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)

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