BRS 214
Introduction to Psychology
Week 2-3
The relevance of psychology to
the field of rehabilitation.
DAWN STEWART
BSC, MPA, PHD
Introduction to Psychology
Rehabilitation is the process of helping an
individual achieve the highest level of
independence and quality of life possible physically, emotionally, socially, and spiritually.
Rehabilitation does not reverse or undo the
damage caused by a stroke, but rather helps restore
the individual to optimal health, functioning, and
well-being. Rehabilitate (from the Latin
"habilitas") means "to make able again.
Introduction to Psychology
Psychosocial rehabilitation is defined as a process that
facilitates for individuals who are impaired, disabled or
handicapped by a mental disorder to reach an optimal level
of independent functioning in the community.
To the extent that effective rehabilitation involves new
learning on the part of the individual living with the
impairment or disability, it would seem that behavioral
psychologists especially should be centrally involved in the
design, delivery and evaluation of services to those seriously
injured or living with a chronic ill-health condition.
Coping successfully with many of the situations faced by
those living with disabilities requires
Introduction to Psychology
Recent research has highlighted the importance of
depression and anxiety as independent risk factors
for mortality in cardiac patients.
It is critical that clinically significant levels of
distress are identified, both in-hospital and after
discharge, to target patients who require specific
psychological intervention, in addition to
conventional cardiac rehabilitation.
Introduction to Psychology
A disease, whether inborn or acquired through the
years, and accidents, may cause a person’s
disability.
Temporary or permanent, however minor or
serious, this can greatly affect the lives of the
victim and those close to them.
Persons would need constant reassurances, and
plenty of love for them to find meaning in their
lives again. This is where rehabilitation psychology
comes in.
Introduction to Psychology
When speaking of disability, it does not necessarily
mean a total injury or impairment of the physical
aspect.
It can be anything from physical, sensory, cognitive, or
emotional limitation of functions. However small this
disability is, the impact in the lives of the person and
their family is still there.
It could affect their relationships with other people,
their work, and learning ability. This is the reason
rehabilitation psychology is necessary.
Introduction to Psychology
There are many services rehabilitation psychology provides.
There is health and behavior consultation. This allows one
to learn about information on a particular health condition
and how it can affect one’s life.
Counseling and psychotherapy. This is geared towards
influencing one’s attitudes and emotions with the need to
change one’s behavior.
Cognitive remediation is a service that helps an individual
achieve cognitive abilities necessary with school or work, or
their life in general, and is important in their practice of
independence in the community as well.
Introduction to Psychology
Rehabilitation Helps the Disabled Return to
Functional Living.
Rehabilitation psychology caters to an individual
with emotional problems due to a disability. It
aims to help the person and his family to cope and
take control of their life again after a disability. It is
directed to give hope and happiness in the lives of
disability victims.
Introduction to Psychology
Rehabilitation is an integrated program of
interventions that empower individuals with
disabilities and chronic health conditions to achieve
“personally fulfilling, socially meaningful, and
functionally effective interaction” in their daily
contexts.
Rehabilitation Psychology is a specialty area within
psychology that focuses on the study and application of
psychological knowledge and skills on behalf of
individuals with disabilities and chronic health
conditions in order to maximize health and welfare,
independence and choice, functional abilities, and
social role participation across the lifespan.
Introduction to Psychology
Rehabilitation Psychologists’ work includes assessment
and intervention regarding the range of physical,
personal, psychosocial, cognitive, and behavioral
factors that may be affected, such as neuro cognitive
status, sensory difficulties, mood/emotions, desired
level of independence and interdependence,
mobility/freedom of movement, self-esteem and selfdetermination, behavioral control and coping skills,
subjective view of capabilities and quality of life.
Introduction to Psychology
Rehabilitation Psychologists consider the
influences of culture, ethnicity, language, gender,
age, developmental level, sexual orientation, social
network, residence and geographic location,
socioeconomic status, and relative visibility and/or
assumption of disability on attitudes and available
services.
