Rehabilitation: Psychology's greatest opportunity?

Abstract

Rehabilitation is one of the fastest growing areas in the health industry. Supported by several key pieces of legislation, psychologists have established themselves as integral health care providers in rehabilitation. Although psychologists have benefited from legislated membership in rehabilitation, most individual psychologists and the psychological associations have failed to recognize the importance of public policy for the practice of psychology. Escalating health care costs have resulted in major revisions in the manner in which health insurers reimburse treatment. Medicare, the major federal health insurance provider, increasingly has been viewed as a model for the provision of all health care. The historic exclusion of psychologists from Medicare has limited the scope of psychologists' practice and the growth of professional psychology. The recent inclusion of psychologists in Medicare improves but does not solve practice and policy issues confronting psychology. Knowledge of national health policy formulation and greater participation by psychologists in health policy is necessary to secure the scope of professional practice most psychologists expect.

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“…The Rehabilitation Act of 1973, as amended , emphasized treatment and goal-oriented outcomes, without physician supervision, and with emphasis on psychological diagnosis, evaluation and treatment. This has helped establish rehabilitation as an area in which psychologists can achieve parity with physicians (Frank et al, 1990). The Education for All Handicapped Act of 1975 (Public Law No.…”

“…The Education for All Handicapped Act of 1975 (Public Law No. 94-142) included psychologists as core clinicians conducting assessment and treatment (Frank et al, 1990). Both these pieces of legislation emphasize functional outcomes, which is an area in which psychologists have much to contribute (Frank et al, 1990).…”

“…94-142) included psychologists as core clinicians conducting assessment and treatment (Frank et al, 1990). Both these pieces of legislation emphasize functional outcomes, which is an area in which psychologists have much to contribute (Frank et al, 1990). Frank (1993) lists a number of factors leading to inevitable change in the American health care system.…”

“…As the Federal Government and large health care corporations are involved in the shift toward less expensive forms of treatment, rehabilitation will occur more often in hospital-based outpatient facilities, nonhospital comprehensive outpatient rehabilitation facilities (CORFs), subacute skilled nursing facilities (SNFs), intermediate care facilities, and the home (DeJong & Sutton, 1995;Frank et al, 1990). However, these different treatment settings vary greatly in amount and type of services provided and may have significant variation in long-term outcomes such as independent living and community integration.…”

“…However, these different treatment settings vary greatly in amount and type of services provided and may have significant variation in long-term outcomes such as independent living and community integration. In addition, services will more often be delivered by paraprofessional staff (Frank et al, 1990), and this may not have the same long-term outcomes as treatment by professional staff.…”