Jump to content

Role of Psychologist in a Rehabilitation Team

Original Editor - Sehriban Ozmen

Top Contributors - Sehriban Ozmen, Kim Jackson, Oyemi Sillo, Naomi O'Reilly, Ashmita Patrao and Rishika Babburu

Introduction

Rehabilitation Psychologists are experts in a speciality area within psychology (Rehabilitation Psychology) that focuses on the study and application of psychological knowledge and skills on behalf of individuals with disabilities and chronic health conditions. [1]

Their roles in a rehabilitation team are diverse, including:

  • maximizing health and welfare, independence and choice, functional abilities, and social role participation [1]
  • treating the full spectrum of emotional, cognitive, familial, social, and vocational consequences of disability encountered by consumers of rehabilitation services [1]

Clinical Conditions

Neuropsychological assessment and intervention are critical elements of a successful rehabilitation program for those whose disability includes cognitive impairment. [1] Some of the studied areas for Rehabilitation Psychologists are listed according to the third edition of the "Handbook Of Rehabilitation Psychology" book [2]:

Role in Chronic Pain

Chronic pain is a serious public health concern that has a high prevalence. It can result in distress and disability.  [3] Using an appropriate psychological approach, a rehabilitation psychologist can play an important role in improving them.

  • A recent review study [4] that has searched the level of evidence for improving the pain, disability and distress outcomes among people with chronic pain (headaches excluded), concluded that cognitive behavioural therapy (CBT) was mostly moderate, (except for disability, which rated as low quality); behavioural therapy and acceptance and commitment therapy was of moderate to very low quality.
  • Other psychological approaches, including acceptance and commitment therapy, mindfulness, biofeedback, hypnosis, and emotional awareness and expression therapy, have garnered varying degrees of evidence across multiple pain conditions. [5]

Role in Burn Injuries

Burn is a traumatic injury to the skin or other organic tissue that frequently results in psychological morbidities among those who have sustained it. For instance, a patient with major burns may develop depression and anxiety disorders due to the pain, loss of control, fear and the demands of burn rehabilitation that he/she suddenly faces. Wound healing and recovery can be affected negatively if these disorders and the psychological needs which differ at each stage of rehabilitation (resuscitative or critical, acute, and long-term rehabilitation) of burn patients are neglected.

A rehabilitation psychologist can play a potential role in lessening patients' distress and improving wound healing outcomes. In studies, it was found that: [6]

  • patients who engaged in positive psychological coping strategies, such as progressive muscular relaxation and deep breathing during painful dressing changes, left the hospital on average 1 week earlier than the control group
  • psychological interventions (such as counselling - emotion focused, counselling - problem focused.) significantly reduced the risk of depression, anxiety, and hospital stay compared to usual care in burn patients.

Nevertheless, studies have also stated that further studies with rigorous design, large sample size, and multiregional cooperation are needed. [6]

Role in Traumatic Brain Injury

In some patients with traumatic brain injury, symptoms such as poor concentration and slowed cognition may be persistent for months or years after the concussion. To treat those persistent complaints and improve associated long-term functional impairment, reduced quality of life, and social costs, due to lost productivity and increased health service usage; a rehabilitation psychologist can apply various psychological treatment methods which include cognitive behavioural therapy, psycho-educational approach, counselling, education or reassurance, dialectical behaviour, mindfulness, and acceptance and commitment therapies. Cognitive behavioural therapy is the most promising one among them, however, the underlying evidence is considered limited because of small sample sizes, short duration follow-up, and methodological inconsistencies. [7][8]

Resources

References

  1. ↑ 1.0 1.1 1.2 1.3 Frank RG, Elliott TR, editors. Handbook of rehabilitation psychology. Washington, DC: American Psychological Association; 2000.
  2. ↑ Arndt TR, Frank RG, Caplan B. Handbook of Rehabilitation Psychology. 2019.
  3. ↑ Driscoll MA, Edwards RR, Becker WC, Kaptchuk TJ, Kerns RD. Psychological interventions for the treatment of chronic pain in adults. Psychological Science in the Public Interest. 2021 Sep;22(2):52-95.
  4. ↑ de C Williams AC, Fisher E, Hearn L, Eccleston C. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane database of systematic reviews. 2020(8).
  5. ↑ Driscoll MA, Edwards RR, Becker WC, Kaptchuk TJ, Kerns RD. Psychological interventions for the treatment of chronic pain in adults. Psychological Science in the Public Interest. 2021 Sep;22(2):52-95.
  6. ↑ 6.0 6.1 AYMAN AE, Dalia M, MEDHAT SH, AHMED SE, MOWAFY M, MAGDY M. Impact of psychological rehabilitation on healing of burn patients. The Medical Journal of Cairo University. 2021 Sep 1;89(September):1471-9.
  7. ↑ Sullivan KA, Kaye SA, Blaine H, Edmed SL, Meares S, Rossa K, Haden C. Psychological approaches for the management of persistent postconcussion symptoms after mild traumatic brain injury: a systematic review. Disability and rehabilitation. 2020 Jul 30;42(16):2243-51.
  8. ↑ Gómez-de-Regil L, Estrella-Castillo DF, Vega-Cauich J. Psychological intervention in traumatic brain injury patients. Behavioural neurology. 2019;2019(1):6937832.

 

Retrieved from "https://www.physio-pedia.com/w/index.php?title=Role_of_Psychologist_in_a_Rehabilitation_Team&oldid=357374"