The experience of neuropsychological assessment, views of clients with traumatic brain injury

It is estimated that every year in the UK, more than one million people attend Accident and Emergency following a head injury. Neuropsychological assessment to detect impairments after a traumatic brain injury is a primary aspect of care. There is little information on how the neuropsychological assessment is experienced. This study captures the experience of undergoing a neuropsychological assessment from the viewpoint of clients with traumatic brain injury. Semi-structured Interviews were conducted with eight clients with traumatic brain injury, who had recently undergone a neuropsychological assessment. These were analysed using Interpretative Phenomenological Analysis.
Overall, the experiences of undergoing a neuropsychological test were variable, with reports of positive and negative experiences. Participants valued being treated as equal partners during the assessment process while also respecting that the assessor held the knowledge and expertise to aid their understanding of the injury. Assessor qualities and the relationship with the assessor affected participants’ assessment experiences. Familiarity with the assessor allowed participants to relax, whilst an unfamiliar assessor lead to uncertainty and anxiety. Participants had mixed views for the reason for the assessment. They approached the assessment with determination and a need to try their best. Feelings of anxiety, confusion, anger and frustration were reported. Participants also described feelings of relief and an eagerness to complete the tests. There was an overall sense that the assessment provided awareness about their difficulties after head injury, from which they could progress. Participants spoke about the fatigue experienced during the assessment which they felt negatively impacted on their assessment experience, as did a poor assessment environment. The analysis has demonstrated that undertaking a neuropsychological assessment is not a neutral experience for clients with a TBI.
The results of the study are considered in the light of existing research and its clinical implications.