Careers in rehabilitation psychology.

Rehabilitation psychology is the study and application of psychosocial principles on behalf of people who have physical, cognitive, developmental, or emotional disabilities. Whether their disabilities are congenital or acquired, people who are disabled may face personal, social, and situational barriers to effective functioning in society. Some barriers are inherent in the disabling condition, while others arise out of widespread myths which contribute toward a devaluation or neglect of people who are perceived as different from others.

Dembo, Diller, Gordon, Levitan, and Sherr (1973) conceptualized rehabilitation as that branch of psychology characterized by concern with the amelioration of problems of deprivation and disability. Other authors distinguish rehabilitation psychologists from other psychologists because of the importance placed on the stresses arising from socio-environmental factors: the rehabilitation psychologist focuses on assisting people with disabilities to identify and remediate barriers in their interpersonal or physical environment that may be impeding their maximum participation in the community at large (Eisenberg and Jansen, 1983).

Rehabilitation Psychology as a Professional Identity

In 1949, the National Council on Physical Aspects of Disability was formed as a special interest group. The Division of Rehabilitation Psychology of the American Psychological Association (APA Division 22) was established in 1956 as an organization of psychologists concerned with the psychological and social consequences of disability and with ways to present and resolve problems involving disability. Today, the division has a membership of over 1,200 psychologists and supports a professional journal, Rehabilitation Psychology, a membership newsletter, the Rehabilitation Psychology News, and numerous continuing education programs aimed at rehabilitation psychologists. The division also serves a professional advocacy and disability policy-making function in providing information and recommendations to governmental agencies involved in the creation of policies which impact on people with disabilities. The division has also developed standards for providers of rehabilitation services and recommended guidelines for preand post-service training. Employment Settings

Rehabilitation psychologists can be found in a wide variety of settings, serving in any one or several of a number of functions, such as clinical practice, providing counseling or assessment services, administration of rehabilitation programs, research in a variety of areas relating to disability, and education of rehabilitation psychology or rehabilitation counseling professionals.

A survey of members of the American Psychological Association conducted in 1989 provides some useful information on the existing employment settings of rehabilitation psychologists. Of the 925 members of APA Division 22 who completed the American Psychological Association demographic forms in 1989, 51 percent were employed in health service provider areas, such as in clinical and counseling psychology positions. Twenty-four percent reported being involved in independent practice, while others reported university settings (18 percent), hospitals (18 percent), and other human service settings (16 percent) as their primary place of employment. Two-thirds of these members indicated they were involved in management or administrative activities; 79 percent reported that they were involved in health and mental health related services.

From data being gathered by the APA for 1991(1), we see that average annual salaries for licensed psychologists in direct human services with less than 10 years experience are in the $30,000 to $45,000 range, dependent upon whether the professional is employed by a public, private, or Veterans Administration hospital. Licensed psychologists in direct human services with more than 10 years experience currently average an annual salary of approximately $50,000. Those working in private group practices may earn from $10,000 to $20,000 more than the above salaries each year, with average annual salaries in the $50,000 to $70,000 range.

The APA conducts such surveys every 4 years; another survey will be conducted in 1993. (For further information, contact the APA Office of Demographic, Employment and Educational Research at [phone].)

Training

In the 1989 report from the Office of Demographic, Employment and Educational Research of the American Psychological Association, a profile of the membership of APA Division 22 in 1989 (N=925) showed that 87 percent had doctoral degrees, while 77 percent reported being licensed and/or certified (American Psychological Association, 1989). Many rehabilitation psychologists now practicing were trained as clinical or counseling psychologists and report that it was through their internship or work experiences that they became interested in working with disabled people (Eisenberg & Jansen, 1983).

Leung, Sakata, and Ostby (1990) surveyed 197 APA-accredited clinical and counseling doctoral programs regarding their offerings in rehabilitation; 90 (46 percent) were returned in usable form. The results showed that 1 out of 62 clinical psychology programs and 7 of 28 counseling psychology programs offered rehabilitation psychology as a minor. The results of this study point to the need for inclusion of courses in rehabilitation psychology in existing APA-accredited clinical and counseling doctoral programs, as well as the need for opportunities for continuing education and postdoctoral training to assist practitioners already in the rehabilitation field who have had little or no specialized training.

Elliott and Gramling (1990) suggest a number of areas which students who want to work in physical rehabilitation settings should get training, such as: assessment of intelligence, personality, environmental and situational factors, and brain behavior relationships of people who have chronic injuries and illnesses; strategies for adapting traditional assessment procedures for those who have chronic injuries and illnesses; assessment of the behavioral problems that may interact with somatic aspects of the disability; outcome measurement techniques, such as patient activities of daily living; and assessment of health status variables. The APA Division of Rehabilitation Psychology is currently developing guidelines for both pre-service doctoral level and postdoctoral level training in rehabilitation psychology. (Draft guidelines for education and training in rehabilitation psychology can be obtained by calling Robert Glueckauf, chairperson of the Education and Training Committee for the APA Division of Rehabilitation Psychology, at (317) 274--6765.)

