Empowering minds: revolutionizing cognitive and emotional health assessment with stepped care and digital tools

The field of neuropsychology has been slow to adapt the use of new technologies, relative to other healthcare fields, accounted for by multiple factors, including a lack of sufficient normative data, reliability, and validity for novel measures; low motivation by testing companies to develop measures that utilize modern psychometrics; and comfort in continuing to use measures and processes that have been used for decades in clinical practice. While these are all reasonable rationales for continuing to practice what we know, we find ourselves in a zeitgeist with rapidly developing technologies that can change and improve the way that we practice. At the same time, there is a growing recognition of cognitive health as a critical vital sign that needs to be well-managed throughout the lifespan to contribute to general good health and well-being, requiring large-scale screening efforts at the population level. Neuropsychologists are specialty care practitioners with limited bandwidth to provide comprehensive evaluations. Stepped-care models in neuropsychology that deploy novel technological innovations provide a solution to both challenges heretofore described. This manuscript, an adaptation of this author's 2024 Society for Clinical Neuropsychology's Presidential Address, illustrates models of stepped-care in neuropsychology and describes how novel tools, currently employed primarily in research settings, can eventually be integrated into the clinical practice of stepped-care neuropsychology. It also describes steps that our field is taking now to enter the new age of digital healthcare provision.