Index of Articles for the Spring 2008:
A Summary of Term Papers from a Graduate
Course in Rehabilitation
Counseling
Returning to Work after a Traumatic Event: A
Therapeutic Approach
The Role
of Positive Psychology in Eating Disorder Prevention Programs
Vocational Outcomes for Traumatic Brain Injury
Disability & the Penal
System: Claiming the Rightful Place for the Mentally Ill within Society
A Critical
Rationale for the Inclusion of
these Summaries
Rehabilitation psychology is the helping profession dedicated to assisting people who are struggling with the effects of medical impairment and vocational disability. Rehabilitation psychologists and counselors provide services to people affected by social and occupational disabilities, including: assessment, counseling, implementation of compensatory strategies, stress management for caregivers, education and consultation, and, when possible, return-to-work planning and execution.
It should be heartening to
professionals in vocational rehabilitation to learn that graduate students in
counseling and psychology programs are being exposed to state-of-the-art
methods and materials. A recent graduate
course in rehabilitation counseling at
The topics (and their student authors) are summarized below:
Returning to Work
after a Traumatic Event: A Therapeutic Approach (L.S.)
Injured persons must invest in their own recovery. It is the clinician’s responsibility to help clients become aware of their specific problems and, by extension, the process they will have to follow to reduce stress.
This paper recounts some of the causes including injury-related distress, post-traumatic stress disorder, child and spousal abuse, and, the most extreme of psychological insults, spinal cord injury. This paper list therapies currently in use:
§ organizing support groups
§ teaching the concept of self-induced positive outcomes
§ assisting to build self-esteem
§ identifying comfort/discomfort boundaries
§ teaching the avoidance of negative patterns (stigmas imposed by society)
The Role of
Positive Psychology in Eating Disorder Prevention Programs (D.B.)
After reviewing the “historic missions” of psychology, this paper looks at positive psychology as a productive approach to preventing and treating eating disorders. Positive psychology is compared to the traditional methods of ascribing a starting point for treatment derived from the Diagnostic and Statistical Manual of Mental Disorders (DSM, 2000).
Positive psychology may be used successfully in addressing eating disorders such as anorexia nervosa and bulimia nervosa. Applying positive psychology as preventive measures for eating disorders in young people is referenced, and this paper quotes Martin Seligman and Mihaly Csikszentmihalyi and their advocacy of working to make life fulfilling by focusing on such subjective human experiences as individual well-being, contentment, optimism, and happiness. As suggested in this paper, this approach shifts the focus from the socio-cultural pressure of “thin is ideal” to positive emotions in the pursuit of gratification.
Rehabilitation Psychology through Positive Psychology (A.
M. K.)
“Rehabilitation seeks to minimize the effects of impairment and maximize abilities.” One significant aspect of the methods and materials of positive psychology is to help clients realize their strengths. One aspect of positive psychology is the identification of critical values and strengths by which individuals can live their lives. Seligman and his colleagues catalogue these values and provide tests to identify individual strengths.
This paper states that although positive psychology is still a relatively new concept, Seligman projects that the ongoing research will reveal new methods of treating dysfunctionality. This paper quotes a piece co-authored by Shelly Gable and Jonathan Haidt in What (and Why) Is Positive Psychology? “The real goal of positive psychology is to build up what we know about resilience, strength, and growth to integrate and complement the existing knowledge base of psychology.”
Appendices to this paper include the specific “values in action” of positive psychology, as well as several “inventories of strengths” provided in the Seligman et al literature.
This paper builds on a personal knowledge of the trials and tribulations of a person with a bipolar disability.
The premise of this paper is that “there is a huge disincentive to work.” It also explores the difficulty and cost of having adequate insurance for mental heath issues. This issue is presently a consideration in the U.S. Congress.
