Springer Series in Rehabilitation and Health – serie

Despite medical technological advances, the major killers with which we must currently contend have remained essentially the same for the past few decades. Stroke, cancer, and heart disease together account for the vast majority of deaths in the United States. In addition, due to improved medical care, many Americans who would previously have died now survive these disorders, necessitating that they receive appropriate rehabilitation efforts. One result of our own medical advances is that we must now accept the high costs associated with providing quality care to individuals who develop one of these problems, and we must avail ourselves to assist of afflicted individuals. families Despite the relative stability of causes of death and disability, the health-care field is currently experiencing tremendous pressures, both from professionals with­ in the field, who desire more and better technology than is currently available, and from the public and other payers of health care (e.g., insurance companies), who seek an end to increasing health-care costs. These pressures, along with an increased emphasis on providing evidence of cost-effectiveness and quality assurance, are substantially changing the way that health-care professionals perform their jobs.

Health workers who provide services to persons with severe mental illness are frequently under enormous stress; burnout is common. Alleviating such stress is the objective of Interactive Staff Training. The book provides rehabilitation and mental health professionals with a strategy to help them and their colleagues work as a well-integrated team. This strategy has been implemented in teams serving more than 10,000 persons with psychiatric disabilities. The text combines a careful description of the central theory behind the strategy with pleanty of clinical anecdotes that illustrate its practical, everyday benefits.

Experts from academia, clinical settings, and the business world pool their knowledge about work injury prevention and management in the new Sourcebook of Occupational Rehabilitation. The 22 contributions in this wide-ranging reference address aspects of the three primary areas of service delivery: prevention, assessment, and rehabilitation. The text takes a multidisciplinary viewpoint toward its subject in order to shed light on the mechanisms and management of work-related disorders. It boasts a wealth of current and in-depth information, and takes a practical `applications approach' to rehabilitation

TItis volume is the first effort to compile representative work in the emerging research area on the relationship of disability and physical environment since Barrier-Free Environments, edited by Michael Bednar, was published in 1977. Since that time, disability rights legislation like the Americans, with Disabilities Act in the United States, the worldwide growth of the independent-living move­ ment, rapid deinstitutionalization, and the maturation of functional assessment methodology have all had their impact on this research area. The impact has been most noticeable in two ways-fostering the integration of environmental vari­ ables in rehabilitation research and practice, and changing paradigms for environ­ mental interventions. As the contributions in this volume demonstrate, the relationship of disabil­ ity and physical environment is no longer of interest primarily to designers and other professionals concerned with managing the resources of the built environ­ ment. The physical environment has always been recognized as an important variable affecting rehabilitation outcome. Until recently, however, concepts and tools were not available to measure its impact in clinical practic~ and outcomes research. In particular, lack of a theoretical foundation that integrated environ­ ment with the disablement process hampered development of both research and clinical methodology. Thus, the physical environment received little attention from the mainstream rehabilitation research community. However, this situation is changing rapidly.

This book is an extension of my 1992 book entitled The Social Context of Chronic Pain Sufferers. Many ideas nominally explored there are elaborated in this volume, which is an attempt to fill a major gap in the chronic pain literature. Although there has been a virtual flood of new works on the medical and psychological aspects of chronic pain, such enthusiasm is somewhat muted in relation to the social environment of the patient. Although there is universal recognitionamongpain expertsthat biological, psychological,and socialfactors influence the experience ofpain, the social component (forreasons that are - clear) has failed to attract much attention. Theneed forabook focusedonsocialrelationsisobvious.Thepatientisnot merelyacarrierof symptoms.Thereis alargesocialrealityinthe background of each patient; that reality can have multidimensional consequences, from the way pain is perceivedto seriousfinancialhardshipand other sourcesof stress, c- plicating treatment, management, and, ultimately, the prognosis. Clinicians rec- nize the value of incorporating the social dimension in the overall evaluation and treatment of the patient. This book attempts to accomplish that task.In order to achieve that objective, this volume addresses many important e- ments inthepatient'ssocial environment-the mostsignificantbeingthefamily. Beyond the family, for a vast majority of patients, work represents a major source of economic security and self-esteem. Job loss, common in this population and a major cause of much personal and family distress, needs critical examination.

