FAQ
Most of the common questions we receive are answered in these FAQ, organized by general topic. We are happy to answer additional questions by phone or in writing – reach out by telephone, email info@brainhealthpllc.com, or complete our Contact Form here.
General Policies
You will need to contact your insurance company to get answers specific to your plan and contract in order to verify coverage or to determine out-of-network benefits.
We make every reasonable effort to safeguard your privacy with use of a HIPAA-compliant Electronic Health Record (EHR) system integrated with secure payment processing and telehealth platform. We use our EHR system (IntakeQ) and its Client Portal, rather than email, for routine communications. Our EHR can send appointment reminders by text or email at your request, but we do not respond to text messages sent to the office phone number. Links to standardized rating scales are emailed directly to the recipient from test publishers’ HIPAA-compliant websites. Our consent forms have more information about electronic security and privacy.
Yes! We also test for functional challenges associated with medical and neurological disorders.
Not necessarily. For example, the breadth of Dr. Shapiro’s target client population has expanded along with her clinical skills and areas of expertise over decades of clinical work. We provide routine (neuro)psychological testing to children, adolescents, and young adults. Adult ADHD evaluation referrals are accepted on a case-by-case basis. Concussion management and sleep-related services are provided across the lifespan up to Medicare-eligible populations as medical and neurocognitive challenges
associated with aging fall outside our scope of training and expertise.
Reach out to us by phone or email, or by completing the brief Contact form on the website. A member of our team will follow-up to schedule an appointment or brief consult and to answer any questions you may have. We are happy to schedule a brief call with Dr. Shapiro or anyone else prior to scheduling if you are unsure of how best to proceed or if we can best meet your needs. If we can’t, we are happy to provide referrals.
Most states require licensure in the state in which the client is located at the time of services. Some states allow some limited practice by psychologists licensed in other states, while others require a full application for licensure in order to provide services to someone in that state. Dr. Shapiro has a full and unrestricted license to practice psychology in person and via telehealth in GA, IA, NC, and NE. She also holds APIT authorization to provide unlimited telehealth services and limited in-person services in 40+ states under PSYPACT, an interstate compact. For the most updated listing of participating states, click here.
It depends on the questions you’re asking, or the concerns prompting you to reach out to someone. Just as a nurse practitioner can provide good medical care for some medical disorders, some mental health professionals without doctoral-level training can provide good care, too. Psychiatrists are medical doctors with the same breadth and depth of training as a psychologist – also a doctor – but in the field of medicine. They explore medical / physiological bases of cognitive, emotional, or behavioral difficulties and rely primarily on medical management of disorders (prescribing). Although some psychiatrists obtain additional training in psychotherapy, it is not typically of comparable breadth and depth as compared to masters- or doctoral-level psychotherapists like counselors or psychologists.
Most doctoral-level (PhD or PsyD) psychologists have 2-3 times more years of coursework and supervised pre-degree clinical training than masters-level providers, with additional post-doctoral fellowship training as well. Even so, a counselor who has chosen to specialize in one particular skill or service could ultimately have more training and expertise in that skill or service than a more broadly trained doctoral-level psychologist! Thus, it is important to ask what kind of experience and training a given provider has for your referral concerns, since the nature and level of the degree doesn’t always provide a complete picture. When it comes to psychological testing, you should look for someone who has had multiple classes in the science of testing (psychometrics) and assessment itself, in addition to months of dedicated, supervised test administration, interpretation, and report-writing.
Concussions
Nope! Most people diagnosed with a concussion do not “pass out” or “black out” (lose consciousness). One of the biggest problems in treating concussions is the absence of recognition and identification of the injury. Look here for a brief definition of what a concussion is, and common signs and symptoms. Sometimes, the only symptom after a hard direct or indirect hit is that the person “just doesn’t feel right” – if unsure, allow evaluation by a trained professional before allowing return to sports with risk of contact to the head. Returning to sport prior to complete recovery can trigger more serious, and sometimes (albeit rarely) life-threatening brain injury.