This paper also addresses the difficulty for a person with bipolar disorder in finding employment, especially in terms of the stresses accompanying employment that exacerbate the disease. This paper also offers four ideas that should be addressed in terms of this disability:
1. Let people with this disorder keep Medicare to pay for doctor visits even after they become employed.
2. Provide financial incentives for staying on the job.
3. Create universal health care.
4. Increase the amount of time a person can receive Social Security disability payments after he/she is employed.
Vocational
Outcomes for Traumatic Brain Injury (C. R.)
This paper begins with the premise that traumatic brain injury (TBI) “is problematic for the rehabilitation industry because of the low rates of successful return to employment following the injury.” In fact, the writer indicates that for those who do not receive rehabilitation assistance, “only half will find a job,” and of those who do, “an estimated 75% will lose their jobs within 90 days.”
The literature, in terms of the factors that affect vocational rehabilitation outcomes for those who suffer from TBI, include:
§ Demographics (race, gender, etc.)
§ Emotional and psychological factors
§ Level of self-esteem
§ Level of neuropsychological functioning
§ Level of neuropsychological decline
§ Level of insight
§ Levels of support (family and friends, etc.)
§ Level of emotional distress
This paper posits that the level of family support “is a big predictive factor in determining whether a patient will return to work.” Four areas that rehabilitation professionals should focus on to improve the process include cognitive skills, computer training, interviewing skills, and prosthetic aid training (where applicable).
This paper ends by pointing out a dramatic increase in the need for rehabilitation for patients with TBI in terms of armed services veterans and addresses the claim that “many” are sent back to duty without adequate treatment after sustaining TBI.
Teaching Children Optimism (T.W.)
The concept of “optimism,” a forerunning concept of
positive psychology, “can be used and taught to prevent depression.” Depression is being detected in people of
younger ages and is becoming significantly more common than it has been in the past.
The writer puts forward the reality that optimism
can be taught as an injury prevention tool, and that early intervention is
critical. This paper also contrasts
learned optimism and pessimism and states that pessimism is, too frequently,
handed down by significant adults. This
paper quotes Seligman as saying that “
The writer also offers a correction to the situation, especially in the form of the work of the Penn Prevention Program, which is also known as the “Penn Resiliency Project” (PRP). Teaching resilience is a key objective in positive psychology, and this paper states that a major goal of the Penn program is to “promote optimistic thinking to help children and adolescents respond to the daily challenges and problems that are encountered during the middle and high school years.”
In the PRP, teachers work on “life skills, helping with stressors and problem solving.” The program will ultimately offer workshops for teachers and counselors.
Disability and the
Penal System:
Claiming the Rightful Place for the Mentally Ill within Society (J.L.M.)
This paper addresses the issue of the mentally ill and their “rightful place in society,” with a special look at individuals who are incarcerated with mental illnesses. This paper reviews federal laws that address this issue, ending with references to the establishment of “mental health courts” and a legal concept called “therapeutic jurisprudence.”
The larger problem of this issue is “controlling environmental influences,” which becomes more critical when the detainee is released. Success in the community is dependent on the individual embracing “structure.” The rehabilitation process that is best equipped to influence this aspect of release from incarceration is called case management. Some cases may start as jail-based, pre-release contacts, while generally, the case management begins in community-based settings. Another factor in terms of incarceration is a relatively new concept called “gradual release.”
This is an exercise fraught with the potential for criticism, which may very well be valid. The critiques may come from two sources: the students whose papers we summarized and the rehabilitation professionals reading this article.
The message we want to convey is that students, at least graduate students, are up on the latest concepts and processes in rehabilitation counseling. We feel good about that, and we wanted to share that fact with all of our colleagues.
We will have a more difficult time in begging the indulgences of the students we are summarizing in respect to our representing, in a reasonable way, both the substantive ideas and the general ideas of their papers. Certainly, we have not captured all of their salient points or even their general, overall ideas. We may even have distorted their individual views. For these failures, we apologize.
But we did want to share the idea with our colleagues that our institutions of higher education are doing a exemplary job in respect to preparing our next generation of rehabilitation professionals. We hope, after looking through the ideas above, you will agree.