The spread of coronavirus disease 2019 (COVID-19) has placed many individuals in need of critical care, with a high proportion of hospitalized patients being admitted to intensive care units (ICU) to treat acute outcomes of COVID-19 (e.g., respiratory failure via mechanical ventilation). The ICU is known to be a setting where individuals are at a high risk of experiencing significant psychological difficulties, and patients with COVID-19 are particularly susceptible to such experiences, which can impact their recovery process (e.g., postintensive care syndrome). This article seeks to highlight the intersection between critical care related to trauma and COVID-19 and point providers toward opportunities for anticipating and managing secondary effects in effort to promote psychological adaptation.

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Caregivers are vital to our health care system and its sustainability, yet extensive literature has recognized caregivers' vulnerabilities for experiencing financial, physical, and emotional difficulties-compromising the sustainability of their services. The risks associated with being a caregiver are not well-defined and warrant further exploration to guide national health initiatives underway. This brief report sought to identify risks that may be associated with the wide-ranging secondary effects of being a caregiver. Specifically, health care coverage and utilization were compared between caregivers and noncaregivers in a large national sample. Method: A cross-sectional study design was used with data from the 2015 Behavioral Risk Factor Surveillance System. Risk ratio analyses were conducted to assess how many times more likely unpaid adult caregivers were for experiencing specific risks related to health care access, relative to noncaregivers. Results: Caregivers (n ϭ 24,034; 64.5% female; 69.6% preretirement age) were more at risk for lacking health care coverage and underutilizing needed health care service due to cost, when compared to noncaregivers (n ϭ 84,412; 57.3% female; 61.8% preretirement age). Caregivers were also at an increased risk for lifetime diagnosis of a depressive disorder and activity limitations due to a health challenge. Conclusions: Our findings highlight the need for the development of low-cost and accessible clinical services available to caregivers. Rehabilitation psychology can offer unique and instrumental contributions for addressing this growing population's health care needs by informing disability-focused public health agendas and incorporating caregivers into rehabilitation programs for care recipients. Impact and ImplicationsCaregivers provide valuable services that benefit individuals with disabilities and society as a whole; however, despite identification as a population of interest in current public health initiatives in the United States, few studies have examined factors that influence health care access and utilization among caregivers at the population level. This study contributes to the literature by providing preliminary analysis of epidemiological data, specifically examining for potential differences between caregivers and noncaregivers with regard to health care coverage and financial barriers to health service utilization. The findings indicate that caregivers may be at a greater risk for lacking health care coverage and not accessing needed health care services due to costs-both of which have been shown to be determinants of adverse health outcomes.

Maria, a 28-year-old Latina American woman, presents with somatic symptoms of anxiety (e.g., muscle tension, headaches, gastrointestinal disturbance) and intermittent depression. Despite her initial emphasis on somatic concerns, assessment reveals diffuse distress about many domains. Specifically, she reports perseverative thoughts about whether her part-time online business will fail. Maria also spends hours worrying about the adequacy of education for her two elementary school-age children and her own competence as a parent, given her own developmental history of neglect. Moreover, she routinely questions her balance of work and parenting. In her marriage, she ruminates about whether she had found the right husband, given their personality differences. At her worst, she feels unable to stop thinking about such issues, wondering if it makes her physically ill. Maria's chronic preoccupation with these domains feeds symptoms of anxiety and irritability, occasional panic attacks, shame, and at times, suicidal ideation. She copes with negative emotions by alternating between avoiding direct problem-solving (e.g., completing taxes for her business, seeking help) and perfectionistic overcommitment. Expecting that others would not support her, she chronically takes care of others' needs but avoids disclosing her needs to her husband or friends. This leads to resentment punctuated by occasional angry complaints-followed by apologetic, passive behavior. Although Maria possesses the important strengths of resilience and determination, she reports a recurring sense of a life spinning out of control. 1 1 All clinical case material has been altered to protect patient confidentiality.

Advancements in critical care medicine have improved survival rates for patients experiencing critical illness in intensive care units (ICUs). Although mortality has declined, more than half of ICU survivors experience functional impairments that persist beyond discharge. Of particular concern is ICU‐related cognitive impairment, which can extend across the care continuum, ranging from acute and transient presentations in the ICU (eg, delirium) to long‐term impairments years after discharge. ICU‐related cognitive impairment has received increased attention in the literature, particularly as it relates to ICU survivors who have received and survived critical care in the context of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic and are now experiencing postacute sequelae of SARS‐CoV‐2 infection. The medical complexity and heterogeneity of ICU survivors, coupled with the multifactorial etiology of ICU‐related cognitive impairments, lead to challenges in how to optimize care for ICU survivors at various stages of recovery. This review aims to provide an overview of cognitive outcomes associated with critical illness by integrating recent literature focused on etiology, assessment, and interventions in the context of ICU‐related cognitive impairments. The narrative review employs a biopsychosocial framework to comprehensively evaluate the multifactorial nature of ICU‐related cognitive outcomes. Authors also highlight that multidisciplinary teams composed of key rehabilitation providers are likely best suited for optimizing recovery trajectories of ICU survivors.