the role of psychology in psychosocial rehabilitation srividya iyer, m.a. university of nebraska -...
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The Role of Psychology in Psychosocial Rehabilitation
Srividya Iyer, M.A.University of Nebraska - Lincoln
Key roles for psychologists in rehabilitation
• Assessment
• Treatment
• Case Conception
Assessment
• Identify strengths and problem areas• Broad categories
- neuropsychological
- sociocognitive
- risk assessment
- interview-based measures • Repeated assessment over time
Assessment• Neuropsychological Assessments
- To quantitatively assess nature and severity of neurocognitive
impairments & - To understand how they may be barriers to rehabilitation
• Attention, Memory, Intelligence, Executive Functioning (concept formation, problem solving)
• Examples: WAIS, Card Sorting Task, Digit Span
Assessment
• Sociocognitive Assessments
- Cognition related to formation of attitudes & beliefs, understanding people, interpersonal events and social relationships
• Insight, Locus of Control, Attitudes, Problem Solving, Emotion Recognition, Coping
• Examples: Coping Strategies Task (CST; Rivera Mindt, 1998), Insight Scale (Birchwood, 1993)
Assessment
• Risk Assessment e.g. Assess need for suicide precautions using standardized suicide screening assessments
• Trauma Screening: Assess trauma history & related treatment considerations
• Interview-based Measures to assess symptoms and episodes e.g. Brief Psychiatric Rating Scale
• Assessments to aid in diagnosis and case conception e.g. PAI, MMPI, MACI
Assessment• Analysis of Behavioral and
Milieu Data e.g. Nurses Observational Data for Inpatient Evaluation (NOSIE; Honigfield, Gillis, & Klett, 1966; Psychiatric Tech Rating Scales)
Daily Schedule Competence
0
10
20
30
40
1 2 3 4 5 6
Time (months)
Val
ue
Socialization
0
10
20
30
40
1 2 3 4 5 6
Time (months)
Val
ue
Irritabilty
0
10
20
1 2 3 4 5 6
Time (months)
Valu
e
Treatment
Individualized Behavior Management Programming • Use of learning principles to reduce undesirable
behaviors and/or increase the frequency of desirable behaviors
• Privileges, money, social responses etc delivered selectively depending on presence or absence of target behaviors
Treatment
• Group/Individual treatment approaches to
exercise specific neurocognitive skills
Examples: attention exercises, Integrated Psychological Therapy (Brenner et al., 1994)
• Group/Individual treatment approaches to remedy sociocognitive deficits
Examples: Interpersonal Problem Solving, Social Skills Training, Cognitive Behavioral Therapy
Treatment
• Addressing specific needs of participants
– Self-monitoring sheets– Mood monitoring sheets– Symptom monitoring sheets– Daily Statement– Posters – Specific Problem Solving Worksheet
Other Roles
• Contribute to treatment planning and treatment progress review
• Data Management
- Utilize for treatment
- Assess change over time
- Help ensure quality assurance
- Delineate some common patterns of recovery
Case Conception: Mental illness is vicious cycles between many levels of personal and social
functioning
Neuro-physiological
Social-environmental
Neuro-psychological Behavioral
Social-cognitive
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