An Exploration of the Perspectives of Neuropsychologists Working With Clients From Ethnically, Culturally and Linguistically Diverse Backgrounds

The ethnic minority population of the UK is growing rapidly. Research has shown that factors such as, culture, language and ethnicity can influence cognitive functioning and performance on neuropsychological tests. Most neuropsychological assessment measures have been standardised on individuals from Euro-American, English-speaking backgrounds and have therefore little relevance to people from diverse backgrounds. This can place neuropsychologists in a difficult dilemma, who are required to conduct an adequate assessment and interpretation of a client’s cognitive function but are presented with unique challenges when working with diverse populations. Little is known about the neuropsychological assessment and practices involving ethnic minority groups in the U.K. Thus, the current study aimed to explore the experiences and practices of clinicians working in cross-cultural and cross- linguistic neuropsychology.
A cross-sectional research design was utilised, and a sample of professionals working in neuropsychology were recruited from various forums through purposive sampling. The study sample was representative of clinical neuropsychologists in the U.K based on the BPS Division of Neuropsychology (DoN) membership. Respondents (N= 78) completed a self-report questionnaire consisting of open (quantitative) and closed-ended (qualitative) questions via an online survey platform.
Frequencies were reported for quantitative data whereas qualitative data were subjected to two waves of analysis. Content analysis was firstly used to tabulate and summarize open-ended responses. Recurring themes from this data were then abstracted using thematic analysis.
Several themes emerged from the data including: a lack of training, challenges of working across culture, awareness of culture, neuropsychological tests and norms, clinical interview and interpreters. Overall, the quantitative data supported findings from the qualitative data. The findings were analysed in order to draw overall conclusions relating to neuropsychologists’ assessment practices, challenges faced by them and the wider profession and recommendations for improving cross-cultural and cross-linguistic neuropsychology. It is hoped that the results from this study stimulate research in the area of culture and language in neuropsychological practice as well as improve cultural competence at an individual and organisational level.