and Body Image
BRUCE D. RYBARCZYK
JAY M. BEHEL
Rehabilitation medicine is a broad field that provides a range of inpatient and outpatient services to enhance the overall health and functioning of individuals with various chronic diseases and disabilities. The same breadth is found in rehabilitation psychology, which encompasses the study and application of psychosocial principles on behalf of persons who have physical, sensory, cognitive, developmental, or emotional disabilities. For this chapter we narrow the scope of discussion to the disability groups that rehabilitation psychologists have the most experience serving: those who are admitted to an inpatient rehabilitation unit with an acquired disability. Common acquired disabilities in this setting include traumatic brain injury, spinal cord injury, stroke, amputation, and various neurological conditions that result in physical impairment and/or chronic pain.
Rehabilitation psychologists frequently cite body image changes as a central issue in the adjustment process faced by individuals with an acquired disability. Body image is generally viewed by clinicians as a critical element of an individual's overall self-concept. Sometimes body image plays a central role in the adjustment process, and other times it is secondary to more global adjustments in self-concept (e.g., from nondisabled to disabled, "independent" to "dependent," employed to unemployed, etc.). These more fundamental changes in self-concept may take precedence over changes in body image, and body image changes may not be fully integrated until these other issues are addressed. In other cases, a focus on body im-