY 23742

Office Address:

Lakeshore Center

3281 East Guasti Road

Suite 700

Ontario, CA 91761

Mailing Address:

P.O. Box 1273

Claremont, CA 91711

Phone:  909-480-8235

Email:  drfine@dremilyfine.com

Fax:  909-354-3363

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)

What is a Neuropsychological Evaluation?

  • 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.

What does the Neuropsychological Immigration Evaluation entail?

  • 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.

What does the Psychological Immigration Evaluation entail?

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.

What type of evaluation do I need?

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 for the type of evaluation you are requesting.  For any evaluation that requires Dr. Fine to review your records prior to the initial appointment, a retainer of $1000 is due upon receipt of your records.  For all other evaluations, the retainer of $1000 is due at the time of your appointment.  The remainder or refund (if applicable) for evaluations will be due just prior to submission of the report (to you or the ordering agency).  Dr. Fine accepts payment in the form of cash, money order, or credit card.  

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.

Dr. Fine is an out-of-network provider for 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.  

How much does an evaluation cost?

“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) 

What is a Clinical Neuropsychologist?

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

  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.

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

How do I know if a professional is qualified to conduct neuropsychological assessment?