Psychology and Medical Rehabilitation: Moving Toward a Consumer-Driven Health Care System

Changes in health care will provide both opportunities and threats for rehabilitation psychologists. We must demonstrate the relevance of our clinical services to important outcomes or risk being excluded as treatment providers. With shifts to nonhospital settings, we can provide increasing clinical and administrative leadership. However, we must redefine models of treatment to include home care and telepsychology, practice guidelines and critical paths, involvement of paraprofessionals, case management, injury prevention, and health promotion. We should be involved when datasets are established to define disability-related health policies and reimbursement and be proactive in Medicare, Medicaid, and managed care reform to develop treatment packages to decrease long-term handicap. Collaboration with consumers is critical. We must frame research questions to address current policy issues. Our skills can help improve the effectiveness of human behavior, whether it be patients with illness, consumers with disability, health care providers, health systems managers, or legislators.     

Neuropsychological evaluation and rehabilitation in mental retardation

A discussion is provided of issues related to neuropsychological assessment of mentally retarded individuals. The first matters considered are test selection in relation to mental age and diagnostic issues. Various methods of evaluation are then considered, including assessment of orientation to sound and visual stimuli, language comprehension, right-left discrimination, and abstract and symbolic processes. Methods are also reviewed for detailed evaluation of language functions including testing for aphasia and for academic skills such as reading, writing, and calculation, as well as for spatial and constructional abilities. A section is devoted to use of neuropsychological assessment for rehabilitation of various disorders such as congenital aphasia, alexia, and spatial-constructional disorders.     

Correlates of Regimen Adherence in Cystic Fibrosis

The present investigation studied psychological and familial factors associated with self-care adherence in a sample of 50 children (ages 9 to 17 years) with cystic fibrosis (CF). Children and their parents were recruited through an outpatient pediatric pulmonary medicine clinic at a metropolitan children's hospital. Participants were interviewed and administered measures of family behavior and child psychological variables. Regimen adherence was measured using a telephone interview approach across three occasions per participant. Hierarchical multiple regression with age, perceived family behaviors, health locus of control, and self-competency as predictors, accounted for 53.8% of the variance in regimen adherence. Findings suggest that higher self-esteem and younger age are related to higher rates of regimen adherence among children with CF.     

Psychological Applications in Clinical Sports Medicine: Current Status and Future Directions

This article describes the role of psychologists in clinical sports medicine. Following an overview of the specialty's professionals, settings, and modalities, opportunities for psychological intervention in the prevention and rehabilitation of sport injuries are examined. The current status of psychology in clinical sports medicine is discussed and recommendations for the future are provided. It is concluded that although the involvement of psychologists in clinical sports medicine is not currently extensive, there is reason to believe that psychological applications in the sports medicine arena will expand in the future.     

A brief history of Russian aphasiology

This paper analyzes early Russian contributions to the study of aphasia, dated between 1789 and 1941. Different approaches to the problem of the organization and localization of verbal functions as well as to the understanding of mechanisms of aphasia and principles of aphasia rehabilitation are discussed. Comparisons with European and North American contributions and with contributions from later Russian writing (e.g., Luria's period) are presented to demonstrate their interconnections in shaping the course of Russian aphasiology.     

Neuropsychological rehabilitation after brain injury: Scientific and professional issues

Neuropsychological rehabilitation after acquired brain injury is an important contribution to our health-care system. Despite a growing database which supports its clinical utility, the insurance coverage for this form of care is now being threatened. This paper addresses some of the professional and scientific issues that psychologists need to face in order to continue to provide these services.Invited Address, President's Mini-Convention To Your Health: Psychology Through the Life Span, American Psychological Association Convention, New York, August 12, 1995.     

An Overview of Charles Alexander's Contribution to Psychology: Developing Higher States of Consciousness in the Individual and the Society

This paper reviews over 100 publications of Charles N. (Skip) Alexander. Skip theoretically showed that the four higher states of consciousness described by Maharishi's Vedic psychology logically extend the developmental sequence delineated by 20th century psychology. His empirical research found that the Transcendental Meditation^® technique provides the direct experience of transcendental consciousness (the first higher state, which is the silent basis of the mind) and that this practice accelerates development in children, unfreezes development in prison inmates, advances ego development in adults, increases productivity in businesses, decreases blood pressure, increases longevity, effectively treats substance abuse, and reduces prison recidivism. Skip and colleagues were the first to discover the EEG signature of cosmic consciousness (the second higher state), and he showed that developmental advances in individuals impact the larger society via a common field of collective consciousness, including decreasing armed conflicts and improving the quality of life.     

Counsellors' focus on competitive employment for people with severe mental illness: an application of the theory of planned behaviour in vocational rehabilitation programmes

Although the evidence-based Individual Placement and Support programme highlights the importance of the vocational rehabilitation (VR) counsellors' focus on competitive employment during career counselling, studies have shown that counsellors do not always target such jobs. This study examines which determinants affect the counsellors' intentions using an extended version of the Theory of Planned Behaviour. Cross-sectional data of 263 VR counsellors of three public employment services were analysed using structural equation modelling. A path model comprising attitudes, prior behaviour, and subjective and moral norms explained 69% of the variance in intentions. The findings indicate that counsellors focus more on competitive employment when they (1) view the placement in a competitive job as positive, (2) experience support and (3) have prior relevant experiences.     

精神分裂症治疗的理性思辩

神经解剖、神经生化的研究进展为阐明精神分裂症的病理机制提供了基础,但在精神分裂症的发病中遗传学、环境中的生物学和社会心理因素亦不容忽视.依循系统论的整体性、稳定性观点,采取药物、心理与心理社会康复治疗的综合治疗是目前的最佳方案.     

Reactions to Organizational Alcohol Testing and Treatment Programs

We used organizational justice theory to explore reactions to employer-sponsored alcohol testing and alcohol treatment policies among a sample (N = 1,777) of the employed public in a western state. Level of alcohol use and safety-sensitivity of the job were related to the perceived fairness of alcohol testing. In addition, voluntary treatment policies were rated more positively than coerced or monitored policies in terms of fairness and organizational attractiveness. Alcohol use moderated the effects of treatment policy on perceived fairness and organizational attractiveness, although the effect sizes were small. These results support the use of organizational justice theory to explain reactions to organizational alcohol testing and treatment and provide a basis for future research in this area.