Inpatient rehabilitation diabetes consult service: A rehabilitation psychology approach to assessment and intervention.

Problem: Diabetes clinical practice recommendations call for assessment and intervention on diabetes self-management during inpatient hospitalization. Although diabetes is prevalent in inpatient rehabilitation settings, diabetes self-management has not traditionally been a focus of inpatient rehabilitation psychology care. This is because diabetes is often a secondary diagnosis when an individual is admitted to rehabilitation for an acute event. Objectives: The authors provide a rationale for a role for rehabilitation psychologists in assessing and intervening on the psychosocial, behavioral, and functional self-management needs of individuals with diabetes within the rehabilitation setting. The development of a rehabilitation psychology Inpatient Rehabilitation Diabetes Consultation Service is described. Theoretical and empirical bases for compilation of the assessment and intervention materials are provided. Format and implementation of the service on a university-affiliated inpatient rehabilitation unit is described, with special consideration given to professional issues faced by rehabilitation psychologists and teams. Results: A flexible consultation model was implemented using a guided diabetes psychosocial assessment with brief educational handouts addressing selected key topics (i.e., hyperglycemia, hypoglycemia, blood sugar monitoring, nutrition, physical activity, medication, and, A1C and average blood sugar). The consultation service was feasible and well-accepted by treated individuals and the rehabilitation team. Conclusions: Rehabilitation psychologists are uniquely positioned to address the functional, psychosocial, and behavioral needs of individuals with diabetes. With further research to assess clinical outcomes, this approach may further address practice recommendations for inpatient diabetes care. Moreover, such a diabetes consultation model may be useful on an outpatient rehabilitation basis as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

National rehabilitation policy and rehabilitation psychology.

This article presents a summary of legislation that has influenced psychology’s role in the rehabilitation process since 1918, when the Soldier Rehabilitation Act was passed. The increasingly important role that psychologists have played in the rehabilitation process is detailed and implications for the role that psychologists must now play in the public policy arena are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospects for a Positive Psychology of Rehabilitation.

Positive psychology explores factors that make life worth living and the human strengths that enable individuals to confront challenges, appreciate others, and regard daily experiences as meaningful. This nascent area's focus can inform the direction of future research and practice in rehabilitation psychology. The authors discuss rehabilitation psychology's positive core strengths, identify positive psychology's levels of analysis and the implications for rehabilitation psychology, review subjective experiences following disability to illustrate positive rehabilitation psychology, consider some integrative positive models for research and practice, and recommend positive resources for rehabilitation psychologists. On the basis of existing strengths and emerging perspectives, the authors conclude that the prospects for a positive psychology of rehabilitation are excellent. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The APA Ethical Principles as a foundational competency: Application to rehabilitation psychology.

Overview: Competence is a core component of ethical conduct as reflected in its addition as an ethical standard in the 2002 APA Ethics Code. Successfully operationalizing and assessing competence provides psychologists a means to improve education and training, advance the field of practice, and create a framework for accountability to the public. Much of the recent competency discussion has been in response to a proposed Cube Model, with its three axes being foundational competencies (practice building blocks, such as scientific knowledge, ethical standards), functional competencies (attributes of providing services, such as assessment, intervention), and developmental progression (acquiring increasing competence over the course of one's education and career). Ethics is included on the foundational competency axis and has been operationalized to the extent that subcomponents and benchmarks have been promulgated. The competency model as proposed faces multiple challenges, including gaining consensus regarding its components, addressing reliable and valid assessment over time, and creating a culture of acceptance. We propose the Ethical Principles as an alternative framework for conceptualizing ethics as a foundational competency given the Ethics Code is already time tested and includes a serial review process for broad discipline input and adaptability. We apply the Ethical Principles as foundational components to rehabilitation psychology training at internship, postdoctoral, and specialty levels to illustrate the model. Conclusion: Rehabilitation psychology should engage in the competency movement at the predoctoral and postdoctoral level. The application of the Ethical Principles as a foundational competency to rehabilitation psychology represents a first step in this dialog. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

On missing the point: A reply to Jaques et al.

