Psychiatric rehabilitation
Encyclopedia
Psychiatric rehabilitation, also known as psychosocial rehabilitation, and usually simplified to psych rehab, is the process of restoration of community functioning and well-being of an individual who has a psychiatric disability (been diagnosed with a mental disorder). Rehabilitation work undertaken by psychiatrists, social workers and other mental health professionals (psychologists and occupational therapists, for example) seeks to effect changes in a person's environment and in a person's ability to deal with his/her environment, so as to facilitate improvement in symptoms or personal distress. These services often "combine pharmacologic treatment, independent living and social skills training, psychological support to clients and their families, housing, vocation
al rehabilitation, social support and network enhancement, and access to leisure activities." There is often a focus on challenging stigma
and prejudice
to enable social inclusion, on working collaboratively in order to empower clients, and sometimes on a goal of full psychosocial recovery.
The Board of Directors of the United States Psychiatric Rehabilitation Association USPRA approved and adopted the following standard definition of psychiatric rehabilitation: Psychiatric rehabilitation promotes recovery, full community integration and improved quality of life for persons who have been diagnosed with any mental health condition that seriously impairs their ability to lead meaningful lives. Psychiatric rehabilitation services are collaborative, person directed and individualized. These services are an essential element of the health care and human services spectrum, and should be evidence-based. They focus on helping individuals develop skills and access resources needed to increase their capacity to be successful and satisfied in the living, working, learning, and social environments of their choice.
.
Although current literature in the United States uses the names psychosocial rehabilitation and psychiatric rehabilitation interchangeably, around 2005 the professional organization IAPSRS (International Association of Psychosocial Rehabilitation Services) changed its name to USPRA (United States Psychiatric Rehabilitation Association
) and the trend is toward the use of "psychiatric rehabilitation".
and is not based on a medical model of disability
and the concept of mental illness
. However, it can also incorporate elements of a social model of disability
. A sometimes similar but sometimes alternative approach employs the concept of psychosocial recovery rather than rehabilitation, and is less centred around professional services.
Problems experienced by people with psychiatric disabilities are thought to include difficulties understanding or dealing with interpersonal situations (e.g., misinterpreting social cues, not knowing how to respond), prejudice or bullying from others because they may seem different, problems coping with stress (including daily hassles such as travel or shopping), difficulty concentrating and finding energy and motivation.
(or outreach) teams assisting with social service agencies, medication management, housing, employment, family issues, coping skills and activities of daily living and socialising.
Psychosocial Rehabilitation (PsR) can be described as consisting of eight main areas of work: Psychiatric (symptom management); Social (relationships
, family, boundaries, communications & community integration); Vocational and or Educational (coping skills, motivation
); Basic Living Skills (hygiene
, meals, safety, planning, chores); Financial (budget
s); Community and or Legal (resources); Health and or Medical (maintain consistency of care); and Housing (safe environments).
Vocation
A vocation , is a term for an occupation to which a person is specially drawn or for which they are suited, trained or qualified. Though now often used in non-religious contexts, the meanings of the term originated in Christianity.-Senses:...
al rehabilitation, social support and network enhancement, and access to leisure activities." There is often a focus on challenging stigma
Social stigma
Social stigma is the severe disapproval of or discontent with a person on the grounds of characteristics that distinguish them from other members of a society.Almost all stigma is based on a person differing from social or cultural norms...
and prejudice
Prejudice
Prejudice is making a judgment or assumption about someone or something before having enough knowledge to be able to do so with guaranteed accuracy, or "judging a book by its cover"...
to enable social inclusion, on working collaboratively in order to empower clients, and sometimes on a goal of full psychosocial recovery.
The Board of Directors of the United States Psychiatric Rehabilitation Association USPRA approved and adopted the following standard definition of psychiatric rehabilitation: Psychiatric rehabilitation promotes recovery, full community integration and improved quality of life for persons who have been diagnosed with any mental health condition that seriously impairs their ability to lead meaningful lives. Psychiatric rehabilitation services are collaborative, person directed and individualized. These services are an essential element of the health care and human services spectrum, and should be evidence-based. They focus on helping individuals develop skills and access resources needed to increase their capacity to be successful and satisfied in the living, working, learning, and social environments of their choice.
