Clinical Services
Neuropsychological and Psychological Evaluations
In terms of neuropsychological evaluations offered at the Neurobehavioral Institute of Miami, a culturally and linguistically sensitive approach is the trademark of this service. This is particularly relevant to the Hispanic, Spanish speaking population of Miami-Dade County, as well as the surrounding Spanish speaking countries. To this effect, the Neurobehavioral Institute of Miami maintains a close working relationship with its affiliates and corresponding institutions in Spain, the Dominican Republic, Argentina, Panama, and Colombia.
The Neurobehavioral Institute of Miami has an extensive holding of neuropsychological and psychological instruments, in both English and Spanish, which are available for use with the patients seen at the Neurobehavioral Institute of Miami. A process oriented eclectic approach to neuropsychological evaluation is used at the Neurobehavioral Institute of Miami. Neuropsychological batteries are configured in terms of the diagnostic question that has prompted the evaluation, the availability of norms and published research on the use of each instrument selected relative to the linguistic, ethnic, and demographic characteristics of the patient, as well as relative to the syndrome suffered by the patient. These considerations are also taken into account in the interpretation of the results obtained in each of the instruments administered.
In order to improve the accuracy of neuropsychological findings obtained in Hispanic, Spanish speaking patients, the Neurobehavioral Institute of Miami has assumed a leading role in a multi-national initiative to develop appropriate normative data bases for these patients.
The Neurobehavioral Institute of Miami has an extensive holding of neuropsychological and psychological instruments, in both English and Spanish, which are available for use with the patients seen at the Neurobehavioral Institute of Miami. A process oriented eclectic approach to neuropsychological evaluation is used at the Neurobehavioral Institute of Miami. Neuropsychological batteries are configured in terms of the diagnostic question that has prompted the evaluation, the availability of norms and published research on the use of each instrument selected relative to the linguistic, ethnic, and demographic characteristics of the patient, as well as relative to the syndrome suffered by the patient. These considerations are also taken into account in the interpretation of the results obtained in each of the instruments administered.
In order to improve the accuracy of neuropsychological findings obtained in Hispanic, Spanish speaking patients, the Neurobehavioral Institute of Miami has assumed a leading role in a multi-national initiative to develop appropriate normative data bases for these patients.
Interventions
The intervention approach implemented at the Neurobehavioral Institute of Miami is multi-modal in nature. In this regard, another important line of service offered by the Neurobehavioral Institute of Miami through its clinical branches and affiliates, Neurobehavioral Services, Inc., Neurocognitive Rehab, Inc., and Neuro Rehabilitation Associates, LLC, is cognitive rehabilitation. Through the use of computer softwares, a restorative approach is followed in cognitive rehabilitation, based on sound findings from neuropsychological evaluations, and derived from a number of theoretical models of attention, memory, and executive functions.
The approach to cognitive rehabilitation used in the Neurobehavioral Institute of Miami is restorative in nature, as opposed to compensatory. That is, based upon an analysis of the functions assessed by means of the neuropsychological evaluation, a determination is made as to the relative cognitive strengths and weaknesses presented by the patient, and a program of intervention is designed using the identified strengths to remedy the identified weaknesses. The use of computer software allows the cognitive rehabilitation process to be characterized by high frequency of presentation of stimuli, the use of high intensity stimuli, and immediate feedback on the performance of the patient in the exercises used.
The parameters usually monitored in the cognitive rehabilitation interventions used at the Neurobehavioral Institute of Miami include simple and choice reaction time, level of exercise difficulty, average number of correct responses, and average number of incorrect responses, among others. The proportion of successes in any session is closely monitored following what has been described as the 70/30 rule.
That is, the exercise provides the patient for a 70% opportunity for success, while it also provides a 30% challenge. This avoids habituation, while at the same time it also avoids reaching a level of frustration. The parameters mentioned above are constantly monitored and adjusted, according to individual performance.
