BY:AJAY KUMAR SHARMA

IST YEAR M.SC.(N)

Introduction.
Rehabilitation is a dynamic, active program
that enables an ill and disabled person to
achieve his greatest possible level of
physical, psychological, mental, social and
economic functioning.

Rehabilitation therapy.
Rehabilitation is defined as a process of
identifying and preventing or minimizing
the causes of severe disablement
accompanying psychiatric disorder, while
the same time helping the individual to
develop and use his or her talents and thus
to acquire confidence and self-esteem
through success in social rules.

The rehabilitation team

Rehabilitation efforts are more successful
when a multidisciplinary team is involved
comprising
of
psychiatrist,
clinical
psychologist, psychiatric social workers,
psychiatric nurses and occupational
therapists. In addition to professional staff,
rehabilitation involves active co-ordination
and collaboration with family members, lay
volunteers
and
non-governmental
organizations.

Rehabilitation therapy in inpatient setting.

Rehabilitation therapy in inpatient setting
includes psycho-education. In this setting the
members of family, especially the primary care
givers need to be provided with Information regarding the nature of illness from
a multilateral view point.
An understanding of core symptoms both
positive and negative.

 Formal instruction with medication

managements, particularly in relation to sideeffects.
Guidance in practical issues that arise in the day
to day management of a patient.
Providing accurate information helps reduce
distress caused by unrealistic expectations or
superstitious beliefs.

Rehabilitation therapy in outpatient

setting.

Functional assessment.
Skill development.

Cognitive training.
Family focused intervention.

Functional assessment.

Functional assessment especially in the

early phases of illness helps to plan the
rehabilitation process and allow the
professional to target interventions to the
patients special needs and state of
impairment and disability.
Assessment of cognitive functions is
helpful in making decisions about future
educational and vocational plans.

Skill development.
Impairment in social functioning
is almost characteristic of major mental illness.
It is an independent domain of the illness.
Poor social competence contributes to the
impoverished quality of life and social
isolation
Social skills training is a highly structured
psychological intervention, based on behavioral
and learning principles and emphasizes
modeling, role playing, social reinforcement.

Cognitive training.
Patient with major mental disorder exhibit a
variety of information processing deficit
particularly in attention, memory, reasoning
and concept formation
Cognitive training is provided on a series of
tasks adapted from neuropsychological test
procedures, such as card sorting and word
finding which focus on frontal lobe
functions.

Family focused intervention.

The family is an important resource in the
overall management in need to maintain the
patient in the community and at an optimal
level of functioning. Burden of caring for an
ill relative is high and that families are in
need of support maintaining regular contact
with the treating team provides are taught
how to maintain a moderate interpersonal
distance with the patient and set appropriate
limits.

Community facilities for rehabilitation

therapy.

Day hospitals
Half way houses.
Group homes.
Foster homes.
Sheltered workshop.

Day hospitals

A hospital programme organized on a day time

basis. The patient receives a full range of
treatment, services and return home at the end
the day. The concept, introduced by D.E.
Cameran in 1946, is now being used in
rehabilitation and psychiatric care. A day
hospital is staffed by a trained psychiatric
nurse, psychiatrist and other team members.
In India, day hospitals are available, though
less for mentally ill but comparatively better for
mentally retarded.

Half way houses.

It is transition facility for mental patients
who no longer need the full services of a
hospital but are not yet ready for a
completely independent living. They need
supervision for medication and for
carrying on domestic activities. If they are
still in job, they will leave for the job, they
will leave for the job and come back to
this half way house. Medical facilities are
regularly provided.

Group homes.
These homes may belong to a hospital or
rented by 15 to 20 mentally ill recovering
patients. These ex-patient stay together,
meet their financial commitments and live
in a society like other members. They try
to provide moral, emotional and social
support to each other. If one of the
members is leading towards relapse, they
try to help him by providing support.

Foster homes.
It is a home in which a patient recovering
from a mental disorder is placed in a
voluntary family by a social agency for
family care. The family is paid by the
agency. Placement may be temporary or
permanent. The patient gets a home like
environment.

Sheltered workshop.
The patient may find it difficult to compete
for employment. He should be encouraged
to attend a sheltered workshop, which is a
work oriented rehabilitation facility with a
controlled working environment to fulfill the
individuals vocational goals. In these
workshops ex-long term mentally ill patients
can utilize their experience and abilities by
relearning. This will help them make
progress towards a normal living and
economic indepence.

Summary.
So far we have discussed about
rehabilitation therapy, the rehabilitation
team, rehabilitation therapy in in-patient
and out-patient setting, community facilities
for rehabilitation.