Editorial Introduction to the Special Issue on Neuropsychological Interventions

Abstract

As the numbers of adults affected by neurocognitive disorders rise, there is an increasing requirement for neuropsychological interventions to maximize quality of life for patient and family, and to decrease the economic burden associated with specialized long-term care (Huckans et al. 2013). Consequently, there is a critical need for evidence-based techniques that combine the best available research evidence with clinician expertise in providing care to individual patients (Chelune 2010).While neuropsychologists traditionally undergo robust training in cognitive and behavioural assessment and focus their professional efforts on evaluation and diagnosis, many neuropsychologists are increasingly integrating this core training with intervention techniques to compensate for, or mitigate the effects of, neurologic disease. Provision of interventions involves both functional and foundational core competencies according to recent models (Stucky et al. 2010). However, training and practice in neuropsychological interventions has been widely neglected, for example, in the United States where less than 48 % of neuropsychologist respondents reported receiving specific training in intervention skills (Shultz et al. 2014).This special issue of Neuropsychology Review highlights diverse interventions for two important clinical populations with neurocognitive disorders, namely, people with geriatric and psychiatric conditions. The purpose of this special issue of systematic reviews is to increase scientific knowledge regarding neuropsychological interventions for both clinicians and researchers.The first two papers target early cognitive change associated with progressive dementia. Mild cognitive impairment (MCI), which is often prodromal Alzheimer disease, has been a focus of numerous clinical trials with particular emphasis on cognitive outcomes. Unfortunately, many trials have paid considerably less attention to non-cognitive factors that could demonstrate generalization of treatment benefits, although non-cognitive factors are often included as secondary endpoints. Chandler and colleagues review non-pharmacological intervention studies in older adults with MCI, specifically studies that report what Chandler and colleagues describe as "generalizability outcomes," including activities of daily living (ADLs), mood, quality of life (QOL), and metacognitive outcomes. A central finding of Chandler and colleagues review is that, while there may be some promise among the interventions studied, heterogeneity among both interventions and outcomes hinders efforts to synthesize findings across studies into a meaningful pattern of conclusions.Mowszowski and colleagues also set out to study cognitive changes following intervention in older adults. These authors were interested in both adults with MCI and cognitively healthy subjects, targeting executive functioning using a strategy-based cognitive training paradigm. Although their inclusion and exclusion criteria led the authors to retain so few studies of adults with MCI that systemati...