Department of Psychiatry

Division of Clinical Psychology

Adult Rehabilitation Psychology

The Rehabilitation Psychology minor rotation takes place at the University of Colorado Hospital.  Primarily, the intern will evaluate and treat patients, work with families, and attend interdisciplinary case conferences on the rehabilitation unit.  Additionally, the intern may be asked to consult on patients on any of the different medical floors in the hospital, including the medical intensive care units and the Burn/Trauma unit.

Goals of the Training Program

The Rehabilitation Psychology minor rotation is offered through the Department of Physical Medicine and Rehabilitation with the University of Colorado School of Medicine.  Goals of the Rehabilitation Psychology training program include:

1)  Developing an understanding of psychological adjustment to new physical disability, traumatic or catastrophic injury, or chronic illness
2)  Learning psychotherapeutic strategies and treatment options appropriate to various stages of adaptation to physical injury or illness
3)  Developing proficiency in administration of brief neuropsychological screening batteries with a medical population

Objectives of the Training Program

The psychology intern will learn to conduct an assessment of psychosocial functioning in patients with a broad spectrum of physical illness or injury. 

The psychology intern will demonstrate understanding of the major theories of adjustment to disability, through appropriate psychotherapeutic interactions with patients and family members.

The psychology intern will learn to use behavioral intervention strategies to maximize patient participation in a physical medicine and rehabilitation setting.

The psychology intern will learn and independently utilize non-pharmacological pain and anxiety management treatment strategies (i.e., visualization, diaphragmatic breathing).

The psychology intern will demonstrate an understanding of basic neuroanatomy and the cognitive implications of common types of neurological injury and/or disease.

The psychology intern will participate in an interdisciplinary approach to patient treatment and will impart clinical information (i.e., diagnosis, cognitive functioning, psychological adaptation) effectively to other health professionals, family members and community agencies.

Specific Training Activities

Required Activities

Psychotherapy:  Inters will treat an average of 2 to 3 patients per week (approximately 5 to 6 hours), utilizing brief, problem-focused, family, and/or cognitive-behavioral intervention strategies.

Patient management activities:  Interns will attend weekly case conferences and treatment planning meetings on the patients they are following, as well as family conferences when necessary.  Interns will complete admission paperwork, regular chart notes, and discharge summaries in a timely manner.

Neurocognitive Screening Assessments:  Each month, the intern will complete 1-2 screening batteries (approximately 1 hour of testing) of adult patients.  Referrals may come from the rehabilitation unit or any of a wide variety of medical services within the hospital.

Optional Activities

Patient and Family Support Groups:  Two monthly psycho-educational groups provide the intern with more opportunities to understand the impact of either a burn injury or a primary brain tumor on the patient and their loved ones.

Ethics Consultations:  There is a monthly Ethics Committee meeting that provides an overview of the role of Ethics in a hospital setting.  In addition, there are opportunities to participate in the Ethics Team Consultations requested when a difficult situation arises with conflicts between the medical team and the patient and family or conflicts/disagreements among the medical team members. 

Acute Care Rounds:  The intern may attend weekly acute care rounds in which all patients in the hospital receiving rehabilitation services are discussed for the purpose of generating referrals to physical therapy, occupational therapy, speech therapy, rehabilitation psychology, and participate in treatment planning.

Neurosurgery/Neuroradiology Rounds:  The intern may attend weekly neurology/neuroradiology walking rounds in which all inpatient neurosurgical patients are discussed and briefly evaluated at bedside by an interdisciplinary team (neurosurgeons, nurses, case manager, rehabilitation psychologist, rehabilitation physician).  Following patient rounds, the intern may participate in neuroradiology rounds during which brain CT and MRI scans are reviewed and discussed. 

Training/In-Services:  The intern is welcome to attend a variety of special seminars, trainings, and in-services held regularly by various rehabilitation specialists (occupational therapy, physical therapy, speech-language pathology).

Theoretical Approaches

There is no single theoretical approach utilized exclusively in the rehabilitation psychology setting.  In general, our work is guided by the principles of health psychology and behavioral medicine, which emphasize the connection between body and mind.  Our work is usually brief, family or systems focused, and cognitive-behavioral in nature.  However, the wide array of circumstances confronting our patients demands flexibility in our approach to therapeutic activities.  For example, at any given time the Rehabilitation Psychology intern may be engaged in behavioral management of a head injured patient, helping a trauma patient grieve the loss of a loved one, and/or assisting the spouse of a spinal cord injured patient express concerns about sexuality.

Types of Clinical Approaches

Patient and family psychoeducation regarding a wide array of topics, including behavior after brain injury, affective reactions to medical problems, family adjustment to new disability, etc.

Consultation to a wide variety of medical professionals

Problem-focused, brief psychotherapy with medical patients and their families

Consultation to interdisciplinary treatment team regarding psychological and/or cognitive factors within discipline specific treatment approaches

Population of Clients

The patients seen by the Rehabilitation Psychology services division of the Department of Physical Medicine and Rehabilitation range in age from teens to geriatrics.  The patients are referred for evaluation and treatment of cognitive and/or psychological issues related to, or arising from, physical illness or injury.  Because of the specialized programs available within the University of Colorado Health Sciences Center, patients come from both urban and rural settings from within Colorado as well as from several surrounding states.  The patients and their families are diverse in terms of their educational, cultural and socioeconomic backgrounds.

Supervision

The intern will be supervised for clinical activities on the rehabilitation unit by one psychologist for approximately 1-1/2 hours per week.  Currently the supervisor in Rehabilitation Medicine is Wendy L. Clyne, Psy.D.  (Clinical Psychology, University of Denver, 1988).  Her areas of expertise are treatment of persons with burns, disfigurement, traumatic injury and working with terminal patients.