ABPP Rehabilitation Psychology cheat sheet

Rehabilitation psychology addresses the psychological and social consequences of disability across the lifespan, emphasizing person-environment interaction rather than disability alone.

The WHO ICF model classifies functioning at three levels: body functions and structures, activities, and participation, with contextual environmental and personal factors.

The social model of disability locates the disabling barrier in the environment and attitudes; the medical model locates it in the individual's impairment.

The biopsychosocial model integrates biological, psychological, and social determinants and underpins most contemporary rehabilitation assessment and treatment.

Disability identity development describes movement from internalized stigma toward disability pride and community connection, paralleling minority identity models.

Adjustment to disability is best modeled as a nonlinear process of assimilation and accommodation rather than fixed stages of grief.

The independent living movement and disability rights advocacy shifted rehabilitation goals from normalization toward consumer control and autonomy.

Secondary conditions (pain, depression, pressure injuries, deconditioning) are preventable comorbidities of disability and are core rehabilitation targets.

Core values of the specialty include autonomy, dignity, functional independence, and the person's right to define their own rehabilitation goals.

Cognitive screening instruments detect impairment but do not diagnose; abnormal scores require follow-up with comprehensive neuropsychological evaluation.

Depression and anxiety measures validated in the general population may show somatic-item inflation in people with neurological or medical conditions; interpret with caution.

Performance validity testing evaluates effort on cognitive measures; symptom validity testing evaluates overreporting of symptoms; both are distinct from malingering diagnosis.

A score below the cutoff on a validity measure indicates invalid data for that administration, not a conclusion about the person's character or intent.

Premorbid ability estimates derive from demographic regression, word reading, or best-performance history, and anchor interpretation of current cognitive scores.

Ecological validity refers to the degree to which test performance predicts real-world functioning; self-report and informant-report add incremental information.

Functional assessment addresses activities of daily living, instrumental activities, and participation, and informs level-of-care and return-to-work decisions.

Serial assessment requires equivalent or alternate forms and attention to practice effects, which inflate scores on repeated administration.

Pain assessment in cognitive impairment relies on behavioral observation tools and caregiver report rather than numeric rating scales alone.

Cognitive behavioral therapy is first-line psychological treatment for depression and anxiety in rehabilitation and can be adapted for cognitive and communication limitations.

Motivational interviewing targets ambivalence about behavior change; it is directive in goal but nonconfrontational in style and predicts adherence.

Goal setting using the SMART framework (specific, measurable, achievable, relevant, time-bound) improves engagement and outcome tracking.

Problem-solving therapy is effective for depression in populations with executive dysfunction or chronic medical illness.

Behavioral activation reduces depression by increasing scheduled engagement in valued activity rather than by changing cognitions.

Coping skills training distinguishes problem-focused coping, emotion-focused coping, and meaning-focused coping, matched to controllable versus uncontrollable stressors.

Relaxation and biofeedback techniques reduce physiological arousal in pain, spasticity, and anxiety conditions and require skill generalization training.

Caregiver interventions reduce caregiver burden and improve patient outcomes; caregiver distress is an independent treatment target.

Return-to-work interventions combine graded work exposure, workplace accommodation planning, and coordination with vocational rehabilitation.

The rehabilitation team typically includes physiatry, nursing, physical therapy, occupational therapy, speech-language pathology, psychology, social work, and vocational counseling.

Interdisciplinary teams share assessment and jointly set goals; multidisciplinary teams work in parallel; transdisciplinary teams blur role boundaries with cross-training.

Consultation models include client-centered case consultation, consultee-centered consultation, program-centered administrative consultation, and consultee-centered administrative consultation.

Team functioning is assessed along shared goals, role clarity, communication quality, and decision-making processes; role ambiguity predicts conflict.

Informed consent for rehabilitation treatment requires capacity, voluntariness, disclosure of risks and alternatives, and documentation.

Family systems factors, including caregiver capacity and family communication patterns, shape discharge planning and community reintegration.

Discharge planning begins at admission and addresses environmental accessibility, durable medical equipment, transportation, and community supports.

Systems-level barriers include insurance authorization limits, fragmented care transitions, and inaccessible transportation and housing.

Ethical conflict on teams is addressed through the shared decision-making process, ethics consultation, and the patient's expressed values.

The four core ethical principles are respect for autonomy, beneficence, nonmaleficence, and justice; veracity and fidelity are commonly added.

Informed consent requires decision-making capacity, adequate disclosure, comprehension, voluntariness, and authorization; capacity is decision-specific.

Confidentiality may be limited by legal reporting duties, imminent danger to self or others, court order, and abuse or neglect reporting laws.

The Health Insurance Portability and Accountability Act governs protected health information; state law may impose stricter requirements that control.

Duty to protect, as established in Tarasoff, requires reasonable steps such as warning or protective action when a client poses serious threat to an identifiable person.

Scope of competence requires practicing within training and experience; emerging areas require supervision, consultation, or additional education.

Multiple relationships are not automatically unethical; risk increases when the relationship could impair objectivity or exploit the client.

Test security and copyright law restrict reproduction of psychological test materials; release of raw data is governed by ethics codes and law.

Documentation standards require contemporaneous, accurate records sufficient to support clinical decisions and third-party review.

Scope of practice is defined by state licensure law and may differ from the scope of competence defined by professional training and experience.

Mandated reporting duties for suspected child, elder, or dependent adult abuse override confidentiality and vary by jurisdiction.