History
From the 1960s and 1970s, the process of de-institutionalization meant that many more individuals with mental health problems were able to live in their communities rather than being confined to mental institutions. Medication and psychotherapy were the two major treatment approaches, with little attention given to supporting and facilitating daily functioning and social interaction. Therapeutic interventions often had little impact on daily living, socialization and work opportunities. There were often barriers to social inclusion in the form of stigma and prejudice. Psychiatric rehabilitation work emerged with the aim of helping the community integration and independence of individuals with mental health problems. "Psychiatric rehabilitation" and "psychosocial rehabilitation" became used interchangeably, as terms for the same practice. These approaches may merge with or conflict with approaches based in the Psychiatric survivors movementPsychiatric survivors movement
The psychiatric survivors movement is a diverse association of individuals who are either currently clients of mental health services , or who consider themselves survivors of interventions by psychiatry, or who identify themselves as ex-patients of mental health services...
.
Although current literature in the United States uses the names psychosocial rehabilitation and psychiatric rehabilitation interchangeably, around 2005 the professional organization IAPSRS (International Association of Psychosocial Rehabilitation Services) changed its name to USPRA (United States Psychiatric Rehabilitation Association
United States Psychiatric Rehabilitation Association
The United States Psychiatric Rehabilitation Association , formerly known as the International Association of Psychosocial Rehabilitation Services is the professional association for practitioners of the field of psychiatric rehabilitation and persons and families living with psychiatric...
) and the trend is toward the use of "psychiatric rehabilitation".
Theory
The concept of psychiatric rehabilitation is associated with social psychiatrySocial psychiatry
Social psychiatry is a branch of psychiatry that focuses on the "interpersonal" and cultural context of mental disorder and mental wellbeing. It involves a sometimes disparate set of theories and approaches, with work stretching from epidemiological survey research on the one hand, to an indistinct...
and is not based on a medical model of disability
Medical model of disability
The medical model of disability is a sociopolitical model by which illness or disability, being the result of a physical condition, and which is intrinsic to the individual , may reduce the individual's quality of life, and causes clear disadvantages to the individual.It is today specifically...
and the concept of mental illness
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
. However, it can also incorporate elements of a social model of disability
Social model of disability
The social model of disability is a reaction to the dominant medical model of disability which in itself is a Cartesian functional analysis of the body as machine to be fixed in order to conform with normative values...
. A sometimes similar but sometimes alternative approach employs the concept of psychosocial recovery rather than rehabilitation, and is less centred around professional services.
Problems experienced by people with psychiatric disabilities are thought to include difficulties understanding or dealing with interpersonal situations (e.g., misinterpreting social cues, not knowing how to respond), prejudice or bullying from others because they may seem different, problems coping with stress (including daily hassles such as travel or shopping), difficulty concentrating and finding energy and motivation.
Services
Psychiatric rehabilitation services may include: workplace accommodations, supported employment or education, social firms, assertive communityAssertive Community Treatment
Assertive community treatment, or ACT, is an intensive and highly integrated approach for community mental health service delivery. ACT programs serve people whose symptoms of mental illness result in severe functional difficulties that interfere with their ability to achieve personally meaningful...
(or outreach) teams assisting with social service agencies, medication management, housing, employment, family issues, coping skills and activities of daily living and socialising.
Psychosocial Rehabilitation (PsR) can be described as consisting of eight main areas of work: Psychiatric (symptom management); Social (relationships
Intimate relationship
An intimate relationship is a particularly close interpersonal relationship that involves physical or emotional intimacy. Physical intimacy is characterized by romantic or passionate love and attachment, or sexual activity. The term is also sometimes used euphemistically for a sexual...
, family, boundaries, communications & community integration); Vocational and or Educational (coping skills, motivation
Motivation
Motivation is the driving force by which humans achieve their goals. Motivation is said to be intrinsic or extrinsic. The term is generally used for humans but it can also be used to describe the causes for animal behavior as well. This article refers to human motivation...
); Basic Living Skills (hygiene
Hygiene
Hygiene refers to the set of practices perceived by a community to be associated with the preservation of health and healthy living. While in modern medical sciences there is a set of standards of hygiene recommended for different situations, what is considered hygienic or not can vary between...
, meals, safety, planning, chores); Financial (budget
Budget
A budget is a financial plan and a list of all planned expenses and revenues. It is a plan for saving, borrowing and spending. A budget is an important concept in microeconomics, which uses a budget line to illustrate the trade-offs between two or more goods...
s); Community and or Legal (resources); Health and or Medical (maintain consistency of care); and Housing (safe environments).
External links
- Anthony, W. A., & Farkas, M. D."Primer on the Psychiatric Rehabilitation Process", Boston UniversityBoston UniversityBoston University is a private research university located in Boston, Massachusetts. With more than 4,000 faculty members and more than 31,000 students, Boston University is one of the largest private universities in the United States and one of Boston's largest employers...
.