Replies to comments by Jaques et al (see record 2005-09346-002) on the author's original article (see record 1980-33168-001). I daresay that virtually every author who must respond to criticism thinks that the critical reader missed the point. In this case, I must join the legion of misunderstood authors. The article is entitled, "Psychological Services in Rehabilitation Medicine: Clinical Aspects of Rehabilitation Psychology." I attempted a very brief overview of the roles and functions of rehabilitation psychologists, not rehabilitation counselors. Somebody missed the point! Further, as I stated both in the abstract and in the summary, I was focusing on traditional clinical and counseling applications. I am a psychologist, and I wrote this particular article for an audience of professional psychologists to try to introduce some of the issues involved in psychological practice in this particular setting. I think that I accomplished that rather straightforward goal, and I hope that some of the readers will now consider rehabilitation psychology as an area of specialization that does utilize the skills learned in traditional clinical and counseling psychology doctoral programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fellows Address: Excellence in rehabilitation psychology—The ABPP diplomate in rehabilitation psychology.

Rehabilitation psychology, Division 22 of the American Psychological Association, has successfully completed a program for defining excellence among rehabilitation psychologists. This program is certified under the American Board of Professional Psychology (ABPP) and awards a diplomate based upon a thorough examination of education and experience, and the successful passing of a rigorous examination. Excellence in rehabilitation psychology is characterized by a very broad educational base, as well as a training base which includes more than a casual acquaintance with information from literally hundreds of areas of life. This very broad-based education and training is applied to a highly specific population of persons requiring and seeking rehabilitation. The diplomate in rehabilitation psychology marks a milestone in providing health service providers with highly trained and credentialed psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Facilitating rigorous qualitative research in rehabilitation psychology.

Qualitative research methods have much to contribute to theoretical and applied knowledge in rehabilitation psychology. However, as a discipline, rehabilitation psychology has been behind the curve in employing qualitative methods. Objectives: This article is a summary of the state of qualitative research in rehabilitation and an introduction to various methodological dimensions to consider in implementing qualitative rehabilitation psychology research. Types and examples of qualitative rehabilitation research are presented. Criteria for evaluating qualitative research are discussed. Finally, the majority of this article is devoted to presenting the various methodological dimensions on which researchers must make decisions in designing and implementing rigorous qualitative research (e.g., paradigms, methods, data collection strategies, data analysis procedures, reliability/validity). Conclusions: Rehabilitation psychology has much to gain through qualitative research, and success in incorporating qualitative evidence will be ensured by rehabilitation psychologists learning and rigorously implementing qualitative methods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of training in rehabilitation psychology practice in the United States and Canada: 2007.

Objective: Examine the structures, processes, and outcomes of training for rehabilitation psychology practice in the United States and Canada during 2007. Methods: Public data sources provided 947 potential training sites and programs, with 635 meeting selection criteria, from which 328 unique sites were identified. Of these, 117 sites (36%) reported providing training in rehabilitation psychology practice, and were sent a survey. Eighty percent (80%) returned the survey (n = 94). Results: There were nearly equal numbers of intern and resident training sites. Of the resident training sites, 46% had a complete rehabilitation focus, and 41% had faculty with American Board of Rehabilitation Psychology (ABRP) certification. Resident training sites ranged from 73% to 100% in meeting the Patterson and Hanson (1995) training guidelines, and ranged from 7% to 100% in formally teaching the current ABRP required competencies. Discussion: Many rehabilitation patients receive psychological services from practitioners whose professional emphasis is not in rehabilitation psychology, and many trainees involved with rehabilitation populations do not receive comprehensive training in rehabilitation psychology. There is a need for increased structure in and funding of training programs for rehabilitation psychology practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to special issue: Rehabilitation psychology and persons with psychiatric disabilities: Are they mutually exclusive?

This guest-edited issue of the journal illustrates the relevance of psychiatric rehabilitation to rehabilitation psychologists. It demonstrates that the focus of psychiatric rehabilitation includes some areas of functioning typically identified with rehabilitation psychologists, for example, vocational, residential, and family functioning. Further, it shows that traditional assessment methodologies and treatment settings are beginning to reflect a psychiatric rehabilitation orientation. Finally, it illustrates the philosophy and treatment models that form the basis of physical rehabilitation as also underlying psychiatric rehabilitation. It is hoped that this issue of Rehabilitation Psychology will assist in the resolution of the debate over contextual issues by considering why psychologists working with psychiatrically impaired persons may be identified as rehabilitation psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expanding the concept of acculturation in Mexican American rehabilitation psychology research and practice.

