Psychotherapy and Psychological and Neuropsychological Evaluations

Why Are Psychological Evaluations Requested or Required Before Certain Surgeries?

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Medical procedures such as spinal cord stimulator implantations or bariatric surgeries may require that patients receive psychological clearance before surgery for any combination of the following reasons:

• Your insurance company may require that you go through a psychological evaluation, as they will be spending a lot of money on the surgery and want to make sure that you will benefit from it.

• There is considerable evidence that psychosocial variables can positively and negatively affect the outcome of invasive procedures (Burchiel et al., 1996; Giordano & Lofland, 2005; Heckler et al., 2007; Gatchel, 2001; Gatchel & Mayer, 2008). Thus, a thorough assessment of these factors is a critical part of the screening process for appropriateness for surgery. If particular risk factors are present, various non-surgical treatment and/or modification of lifestyle factors may be required prior to gaining clearance to proceed with surgery.

• It is important that individuals undergoing surgery have a clear understanding of the procedure and potential risks and benefits, and have realistic expectations for the outcome.

What Should I Expect During A Pre-Surgical Psychological Evaluation?

The psychological evaluation typically lasts between 2-4 hours and consists of a clinical interview, psychological testing, and cognitive screening. Dr. Fine also reviews medical records and writes a report, which would be sent to the referring physician. The report includes any mental health diagnoses, risk and protective factors for the patient, and recommendations for treatment and/or lifestyle modification, which may improve the outcome of the surgical procedure.