REHABILITATIVE

& RECOVERY

Faiza Jokhio
MSN student
Ziauddin University, CON
OBJECTIVES
 Define tertiary prevention
and rehabilitation

rehabilitation and recovery

 Discuss the behaviors and
rehabilitative needs of
people with serious mental
health problems
 Discuss response of families
and Communities towards
rehabilitative needs of
clients 2
DEFINITION OF TERTIARY PREVENTION
 Tertiaryprevention is to limit the amount of
disability and maladaptive functioning resulting

rehabilitation and recovery

from an illness. Although concepts of tertiary
prevention can be applied anyone who has
experienced an episode of illness, they are
particularly relevant to those with serious and
persistent mental illness, sometime called
chronic mental illness.
(Sandra J. Sundeen)
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REHABILITATION
 Psychiatric rehabilitation is
combined of services

rehabilitation and recovery

incorporating social,
educational, occupational,
behavioral and cognitive
interventions aimed at long-
term recovery and
maximization of self
sufficiency.

(Sandra J. Sundeen) 4
RECOVERY
 A journey of healing and
transformation enabling a

rehabilitation and recovery

person with a mental health
problem to live a
meaningful life a
community of his or her
choice while striving to
achieve his or her full
potential.
(Sandra J. Sundeen) 5
DISABILITY LIMITATION

Handicap

rehabilitation and recovery

Disability

Impairment

Disease
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 rehabilitation and recovery
REHABILITATION NEEDS WITH MENTAL HEALTH
PROBLEMS

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COMPLEX NEEDS, MEDIUM SUPPORT
 Possible cognitive and
physical problems

rehabilitation and recovery

linked with long-term
illness and medication.
 limited survival skills
and be lacking basic life
skills.
 Poor role functioning in
all areas.
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COMPLEX NEEDS, STANDARD SUPPORT
 Psychotic history, symptoms
currently controlled and causing

rehabilitation and recovery

minor problem.
 Currently experience recovery

 Impairment in self esteem,

efficacy and helplessness.
 Full or near functioning.

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COMPLEX NEEDS, HIGH SUPPORT
 Have history of psychotic uncontrolled
symptoms.

rehabilitation and recovery

 Present with very severe symptoms like severe
anxiety or depression.
 Have significant disability with impact on role
functioning.
 Possible cognitive and physical problem
linked with long term illness and medication.
 Lacking in basic life skill and poor role
functioning in all areas. 10
 rehabilitation and recovery
BEHAVIOR RELATED MENTAL ILLNESS

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DAILY LIVING ACTIVITIES
 Housekeeping

 Shopping

rehabilitation and recovery

 Food preparation
 Money management

 Personal hygiene

A major goals of recovery is to help

the person develop independent
living skills.
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INTERPERSONAL RELATIONS
 Social withdraw
depression

rehabilitation and recovery

 Social isolation.

 Problem in perceiving
schizophrenia
 Processing communication

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LOW SELF ESTEEM
 Aware of low achievement
 Lack of ability to maintain

rehabilitation and recovery

employment
 Live independently

 Marry

 Feel cheated of life experience.

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MOTIVATION
 Success and greater competence
result in increased anxiety cause

rehabilitation and recovery

regression.
 Attribute uneasiness with success to
fear it lead to higher expectations
from others.
 Fear of failure results in reluctance
to try new experience.
 Lack of motivation lead to low
energy.
 Active but physical unable. 15
 STRENGTH
 Rehab and recovery depends on the control of illness.
 Development of health potential by mobilizing
strengths.

rehabilitation and recovery

 Related to recreational and leisure activities.

 Work skills, educational accomplishment, self-care

skills, special interest, talents and abilities.
 Positive interpersonal relationship.

 Need help in defining skills, abilities and interests as

strengths.
 Low self esteem leads to believe, have only problems,
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not strengths.
NONADHERENCE
 Failure to take
medications lead to

rehabilitation and recovery

rehospitalization.
 Denial of illness reason
for the treatment regimen.
 Asking question regarding
medication may also
increase adherence.

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 SUPPORT NEEDS EXPRESSED BY

rehabilitation and recovery

FAMILY CAREGIVERS

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Needs Description

Emotional support

Acceptance Care giver despite of persons

rehabilitation and recovery

relationship.
Commitment Share the burden of care givers, show
commitment .
Social Social contacts and companionship for
involvement the caregivers.
Affective Show love and care for the caregiver.

Mutuality Mutuality in supportive exchanges. 19

 Feedback
Affirmation Validation of the actions, feelings and

rehabilitation and recovery

decisions associated with caregivers.

Listening Active listening by the support person, allow

unburdening by the caregivers.

Talking Opportunity to talk with other person.

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 Information or cognitive support

Illness information About illness, care, or supervision

Behavior About behavior management strategies.

rehabilitation and recovery

management

Coping Advice about personal coping strategies

for the caregivers

Decision Help in the decision-making process

around caregivers issues and offering
solutions.
Perspective Supportive interaction that give new 21
perspective to caregiver for care.
 Instrumental support
Resources Help in locating resources, negotiating
systems, or advocating for needs.
Respite Provision of time off the caregiver and support

rehabilitation and recovery

for the caregivers own needs.
Care help Provision of help with the actual tasks of
caregiving, including physical care assistance
and monitoring activities.
Backup Help is available when needed, including
financial help.
Household Help with activities such as repairs, grocery
shopping, housecleaning. 22
 PLANNING AND

rehabilitation and recovery

IMPLEMENTATION

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PLANNING AND IMPLEMENTATION
The individual
 Develop strengths and

rehabilitation and recovery

potential
 Learn living skills

 Manage one’s illness.

 Access environmental
supports.

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DEVELOP STRENGTHS AND POTENTIAL

 Nursing intervention that

develop strengths and

rehabilitation and recovery

potentials can help patients
develop independent living
skills, interpersonal
relationships and coping
resources and thus help
meet their special needs.

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LEARN LIVING SKILLS
 Patientsare taught structured ways of
examining and modification their own

rehabilitation and recovery

thoughts and behavior to become
more skilful at managing difficult
situations include holding
conversations, establishing and
maintaining friendship, managing
medications, grooming and numerous
other activities that leads a happy,
successful life.
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MANAGE ONE’S ILLNESS
 Psychoeducation ( patient
and family)

rehabilitation and recovery

 Behavioral adapting for
medications.
 Training is reversion
prevention
 Coping skills training.

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ACCESSING ENVIRONMENTAL SUPPORTS
 Rehabilitation program
a. Fountain house (phase I, residential phase learn

rehabilitation and recovery

living skill)
b. Support employment programs
c. Education offered in a supportive environment
can increase self esteem.
d. Nurses intervene in the community to
encourage establishment of tertiary prevention.
e. Evaluation of the services given to patients,
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family and community for achievements.
REFERENCE
 Gail W. Stuart: Principles and Practice of
Psychiatric Nursing, 9th edition (2009)p199-216

rehabilitation and recovery

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