Faculty Bibliography

Two predoctoral psychology interns share their personal reflections of neurological injuries they experienced during their adolescence and how it has informed and shaped their clinical work. Through their reflections, they provide insights and lessons learned as they have the unique first-hand experience of being a patient and now a rehabilitation psychology trainee and provider. Additionally, they describe how they have applied such knowledge during their clinical work with clients experiencing neurological and chronic health conditions. Issues involving communication with clients, families, and the treatment teams, the benefits and risks of self-disclosure, and the role of hope, meaning in life, and spirituality are discussed. The clinical practice implications of these insights are invaluable for trainees and healthcare specialists at all levels of experience, including the crucial role of supervision during the predoctoral internship year. Recommendations are made for clinical practice including providing developmentally appropriate communication and promoting an environment for growth and recovery. The authors are hopeful that the reflections provided in this article can inspire other trainees to feel comfortable in sharing their personal medical and psychological challenges as appropriate and relevant to help integrate their professional development.

OBJECTIVE: This article reviews the prevalence, underlying mechanisms, and challenges of treating encephalopathy and delirium in the postsurgical and medically compromised cardiopulmonary patient receiving services on an acute inpatient rehabilitation unit. Additionally, pertinent information is provided on conducting an evaluation to assess for neurocognitive sequelae of the above-mentioned conditions to help achieve better treatment outcomes. METHOD: Review of the medical and neuropsychology literature is provided along with 2 case reports to illustrate evaluation of a persisting toxic-metabolic encephalopathy and a resolving delirium and the treatment team's effectiveness in producing a more optimal treatment outcome. The unique role of the rehabilitation psychologist, special treatment considerations, and the importance of integrated follow-up neurorehabilitation services for the cardiopulmonary patient and caregivers also are emphasized. RESULTS: Encephalopathy and delirium are 2 related, but somewhat different, conditions that can emerge postoperatively, any time during acute care hospitalization, and often enough, during impatient or subacute-care rehabilitation. Their association with long-term harm and poor outcome warrant early identification and immediate medical intervention. IMPLICATIONS: Encephalopathy and delirium can significantly affect rehabilitation outcomes and, as such, rehabilitation psychologists are encouraged to systematically screen for the presence of delirium and encephalopathy in the cardiopulmonary rehabilitation setting so to enhance treatment efficacy and quality of life in affected individuals. (PsycINFO Database Record

This paper will discuss the transition from multidisciplinary to interdisciplinary and transdisciplinary team approaches to pain management at New York University Langone Medical Center - Rusk Institute of Rehabilitation Medicine. A transdisciplinary team approach to pain management emphasizes mutual learning, training, and education, and the flexible exchange of discipline-specific roles. Clinicians are enabled to implement a unified, holistic, and integrated treatment plan with all members of the team responsible for the same patient-centered goals. The model promotes and empowers patient and family/support system goals within a cultural context. Topics of exploration include the descriptions of three team approaches to patient care, including their practical, philosophical, and historical basis, strengths and challenges, research support, and cultural diversity. Case vignettes will highlight the strengths and limitations of the transdisciplinary team approach to pain management throughout a broad and diverse continuum of care, including acute medical, palliative, and perioperative care and acute inpatient rehabilitation services.

Pediatric specialists are faced with many challenges when confronted with young patients diagnosed with acquired or congenital disabilities. In addition to the myriad of presenting medical issues, team members also need to acknowledge and address contributing psychological, social and environmental factors when working with medically involved children. Specifically, the understanding of developmental, cognitive, familial, and emotional considerations is essential for tailoring more successful individual treatment plans. The purpose of this article is to address the multidimensional aspects associated with the treatment of children presenting with physical or neurological impairments. Specifically, psychological and neuropsychological perspectives will be discussed and case examples will be presented in an effort to propose a comprehensive approach for the promotion of better outcomes in pediatric patient care

A week after the horrific assault on the World Trade Center and Pentagon, a group of analysts gathered to support each other and share their impression of how the events were affecting their patients and themselves. This article consists of a partial sampling of some of the thoughts and clinical material raised during the meeting. The material is purposely presented in relatively raw form. No attempt is made to construct an argument, draw generalizations, or theorize. Rather, the authors offer readers a snapshot of what was foremost on the participants' minds during those dreadful days and the types of clinical encounters in which they were engaged. These are highly individual yet overlapping voices of 6 clinicians who explicitly acknowledge that they cannot see the forest for the trees.

In this study, we assessed the coping process in 35 mothers of premature and at-risk infants using a cognitive-behavioral theory to examine the relation among the stressful event, appraisal of the event, coping, and psychological symptomatology. Results show that 60% of the participants presented with clinically significant levels of distress. Tests of additional hypotheses and rt:search questions addressed the role of appraisals and coping strategies. Hierarchic;ar regression analysis revealed that 58% (adjusted R-2) Of the variance in distress was explained by four variables. The appraisal of uncontrollability, confrontive coping, and escape-avoidant coping were predictive of increased distress. The coping strategy of accepting responsibility was predictive of decreased distress. Satisfaction with the child's physician was a significant indicator of better functioning

OBJECTIVE: To investigate differences in team functioning between the multidisciplinary and transdisciplinary models when treating children with disabilities. DESIGN: A crossover trial. SETTING: An outpatient educational and rehabilitation program in a rehabilitation institute based at a university medical center. PARTICIPANTS: A population-based sample of 19 rehabilitation specialists and educators. INTERVENTION: Participants attended four team meetings using the multidisciplinary approach and then attended four team meetings using the transdisciplinary approach. OUTCOME MEASURES: Behavioral ratings of team participation (Transdisciplinary Team Rating Scale) and self-report instruments of team development (Team Assessment Questionnaire) and treatment planning and goal development (Staff Perception Questionnaire). RESULTS: Results of t tests confirmed the hypothesis that there was more team member participation during transdisciplinary meetings than during multidisciplinary meetings (p=.027). There were no differences in levels of team development (p=.329); however, staff members favored the transdisciplinary model for treatment planning and goal development (p < .001). CONCLUSION: This study provides evidence of the effectiveness of the transdisciplinary model. Further research is now needed to investigate outcome variables such as rate of success in attaining treatment goals when using this model