The acculturation process is increasingly being viewed as an important variable that provides a context for understanding Mexican American health disparities. Although rehabilitation psychologists have noted the importance of utilizing acculturation in research and practice, scholars continue to use out-dated conceptualizations and models of acculturation. Objectives: The authors provide a brief overview of current trends in acculturation theory and research. Limitations of current rehabilitation research and how acculturation theory can help explain Mexican American health outcomes are discussed. Finally, recommendations for rehabilitation research and practice are provided. Conclusions: The authors recommend that rehabilitation scholars develop and test theoretical models that incorporate multiple dimensions of acculturation in order to understand how it influences Mexican American health outcomes. Rehabilitation professionals should incorporate acculturation theory and culturally informed interventions into rehabilitation practice with Mexican Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Counseling adults in transition: Linking practice with theory.

Reviews the book, Counseling adults in transition: Linking practice with theory by Nancy K. Schlossberg (1984). Rehabilitation psychologists can profit from this book because of its concise contents, its intensive examination of life's transitions, its gerontological perspectives, its insistent "linking" of otherwise linear thinking, and its pervasive implications for work with rehabilitation clients. This statement of the book's value for our field is given to start with, since its title might suggest that it is relevant only to rehabilitation counseling. Schlossberg ably discusses theories and practices of interest to rehabilitation psychologists and reviews research with pertinent heuristic possibilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mitchell Rosenthal (1949-2007).

Mitchell Rosenthal, a central figure in the emergence of traumatic brain injury (TBI) rehabilitation and the professionalization of rehabilitation psychology, died unexpectedly on May 31, 2007, at the age of 58 from complications following cardiac surgery. Rosenthal was a major figure in the development and evolution of the Traumatic Brain Injury Model Systems program and the Traumatic Brain Injury Rehabilitation and Research Centers. From 1999 to 2004, he was the principal investigator for the TBI National Database Center funded by the National Institute on Disability and Rehabilitation Research. Rosenthal's leadership roles in rehabilitation psychology were many and significant. He was a founding member of the American Board of Rehabilitation Psychology and served on the Board of Trustees of the American Board of Professional Psychology at his death. His advocacy for rehabilitation psychology was evident throughout his career. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pharmacotherapy for postacute traumatic brain injury: A literature review for guidance in psychological practice.

Objectives: The purpose of this review is to educate and guide the actions of rehabilitation psychologists by providing a summary of the current literature on pharmacotherapies and treatment effectiveness for the chronic sequelae associated with severe traumatic brain injury (TBI). A number of medications are reviewed for use in treating deficits in arousal, cognition, function, and other problems associated with TBI. Findings for their use in this population are summarized. Cautions, limitations, and directions for future research are discussed. Conclusions: Pharmacological management of chronic symptoms of TBI is commonplace in rehabilitation practice. Clear clinical guidelines for the use of pharmacotherapy in TBI are lacking, however, because of the few conclusive findings regarding the effectiveness of any particular agent. Rehabilitation psychologists frequently encounter patients treated with numerous medications and, therefore, need to be aware of potential effects on cognitive and functional abilities. Additionally, rehabilitation psychologists should be aware of available and empirically supported pharmacotherapies as they are in a position to comprehensively assess the patient and provide requested consultation to the treating physician concerning the patient's need for and likelihood of benefiting from various pharmacological agents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists and rehabilitation: New roles and old training models.

The role of psychologists in physical rehabilitation settings has expanded considerably over the past decades. Unfortunately, the lack of clarity regarding roles, functions, and research of psychologists in inpatient and outpatient rehabilitation settings has hampered efforts to establish guidelines for training graduate students to work in rehabilitative settings. Despite ongoing debate since the Princeton Conference in 1958, no guidelines have been recommended by Division 22 of the American Psychological Association (Division of Rehabilitation Psychology) for training doctoral students in clinical and counseling psychology programs for work in rehabilitation. This article asserts that psychology graduate students who want to work in physical rehabilitation settings should (a) have core training in psychology and (b) receive coursework and practica in working with persons who have chronic illnesses and injuries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On psychological identity and training: Boulder is better for rehabilitation psychology.

This article addresses issues of training in applied psychology, generally, and rehabilitation psychology, specifically. The long-term success and growth of rehabilitation psychology will depend, in part, on how the field answers the following questions: How do rehabilitation psychologists define their area of competence? How is this competence to be achieved? A review of recent literature suggests that rehabilitation psychology has yet to resolve fully the fundamental issues of a young subspecialty: identity, training, and long-term direction. We maintain that the scientist-practitioner model should continue to be the framework for training future rehabilitation psychologists. Furthermore, subspecialty and cross discipline training should be completed following core training in an appropriate specialty of psychology (i.e., counseling or clinical). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Geriatric rehabilitation.

