Feature

If you're not already interested in the psychology of rehabilitation, "You will be," promises Timothy Elliott, PhD, incoming editor of APA's newest journal, Rehabilitation Psychology. That's because it's a topic that will likely strike a chord with most Americans at one time or another, he says.

"In our society, the number one health-care problem centers on the delivery of acute and ongoing services to people who live with a chronic health condition," says Elliott, a psychology professor at the University of Alabama at Birmingham. And the number of people with chronic disease is increasing, he explains, due in part to the aging of baby boomers but also to epidemics such as diabetes, cardiovascular disease and HIV.

In fact, some chronic diseases--such as diabetes--often culminate in subsequent disabilities imposed by stroke, visual impairments or limb loss, he explains. Yet, Elliot says, the major drivers of secondary complications and optimal adjustment--behavioral and social mechanisms--are typically overlooked in public and health-care policy.

The importance of those mechanisms, says Elliott, underscores the key role of Rehabilitation Psychology (RP) in publishing and generating more research on people's adjustment to living with chronic health conditions--research that sheds light on "the processes that distinguish those who live optimally and those who are at risk for complications," he says.

Understanding those processes will require studying "theory-driven models that predict outcomes valued by consumers and health-care programs," he adds. "Ideally, research of this type will inform innovative services and interventions that promote the health and well-being of people and families living with chronic health conditions."

Much of the rehabilitation research until now, Elliott explains, "has been grounded in a medically based perspective--one "invested in the study of problems observed and treated in clinic life." The result? "Little is known about the psychological and social mechanisms and dynamics that characterize those who live optimally with their condition," he says.

To help change that, as editor of RP, he aims to showcase research indicating the key role psychological variables play in adjustment. In fact, says Elliott, psychology plays a bigger role in managing or rehabilitating a disability than does the degree or nature of the physical impairment.

"We have yet to understand the ways in which individuals experience positive growth and meaning after a disability," he says.

He will feature promising research on helping people return to their jobs, enhance their family life and resume leisure activities and hobbies. In addition, Elliott, whose own research has examined, among other things, the worth of home-based problem-solving interventions for family caregivers of those with spinal cord and brain injuries, will be particularly interested in seeing more intervention and outcome studies in the journal. Other topics he'd like to see in the journal include diabetes, multiple sclerosis, caregiver adjustment, patient-driven health care, and the use of long-distance telephone counseling and Internet-based video conferencing to provide services.

In fact, there is "no end in sight," he says, to ways psychology can examine chronic illness and disability. "There are so many different theories of adjustment, and all of them could be applied and examined in the journal."

"We are proud of our multidisciplinary heritage," he says. "But the field needs an outlet that places a premium first on psychological approaches and theory in all aspects of chronic diseases and disabilities, and that's what we want to see happen with Rehabilitation Psychology."

RP was formerly the journal of APA's Div. 22 (Rehabilitation), and is debuting as an official APA journal this month.