European Clinical Neuropsychology: Role in Healthcare and Access to Neuropsychological Services

Abstract

This study analyzed aspects of the work of clinical neuropsychologists across Europe. There are no published comparisons between European countries regarding the nature of clinical neuropsychologists’ work. Forty-one national psychological and neuropsychological societies were approached, of which 31 (76%) responded. Data from seven countries with less than 10 neuropsychologists were excluded. A license is required to practice clinical neuropsychology in 50% of the countries. Clinical neuropsychologists work independently in 62.5%. Diagnostic/assessment work is the most frequently reported activity (54%). Most neuropsychologists work in public hospitals, followed by health centers. Adult neuropsychology was the most frequent area of activity. Services in public institutions are covered by public entities (45.8%), or by a combination of patient funds and public entities (29.2%) and only 4.2% by the patient; whereas services in private institutions are covered by the patient (26.1%) and the combination of patient, public entities (21.7%) or patient and private entities (17.4%). The data suggest that the number of neuropsychologists working across European countries is considerably low in comparison to other medical professionals. The results of the survey identified similar aspects of neuropsychologists’ work, despite variations in terms of reimbursement and mechanisms, reflecting economic and healthcare differences. Estimates on the number of clinical neuropsychologists suggest insufficient access to neuropsychological services.

Status of Clinical Neuropsychology Training in Finland

“…It will also depend on the health care system and clinical practices. Preferably, the number of neuropsychologists should be in line with the number of other relevant professionals such as neurologist or psychiatrist [see Kasten et al (2021) for comparison]. Low number of trained specialists can partly, or temporarily, be compensated by organizing the work accordingly.…”

“…Treatment and rehabilitation is an integral part of clinical neuropsychology along with assessment ( Laaksonen, 1987 ; Norup et al, 2017 ; Turunen et al, 2019 ) and the need of professional neuropsychologists providing such services is growing ( Kasten et al, 2021 ). Therefore, it is essential that the specialization training equally accounts for the foundational and functional competencies (e.g., theoretical basis, evidence-based methods) necessary for neuropsychological interventions.…”

“…In Scandinavia, only 42% of psychologists working in neuropsychology report to have been approved as specialists ( Norup et al, 2017 ). There are bottlenecks in educational availability and since the title of clinical neuropsychologist is not protected by law in any of the Nordic countries ( Kasten et al, 2021 ), also psychologist with less training enter the field. An established training can serve in strengthening the profession and its independent status ( Hokkanen et al, 2019 ; Kasten et al, 2021 ).…”

“…There are bottlenecks in educational availability and since the title of clinical neuropsychologist is not protected by law in any of the Nordic countries ( Kasten et al, 2021 ), also psychologist with less training enter the field. An established training can serve in strengthening the profession and its independent status ( Hokkanen et al, 2019 ; Kasten et al, 2021 ). There is still a considerable need to develop training models in Europe to ensure consistent professional competencies and quality of neuropsychological practices.…”

Clinical Neuropsychology in Germany

“…According to studies by the Task Force Clinical Neuropsychology of the European Federation of Psychological Associations (EFPA), there are currently a lot of similarities, but also differences in the legal basis and the training of clinical neuropsychologists (see for example: Hokkanen et al, 2018 , 2020 ; Kasten et al, 2021 ). As in Germany, almost all countries require a master’s degree as a minimum requirement (e.g., Austria, Belgium, Denmark, Estonia, England, Finland, France, Iceland, Luxembourg, Portugal, Switzerland, and Turkey).…”