Behavioral pain management programs are also implemented on behalf of the patients seen at the Neurobehavioral Institute of Miami. Through the use of transactional psychophysiology, a cognitive neuroscience model for behavioral pain management followed. A thorough understanding of the physiology of the central and autonomic nervous systems allows the staff of the Neurobehavioral Institute of Miami to help patients become aware of the functioning of pain receptors in the brain and what they can do to lower their activity, substituting it for the activity of other areas of the brain, and consequently lowering the pain level. Similar approaches are used at the Neurobehavioral Institute of Miami to help patients deal more effectively with sleep disorders and headaches.
Patients seen at the Neurobehavioral Institute of Miami very frequently suffer from symptoms of anxiety and depression. These may be reactive to the adversity represented by suffering from a neurological condition, as well as many other factors inherent in the situation patients find themselves in, as a result of this. Other symptoms often represent the brain based dysfunction associated with the patient’s neurological disorder. These patients are offered verbal supportive psychotherapy, as part of the multi-modal program of intervention implemented at the Neurobehavioral Institute of Miami. The psychotherapeutic approach followed in the Neurobehavioral Institute of Miami is cognitive-behavioral in nature. When the neurological illness suffered by the patient results in a dysfunctional family dynamic, a systemic approach is used to intervene.
Another important component of the multi-modal treatment programs implemented with the patients at the Neurobehavioral Institute of Miami is applied behavioral analysis. Following a functional capacity evaluation, a program of contingency management is implemented in order to help the patient install new behaviors, increase the frequency and effectiveness of others, and reduce maladaptive behaviors.
The approach to cognitive rehabilitation used in the Neurobehavioral Institute of Miami is restorative in nature, as opposed to compensatory. That is, based upon an analysis of the functions assessed by means of the neuropsychological evaluation, a determination is made as to the relative cognitive strengths and weaknesses presented by the patient, and a program of intervention is designed using the identified strengths to remedy the identified weaknesses. The use of computer software allows the cognitive rehabilitation process to be characterized by high frequency of presentation of stimuli, the use of high intensity stimuli, and immediate feedback on the performance of the patient in the exercises used.
The parameters usually monitored in the cognitive rehabilitation interventions used at the Neurobehavioral Institute of Miami include simple and choice reaction time, level of exercise difficulty, average number of correct responses, and average number of incorrect responses, among others. The proportion of successes in any session is closely monitored following what has been described as the 70/30 rule.
That is, the exercise provides the patient for a 70% opportunity for success, while it also provides a 30% challenge. This avoids habituation, while at the same time it also avoids reaching a level of frustration. The parameters mentioned above are constantly monitored and adjusted, according to individual performance.
Behavioral pain management programs are also implemented on behalf of the patients seen at the Neurobehavioral Institute of Miami. Through the use of transactional psychophysiology, a cognitive neuroscience model for behavioral pain management followed. A thorough understanding of the physiology of the central and autonomic nervous systems allows the staff of the Neurobehavioral Institute of Miami to help patients become aware of the functioning of pain receptors in the brain and what they can do to lower their activity, substituting it for the activity of other areas of the brain, and consequently lowering the pain level. Similar approaches are used at the Neurobehavioral Institute of Miami to help patients deal more effectively with sleep disorders and headaches.
Patients seen at the Neurobehavioral Institute of Miami very frequently suffer from symptoms of anxiety and depression. These may be reactive to the adversity represented by suffering from a neurological condition, as well as many other factors inherent in the situation patients find themselves in, as a result of this. Other symptoms often represent the brain based dysfunction associated with the patient’s neurological disorder. These patients are offered verbal supportive psychotherapy, as part of the multi-modal program of intervention implemented at the Neurobehavioral Institute of Miami. The psychotherapeutic approach followed in the Neurobehavioral Institute of Miami is cognitive-behavioral in nature. When the neurological illness suffered by the patient results in a dysfunctional family dynamic, a systemic approach is used to intervene.
Another important component of the multi-modal treatment programs implemented with the patients at the Neurobehavioral Institute of Miami is applied behavioral analysis. Following a functional capacity evaluation, a program of contingency management is implemented in order to help the patient install new behaviors, increase the frequency and effectiveness of others, and reduce maladaptive behaviors.