Involuntary commitment standards require mental disorder plus dangerousness to self or others or grave disability, defined by state statute.

Fitness-for-duty and disability evaluations require role clarity: the evaluator serves the referring party, and the evaluee must be informed of limits to confidentiality.

Forensic and administrative evaluations differ from treatment in purpose, confidentiality, and the duty to the evaluee; therapeutic and evaluative roles should not be combined.

Guardianship and supported decision-making alternatives range from power of attorney to full guardianship; the least restrictive option is preferred.

Record retention periods are set by state law and institutional policy; the longer applicable requirement generally controls.

Telehealth practice requires verification of patient identity and location, licensure jurisdiction compliance, and emergency planning.

Ethical decision-making models systematically identify the problem, consult codes and law, consider stakeholders, and document the rationale for the chosen action.

Rehabilitation psychologists must distinguish their treatment role from evaluator roles in disability, workers' compensation, and forensic contexts.

Informed consent for assessment includes the purpose, anticipated use of results, who will receive the report, and limits of confidentiality.

Third-party observers during evaluations can alter performance; requests should be evaluated against validity concerns and documented.

Release of test data is governed by ethics code provisions on test security, copyright, and the patient's right of access under privacy law.

Competence in cultural and linguistic diversity requires appropriate norms, interpreter use, and caution with translated instruments lacking validation.

Supervision responsibilities include delegated authority, ongoing evaluation, and accountability for supervisee services and documentation.

Impaired practitioner obligations include intervention, documentation, and reporting to the appropriate authority when patient safety is at risk.

Advocacy at the systems level, including policy and accessibility advocacy, is an ethical aspiration consistent with the principle of justice.

Ethical standards prohibit sexual relationships with current clients and impose time-based restrictions with former clients defined by the applicable code.

Bartering and fee arrangements are permitted only when not exploitative and when the arrangement is not clinically contraindicated.

Advertising and public statements must be accurate and not create false expectations about outcomes of rehabilitation.

Research ethics require institutional review board approval, informed consent, and protections for populations with impaired decisional capacity.

Conflict of interest disclosure is required when financial or personal interests could influence professional judgment, including vendor and equipment relationships.

Peer review and quality improvement activities use aggregated or de-identified data where possible to protect patient privacy.

When ethical obligations conflict with law or institutional policy, psychologists attempt informal resolution first and document the process.

Cultural humility involves ongoing self-reflection about power, bias, and the clinician's own cultural position in the therapeutic relationship.

A psychologist may breach confidentiality when required by law or when necessary to protect the client or a third party from serious harm.

Privilege belongs to the client and may be waived only by the client or the client's legal representative.

Records requested by subpoena require verification of authorization or court order before release, with legal consultation as needed.

Emergency detention and involuntary hold procedures are governed by state statute and require documentation of the clinical basis.

Capacity to consent to treatment differs from capacity to make financial or testamentary decisions and must be assessed specifically.

Psychologists avoid delegating clinical judgment to unqualified persons and retain responsibility for supervisee work.

Termination and referral obligations require advance notice, provision of alternatives, and avoidance of abandonment.

Professional will and records disposition planning protect clients in the event of the psychologist's incapacity or death.

Ethical decision-making in rehabilitation frequently involves balancing autonomy and safety in discharge and placement decisions.

Informed refusal allows a capable patient to decline recommended treatment, including against team advice, after risks are disclosed.

Paternalism is justified only in narrow circumstances, such as imminent risk in a patient lacking capacity, and must be documented.

Patient rights in rehabilitation settings include participation in treatment planning, access to records, and freedom from restraint and seclusion except in defined emergencies.

Restraint and seclusion use requires a clinical order, time limits, monitoring, and documentation under federal and state regulation.

Whistleblowing obligations arise when institutional practices endanger patients; internal channels are exhausted first where feasible.

Insurance utilization review decisions can be appealed; psychologists document medical necessity with functional evidence.

Cultural and linguistic accommodation in consent and treatment is both an ethical and a legal requirement in many jurisdictions.

Therapeutic privilege, withholding information to avoid harm, is narrowly justified and generally discouraged in favor of supported disclosure.

Research with people with disabilities should include accessible consent formats and accommodations consistent with the Americans with Disabilities Act.

Confidentiality in group or team settings requires explicit limits disclosure to patients before participation.

Boundary crossings differ from boundary violations: crossings may be benign or therapeutic, while violations exploit or harm the client.

Gift acceptance is guided by value, cultural meaning, and potential for exploitation or harm to the therapeutic relationship.

Competence to stand trial and other forensic opinions require specialized forensic training and are outside general rehabilitation practice.

Ethical obligations continue after employment ends; departing clinicians plan for continuity of care and records transfer.

Documentation of informed consent, risk assessment, and consultation protects both patients and clinicians in legal review.

The Americans with Disabilities Act prohibits discrimination and requires reasonable accommodation in employment and public services.

The Family and Medical Leave Act provides job-protected leave for qualifying medical and family needs, with eligibility thresholds.

Workers' compensation systems provide no-fault benefits for work-related injury and typically include vocational rehabilitation provisions.

Social Security disability determinations use sequential evaluation of impairment severity and residual functional capacity.

Federal special education law provides for transition planning and accommodations for students with disabilities.

Informed consent for research with cognitively impaired adults may require legally authorized representatives and assent procedures.

Ethical practice requires recognizing when personal values about disability could bias clinical recommendations.

Cultural formulation in rehabilitation considers explanatory models of illness and disability, stigma, and family decision-making norms.