The findings indicate that health-service psychologists are involved in critical-care settings and in various roles. A more broad-based survey of hospitals across the United States would be required to identify how frequently health-service psychologists are consulted and what specific services are most effective, valued, or desired in critical-care settings. (PsycINFO Database Record

To optimize response to rehabilitation, it is important to understand the behavior of post-ICU patients within a full biopsychosocial context including debility, cognitive and emotional impairment, disruption of role identities, and environmental factors. The psychologist can provide education about predictable barriers to participation for the post-ICU patient, and guide individual, family and team interventions to ameliorate those barriers. (PsycINFO Database Record

The term Bfrequency^in applied behavior analysis and behavior measurement generally refers to cycles per unit time, or a count (usually of behavior) divided by the time during which it occurred. In statistics, however, the term refers to a count of items in a data set. This meaning of Bfrequency^as synonymous with Bcount^has been adopted by one major text and the Behavior Analyst Certification Board®. Another major text uses Bfrequency^and Brate^interchangeably when referring to behaviors per unit time. Both texts advise readers not to use counts of behavior without reference to the time base of the observation, and in the context of that advice, the count and time information thus provide rate data. We suggest that within applied behavior analysis (ABA) and behavior measurement the term Bfrequency^should not refer to Bcount^but instead to Brate,^and that references to counts without information about observation time should be avoided. Keywords Behavioral measurement . Frequency . RateSkinner once cited rate of response and the cumulative record as his two greatest contributions (Evans 1968). A count of some behavior or class of behavior recorded over a known period of time provides the two components of rate, often stated as Bcount per unit time.R ates may be recorded over short time intervals (e.g., correct math problems solved in 60 seconds), during which time we may observe no other behaviors, or longer intervals (e.g., affectionate comments to spouse per week), during which time we might observe many behaviors of other classes or have periods when the spouse is not present. Thus, the basic * Charles T. Merbitz

Vigorous international debate continues regarding standards of evidence in rehabilitation and guidelines for evidence reviews, as these impact reimbursement and drive scientific and clinical practices. A large portion of rehabilitation research funding in the United States goes toward the development of standardized rating scales and taxonomies of treatments. Another trend—quality improvement—is increasingly evident in the study of services in medicine, nursing, and psychotherapy, and is just beginning to enter the rehabilitation literature. Among many contributions, international communities collaborating in quality improvement have promoted greater awareness of the challenges and opportunities posed by complex adaptive systems. In this chapter, after reviewing dominant trends, we describe how methods of research from the quality improvement tradition and other methods compatible with it may transform processes and outcomes in rehabilitation.

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