Psychologists and rehabilitation: New roles and old training models.

Abstract

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.The number of psychologists interested in the rehabilitation of individuals with physical disabilities and chronic physical disorders has continued to grow since the mid 1900s. The formation of Division 22 (Division of Rehabilitation Psychology) of the American Psychological Association (APA) in 1958 served to formalize psychologists' interest in this area of specialization. Unfortunately, the broad philosophical scope of this division has hindered the development of guidelines for training graduate students for work in physical medicine and rehabilitation settings. The more recent emergence of other specialty areas concerned with the application of psychological principles in health-care settings (e.g., behavioral medicine and health psychology) has obfuscated directives for training in rehabilitation. Current doctoral training programs in clinical and counseling psychology are in a position to meet the increasing demands for psychologists who are skilled in rehabilitation. In this article, we address the preparation of doctoral-level psychologists for future work in rehabilitation and propose that such training should begin with prerequisite core training in psychology, both experimental and applied. In addition, specialized training that emphasizes competent psychological practice with persons who have health-related disorders and disabilities in health-care settings should be provided. The appropriateness and quality of this specialized training is not dependent on the specialty area's designation (e.g., health psychology, behavioral medicine, neuropsychology, or rehabilitation psychology), but rather on the content of the curricula and practica experiences.

Supervision in rehabilitation psychology: Application of Beatrice Wright’s value-laden beliefs and principles.

“…Training in the specialty area of rehabilitation psychology requires exposure to specific knowledge, skills, and attitudes, beyond those of general psychology. Elliott and Gramling (1990) asserted that traditional clinical programs could provide sufficient foundational training for clinicians entering the specialty of rehabilitation psychology. However, graduate students rarely have adequate exposure to the concepts that are fundamental to the practice of rehabilitation psychology.…”

Revisiting a Constructive Classic: Wright's Physical Disability: A Psychosocial Approach.

“…Many clinicians entered the rehabilitation field with little knowledge of important rehabilitation research that often appeared in scholarly outlets that were "out of the mainstream" of academic psychology (Shontz & Wright, 1980). However, these psychologists were familiar with health psychology and neuropsychology, and over time their influence in the preparation, training, and credentialing of psychologists mirrored that of their colleagues in those specialties (Elliott & Gramling, 1990). The "value-laden" beliefs of rehabilitation, as postulated by Wright in the preface to the 1983 edition (see below), remained relevant to the rehabilitation enterprise.…”

Rehabilitation psychology: We zigged when we should have zagged.

“…This self-examination led to a narrowing of the definition of the field. In an effort to differentiate rehabilitation psychology from these emerging specialties, Shontz and Wright (1980) suggested that students should be trained in the "principles, values, theories, history, and social psychology of persons with disabilities as originally defined at the Princeton conference" (Elliott & Gramling, 1990).…”