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

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10

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30

40

1 2 3 4 5 6

Time (months)

Val

ue

Socialization

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10

20

30

40

1 2 3 4 5 6

Time (months)

Val

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Irritabilty

0

10

20

1 2 3 4 5 6

Time (months)

Valu

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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