Future Employment Opportunities

Rehabilitation is the fastest growing area in the health care industry today. The growth in rehabilitation can be attributed to a number of factors. First, the number of aged people in the American population is increasing greatly, resulting in more people with chronic conditions which require rehabilitation. Second, advances in medical management of trauma have led to higher survival rates for accident victims (Frank, Gluck, & Buckelew, 1990).

In addition, key federal legislative initiatives in the past 20 years have given the needs and rights of people with disabilities greatly increased emphasis in education, employment, and other aspects of American life. This has also provided increased opportunities for psychologists to serve people who are disabled and to uniquely contribute to their enhanced participation in the community. Both the Rehabilitation Act of 1973, as amended (P.L. 93-112), and the Education for all Handicapped Children Act of 1975 (P.L. 94-142), renamed in 1990 the Individuals with Disabilities Education Act  (P.L. 101-476), emphasize functional outcome rather than diagnosis or medically oriented treatment approaches, an area where psychologists can make significant contributions (Frank, Gluck, & Buckelew, 1990).

More recently, the Americans with Disabilities Act of 1990 (P.L. 101-336, or ADA) even further expands the potential role of psychologists in furthering the interests of people with disabilities. The services and skills of psychologists can be used in disability determination, in identification of reasonable accommodations for people who have a history of severe and persistent mental illness, to assist in adaptation of pre-employment screening, and to educate employers, employees, and others about the barriers of discriminatory attitudes toward disability.

While rehabilitation psychologists have more often in the past served in medical and health-related settings, the above identified federal legislative initiatives will make it necessary and desirable that the role of the psychologist expand into the community. Rehabilitation psychologists are also needed to assist independent living centers and community-based employment programs and to serve as advocates in their own communities and at state and federal levels to provide input to the policy-making process (Solarz, 1990). For rehabilitation psychologists, career opportunities now and for the future have never been brighter.

If you are a psychologist and would like further information about significant issues of concern to psychologists working with and on behalf of people with disabilities, you may contact the Committee on Disabilities Issues in Psychology of the American Psychological Association (APA) in Washington, DC, at [phone]. If you would like information about membership in the American Psychological Association or the requirements for professional credentialing as a psychologist, call APA at [phone]. Information about membership or current initiatives of the Division of Rehabilitation Psychology of the American Psychological Association can be obtained by calling [phone] or [phone].

Notes

1. Personal communication with Jessica Kohout, Office of Demographic, Employment and Educational Research of the American Psychological Association, Washington, DC, March 11, 1992.

Bibliography

American Psychological Association. (1989). Profile of Division 22 members. Washington, DC: Author, Office of Demographic, Employment & Educational Research.

Dembo, T., Diller, L., Gordon, W.A., Levitan, G., & Sherr, R.L. (1973). A view of rehabilitation psychology. American Psychologist, 28, 719-722.

Eisenberg, M., & Jansen, M. (1983). Rehabilitation psychology: State of the art. In E.L. Pan, T.E. Backer, & C.L. Vash (Eds.), Annual Review of Rehabilitation (Vol. 3, 1-31). New York: Springer.

Elliott, T. & Gramling, S. (1990). Psychologists and rehabilitation: New roles and old training models. American Psychologist, 45(6), 762-765.

Frank, K., Gluck, J. & Buckelew, S. (1990). Rehabilitation: Psychology's greatest opportunity. American Psychologist, 45(6), 757-761.

Jansen, M. & Eisenberg, M. (1986). The roles and functions of rehabilitation psychologists in medical settings: Current trends. Rehabilitation Research Review. Washington, DC: D:ATA Institute.

Leung, P., Sakata, R., & Ostby, S. (1990). Rehabilitation psychology professional training: A survey of APA accredited programs. Rehabilitation Education, 4(3), 177-183.

Solarz, A. (1990). Rehabilitation psychologists: A place in the policy process? American Psychologist, 45(6), 766-770.

Dr. Bruyere is Director of the Program on Employment and Disability in the School of Industrial and Labor Relations at Cornell University, Ithaca, New York, and Immediate Past President of the Division of Rehabilitation Psychology (APA Division 22) of the American Psychological Association. She holds a doctoral degree in Rehabilitation Psychology from the University of Wisconsin-Madison and is a certified rehabilitation counselor.