REHABILITATION

AND RECOVERY
OBJECTIVES
By the end of the session learners will be able
to :
1. Define tertiary prevention and rehabilitation
2. Discuss the behaviors and rehabilitative
needs of people with serious mental health
problems
3. Discuss response of families and
communities towards rehabilitative needs of
clients.
 RECOVERY
 Recovery is the process in which people are
able to live, work, learn, and participate fully
in their communities.
RECOVERY
 Recovery is a journey of healing and change
enabling a person with a mental health problem to
live a meaningful life in a community of his or her
choice while to achieve his or her full potential
 PSYCHIATRIC REHABILITATION

Psychiatric Rehabilitation known as Psychosocial

Rehabilitation is a comprehensive strategy for
meeting the needs of persons with severe and
persistent mental illness.
it refers to efforts to restore persons with
psychiatric disabilities to optimal state of
constructive activity.
CONT…

 R ecovery refers to individuals level of progress

i.e. his/her ability to cope with the illness/
disability and self image as a functioning person.
 TERTIARY PREVENTION IN PSYCHIATRIC
CARE
 Goal of tertiary prevention is to limit the amount of disability and
maladaptive functioning resulting from an illness.

 Concepts of tertiary prevention relevant to patients with serious

mental illness.

 1 in 17 adults in USA have a serious mental illness.

 Nurses care for these people in a variety of settings

 REHABILITATION
 Tertiary prevention is carried out through activities identified as
rehabilitation, which is the process of helping the person return
to the highest possible level of functioning.
 Psychiatric rehabilitation is a combination of services
incorporating social, educational, occupational, behavioral, and
cognitive interventions aimed at long-term recovery and
maximization of self-sufficiency.
 Psychiatric rehabilitation grew out of a need to create
opportunities for people diagnosed with severe mental illness to
live, learn, and work in their own communities.
 Psychiatric rehabilitation uses a person-centered, people-to-
people approach that differs from the traditional medical model
of care
 PSYCHIATRIC
REHABILITATION

Rehabilitation work
is undertaken by
Psychiatrist,
Psychologist,
Occupational
therapist, Social
worker, and
Counselors
 GOALS OF PSY
REHABILITATION

• To achieve Recovery
• Maximum Community
integration
• Possible quality of life
CHARACTERISTICS OF SERIOUS
MENTAL ILLNESS

People who have SMI are likely to have primary and secondary
symptoms.
 Primary symptoms are directly caused by the illness. For example,
hallucinations and delusions are primary symptoms of schizophrenia,
and elation and hyperactivity are primary symptoms of bipolar
disorder.
 Secondary symptoms, such as loneliness and social isolation, are
caused by the person response to the illness or its treatment.
 CONT…
 Behaviors related to primary symptoms may violate social
norms and be considered unusual. Society tries to protect
itself from the persons norm violation. As behavior
problems become more serious, people increasingly
identify themselves as mentally ill. They begin to relate to
society in terms of this identity rather than others, such as
wife, mother, husband, father, or worker. The persons
acceptance of mentally ill status and adjustment to society
in terms of this role are accompanied by the secondary
symptoms of SMI.
 BEHAVIORS RELATED TO SERIOUS MENTAL ILLNESS
 Blocks to recovery of individuals with SMI include poverty,
victimization, and stigma.

 People with SMI are often unemployed, less likely to be involved

in close relationships, and tend to have fewer financial resources
than their peers.

 Stigma experienced by those who are mentally ill has been linked
to self-esteem.
CONT…
 A study of women with mental illness found that when
there was low perception of discrimination and the women
did not believe that discrimination was sincere, they had
higher self-esteem.

 Thus the effects of stigma, poverty and victimization

should be included in patient assessment and treatment
planning.
Guiding principles of Psy
Rehabilitation
• Individualization of services

• Maximum client involvement, preferences, and

choices
• Partnership b/w services provider and services
recipient
• Normalized community based services
• Focus on strengths
 CORE ELEMENT OF PSY
REHABILITATION

Rehabilitation process precede

through
1- Consumer choices
(involvement) 2- Assessment of
readiness include:
 Need for change
 Commitment for change
 Environment awareness
 Self awareness
 CORE ELEMENT OF PSY R
3- Rehabilitation Diagnosis is based on
overall
 rehabilitation goal
 Functional assessment; which area
need to work, assessment of
strengths and weakness.
 Resources assessment ;
availability of the resources
 CORE ELEMENT OF PSY R
4 Rehabilitation plan; the goals and objective
that client need to achieve and skills
acquisition
5 Rehabilitation interventions: strategies for
acquiring skills, behavior strategies
6 Evaluating rehabilitation progress
PSYCHIATRIC
REHABILITATION PROGRAMS

• Clubhouse program
• Partial
Hospitalization
program
• Day Care Program
 FAMILY PSYCHOEDUCATION
• Mental illness education
• Problem solving
• Stress reduction
• Long-term duration
• Family and consumer are
involved
 FAMILY PSYCHOEDUCATION
OUTCOMES
• Reduces relapse
• Reduces hospitalizations
• Improves family knowledge of mental
illness,
medications, etc.
• May improve family problem solving
• May reduce family stress
• May assist family ͚recovery͛
 SUPPORTED EMPLOYMENT
• Goal is integrated employment
• Consumer preferences are vital
• ͚Rapid job search and placement
• Integrated with psychiatric treatment
 SUPPORTED EMPLOYMENT
OUTCOMES
• Obtaining integrated employment
• Increased job tenure
• Improved performance on the job
• May improve job satisfaction
• May increase earned salaries
• May have a positive effect on symptoms
and course of illness
 SUPPORTED EDUCATION
SERVICES
• Supported Education Model : most
precious gift is the realization of own
potentials regardless of disability
• Strengthen the recovery
• Build self esteem and determination
• Build Normalization in society
• Support and relationship
• Hope and recovery
 SUPPORTED EDUCATION
SERVICES

• Barriers
stigma, personal stress,
economical instability
• Out comes :
 Normalization
Hope and recovery
Empowerment
 Improved quality of life
 REHABILITATION PROGRAM
• Day Care Program
Core element of Day care
 Assessment and rehabilitation goals
 Planned activities
 Individual services
 Cognitive behavior interventions
 Social and emotional support
 Group based skills acquisition
 Family services
 DAY CARE ACTIVITIES
• Social gathering session
• Exercises session
• Focus group sessions
• Individual session
• Arts & crafts session
• Leisure activities
• Indoor and out door sports activities
• Library session
CONT…

• Music session
• Gardening session
• Cooking session
• Laundry session
• Supported education session
• Supported employment
• Family session