Readers have access to legions of books dealing with the molecular, genetic, neurochemical, neurophysiological, neuroanatomical, neuroradiological and psychological aspects of pain as well as with the clinical approaches to pain from various medical disciplines. Why then is it necessary to publish a book on the pathophysiologyofpain perception? Pain can result either from noxious events due to lesions, injuries, diseases, etc. , or from disturbances in the system transducing, transforming, and processing the potential pain signal or from an interaction of both. Under certain pathological conditions, the pain-processing system, which includes both physiological and psychological components, can produce the experience of pain in the absence of any peripheral noxious event. This book primarily ex- amines these pathological alterations in the pain-signalling system, and the authors provide information on the functioning of the pain-processing system under normal and pathological conditions. The understanding of pain perception is essential for optimal diagnosis and treatment of acute and chronic pain.Considerable evidence now indicates that alterations in pain per- ception are characteristic of many clinical pain states. Whether disturbed pain perception is a truly etiological or only a maintaining factor-c-or even a mere epiphenomenon of chronic functional pain-is reviewed in detail by L. Arendt-Nielsen, C. R. Covelli, R. B. Fillingim,]. M. Gillespie, T. Graven-Nielsen, E. Kosek, S. Lautenbacher, M. Peters, A. Pielsticker, DO. Price, G. B. Rollman, P. Svensson and G. N. Verne for headache, back pain, fibromyalgia, myofascial pain, temporomandibular pain disorder, irritable bowel syndrome and menstrual cycle-related pain disorders.

This book is an extension of my 1992 book entitled The Social Context of Chronic Pain Sufferers. Many ideas nominally explored there are elaborated in this volume, which is an attempt to fill a major gap in the chronic pain literature. Although there has been a virtual flood of new works on the medical and psychological aspects of chronic pain, such enthusiasm is somewhat muted in relation to the social environment of the patient. Although there is universal recognitionamongpain expertsthat biological, psychological,and socialfactors influence the experience ofpain, the social component (forreasons that are - clear) has failed to attract much attention. Theneed forabook focusedonsocialrelationsisobvious.Thepatientisnot merelyacarrierof symptoms.Thereis alargesocialrealityinthe background of each patient; that reality can have multidimensional consequences, from the way pain is perceivedto seriousfinancialhardshipand other sourcesof stress, c- plicating treatment, management, and, ultimately, the prognosis. Clinicians rec- nize the value of incorporating the social dimension in the overall evaluation and treatment of the patient. This book attempts to accomplish that task.In order to achieve that objective, this volume addresses many important e- ments inthepatient'ssocial environment-the mostsignificantbeingthefamily. Beyond the family, for a vast majority of patients, work represents a major source of economic security and self-esteem. Job loss, common in this population and a major cause of much personal and family distress, needs critical examination.

Readers have access to legions of books dealing with the molecular, genetic, neurochemical, neurophysiological, neuroanatomical, neuroradiological and psychological aspects of pain as well as with the clinical approaches to pain from various medical disciplines. Why then is it necessary to publish a book on the pathophysiologyofpain perception? Pain can result either from noxious events due to lesions, injuries, diseases, etc. , or from disturbances in the system transducing, transforming, and processing the potential pain signal or from an interaction of both. Under certain pathological conditions, the pain-processing system, which includes both physiological and psychological components, can produce the experience of pain in the absence of any peripheral noxious event. This book primarily ex- amines these pathological alterations in the pain-signalling system, and the authors provide information on the functioning of the pain-processing system under normal and pathological conditions. The understanding of pain perception is essential for optimal diagnosis and treatment of acute and chronic pain.Considerable evidence now indicates that alterations in pain per- ception are characteristic of many clinical pain states. Whether disturbed pain perception is a truly etiological or only a maintaining factor-c-or even a mere epiphenomenon of chronic functional pain-is reviewed in detail by L. Arendt-Nielsen, C. R. Covelli, R. B. Fillingim,]. M. Gillespie, T. Graven-Nielsen, E. Kosek, S. Lautenbacher, M. Peters, A. Pielsticker, DO. Price, G. B. Rollman, P. Svensson and G. N. Verne for headache, back pain, fibromyalgia, myofascial pain, temporomandibular pain disorder, irritable bowel syndrome and menstrual cycle-related pain disorders.

