REHABILITATION PSYCHOLOGY PRACTICE, ETHICS, AND A CHANGING HEALTH-CARE ENVIRONMENT

The rapid changes in the health care environment have brought about et hical and professional challenges for rehabilitation and rehabilitatio n psychology. The response of rehabilitation psychologists to the thre ats and opportunities of these challenges will significantly impact th e welfare of persons with disabilities and the future of our professio n. Managed care organizations have focused their efforts on the manage ment of acute illness. Persons with disabilities and other chronic ill nesses pose real challenges to current concepts in managed care. Ethic al concerns are being raised about patient access to care, self-determ ination, confidentiality, provider accountability, and marketing in ma naged care systems. Rehabilitation psychologists' familiarity with per sons with disabilities and skills in program development and outcome e valuation place them in a key position to influence the changes in the health care environment. To be effectual, however, fundamental change s must be made in practice, education and training, research focus, an d professional activities.