Yes you can – but it doesn’t mean that you should, and you certainly shouldn’t take them at home alone on your own time and in your own way! Without appropriate conditions, those test results may not be very reliable or valid. And, you want to be sure the person interpreting the testing has appropriate training.
Just as you wouldn’t ask a podiatrist to read a mammogram, you wouldn’t want someone without the appropriate degree and training giving and interpreting tests measuring brain functioning. A weekend workshop isn’t a substitute for 6-8 years of training, and there are no good shortcuts.
Neuropsychologists are often regarded as testing experts, and we have many tools to choose from. Common computerized concussion tests are just one tool for determining if you’re 100% back to your pre- injury functioning, but those tests also have drawbacks and there’s no such thing as a “passing score.” When needed, Dr. Shapiro can administer some tests via telehealth or in-person, assist your local Athletic Trainer or physician with interpretation, or refer you to someone else. Working as a team is essential.
Neuropsychological testing for concussions is not nearly as extensive as “traditional” neuropsychological testing, since functioning is expected to change rapidly over time. Even in cases of chronic or persistent post-concussion symptoms, more than 1-2 hours of formal testing is rarely needed, with evaluations typically including extensive clinical interviewing and symptom assessment, with some oculomotor and/or vestibular screening.
Yes…and no! Everyone recovers at their own rate, but recovery should take days or weeks, not months. Recovery should continue to progress quickly and when it doesn’t, we screen for barriers to recovery and known risk factors for prolonged recovery. A standard 20- or 40-minute medical exam is not going to allow enough time, or yield the information that is needed, to expedite recovery. We provide individualized recommendations for supports in home, classroom, and workplace to help manage symptoms in a way that allows clients to return to life while facilitating recovery. When needed, we refer to related providers in your area with the right training and specialized skills to help you, too.
Again, that’s one of the roles of the Sports Neuropsychologist – to work with you to develop an individualized Care Plan that allows a gradual resumption of daily routines, with short-term adjustments to minimize the symptom triggers that prolong recovery.
Everyone recovers at their own rate because of all the factors that can affect symptoms and recovery. Most healthy individuals recover fully in a few weeks. If recovery seems slow, is taking longer, or you have a history of anxiety, depression, learning or attention problems, poor sleep, prior concussions, dizziness,
migraine or other chronic pain, you want a sports neuropsychologist involved to help manage those risk factors associated with longer recoveries. Sooner vs. later never hurts, as we can usually help speed recovery at any age or stage but work with Sports Neuropsychology is not always needed for everyone.
Many doctors recommend that, but just as a medical doctor decides what kinds of tests – like blood tests or imaging, for example – is needed to evaluate an injury or illness, our Sports Neuropsychologist decides what kind of testing or evaluation is needed for her clients. We use many sources of information to evaluate functioning, but we do not always need hours and hours of the traditional neuropsychological testing that your doctor may be thinking of, either. It all starts with intake questionnaires and an initial 1-2 hour initial evaluation – usually via telehealth. From there our providers work with clients and related providers to determine the best next steps.
Current research indicates that active recoveries are best – that is, mild to moderate levels of physical activity that do not trigger a significant worsening of symptoms, as long as there is no risk of contact or reinjury. Sometimes this is challenging for schools in states in which students are prohibited from returning to sports until recovery is complete, but a well-trained Sports Neuropsychologist can work with school staff – nurses, coaches, and/or Athletic Trainer – to devise a reasonable and safe rehabilitation
plan while recovery is ongoing.
There is no return to sport until the Return-to-Learn is complete, but experts have long recognized the importance of mild physical activity to expedite recovery while the Return-to-Learn is ongoing.
No, it’s not. Continued headaches suggest that recovery is not complete.
Sleep
While some people have “never been good sleepers,” others are ok until some event (such as stress, depression, pain, illness, etc.) triggers insomnia. Disrupted sleep, in turn, can make those things worse.
Research strongly indicates that not only can treatment improve sleep anyway, the improvements to sleep can help reduce those other symptoms.
The National Sleep Foundation offers good information about how much sleep most people need at different ages and stages of life. There are a variety of other factors that can affect sleep need as well. The risks of insufficient sleep – and how insomnia can affect mental and physical health – are, nonetheless, much greater than most realize. Insufficient sleep has been characterized as a public health crisis, and the incremental healthcare costs associated with sleep disorders are surprisingly quite high.