Reviews the book, Geriatric Rehabilitation, edited by Bryan Kemp, Kenneth Brummel-Smith, and Joseph W. Ramsdell (1989). There is an increasing need for rehabilitation services for older adults and, consequently, a growing need for texts about geriatric rehabilitation. Compiling a single volume that effectively covers this diverse area is a challenge. Rehabilitation is not so much a specialized field of knowledge as it is an approach to health care focusing on the restoration of function. A text on geriatric rehabilitation therefore needs to include information on common disabling conditions of the elderly, therapeutic strategies used by a variety of disciplines including medicine, psychology, and physical and occupational therapy, and a conceptual framework for integrating misinformation. Geriatric Rehabilitation was created to provide such a text and, in general, has done so successfully. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Statistical Process Control and Rehabilitation Outcome: The Single-Subject Design Reconsidered.

Rehabilitation psychology embraces the scientist-practitioner model as its professional philosophy. This model's original intent was that the diagnosis and treatment of each individual case was to be regarded as a single and well-controlled experiment. Executing this ideal in rehabilitation has been problematic owing to practical, ethical, and technical concerns. Statistical process control (SPC), a robust, graphical analytic strategy developed in industry, is offered as a means to deploy single-subject designs on the front lines of rehabilitation. The history and construction of SPC control charts are presented followed by case examples relevant to rehabilitation practice (ambulation, depression, cognitive rehabilitation, agitation). SPC control charts are a time-tested, scientifically validated, and pragmatic tool to achieve and document patient outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rehabilitation Psychology, Medical Psychology, Health Psychology, and Behavioral Medicine.

In their recent article, "The Distinctiveness of Rehabilitation Psychology," Shontz and Wright (see record 1981-26520-001) attempt to differentiate rehabilitation psychology from other areas of applied and professional psychology in health settings. Although the authors' historical recounting of early research and theory in rehabilitation psychology is informative, too little emphasis is placed on the relationship between rehabilitation psychology and "mainstream" professional psychology, particularly with regard to its health-setting applications. There appear to be more similarities than differences. The authors' argument runs full circle, namely, that rehabilitation psychology is distinct because of its philosophy, but its philosophy and "principles are valuable to psychologists in many specialties" (p. 919). The notion of involving a patient in his/her care and treatment planning also is not unique to rehabilitation psychology. Shontz and Wright state that rehabilitation psychology is not medical psychology; however, instead of defining medical psychology, they go on to talk about medical care. Medical care is not medical psychology. Further confusion is added by the statement that medical psychology should be a component of rehabilitation psychology. The authors are using medical psychology, health psychology, and behavioral medicine as if they are synonymous, when they are not. Each discipline is made distinct here. Shontz and Wright do not address what the majority of psychologists in rehabilitation do, that is, provide services. In short, although the authors complain about the unfamiliarity of rehabilitation psychology relative to the profession as a whole, their article does little to promote rehabilitation psychology as an area of interest important to professional psychologists in health care and/or rehabilitation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rehabilitation psychology practice, ethics, and a changing health care environment.

Rapid changes in the health care environment have brought about ethical and professional challenges for rehabilitation and rehabilitation psychology. The response of rehabilitation psychologists to the threats and opportunities of these challenges will have an impact on the welfare of persons with disabilities and the future of the profession. Managed care organizations have focused their efforts on the management of acute illness. Ethical concerns are being raised about patient access to care, self-determination, confidentiality, provider accountability, and marketing in managed care systems. Rehabilitation psychologists' skills in program development and outcome evaluation place them in a key position to influence the changes in the health care environment. To be effectual, however, fundamental changes must be made in research psychology practice, education and training, research focus, and professional activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rehabilitation psychology: Realizing the true potential.

As the Division of Rehabilitation Psychology (Division 22) celebrates its 50th anniversary this year, this article reflects on the current status and important trends in health care and technology that are likely to have the largest impact on the science and practice of rehabilitation psychologists in the next decade. These trends include the prevalence of chronic conditions, health disparities, Operation Iraqi Freedom and Operation Enduring Freedom injuries, and caregiver burden. The implications of these trends are also discussed in the context of rehabilitation psychologists' involvement in public policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)