Introduction to Psychology
Although the process of rehabilitation has
traditionally been viewed as ‘physical’ in nature, it is
now considered a multi-faceted process involving
not only the services of surgeons and
physiotherapists but also exercise scientists,
dieticians, athletic coaches and sport psychologists
Introduction to Psychology
Over the last decade, researchers have become
increasingly interested in the psychological impact of
injury and how athletes react to being hurt.
Introduction to Psychology
The grief reaction
With serious injuries that are likely to result in a significant
period of time out of the work or usual activities, persons will
often experience emotional disturbances.
Researchers suggest that persons often follow a five-stage
process following injury:
Denial
Anger
Bargaining
Depression
Acceptance
Reorganisation.
Introduction to Psychology
After the initial shock is over, many persons tend to play
down the significance of the injury.
As the injury becomes more apparent, shock is often replaced
by anger directed internally toward themselves or externally
towards other people.
The responses can vary in intensity depending on situational
and personal factors but can be especially strong in
individuals whose self-concept and personal identity are
based on being ‘an athlete’, ‘a nurse’, a mother’ etc.
The loss of identity due to an inability to perform in their
specific area can cause much distress.
Introduction to Psychology
Following anger, the injured athlete might try bargaining/
rationalising to avoid the reality of the situation.
A runner may promise herself to train extra hard or to be
especially pleasant to those around her if she can recover
quickly.
By confronting reality, and cognitively realising the
consequences of the injury, an athlete can become depressed
at the uncertainty of the future. It must be noted, however,
that depression is not inevitable and has not always been
observed during the grief reaction in research studies.
Introduction to Psychology
 Finally, the person moves towards an acceptance of the
injury and focus is directed to rehabilitation and a return
to sports activity.
 This stage tends to mark the transition from an
emotional to a problem-coping focus as the person
realizes what needs to be done to aid recovery.
 The timescale for progression through these stages can
vary considerably and setbacks during rehabilitation can
lead to further emotional disturbance.
 In cases of very serious injury and ones in which the
emotional reactions are prolonged, the skills of a clinical
psychologist might be required.
Introduction to Psychology
 Researchers found evidence that fear of re-injury,
anxiety, and questioning of their own abilities to
recover were reported by a significant number of
injured persons.
 More recent research, which investigated the
subjective experiences of patients following
reconstructions, highlighted fear of re-injury as
having associations with those who did not adhere to
the rehabilitation programme.
 This fear may be linked to a reduction in self-
motivation for such patients and avoidance rather
than approach behaviours.
 what appears to be lack of motivation on the part of
the injured athlete might actually be a symptom of
emotional distress.
 Although these findings only represent qualitative
data, there are implications for future researchers to
establish if interventions to reduce this fear of reinjury might improve the adherence to rehabilitative
programmes
 Being able to detect those persons who are not
adjusting to their injuries at an early stage can help
to establish the necessary support.
 Poor adjustment can manifest itself in noncompliance or adherence to rehabilitation
programmes, with some persons doing too little
while others may push too hard.
 Physiotherapists have identified non-compliance as a
significant problem preventing effective and efficient
recovery from injury.
Introduction to Psychology
One study identified a number of key characteristics in
athletes who experienced difficulties in adjusting to their
injuries.
These included:
Feelings of anger and confusion
Obsession with the question of when one can return to
sport
Denial (considering the injury to be no big deal)
Exaggerated bragging about accomplishments
Rapid mood swings
Withdrawal from significant others
Fatalistic thinking (whatever I do, things are not going to
improve)
Dwelling on minor physical complaints.
Introduction to Psychology
While psychosocial rehabilitation is an important
part of the overall process of successful management
of chronic mental illnesses, its importance has not
been recognized in many developing countries, and
its practice is still rare compared to the use of
medicines to "cure" illnesses