Something’s missing, and I want to fill the gap

I want to take Rehabilitation Psychology out of the hospitals and bring it into the community, whereby psychology services can be truly ACCESSIBLE to the people who could benefit from them.

I believe Psychology as a health discipline has made tremendous advances and continues to work toward ensuring that community-based care is INCLUSIVE of all individuals regardless of their racial, ethnic, cultural, and religious backgrounds, as well as their gender and sexual orientation- meaning no matter your background, you should be able to confidently walk into a local psychologist’s office and find someone skilled in addressing your emotional/cognitive/behavioral needs.

In contrast, I have not found the same to be true for individuals with chronic health concerns or disability as part of their identity or the identity of their loved one(s). What I’ve found, is that providers with the appropriate training to treat members these communities are almost exclusively housed within hospitals or formal outpatient rehabilitation programs where the primary focus is recovery from the disability or health condition.

While these programs are excellent and essential for addressing acute needs and assisting individuals in their initial adjustment from “healthy person” or “able-bodied person” to “person with a disability” or “person with a chronic illness, I wonder, What happens when those people phase out of that program?

Despite what the media and standard medical education would lead us to believe, there are people who are living in this world (even in our own community) with disabilities and/or chronic health conditions that make their work and leisure activities look different from the norm. Some of these people are living independently, while others are directing assistance provided by professional or family caregivers. These people are working, playing, shopping, and traveling within the able-bodied world and are vulnerable to depression, anxiety, work-stress, relationship issues, and substance abuse just like everyone else.

My fear is that when these people walk, hop, or roll into an outpatient psychology clinic, the average clinical psychologist, therapist, or counselor is going to feel intimidated by their health or disability status, have difficulty looking past it, and be quick to associate their distress only to this status (i.e., “Obviously you’re depressed because you use a wheelchair/have burns, engage in self-catheterization, are post-lung transplant, etc.”). I am afraid that these providers may not be able to appreciate how this status impacts someone’s life without being the only focus of his or her life.

I’ve noticed that these individuals often find themselves in a “limbo” of sorts. They’re not “sick enough” to access the psychologist who treated them in acute care or an outpatient physical rehabilitation program. They also shouldn’t be expected to rely solely on providers housed within specialized programs for individuals with a particular condition (e.g., MS, TBI, stroke, amputation, organ transplant, etc.) Moreover, these programs often have extraordinary hoops to jump though to access services in order for them to manage the demand of patients who have acute needs.

My mission is to use my training and experience to provide well-rounded psychology services to individuals with varying abilities and health needs in the context of everyday life.

For example, let’s say you were diagnosed with transverse myelitis (inflammation of the spinal cord) ten years ago. You completed the prescribed inpatient and outpatient rehabilitation programs, spent a few years living with your family, and have been living independently for the last six years. You work a full-time job and enjoy doing things typical of others your age. You use a wheelchair for mobility, have some peripheral nerve pain, and rely on timed voids and a bowel program to maintain your continence. You have recently noticed that you aren’t enjoying life as much as you used to, you’re feeling burned out at work, and you feel like something is missing in your life. You decide to see if psychotherapy is helpful. You called the rehabilitation clinic where you were seen after your acute hospitalization, but the psychologist there is only taking patients who are currently involved in the comprehensive rehabilitation program. You know there is a psychology clinic in town next to the place you get your hair done, but the thought of explaining your lifestyle to a new person sounds like more work than it’s worth. Ugh. What can you do?

Or consider that you’re the husband of a woman living with a terminal brain tumor that has taken away her ability to understand and produce intelligible language. You’re having difficulty coping with the lifestyle changes this has brought on, not to mention the anticipatory grief. You’ve never seen any type of mental health provider before, but your family is encouraging you to get some support as well as some strategies for coping with your wife’s evolving needs. There is no way you’re going to set foot inside a hospital- you’re not “sick” or “crazy,” but you want a provider who understands the neuropsychological underpinnings of your wife’s condition, and that this isn’t just a “marriage issue.” Where can you go?

After training and working as a licensed psychologist in large medical settings for the last ten years, I’ve had the opportunity to learn from and about many different rehabilitation populations and the disability community. At this point in my life and career, I’m excited about breaking out of the medical centers and some of the restrictions they impose. I am eager to bring Rehabilitation Psychology services to individuals who are out in the world, living their lives, and deserve access to someone who understands and appreciates their lifestyle, challenges, successes, and goals. I’m hoping I can be your “neighborhood rehabilitation psychologist.”