Psychotherapy and Psychological and Neuropsychological Evaluations

Dr. Fine is a particularly useful resource for immigration evaluations, as she is trained in, not only psychological evaluations, but also neuropsychological evaluations.  This is of particular importance in asylum and domestic violence cases, as many immigrants have suffered brain injuries due to blows to the head, suffocation, malnutrition, and/or electrocution, resulting in cognitive deficits, which should be assessed and reported, as documentation of deficits may contribute in a beneficial manner to their cases.  For N-648 evaluations, patients may have suffered any of the aforementioned injuries; a degenerative brain disease, such as dementia; and/or a pre-morbid intellectual disability, which interferes with their ability to take the citizenship exam.  Again, assessment and documentation of these diagnoses may be of benefit to the patients in their cases.

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In addition, Dr. Fine has:

• completed countless trainings and readings through the American Psychological Association (APA), Division 56, Trauma Psychology; the California Psychological Association (CPA); and peer-reviewed journals; and consulted with other psychologists and neuropsychologists, regarding conducting asylum evaluations, hardship evaluations, and N-648 evaluations

• extensive experience working with interpreters with immigrant populations

• read and follows the recommendations detailed in the Istanbul Protocol:  Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, which is the gold standard for particular types of immigration evaluations

• received training in and utilizes culturally and linguistically sensitive neuropsychological and psychological measures and norms

• experience providing testimony in a deposition and communicating with patients' attorneys

In order to become a United States citizen, one is required to take an English and Civics test. The English test has three components: reading, writing, and speaking. The Civics test covers important U.S. history and government topics. However, if an applicant demonstrates a “medically determinable” physical or developmental disability or mental impairment that has lasted, or is expected to last, at least 12 months, that affects the functioning of the individual such that, even with reasonable accommodations, he or she is unable to demonstrate the educational requirements for naturalization, he or she may be granted an exception. Illiteracy alone is not a valid reason to seek an exception to the educational requirements. In addition, advanced age, in and of itself, is not a medically determinable physical or developmental disability or mental impairment. 

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An applicant seeking an exception to the educational requirements submits a Medical Certification for Disability Exceptions (Form N-648) as an attachment to the naturalization application.  A licensed medical professional must complete the form. The medical professional must certify that the applicant’s medical condition prevents the applicant from meeting the English requirement, the civics requirement, or both requirements.  It is important to note that ONLY MDs, DOs, and PSYCHOLOGISTS may complete the N-648 Evaluations.  In a situation where a psychologist is the appropriate professional to be consulted, the majority of cases require a Neuropsychologist. (Please see “What Is A Clinical Neuropsychologist” for a description of this specialized field.) 

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In sum:

• Individuals applying for citizenship must take an English and Civics Exam

• You may be excused from this requirement if you have a disability expected to last at least 12 months, which may include:

  • Intellectual ​Disability

  • Learning Disorder

  • Dementia 

  • Cognitive Impairment Due to Other Conditions (e.g. brain injury, stroke, mild cognitive impairment)

• To be excused from this requirement, an evaluation must be completed by an MD, DO, or PSYCHOLOGIST​.

• Dr. Fine is skilled in conducting these types of evaluations and completing the necessary forms.

Asylum cases pertain to people who have fled from their home country due to persecution and are needing asylum in the US.  In asylum cases, an individual has been subjected to mistreatment and abuse in a foreign country. Frequently, the mistreatment is associated with a political, religious, ethnic, or gender factor. At some point, the individual flees and makes his or her way to the United States and files a political asylum claim. In his or her native country, it is very common that the individual has developed mental health and/or cognitive issues as a result of the abuse.  For asylum cases, it is necessary to assess whether an individual continues to suffer from psychological and/or neuropsychological symptoms after their arrival in the United States and/or whether return to his/her home country would place him/her in danger and/or exacerbate these symptoms. A psychological and/or neuropsychological evaluation helps to gauge how profound the trauma was in the country of origin and how long standing the ramifications.  International law forbids forcing refugees or asylum seekers to return to a country where they are liable to be subject to persecution.

There are several types of hardship evaluations:

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Waiver of Grounds of Inadmissibility (Form I-601)

One applies for a Waiver of Grounds of Inadmissibility when he/she is inadmissible (not allowed entry) to the United States and is seeking an immigrant visa, adjustment of status, certain nonimmigrant statuses, or certain other immigration benefits. Examples of things that might make an intending immigrant inadmissible include committing certain crimes, committing fraud in order to obtain an immigration benefit (for example, used a tourist visa to enter the U.S. in order to get married), appearing likely to become a public charge (receive government assistance), or having stayed in the U.S. unlawfully for more than six months.  In some cases, the waiver can only be granted based on a relationship that the intending immigrant has with a U.S. citizen or lawful permanent resident alien, combined with the extreme hardship that would result to those relative(s) if the immigrant were denied admission to the United States.  This is where a psychological evaluation can be helpful.

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Provisional Unlawful Presence Waiver (Form I-601A)

For a Provisional Unlawful Presence Waiver, one must demonstrate “extreme hardship.”  Extreme hardship need not be unique, nor is the standard as demanding as the “exceptional and extremely unusual hardship” standard that is generally applicable to cancellation of removal.  In these cases, the applicant does not leave the country until the waiver is granted.

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Cancellation of Removal

Cancellation of Removal for non-lawful permanent residents is a defense to deportation for people who are in removal (deportation) proceedings.  For Cancellation of Removal, one must demonstrate the following:

1. You have been physically present in the United States (in any status, or without status at all) for at least ten years.

2. You have been a person of “good moral character” for at least ten years.

3. You do not have any disqualifying criminal convictions.

4. You have a US citizen or Lawful Permanent spouse, parent, and/or child under 21 who would suffer “exceptional and extremely unusual hardship” if you are deported.

A psychological evaluation may be necessary to demonstrate #4.