Hither and thither: How do we innovate?

The Dembo-Wright Lecture provided a forum to discuss how innovation occurs in general and in rehabilitation psychology. The 21st Century will rely upon the creation and enhancement of knowledge. Universities, industries and professional disciplines are challenged to develop models that nurture their development of knowledge jobs that create new systems or products. A new model of nurturing innovation: The Rainforest, relies upon creating ecosystems that bring together and support the critical groups allowing instances that propel spontaneous growth of sustainable enterprises. Over the last 3 decades, rehabilitation psychology has seen disruptive-yet productive-innovation when thought leaders in the field have introduced ideas that move the discipline to entirely new areas of discussion. For rehabilitation psychology, consideration of new models of practice that address the huge needs of the developing world are warranted. The complexity of nurturing innovation in differing environments must be addressed. Progress to date indicates that understanding and defining the interface between machines and humans will be critical to the future of rehabilitation psychology. (PsycINFO Database Record

Investing in our future: unrealized opportunities for funding graduate psychology training.

PURPOSE: Changes in the health care environment have brought challenges and opportunities to the field of psychology. Practitioners have been successful in modifying service models to absorb losses of financial support for behavioral health care, due to managed care and public policy changes, while simultaneously managing the growing need for these services. However, in this reactive mode of responding to evolutions in the health care system, the field of psychology has at times lost sight of the long-term vision required to promote psychology's inclusion in the health care system of the future. In particular, a focus on training psychologists and ensuring the availability of funding to support these activities must be a priority in planning for the future. This article provides an overview of federal programs that currently offer funding for psychology training, as well as other opportunities for federal funding that have been unrealized. Details regarding advocacy efforts that were required to secure available sources of funding are given, followed by consideration of strategies for taking advantage of existing resources and prioritizing advocacy for additional funding. CONCLUSION: Funding for psychology training provides an avenue for increasing the number of well-trained psychologists who can serve patients' mental and behavioral health needs and thereby improve health outcomes. Moreover, capitalizing on available funding opportunities for psychology training and promoting efforts to expand these opportunities will help ensure that the field of psychology is positioned to remain an important contributor to the health care system of the future.

Brain injury and health policy: twenty-five years of progress.

Legislative advocacy is a prerequisite for the development of research and community services benefiting individuals with traumatic brain injury (TBI). Dr Mitchell Rosenthal and other leaders in rehabilitation began the process of advocating for TBI services more than 25 years ago, before many in the field fully appreciated the necessity of these efforts. Since that time, substantial gains have been made through advocacy efforts on behalf of individuals with TBI and their families. This article provides an overview of the TBI advocacy movement, highlighting federal legislation resulting in appropriations for TBI services and protecting the rights of individuals with TBI. Key government entities engaged in developing states' TBI infrastructure and providing services to individuals with TBI and their families are also discussed. In addition to celebrating some of the successes that were initiated by the efforts of Dr Rosenthal and other visionaries, select shortcoming of current legislation is noted to provide insights regarding future advocacy needs.

Health locus of control, gender differences and adjustment to persistent pain.

Locus of control (LOC) beliefs, long thought important in adjustment to persistent pain, were studied among 160 subjects (67 males and 93 females) referred to a comprehensive pain rehabilitation program. The subscale structure of the Multidimensional Health Locus of Control (MHLC) was factorially replicated in our sample. Three unique MHLC profile clusters were identified for both males and females. Among men, cluster assignment was related to age only. The younger male patients reported a stronger internal attributional style. Older male patients relied more heavily on both chance and powerful other factors. Among women, cluster assignment was related to the use of coping strategies. For example, patients with high internal scores only, reflecting a strong internal orientation towards self-management of health care needs, were more likely to utilize Information-Seeking, Self-Blame, and Threat Minimization coping strategies than patients with high scores on both the Internal and Powerful Other factors. It appears that the presence of both Internal and Powerful Other health attributional styles is associated with less frequent use of cognitive self-management techniques. In understanding the LOC scores it is important to rely on pattern analysis of scores. Implications for clinical treatment are discussed.

Physician concern over medication intake: a simple measure of medication use.

Medication use is commonly measured in clinical pain control studies. Equivalence to a standard medication (e.g., morphine), effective dosage, and percent changes from before to after treatment have been used to provide quantitative medication intake measures which are amenable to statistical analysis. Problems with these methods arise when specific medications are not found in an extant table or when combinations of medications interact in their effectiveness or side effects. In the present study, a Q-sort technique, whereby physicians rated concern over medication intake, provided a simple, rapid measure of medication intake which is sensitive to treatment effects and is amenable to statistical analysis.