Date of Award
2024
Degree Type
Dissertation
Degree Name
Doctor of Philosophy in Clinical Psychology
Specialization
Clinical Psychology
Department
Psychology
First Advisor
David Faust
Abstract
The historical influence of Western culture on neuropsychology, coupled with the increasing cultural and linguistic diversity in the United States, underscores the need for culturally responsive neuropsychological assessment practices. As neuropsychologists increasingly work with individuals from diverse backgrounds, unique considerations arise in conducting culturally responsive neuropsychological evaluations. This dissertation focuses on developing a preliminary decision-making checklist to promote cultural responsiveness and stimulate critical thinking in key clinical neuropsychology activities, such as obtaining patient history, selecting and administering tests, evaluating normative data, interpreting results, providing feedback, adapting recommendations, and addressing ethical considerations. A modified Delphi method was employed to develop and refine the checklist items. The process began with a literature review that laid the groundwork for initial items. This was followed by collaboration and a pilot survey with two consultants to gather feedback and clarify checklist items before the initial Delphi survey rounds. Expert panel members were chosen for their expertise in cultural neuropsychology, identified through databases like PubMed, Google Scholar, and PsycINFO using targeted keywords. Invitations were sent to 15 neuropsychologists, with nine agreeing to participate. Eight contributed to the first survey round, and seven completed the second round. The data collection combined qualitative feedback with quantitative ratings on a 7-point Likert scale, evaluating each item's importance and feasibility. Ratings ranged from 1 (not important at all) to 5 (important) and 7 (extremely important). An item reached agreement if it received a median score of 5 or higher, and consensus was achieved when at least 70% of experts rated an item as 5 or above. The initial literature review resulted in 36 checklist items, which were refined based on the consultants’ input and utilized in the first round of the Delphi survey. Eight experts assessed the items, providing qualitative feedback for modifications. Following the first round, importance analysis indicated that all items received agreement, with consensus achieved for 33 items. Three items did not meet the criteria and were excluded. Based on panel feedback, two items were modified into four, and 12 new items were introduced following a second literature review. The second survey round featured 47 items, rated by seven experts for importance and feasibility. In this round, all items achieved agreement and consensus. One item was divided into three sub-items for clarity, and two items were consolidated, resulting in a refined checklist of 45 items. A parallel analysis of feasibility ratings contributed to the checklist's practicality. This study presents a preliminary decision-making checklist, refined by expert consensus, to promote cultural responsiveness in neuropsychological assessments. As a step towards making neuropsychological assessments more inclusive and effective for diverse populations, this tool aims to guide professionals in identifying culturally relevant factors, taking targeted actions to address them, and making informed, culturally responsive decisions throughout the assessment process. Future research is essential to evaluate the checklist's effectiveness and refine it for optimal utility in clinical practice. Furthermore, the items can serve as a valuable framework for assessing clinical practice, identifying areas for improvement, and guiding training and research initiatives.
Recommended Citation
Kaplan, Burcu, "INFORMING NEUROPSYCHOLOGICAL ASSESSMENTS FOR CULTURAL RESPONSIVENESS: A PRELIMINARY DECISION-MAKING CHECKLIST BY AN EXPERT PANEL" (2024). Open Access Dissertations. Paper 4428.
https://digitalcommons.uri.edu/oa_diss/4428