TItis volume is the first effort to compile representative work in the emerging research area on the relationship of disability and physical environment since Barrier-Free Environments, edited by Michael Bednar, was published in 1977. Since that time, disability rights legislation like the Americans, with Disabilities Act in the United States, the worldwide growth of the independent-living move­ ment, rapid deinstitutionalization, and the maturation of functional assessment methodology have all had their impact on this research area. The impact has been most noticeable in two ways-fostering the integration of environmental vari­ ables in rehabilitation research and practice, and changing paradigms for environ­ mental interventions. As the contributions in this volume demonstrate, the relationship of disabil­ ity and physical environment is no longer of interest primarily to designers and other professionals concerned with managing the resources of the built environ­ ment. The physical environment has always been recognized as an important variable affecting rehabilitation outcome. Until recently, however, concepts and tools were not available to measure its impact in clinical practic~ and outcomes research. In particular, lack of a theoretical foundation that integrated environ­ ment with the disablement process hampered development of both research and clinical methodology. Thus, the physical environment received little attention from the mainstream rehabilitation research community. However, this situation is changing rapidly.

We live in a day and age in which many fields come together to define new ones, and out of these newly defined areas come innovative practices, and emergent ways of thinking. The Sourcebook on Rehabilitation and Mental Health Practice documents one of these new fields, one formed by the coalescence of rehabilitative and mental health services and employment. Only recently have human service practitioners, policy makers, and administrators recognized that there is a growing synergy among these areas once separated by great gulfs of differences in culture, perspectives and values, and technologies. It is not happenstance that rehabilitation, mental health, and employment are becoming increasingly integrated in contemporary human services. There is considerable interest in work in contemporary society although different values and perspectives mediate this interest. For people with disabilities, an interest in work often comes from deep frustration— from not having ready access to work, and from not having enough of it to facilitate an acce- able quality of life or independent living. Some people find work to be a source of problems that negatively affects their functioning. They find the workplace stressful and unsupportive, or they feel that work exacts too much from them, reducing their quality of life and setting into motion numerous negative personal effects (Beck, 2000).

Health workers who provide services to persons with severe mental illness are frequently under enormous stress; burnout is common. Alleviating such stress is the objective of Interactive Staff Training. The book provides rehabilitation and mental health professionals with a strategy to help them and their colleagues work as a well-integrated team. This strategy has been implemented in teams serving more than 10,000 persons with psychiatric disabilities. The text combines a careful description of the central theory behind the strategy with pleanty of clinical anecdotes that illustrate its practical, everyday benefits.

Despite medical technological advances, the major killers with which we must currently contend have remained essentially the same for the past few decades. Stroke, cancer, and heart disease together account for the vast majority of deaths in the United States. In addition, due to improved medical care, many Americans who would previously have died now survive these disorders, necessitating that they receive appropriate rehabilitation efforts. One result of our own medical advances is that we must now accept the high costs associated with providing quality care to individuals who develop one of these problems, and we must avail ourselves to assist of afflicted individuals. families Despite the relative stability of causes of death and disability, the health-care field is currently experiencing tremendous pressures, both from professionals with­ in the field, who desire more and better technology than is currently available, and from the public and other payers of health care (e.g., insurance companies), who seek an end to increasing health-care costs. These pressures, along with an increased emphasis on providing evidence of cost-effectiveness and quality assurance, are substantially changing the way that health-care professionals perform their jobs.