Rehabilitation Service Departments :

Clinical Psychology Department

The patient's psychological state is an important factor in determining the extent to which he or she will benefit from rehabilitation and make a satisfactory long-term adjustment to any residual disability. Psychological problems resulting from the disabling injury or illness may severely hamper progress. For example, depressed patients may have inadequate motivation for the strenuous work involved in rehabilitation, and highly anxious patients may have difficulty directing their energy in a productive manner. Psychological problems that existed prior to the disability can also interfere with rehabilitation if not properly managed. Patient with brain injury may exhibit a variety of behavioural problems, including irritability, impulsiveness and inappropriate social behaviour. The presence of cognitive impairment also limits their ability to benefit from rehabilitation. Behavioural problems, such as non compliance and disruptive behaviours may also affect the rehabilitation progress.

Psychological assessment
In order to understand the psychological and cognitive status of the patient, various psychological and neuro-psychological assessment procedures are utilized. Patients with brain injury generally undergo comprehensive neuropsychological evaluation to assess their residual strengths and weakness and assist in planning for their rehabilitation. Patients with chronic pain are referred for evaluation of psychological and social factors that may be affecting their adaptation. The following areas are the general aspects that will be examined.

The presence of mood problems, such as the depressive and anxiety symptoms

The presence of other psychological problems, such as Acute Stress Disorder or Posttraumatic Stress Disorder for patient who is injured in a traumatic event, Somatoform Disorder, Personality disorders, psychotic symptoms, relational problems, functional complaints, etc.

coping skill and ability

attitude and expectation of rehabilitation

level of acceptance towards the illness

The presence of disruptive behaviour

Neuropsychological assessment: patient with brain injury

personality traits

Carer stress

Pain assessment

Locus of control, self-efficacy and quality of life

Psychological Intervention
Individual and/or group intervention is often provided to facilitate the patient's adaptation to his or her disability. Behavioural modification is used to handle the patient's disruptive behaviour. Other services include pain management, stress management, problem solving, relaxation, biofeedback, communication skills, anger management, social skills, lifestyle modification and psycho education programme, etc. It is sometimes useful to provide information and counselling for the patient's family, to help prepare time emotionally and intellectually for the role they will play in the rehabilitation process.

Research
Research works are carrying out to enrich the knowledge in the field of rehabilitation psychology, to evaluate the service effectiveness and to facilitate the service development.