Right: C. LEMSKY, Ph.D., C. Psych. Neuropsychologist, Clinical Director Left: C. BRANDYS, Ph.D., C. Psych. Neuropsychologist

Neuropsychological services are available for clients of CHIRS who are experiencing new or ongoing difficulties with thinking, learning, memory or behaviour related to their traumatic brain injury or disease. All services are completed or directly supervised by Carolyn Lemsky, Ph.D.,C.Psych., or Clare Brandys, Ph.D.,C.Psych. Both of our neuropsychologists came to CHIRS with extensive training and experience in the field of acquired brain injury. Dr. Lemsky completed specialized training in Neuropsychology and Rehabilitation at the Mayo Clinic, Rochester, Minnesota. She came to CHIRS with experience from a variety of rehabilitation settings including the Rehabilitation Hospital at the Cleveland Clinic, Cleveland, Ohio.

We are also fortunate to have the services of Dr. Brandys. Dr. Brandys has also completed specialized training in Neuropsychology. She came to CHIRS in 2000, with fifteen years of professional leadership experience in Toronto hospitals, including St. Michael's Hospital and Toronto Rehabilitation Institute, in the area of acquired brain injury rehabilitation. Both Dr. Lemsky and Dr. Brandys provide individual services as well as consultation to each of the CHIRS units of service.

Consultation

Our Neuropsychologists are active participants in regular team meetings, program planning and staff training. Each residential unit has weekly, designated consultation time during which program plans are created and modified. Staff are assisted in understanding the complex relationships between an individual's injury, history, personality and the environment. Often, time is spent seeing individual clients and providing direct supervision and being a role model for staff in interactions with clients. The goal of consultation is to ensure that each CHIRS client has a program plan that includes personally relevant goals, strategies for intervention that are appropriate for the individual's strengths and needs, and provision of services that foster community integration and personal growth. To that end, staff are provided with mentoring that is intended to increase their ability to work with individual clients as well as their commitment to providing consistent, high quality service to persons living with acquired brain injury.

Neurobehavioural Evaluations

When there are concerns about behaviour or cognitive abilities, but it is unclear how to proceed with services, a neurobehavioural evaluation may be requested. This evaluation consists of an interview with the person receiving services and others who may have an interest in their care. Areas assessed may include behavioural, emotional or cognitive difficulties. The interview session may include a brief evaluation of cognitive functioning. Outcomes resulting from the evaluation may include specific recommendations for treatment or suggestions for further evaluation.

Neuropsychological Evaluations

Understanding the nature of an individual's difficulty with thinking, learning and memory is often necessary in order to make appropriate plans for care and rehabilitation. Neuropsychological evaluations may be requested by a professional in order to keep track of cognitive changes during the early stages of recovery from an illness or injury, or to plan for a change in care, work or independent living. Neuropsychological testing is the process of evaluating difficulties in learning, memory, language, problem-solving , attention, visual-spatial, fine motor and academic skills using standardized procedures. Tests are conducted individually by Dr. Lemsky or a technician under her supervision over the course of a two to six hour session. In most cases, testing is conducted in a single appointment. After testing is completed, Dr. Lemsky reviews the test results and writes a summary report. A feedback session is scheduled to review the results of the evaluation as well as recommendations for follow-up care.

Individual Psychotherapy

Individual psychotherapy is offered to a limited number of individuals who are having difficulty coping with the effects of their acquired cognitive impairments. Clients who are referred for psychotherapy are interviewed to ensure that their goals are likely to be met by individual therapy. Sessions are generally conducted weekly or bi- weekly for fifty minutes per session. Sessions are adapted to meet the cognitive, emotional and behavioural needs of the client.

Group Therapy

Groups provide the opportunity for learning social skills, increasing awareness of strengths and needs and providing social support. Groups are formed when a number of individuals with like needs are identified. They are generally one and one half hours in length and are supervised or co-led by Dr. Lemsky.

Behaviour Therapy and Cognitive Rehabilitation Consultation

When behavioural or cognitive difficulties are interfering with an individual's ability to benefit from care, consultation with a neuropsychologist may help to clarify goals for treatment and provide recommendations for the provision of services. Dr. Lemsky is available to all CHIRS' residential and community programs to assist in the formulation of plans for individuals' behaviour therapy or compensation for cognitive impairments.

For more information on Neuropsychological Services on a fee for service basis, please contact the CHIRS Intake Department.