Methods of rehabilitation : technical requirements

Prepared by Hassan AbuRahmaSupervised by Dr :Ashraf Aljedy

Objective of variety of methods

To assist the therapist in finding new ways

to overcome client difficulties.

Some methods may appeal more to particular personalities than other.

Methods 1 -psychosocial therapy

2 -group therapy

3 -Behaviour modification

4 -cognitive therapy

5 -social empowerment

6 -pragmatic approaches

Psychosocial therapy

•Emphasises the desirability of moving from a secure psychosocial stage of development to a higher one in manner that is suitable for the individual situations ,the research recommended the sufferer to read books and poetry , see film and listen to song associated with his child hood{pfeffer,

swatz and arcro1989}. •Material need to be selected according to personal

taste and sociocultuer environment

Group therapy

•Two main area of group development may be identified in professional experience

•1 -milieu therapy use of total living experience to achieve therapeutic objectives , possible use non professional such as volunteers , neighbours and friends , { use people as facilitators rather than drug }

Group therapy

•2 -the therapeutic community organises it self democratically with decision making being undertaken by patient and all level staff, to increase self esteem and insight through the media of the inter personal contact experienced in group living and meeting

•These group under degree of criticism in resent years because frailer rehabilitate suffering from schizophrenia but in London have different picture it is attempt to increase level of performance for

patient schizophrenia

Four center created fro variety client

•-1 focal {primary attachment} model

•2 -the re socializing model

•3 -the re educative model

•4 -the reconstructive model

Behaviour modification

•The therapist need some skill such as assessment, goal setting ,realistic program to achieve goal and learning suitable

techniques .

•Therapy has developed it s won specific therapeutic formats

The problem oriented medical recordSocial skills training

PROBLEM ORIENTED MEDICAL RECORD POMR

•Method is best illustrated by actual case

•Example {nurcombe 1987:485} A 16 yr old boy has the following identifiable problems

Sexual preoccupationsEducational deprivation

Poor eye contactPoor self esteem

Difficulties in getting along with his aunt

•There are a large number of problem with boy some priority for action has to determined

•For example lack of educational attainment may be achieved by improving his level of literacy lead to improve self teem

•Introduction to suitable youth group could reduce his sense isolation.

•Sexual preoccupations reduce by sport and out let of energy

Social skill training

•Aims at improving social skill of client•}liberman et al 1985:399{idenify three areas

of skill training •1 -making suitable international exchanges

e.g eye contact, smile ,propionate voice volume and appropriate length of speech

•2 -conversational skill :e.g asking suitable questions and making appropriate rejoinder ,can talk interestingly about self

Social skills training

•3 -problem solving skills : covering areas of job interviewing, money management ,management of medication and coping with difficult social circumstances e.g a hostile landlord

•E.g boy 16 yr can use social skill training group for improvement in social skill practice like proper eye contact, correct voice volume and suitable verbal contact

Social skill training

can assisted by using video replay equipment which allow participants to review their

own progress.

Possible use TV program to simulate role play and skill improvement

Social training

•Training developed by foxx and bittle {1989:2-5} who have identified the following training areas

•1 -coping with the problem of psychotic illness or behavioral problem of those the client is associated with

•2 -coping with mental health services that are inadequate for the individual concerned

•3 -dealing with poor services experienced•4 -coping with irresponsible conduct with other

•5 -coping with work problem •6 -dealing with demand and difficulties of friend ship

•7 -dealing with problem of neighbor

Cognitive therapy

To identifying and changing dysfunctional thinking, behavior, and emotional responses .

In this approach the therapist takes amore assertive role in listing the client assumptions about life and his experiment

This method success with depression and schizophrenia by express feeling and talk with self { self help}

Social empowerment

•To implement this type of approach it is necessary to enable clients to have some form of control of their environment so that they have abase from which to start the rehabilitation process ,therefore clients need a place to which to meet other like themselves somewhere to gain training ,education, work opportunities and leisure pursuits, all this is clearly an expensive enterprise ,especially in

times of economic recession .

Social empowerment

Two type of training working {gloag1985}

1 -formalized program to assess an train people

2 -social program to provided all emotional need of client as help him in suitable form of employment

E.g. horizon house in Philadelphia

Social empowerment

•Also involves the opportunity for sever mental illness to work even given bad economic times but can achieved only through special funding from government and charitable source

•In UK special educational scheme in psychiatric day center enable 55 % of client to obtain work , one sixth of group showed positive changes in their lives such as forming relationship with opposite sex that is help client to belief expressed earlier that work is main factor in rehabilitation.

Pragmatic approaches

Rehabilitation needs to be supported by tangible social services

UK has been centered around the work of psychiatric day centers as focal point of spectrum of required services

Day center program activity

Problem in rehabilitation

1 -client with schizophrenia { negative symptom}

2 -stigma

3 -bias

4 -vocational need

5 -limited funding