Neuropsychology at Arizona State Hospital

James Holmes, Psy.D.
Psy.D.
June M. Stapleton, Ph.D.
Topics
Overview of AzSH
Patients at AzSH
Functions of Psychology Department
Assessment
Treatment
Case example
Overview of AzSH
Only state-funded psychiatric hospital in AZ
Three basic programs:
Forensic
Civil
Sexually Violent Person (SVP) Program at
Arizona Community Protection and
Treatment Center (ACPTC)
Multidisciplinary approach
Approximately 340 patients/residents at AzSH
Patients at AzSH
Program for civil patients
Court-ordered treatment
Gravely disabled (GD)
Persistently and acutely disabled (PAD)
Danger to self/others
Not competent to stand trial
Not Guilty by Reason of Insanity (NGRI)
Patients at AzSH
Program for forensic patients
Guilty Except Insane (GEI)
NGRI
Restoration to Competency (RTC)
Patients also sent for evaluations (e.g. GEI
Evaluation)
Patients at AzSH
Program for SVP
Sent for SVP evaluation
If deemed SVP, civilly committed for
treatment at ACPTC following prison
sentence
Patients at AzSH
Patients are ethnically/culturally diverse
Age range: 18-90
Most patients have multiple issues: Psychiatric,
neuropsychological, personality, and substance
abuse/addictive disorders
Have had cases of Capgras Syndrome, rare
congenital disorders, Dementia of the
Alzheimer’s type, traumatic brain injury (TBI),
and stroke
Functions of Department
Have masters and doctoral level staff,
predoctoral interns, and students
APA-accredited internship site
Function as consultative department
Functions of Department
Roles include assessment,
individual/group/family therapy, consultation
with behavioral issues, and training
Types of evaluations:
Psychological, Psychoeducational,
Neuropsychological, Competency, GEI,
Violence Risk Assessments, and
Psychosexual
Assessment
Neuropsychological assessment used to guide
treatment of patients
Most assessments include a comprehensive battery:
Intelligence
Sensorimotor
Language
Visuospatial
Memory
Personality
Assessment
Add tests for specific issues
Clarify deficit
Symptom validity
Achievement
Assessment helps clarify strengths/weaknesses for
patient
Staff can approach patient with strengths
Clarify if functions due to psychiatric or
neuropsychological issues
May have implications for pharmacotherapy
Treatment
Provide individual and group cognitive
rehabilitation
Most patients well beyond initial injury
Increase awareness
Process losses associated with injury/disorder
Focus on strengths, compensatory strategies
Assistance with using a planner
Treatment
Development of lists
Teaching elaborative rehearsal and memory
strategies
Tasks that target weaknesses, look for progress,
and utilize compensatory strategies
Treatment
Help with personality/behavioral factors:
Impulsivity, anger, and depression
Educate patient on injury,
strengths/weaknesses, and basic
neuroanatomy
Incorporate movies, books, and articles
Case Example