Psychosocial Rehabilitation An introduction

Transcription

1 Psychosocial Rehabilitation An introduction SOCRE-project (visitors from Russia & Kosovo) Groningen, May Lies Korevaar, PhD Professor of Rehabilitation

2 Overview PSR Introduction 1. Who are served by Psychosocial Rehabilitation? 2. What is Psychosocial Rehabilitation? 3. Why focus on Psychosocial Rehabilitation? 1. Who are served by Psychosocial Rehabilitation? 4. PSR competencies 5. A B C of Psychosocial Rehabilitation 5 6 (YOUNG) ADULTS WITH DISABILITIES (physical, intellectual, cognitive & psychiatric) DISABILITIES: LONGTERM AND SEVERE 7 8 2

3 DISABILITIES: THAT RESTRICTS THE PERSON IN FULFILLING VALUED ROLES IN THE COMMUNITY PSYCHOSOCIAL REHABILITATION POPULATION (YOUNG) ADULTS WITH LONGTERM AND SEVERE DISABILITIES THAT RESTRICTS THEM IN FULFILLING VALUED ROLES IN THE COMMUNITY 9 10 Rehabilitation Cube People with chronical diseases and disabilities belong to the most disadvantaged group of people in our society. (Rapportage Gehandicapten 2002). Hanze University Groningen, Department of Rehabilitation University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation12 3

4 EINSTEIN 2. WHAT IS PSYCHOSOCIAL REHABILITATION? University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation13 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation14 THREE ASPECTS OF MH CARE Problemoriented Safety, Health & Stability Environmentally oriented If all we have is a hammer, every problem looks like a nail Treatment (Cure) Developmentally oriented Support (Care) Rehabilitation (Living, Working, Learning, Socializing) University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation15 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation16 4

5 Traditional treatment plan 1. Medication (management) 2. Day-night rhythm 3. Personal hygiene 4. Financial problems 5. Cleaning the room 6. Return to or remain at school Rehabilitation / Treatment plan 1. Return to or remain at school 2. Medication (management) 3. Day-night rhythm 4. Personal hygiene 5. Financial problems 6. (Cleaning the room) University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation17 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation18 Diary exercise Discussion/Activity How much time of your daily work do you spend on problem-oriented aspects of care, how much time on environmentally oriented aspects and how much time on developmentally oriented aspects of care? Treatment and Rehabilitation Focus of Traditional Treatment Focus of Rehabilitation Mission; Cure Mission: Improve Functioning Minimize illness Maximize health Reduce anxiety and improve Increase success and satisfaction in life roles ego functioning Focus: Link Between Past & Present Focus: Link between Present & Future Patient-hood Person-hood Disease and pathology Future goals Stabilization and maintenance Critical skills and supports Intervention: Psychotherapy/ Intervention; Develop Skills and Supports Psychopharmacology Therapist sets the goal Client chooses the goal Assess symptoms and causes Assess and clarify need and functioning Symptom reduction Skill and support development in a preferred environment University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation19 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation20 5

6 Mission of PSR To help people with disabilities increase their functioning so that they can be successful and satisfied in the environments of their choice with the least Mission of PSR To help people with disabilities to choose, get and keep valued roles in the community amount of ongoing professional Intervention Anthony et al, Values Person orientation, a focus on the human being as a whole, rather than as diagnostic label or illness Support, a focus on providing assistance for as long as it is needed and wanted Involvement, a focus on the participation of the client Growth potential, a focus on a person s inherent capacity to grow, and to hope PSR: the link between Health and community Health PSR Community Living => Tenant Working => Colleague Patient =>Client/consumer =>Citizen => Learning => Student Socializing => Church member

7 Rehabilitation process Need for a change consumer Life area? Living Working Learning Socializing Psychosocial Rehabilitation principle Role + Setting of preference Explore (readiness) Choose (rehabilitation goal) Skills + Support Get (skills & support 1) Keep (skills & support 2) Success + Satisfaction Einstein or 3 women 3. Why focus on PSR? University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation27 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation28 7

8 Deinstitutionalzation University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation29 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation30 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation31 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation32 8

9 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation33 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation34 Patients in a Psyhiatric Hospital Housing with support Treatment & Crisis Intervention Day activities Leisure time / Social contacts Somatic care Pastoral counselling Finances University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation36 9

10 Patients in a Psychiatric Hospital One service provider (hospital) Tolerant environment (the village) Family far away University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation37 People with psychiatric disabilities in the community Housing spread over the city / region No work / activities Social isolation MH Services spread over the city / region More service providers Less tolerance Family nearby TREATMENT: BT University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation39 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation40 10

11 PSR: GT CASEMANAGEMENT SUPPORT: GTBT University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation41 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation42 GTBT: TREATMENT + REHABILITATION + SUPPORT Einstein or 3 women University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation43 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation44 11

12 4. PSR Competencies PSR in the curricula of practitioner s education (Nursing, Social Work, Psychiatry, etc.) Problemoriented Environmentally oriented University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation45 Treatment (Cure) 55% Developmentally oriented Support (Care) 40% PSR (Living, Working, Learning, Socializing) < 5% If all we have is a hammer, every problem looks like a nail PSR-practitioner Knowledge Attitude Skills University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation48 12

13 PSR-KNOWLEDGE Partnership, connectedness PHILOSOPHY AND PRINCIPLES OF PSR PSYCHOLOGICAL AND SOCIAL ASPECTS OF PSYCHIATRIC DISABILITIES PSR AND RECOVERY STIGMA, DISCRIMINATION AND SOCIAL EXCLUSION PSR AND TREATMENT PSR AND FAMILY First and foremost the focus of the MH-practitioner must be on what the person/consumer connects to us and others, and not on what him or her distinguish from us and others University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation49 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation50 PSR-SKILLS READINESS ASSESSMENT SETTING AN OVERALL REHABILITATION GOAL FUNCTIONAL ASSESSMENT RESOURCE ASSESSMENT DIRECT SKILLS TEACHING RESOURCE INTERVENTIONS CONNECTING WITH CLIENTS COACHING SKILLS 5. A B C of Psychosocial Rehabilitation University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation

14 of Treatment A B C of PSR University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation53 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation54 ALBERT EINSTEIN? University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation55 University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation56 14

15 Questions & discussion Lies Korevaar University of KwaZulu Natal / Hanze University Groningen, Department of Rehabilitation58 15