The newsletter provides information on upcoming training opportunities, job openings, and announcements. It encourages members to submit articles, cases, clinical pearls, and other contributions to share with the membership. The lead article discusses various perspectives in neuropsychology and emphasizes the importance of a comprehensive evaluation involving multiple sources of information.

1. Malaysian Society of Clinical Psychology
Newsletter
Volume 1, Issue 1 January 2016
Note from the Editor:
One of the values of a newsletter is to share with a membership a variety of information. To that end, I would like to
encourage all members to find some thoughts, cases, “clinical pearls”, and information to share. This also includes news
of new programs, new positions, awards given to members, articles from non-members who would like to share their
expertise, celebrations, and training opportunities. We are all learning and with any luck, will be doing so throughout the
span of our career. I was asked to start it off with an article I wrote. I hope you enjoy it. I look forward to your
submissions.
Thoughts on Neuropsychology:
One Practitioner’s Perspective
Rory Fleming Richardson, Ph.D., ABMP, TEP
There are many ways of
studying the brain and
nervous system. We can
examine it anatomically or as
a static picture of brain
structure through magnetic
resonance imaging. We can
examine it physiologically, or
the brain in action through SPECT scans, PET
scans, functional MRI and others. Based on the
research of Penfield and other neurological
researchers, we can estimate the impact that
damage in specific locations has on function. We
can explore the neurochemical processes and likely
implications. What is of interest is that all of
these may suggest a level of function which simply
is not consistent with the anatomical and
physiological results. The brain and nervous
system is part of a total body. Our assessments
are also based on the present findings, not always
taking into account the adaptive skill and ability of
the organism to survive and adapt. For example,
if a child suffers a brain injury early enough in life,
other parts of the brain may compensate taking on
the functions usually controlled by the damaged
area. In a case I assessed a 45 year old adult had
suffered severe brain damage as a infant, resulting
in a quarter of his brain being destroyed. As he
developed, the functions which were impacted
were assumed by other parts of his brain, and the
localization of different brain functions were fully
compensated for in other parts of his brain.
Although the current MRI presented the absence
of the brain tissue in key function areas, these
functions were shown to be housed in a different
location of his brain (based on PET imaging).
Without the completion of functional testing, the
level of dysfunction could not be determined. A
neuropsychological examination is an assessment
of the level of function of each brain function
which, when added to the history of the patient
and various imaging, can provide not only a
snapshot of current level of function, but also
clues as to the prevailing maladies that the
individual may be suffering from.
It is important to understand that any assessment
is a picture of current status, and only a point, in
a continually changing picture of an individuals
condition. The individual’s current condition is a
continuum of change as events occur that impact
the condition for the better or for the worse. The
picture of current status also includes the
adapting and compensating the patient has made
since the injury or malady occurred.
As a psychologist, I have come to believe that
everything that we call a disorder is made up of
something that we absolutely need, but at levels
which are too high or too low. The focus is to help
biochemistry, neural plasticity, thought processes,
and behaviors to move into a range where the
individual can function best, and achieve the best
quality of life possible. Obviously, to achieve this,
a comprehensive assessment is needed.
Unfortunately, many services that are provided
focus on the symptoms rather than attempting to
achieve a balanced gestalt (whole picture) of the
causes of the imbalances. When the etiology can
be found, treatment can be honed to match
individual needs.
Therapeutic Psychological and Neuropsychological
Assessments are for purposes which include:
(1) to identify current neurological and/or
psychological conditions which the patient is
suffering from,
(2) to determine possible dynamics and their
interplay which could affect treatment,
(3) to determine possible treatment and

