Changes to the brain or spinal cord can have widespread, life changing effects. Dr Mawbey provides expert, specialist services to clients with a range of injuries and disorders, including:
Acquired Brain Injuries
Traumatic Brain Injury
Brain Tumours / Brain Cancer
Motor Neuron Disease
Stroke / TIA
Progressive Supranuclear Palsy
Hypoxic Brain Injuries
Medically Unexplained Neurological Symptoms
Spinal Cord Injuries
Functional Neurological Disorder / Symptoms (FND / FNS)
Neurodevelopmental Disorders e.g. Autism Spectrum Disorder
After changes to the brain, clients might notice difficulties with their thinking skills. This can be in one or multiple areas of cognition (or thinking). These areas include speed of processing information, visual memory, verbal memory, planning and organising, initiating and inhibiting oneself, perception, language, attention and so on.
A full neuropsychological assessment may include a broad assessment of intellectual functioning or a set of tests targeted at assessing a comprehensive range of thinking skills, to give a good picture of a client's strengths and difficulties. If a weakness in a particular areas, such as attention, is identified, then this can be further assessed to determine which aspects of attention are affected. For example, is is dividing attention between two things, switching attention from one stimulus to another or sustaining attention on one thing. Nailing down the difficulty and understanding it, means that it can then be better targeted in rehabilitation.
Neuropsychological assessment information can be vital in many ways, including:
Helping a client and/or those around them build an understanding of their difficulties and how these may be impacting their life.
Providing a baseline measures against which to compare future assessments, in order to determine any deterioration or change over time.
To contribute to diagnosis of disorders and/or providing an idea of how progressed cognitive decline is.
Informing rehabilitation programmes so that a client can accurately target the difficulty and learn to better manage or resolve this.
Supporting a client's return to work, for example in informing workplace amendments and helping employer's understand an employees needs.
Supporting clients who are in education to be set up in such a way that any difficulty has a minimal impact on learning.
These specialist assessments can be in the form of a brief screen or a full assessment last between 1.5-3 hours, depending on the purpose of the assessment. Expert neuropsychological assessment is difficult to access within the NHS, often with lengthy waiting times. Dr Mawbey uses a battery of gold standard assessment tools to conduct neuropsychological assessments, including those used by professionals in the NHS.
When difficulties with thinking skills are identified, either in a cognitive assessment or in day-to-day functioning, there are a range of evidence-based interventions that can support a client to reach optimal levels of functioning.
This approaches may be restorative (with the aim of returning a skill to normal functioning) or compensatory (supporting a person with strategies and aids when cognitive difficulties are unlikely to resolve).
Dr Mawbey works collaboratively with clients, carers and care teams to develop tailored rehabilitation programmes, suited to each client's needs and goals in order to provide optimal support for cognitive functioning in day-to-day life.
Experiencing a change to your brain or spinal cord can have a significant impact on your sense of self and how you feel. It is common to experience difficulties with adjustment to the challenges faced as well as low mood, anxiety, panic or trauma. Consulting a Clinical Neuropsychologist ensures that you will discuss these difficulties with a professional who understands the unique aspects of the diagnosis that you have received and has worked with other clients with similar experiences.
Some diagnoses may also cause cognitive difficulties, that will make it difficult to make the most of talking therapy with a general psychologist or counsellor. For example, processing of information may be slower, difficulties initiating strategies may affect therapy and remembering information between sessions may be challenging. Accessing talking therapy with a Clinical Neuropsychologist will maximise your opportunity to get the most out of a talking therapy as therapy will be tailored to your cognitive strengths and weaknesses.
Dr Mawbey is an expert in providing talking therapy to support clients in managing adjustment and emotional difficulties, in the context of a brain or spinal cord change. This means that she is able to expertly adapt therapies so that they are tailored to a person's needs e.g. if they have aphasia (difficulties with speech) or cognitive changes, then any therapy would be applied in such a way that would mean that a client could get the most out of it, despite these barriers. Dr Mawbey's training also means that if a client has a difficulty associated specifically with a disorder or injury, she will have extensive training and experience in working with clients with such presentations e.g. if a client is experiencing anxiety associated with bladder weakness in multiple sclerosis, or difficulties adjusting to cognitive changes following a stroke or a fear of falling in Parkinson's disease.
The primary talking therapy approach recommended by the National Institute for Clinical Excellence (NICE) in working with clients with brain changes is Cognitive Behavioural Therapy (CBT). Dr Mawbey is trained in this approach and also borrows from other waves of this, including Compassion Focussed Therapy, Narrative Therapy and Acceptance and Commitment Therapy.