Consultation

Chapter 7 discusses the various ways in which the RP may perform their role in a consultatory fashion, which may include serving as a core member of a treatment team, conferring with other healthcare professionals in a more autonomous fashion, consulting with attorneys or the court system in legal proceedings, advising businesses or schools about job site or educational accommodations, and evaluating the individual with reference to impairment/disability issues. It also discusses how, in this role, the RP may encounter different treatment team models across organizations; the interdisciplinary team, multidisciplinary team, and transdisciplinary team, and how issues of behavioural difficulties and/or compliance with treatment may often prompt psychological consultation. It also covers the importance of possessing the ability and willingness to respond to specific referral questions, alongside timeliness, competency, facility in establishing rapport, usefulness of reporting and recommendations, and diagnostic and treatment planning acumen.

Interpersonal Interaction

Chapter 4 discusses how competence in interpersonal interactions mandates awareness of how the RP affects others, and vice versa, and covers the constructs of empathy, respect, dignity, and multicultural factors, as well as recognition of the effects of stress and the importance of maintaining relationship boundaries in interpersonal interactions. It also touches on how not all health professionals share the same code of conduct or understanding of the ways in which interpersonal factors interact with treatment. Lastly it covers how RPs are often in a position to address the psychological impact of differing perceptions of situations, stressors, interactions and other matters among members of a treatment team comprised of a variety of disciplines, and how those differences may affect the course of treatment.

Supervision, Teaching, and Management

Chapter 11 discusses how supervision, teaching and/or management are important aspects of the specialty, and while these roles are typically not primary ones, and may be entirely foreign to some Rehabilitation Psychologists, the ABRP has designated them as complementary to the required competency areas and does not require demonstration of competency. It also covers the several styles of supervision, teaching and managing that exist, how some perhaps are better-suited for one setting over another, and how the RP engaged in these activities must be competent in using the tools of each to foster growth in those being supervised, taught or managed. Lastly, it covers that, although training in supervision has not always been included in psychology curriculum, it has been receiving increased attention.

Assessment

Chapter 6 discusses the broad individual differences in presentation of impairment, handicap and/or disability, and how these necessitate versatility and flexibility in the use of assessment and evaluation tools, as well as how accommodations may need to be provided to adequately assess the individual’s strengths and weaknesses, often requiring skill in nonstandard assessment techniques. It covers how determining the ecological validity of the assessment tools and describing the implications of the findings for treatment planning are key components in reporting the results of rehabilitation psychology assessment. It also touches on how the extrapolation of assessment findings to anticipated impact on functional activities for the rehabilitation patient, including the likelihood of amelioration or remediation of deficits, is a unique contribution provided by the competent RP.

Individual and Cultural Diversity

Chapter 3 discusses how those needing psychological rehabilitation come from diverse backgrounds, how sensitivity to diversity issues is a critical element addressed in the APA Ethics Code, as well as in the Multicultural Guidelines promulgated by the APA, and how 'disability' has come to be viewed as another type of diversity. It also covers how the RP must be aware of these differences and their impact on the treatment process. Also discussed is how the specialty as a whole has embraced the concept of multicultural competence, and how the individual-environment interaction is an essential aspect of understanding disability, encompassing cultural, racial, ethnic, and other such factors. Lastly, it suggests the importance of recognizing one’s own biases as well as those of the patient and family, the treatment team and the societal environment, all of which are essential aspects of culturally competent rehabilitation psychology services.

Ethical and Legal Issues

Chapter 2 discusses how psychologists are expected to practice in accordance with a code of conduct and ethical standards, typically those adopted by the APA, and how several areas of law (including, but not limited to, the Rehabilitation Act of 1973, Americans with Disabilities Act (ADA), and Individuals with Disabilities Education Act (IDEA)) are relevant to rehabilitation psychology in that they specifically address issues pertinent to persons with disabilities. It also covers cases where matters of competency, capacity, disability, accessibility to services and environments, and sensitivity regarding the treatment of individuals with disabilities are at issue, and how both ethical and legal matters frequently require consultation both within and outside of the provision of direct clinical care. Lastly it stresses how those treating patients must be cognizant of the ethical, legal and clinical implications for the practice of the specialty, respect and adhere to those in their daily activities, and seek consultation when appropriate.

Introduction

Chapter 1 discusses the roots of rehabilitation psychology, which are found in the assessment and treatment of persons with a disability, whether congenital or acquired, and how the growth and development of the field can be traced in large part to care provided to returning veterans. It covers the establishment of Division 22 of the American Psychological Association (APA) and of a specialty competency examination board, the American Board of Rehabilitation Psychology (ABRP), which were significant historical milestones. Lastly, it addresses how Rehabilitation Psychology continues to refine standards of education, training and experience, delineating a route toward board certification as well as continuing education offerings to enable maintenance of competence by practicing clinicians.

Intervention

Chapter 9 discusses the role of the RP in interventions, which are fundamental and essential activities that increase the functioning of individuals with disabilities, enhance their quality of life, and help restore them to satisfying and productive lives, and how the RP must ascertain and implement appropriate intervention(s) for given individuals as well as monitor their progress, and modifying treatments as needed. It covers how intervention may be provided on an individual level or with couples and/or families, and how it may address psychological issues (e.g., coping, denial, depression, interpersonal relationships), physical issues (e.g., movement disorders), or cognitive dysfunction (e.g., impaired attention; executive dysfunction). Lastly, it covers the wide array of interventions may be utilized including accommodations, assistive technology, cognitive rehabilitation techniques, medication and behavioral programs, and how some interventions are general and adaptable to a variety of functional states, while others are more condition-specific (e.g., constraint-induced movement therapy for movement disorders; use of the PLISSIT model in treating sexual dysfunction).

Consumer Protection

Chapter 7 discusses the expectation of the RP to act as advocate for and protect the interests of persons with disability and other consumers of rehabilitation psychology services, historically a major focus of the specialty area. It covers how the ABRP expects that candidates demonstrate competency in consumer protection through effective advocacy about laws related to and including the ADA; sensitivity to multicultural and diversity factors, including participation in consumer groups; activity in professional organizations on local, state and national levels; earning board certification in the specialty; and provision of public education services. It also discusses services and community supports for the patients RPs treat, focusing on the patient’s ability to engage maximally in independent living and on increasing patients’ quality of life.

Science Base and Knowledge

Chapter 10 discusses the increased demand on all disciplines for provision of evidence-based (or supported) treatment, and the empirical evidence for the efficacy and cost-efficiency of their work; RPs have needed to demonstrate 'change' in treated patients through measurement of functional outcome, and assessment and measurement of function with attention to the ecological validity of the process. Many Rehabilitation Psychologists and rehabilitation facilities have become accustomed to the requirement that they demonstrate improved outcomes in order to be paid for services. Paid-for services are often recommended following formal assessment using measures that may be repeated (or similar, equivalent measures may be used) to assess progress and/or outcomes, and RPs must demonstrate improved outcomes in exchange for this payment. Also covers is how this has helped to establish a science base for Rehabilitation Psychology techniques that, while chronologically young, is growing and is a fundamental component of the specialty.