2. accommodation needs,
(4) to provide recommendations for further
treatment and assessment, and
(5) provide a prognosis given the information
available.
As part of this evaluation, it is likely that
treatment contacts will or have been included and
that the assessment is to improve the quality and
effectiveness of services.
To achieve the best results in an assessment, the
neuropsychologist wants to obtain the patient’s
best effort as free from fatigue, distractions and
other factors as possible. A neuropsychological
evaluation is not a short assessment. Different
tests are used to test each function. For example
the Halstead-Reitan Neuropsychological Battery is
made up of at least ten separate tests (including
the Wechsler Intelligence Scales and the Wechsler
Memory Scales). Commonly, additional tests are
added to this battery for specific conditions and to
examine specific questions. It is not unusual for
different combinations of testing to result in 12
hours or more, of face to face testing; in addition
to the time necessary for interviewing the patient,
the family members, reviewing records, and the
rigors of scoring, interpretation and writing of the
report. Collectively, a comprehensive
neuropsychological examination could result in 20
hours or more of clinical time. The results of the
neuropsychological examination provides necessary
specifics to clarify the condition, likely contributing
factors and diagnoses, directions for rehabilitation,
and a baseline for changes. The
neuropsychologist is highly trained and must
understand the impact of various medical
conditions on neurologic function, and be able to
interact fluidly with neurologists and physicians in
ferreting out the interplay of psychological and
neurological conditions. It is important to be able
to understand the interplay of the endocrine
functions, the importance of body cycles, and
subtle changes which can impact function.
It is important to know the right questions to ask
and to know what to do with the answers you get.
Some questions have to be asked multiple times in
different ways. For example, if a clinician were to
ask if a patient had a head trauma, frequently the
answer is “no”. If the clinician was to accept this
answer as true without further questioning, the
patient may not recall the baseball that they were
hit in the head with which knocked them out, or
being thrown from a horse and hitting their head,
or any one of a number of alternative events.
Although mild head trauma can leave little impact
on one’s life, there are multiple dysfunctions which
are linked back to mild Traumatic Head Injury.
A neuropsychologist is a detective of function, and
the causes of the limits and scope of that
function. This is a challenging task. It is essential
that new neuropsychologist gain from senior
neuropsychologists, in the course of clinical
supervision, the knowledge and wisdom in
approaching this task.
There are some neuropsychologists who attempt
to complete an assessment based on the memory
of information by the patient. This is obviously
limited since asking a person with memory
problems for a complete history is likely to result in
the omitting of important information. If someone
were to ask a person with memory problems to
provide a full history, you would think the person
silly for expecting that the history given was
complete. It requires the assistance of a
combination of interviews with family and/or
friends, and a review of medical records. Caution
should be taken with medical records. It is not
uncommon that some errors in recording history
may have been made by previous evaluators and
clinicians. In one case, I had a woman who had
never been sexually abused by her father recorded
in her record has having being sexually abused by
her father. Despite repeated attempts to correct
this, she was unable to get the record corrected,
except for a small note by a current clinician that
the previous reported event was not correct.
Part of neuropsychologist’s job is to identify which
part of the brain functions and which do not. The
parts that function can be the needed support for
rehabilitation efforts. To omit this in a report can
potentially undermine treatment efforts in the
future. It is also important to define the factors
which undermine function and the factors which
support function. These are key in developing an
effective treatment plan.
Another part of the neuropsychologist’s task is to
ask the question, “What best describes the
process which led the patient to their current level
of function?” This would appear simple at first,
but if we work through an individual’s history, with
a sustained high fever at the age of six years old,
a left temporal head injury from a baseball at the
age of 12 years, ten years of alcohol abuse, and
Carbon Monoxide posioning during the winter when
he was 20, the picture becomes more complex. To
determine key factors such as date of onset of
specific dysfunctions, premobid conditions, and
course of illnesses, collateral (i.e., family and
others) interviews are essential.
We must remember that research is published
based on findings where subjects with more
complicated clinical profiles have been excluded.
Although this does refine the research, it makes it
essential that the clinician not overgeneralize the
implications of different test scores.
To illustrate the interlinking of factors necessary
for the making of a neuropsychologist, let me
share some of my experiences.
As a zealous learner who completed his bachelors
degree before his twentieth birthday, I have had