Testing
Psychoeducational testing focuses on learning-related questions and is usually not covered by health insurance in-network or out-of-network. School psychologists licensed to work only in schools, or persons with educational degrees, might examine just academic skill levels, whereas licensed psychologists can also include measures of ability and formally diagnose learning disabilities. Psychoeducational evaluations typically focus on how a student is functioning compared to age-peers, but not as consistently
on the why.
Psychological testing is conducted by a licensed doctoral-level psychologist with years of training comparable in length and depth to that of a medical doctor. Psychological testing can diagnose and identify psychiatric and developmental disorders such as anxiety, depression, ADHD, and autism spectrum disorders. Recommendations typically address multiple domains of functioning. Not all clinical psychologists have explicit training in working with educational settings and learning, however.
Neuropsychological testing is typically more broad, comprehensive, holistic, and integrated, and also appropriate for medical or neurological diagnoses in addition to educational, behavioral, social-emotional, cognitive, and developmental diagnoses. Neuropsychology is all about neurodiversity because neuropsychologists recognize that every brain is different! Neuropsychologists have 2 full years of post-doctoral fellowship training in brain-behavior relationships. Knowledge of neuroanatomy and brain functions guides evaluation and diagnostic determinations. By examining underlying neurocognitive processes in greater detail, it can also provide deeper insight into why individuals may be having certain difficulties.
We make every effort to accommodate emergencies and urgent situations, with weekend Concierge services also available. Same-day feedback can be provided if all tests are scored and all data and records are received in advance and all parent(s)/guardian(s) are present, but when possible we prefer to wait a bit and take our time reviewing all of the data again in its entirety, considering all the possibilities and sometimes gathering additional information and specific referrals to facilitate post-testing follow-up and intervention planning.
While this work may be routine for us, it is not at all routine for the client and family. Some time between testing and feedback allows us to thoughtfully consider not just what we think and recommend, but also how best to present that information and which referral resources might be best and accessible.
A comprehensive, updated list can be found here on the website. In general, however, we ask for just about every scrap of relevant information! This includes, for example, all educational records – report cards, all K-12 standardized testing, conference reports, any other standardized testing like PSAT/SAT, AP, IB, ACT tests (and records of accommodations, if provided), and any post high school transcripts. If school-based supports were provided, we would need copies of all of that, such as 504 Plans and meeting notes, IEP’s, Special Education Evaluation data, college accommodations documentation, etc. If the person to be tested ever received speech/language therapy or participated in psychotherapy (even for unrelated reasons) we would want a treatment summary that includes approximate dates of service,
number of sessions, treatment goals, and progress towards those goals. If there was any formal testing, like from a speech/language pathologist (SLP) or occupational therapist (OT) we would also want formal evaluation data in addition to the treatment summary.
If your child has some awareness of their areas of difficulty, or the reasons for which you’re seeking testing simply say that the psychologist is an expert with that sort of thing and will help them, their parents, and teachers figure out why and what to do about it. You can tell them that the psychologist is a doctor, but not the kind who pokes or gives shots. Rather, they’re a brain doctor and an expert on how kids think, learn, and behave. They’ll ask lots of questions, your child will do some work, and we’ll have advice for them and their parents and/or teachers. We’ll explain more when you’re here.
With young children, sometimes the Psychologist explains by telling them that just like they go to their pediatrician for check-ups, they’re a kind of doctor that does school check-ups to help get them ready for __ grade. We recommend you avoid saying they’ll be playing games – unfortunately, there are no games – or that it’s “testing,” because several hours of testing sounds miserable to most people. The Psychologist usually starts the conversation by asking why they think they’re here and goes from there.
Regardless of how it’s described we try to make it fun, with lots of breaks and positive reinforcement for good efforts. Adolescents are often pleasantly surprised that it wasn’t as bad as they expected. Do let us know if your young child has a favorite animal or popular character that could be helpful to incorporate
with stickers, cards, etc.
