A SYSTEMS AND SOCIAL COGNITIVE APPROACH TO TEAM FUNCTIONING IN PHYSICAL REHABILITATION SETTINGS

Recent models for implementing team efforts in physical medicine and r ehabilitation have focused on both interdisciplinary and transdiscipli nary approaches. Such approaches involve team members assuming multipl e responsibilities that cross disciplines. Moreover, these approaches emphasize ''role release,'' that is, a blurring of roles such that eac h member supports and/or takes on responsibilities typically associate d with other disciplines. To date, no empirical research exists that h as documented the clinical effectiveness of such models. In clinical p ractice, anecdotal observations would indicate that interdisciplinary and transdisciplinary teams often appear to fail in both structure and function. From our perspective these approaches directly violate cert ain assumptions inherent in systems models and social-cognitive approa ches to interpersonal functioning. Also, it is argued that inappropria te applications of interdisciplinary and transdisciplinary approaches, although theoretically viable, can potentially result in fragmentatio n of team efforts, staff dissension, and ultimately poor patient outco me. The ways in which systems and social cognitive tenets are violated will be outlined, and recommendations offered for theoretical and pra ctical alternatives to the implementation of interdisciplinary and tra nsdisciplinary team models.