3. the opportunity to study with many senior
practitioners, now considered pioneers in the fields
of psychology, psychotherapy and behavioral
sciences. I started my training, in psychodrama
and group psychotherapy, when I was 20 years
old. That being, I was one of the younger
students and practitioners.
Back in 1974, I was under the tutelage of James
Wade, M.A., a psychologist associate and primary
psychometrist for a large high school in Portland,
Oregon. I learned to administer, score and
interpret the various psychological instruments
available. I remember my interest in learning as
much as possible about the use of the Wechsler
Scales, the various personality tests, and the
projective tests such as the Rorschach and the
Thematic Apperception Test. I was especially
interested in looking at how these tests were used
to come up with prognostic rating scales (Klopher
Method), and how the Wechsler Scales
demonstrated the various functions of the
individual.
Over the years, I had the opportunity to read
about the research, and use of these techniques,
written by Drs. David Wechsler, Joseph Matarazzo,
Edith Kaplin, Ralph Reitan, and others. It was not
until I started my doctoral studies, a second time,
that I was able to continue to hone my skills and
knowledge in the use of these tests as detective
tools. During my training in the early 1990s, I
remember Dr. Ralph Reitan share a story about
how the first neuropsychological lab was put
together. The announcement of the lab had been
made, and a visit was scheduled so that officials
could come and inspect the lab. At that point,
the lab only consisted of one room. So Reitan,
and his fellow colleagues, were instructed by Dr.
Halstead to gather up various tactile,
psychomotor, didactic, and testing instruments to
put in the lab to “make a good show”. After the
visit, the real work to find which tests and
instruments would be of value.
Dr. Reitan impressed upon us the importance in
that “if you are going to identify a problem,
attempt to provide a way of treating it.”
To better prepare myself for the scope of issues
presented in the clinical setting, I completed
several additional medical courses during my
doctoral studies. Without these, it would simply
not be possible to fully understand the scope of
interactions.
In a presentation by Dr. Edith Kaplan on the use of
the Boston Aphasia Screening, she repeatedly
emphasized the importance of watching the
process. It was not good enough to simply obtain
the results for scoring, but imperative to go
beyond the test and learn from observing the
subtle behavior of the examinee. She was an
advocate of process-based use of
neuropsychological assessments. This made an
impression since I had been originally trained as a
psychodramatist and learned to work with a
continuous flow of information which came from
the patient through their words, movements,
subtle prosody and less definable elements.
Each neuropsychological test provides specific
clues to fretting out the neuropsychological health
of an individual.
Neuropsychology is more than simply administering,
scoring and interpreting a set of tests. It requires
the neuropsychologist to continuously expand
his/her knowledge and skill in clarifying the
meaning of the results, being attune to the subtle
observations made during the entire process, being
a detective searching out the course and factors
contributing to a condition, and attempting to help
the patient overcome the limitations that stand in
the way of optimal functioning. These skills are
honed over years of experience, and the
continuing search for understanding the mind and
its relationship to the total person.
Training & Conferences
Gestalt Therapy: Creative Process
This two days’ workshop will cover principles of Gestalt Therapy and the Creative Process of
Gestalt.
FROM 16th to 17th January 2015 FROM 08:30 - 4:30 PM
Contact 016-3454 947 for further information
Dialectical Behavior Therapy for the treatment of Borderline
Personality Disorder
Dr. Keng Shian Ling
January 30th, 2016 (1:30-4:30 p.m.), venue is to be confirmed (see flyer below)

4. Meaning: Making and the Awareness of Death
Speaker : Dr. Mark Yang, PsyD
Date : 20th – 21st February 2016, 9:00am – 4:30pm
Venue : Lighthouse Psychological Wellbeing Centre
18 – 2 (First floor), PJU 1/3d,
SunwayMas Commercial Centre,
47301, Petaling Jaya,
Selangor.
Intended : All mental health trainees and practitioners, psychiatrists, lay or
Participants para-counsellors, as well as Psychology students are welcome to
attend the workshop
Price : Normal price – RM 450
Early bird rate – RM 380 (Registration before 15th January 2016)
Student rate – RM 350

5. Job Opportunities
National University of Singapore
There are several academic positions (the call is open to people with clinical psychology training)
available within NUS in Singapore. As part of its expansion, the Department of Psychology at the
National University of Singapore (http://www.fas.nus.edu.sg/psy/) seeks applications to fill the
following positions:
• 2 Assistant Professors (Tenure-Track positions), and
• 2 Lecturers or Senior Lecturers (Educator-Track positions)
Area of specialization is open, but the Department targets one hire in Industrial/Organizational
Psychology and one hire in Developmental Psychology. Successful applicants are expected to
have a PhD degree by the time of appointment (expected to be July 2016). Remuneration is
competitive and includes medical and other benefits. Significant research start-up funding is
available for the Tenure-Track positions.
http://www.fas.nus.edu.sg/psy/_abtus/search2015.htm
Mahkota Medical Centre
Job opening of clinical psychologist in Mahkota Medical Centre. The details are as below:
Vacancy: Clinical Psychologist (Full-time position)
Department: Rehabilitation
Total vacancy: 1
Responsibilities:
- To provide clinical psychology services to patients and work closely with Consultant
Qualification/Requirements:

6. - Master in Clinical Psychology
- Minimum 1 - 2 years clinical experience (Fresh grad are encouraged to apply)
- Able to speak Mandarin will be added advantage
Kindly write to may.liumy@mahkotamedical.com should you need further information.
Announcements & Recognitions
Please send announcements, recognitions you receive, and any member news you
would like to share to:
mscpmalaysianewsletter@hotmail.com