Community-based rehabilitation (CBR) is a strategy that focuses on enhancing the quality of life of people with disabilities through equal opportunities, rehabilitation, and social integration. CBR is implemented through collaboration between people with disabilities, their families, communities, and support services. It aims to meet basic needs and ensure inclusion and participation. CBR is needed because institutional care is often too expensive, disconnected from community contexts, and does not facilitate community integration upon return home. The basic principles of CBR include inclusion, participation, sustainability, empowerment, and advocacy.

1. COMMUNITY BASED
REHABILITATION

2. COMMUNITY BASED REHABILITATION-
CONCEPT AND CHARACTERISTICS
■ Community Based Rehabilitation(CBR) may be defined,
according to three United Nation Agencies, ILO, UNESCO, and
the WHO, as a
■ "strategy within community development for the
rehabilitation, equalization of opportunities, and social
integration of all people with disabilities. CBR is
implemented through the combined efforts of disabled
people themselves, their families and communities, and the
appropriate health, education, vocational and social
services" (WHO, 1994).

3. CBR FOCUSES ON
■ • enhancing the quality of life for people with
disabilities and their families,
■ • meeting basic needs and
■ • ensuring inclusion and participation.

4. NEED OF CBR
■ Institutional overheads and other major infrastructural expenses make
the process very expensive.
■ Moreover, the endeavours in an institution are often out of context to
the felt needs of the disabled person, and thus falls short of their
expectations.
■ The fact that this person comes from a particular background and
cultural setting is often ignored. The institutional culture is imposed on
the disabled person and they are often expected to function as advised
by the “experts”.
■ In an institutional rehabilitation programme, the community is not
linked with the process. Hence, when the disabled persons return
home, it may become difficult for them to integrate into their
community.

5. BASIC PRINCIPLES OF CBR
■ 1. Inclusion- means the removal of all kinds of
barriers which block People with Disabilities
(PWDs) from access to the mainstream.
■ 2. Participation.
■ 3. Sustainability.
■ 4. Empowerment.
■ 5. Advocacy.

6. ESSENTIAL COMPONENTS
■ The programme should cover all types of PWDs who need rehabilitation services.
■ The programme should be part of mainstream development and have a multi
sectors approach including social integration interventions, health education and
economic programmes.
■ The programme should have access to or generate a good and effective referral
system.
■ The programme should aim at full integration of the PWD into his/her community.
■ The programme should have committed and well trained community members as
service providers. The programme should have gender and disability focus and
balance.
■ The programme should strike a balance between provision of service delivery and
empowering the PWD , family and community through regular transfer of skills.
■ The programme should facilitate the formation and strengthening of the disabled
peoples movement to ensure that the rights of PWDs are not denied through
advocacy at local , state and national level.

7. METHODS OF REHABILITATION
■ NEUROLOGICAL REHABILITATION
■ In this type of rehabilitation, patients suffering from stroke, neuromuscular disease, certain types
of head trauma and spinal cord injury are treated.
■ It aims at making the patient self-dependent
■ It helps create a positive thinking in patient
■ The patient is treated so that he leads a improved life physically, emotionally, and socially.
■ CARDIAC REHABILITATION
■ Cardiac rehab program is designed to help those people who have heart problem. Heart patients
are educated to live a healthy life and reduce stress for the proper functioning of the heart.
■ Educating people about the various risk factors that contribute to developing a heart disease.
These risk factors include, high blood pressure, obesity, smoking, drinking, drug abuse, lack of
physical activity, etc.
■ Recovery programs from heart disease/surgery.
■ Educating people about improving their quality of life.

8. ■ DRUG REHABILITATION
■ Drug rehabilitation programs involve programs that are designed to make an addict free
from the addiction of alcohol, prescription drug and street drugs (cocaine, heroin etc)
■ ALCOHOL REHABILITATION
■ Alcohol rehabilitation program is designed to make an alcoholic free from the addiction. It
involves programs that will teach people the various bad effects of consuming excess
alcohol
■ Effective detox programs that will cleanse the body from the various toxins of alcohol
■ PHYSICAL REHABILITATION
■ Physical rehabilitation is for those people whose lifestyle has changed after they have gone
through a serious illness, surgery, accident or illness. Here the therapist introduces
programs to improve the mobility and functioning of the injured body part of the patient.
■ Proper exercising program is designed to improve the functioning often physical body.
■ Includes therapies that will help a patient re-learn the basic physical and cognitive
functioning.

9. ■ MEDICAL REHABILITATION
■ Medical rehabilitation includes treatment programs that help a person
perform better in all his daily physical and mental activities.
■ Medical rehabilitation is a follow up treatment after any kind of treatment
program.
■ VOCATIONAL REHABILITATION
■ Programs focus on improving major and minor skills that are required in the
basic life.
■ Assessing patient in every step to improve the activities of basic living
■ Vocational rehab program is designed to ---
■ help those people who find it difficult to employment or retain it after they
have gone through certain situation that caused mental or physical disability
in them.
■ Providing physiological and medical assessment Job placement, job training
and on job training

10. ■ VESTIBULAR REHABILITATION
■ It helps in improving the ear deficit by working the central
nervous system. Also deals in improving eye and head
coordination
■ STROKE REHABILITATION
■ This treatment type helps to restore damage that is caused after
a stroke, which is the 3rd leading cause for death worldwide
■ Stroke rehabilitation aims at helping people gain maximum
normal functioning after the occurrence of a stroke.
■ Help the person to get back to normal lifestyle and be
independent in daily activities.

11. MODELS OF REHABILITATION
■ Biomedical Rehabilitation Model
■ Educational Rehabilitation Model
■ Social Rehabilitation Model
■ Economic Rehabilitation Model
■ Community Based Rehabilitation Model
■ Comprehensive Rehabilitation Model

12. BIOMEDICAL REHABILITATION MODEL
■ Medical rehabilitation had its origins in the treatment given to soldiers in the first World
War. Since this time, both medicine and rehabilitation have developed but medical
advances have greatly outstripped those of rehabilitation.
■ Basic Health Measures: Sanitation and hygiene, provision of adequate nutrition,
immunization programmes and public health education
■ Desirable Health Measures: Genetic counseling, family planning and health education In
the small matters trust the mind, in the large ones the heart” Sigmund Freud
Disability prevention
■ Prenatal diagnosis, neonatal screening, health surveillance and medical and surgical
treatment of associated impairments and diseases is very important.
Early intervention
■ Early identification and early intervention can foster optimum growth and development of
children with disabilities. By availability of services at the earliest possible stage, severe
invalidity can be prevented as a consequence of which the disabled is enabled to return
speedily to normal living.

13. EDUCATIONAL REHABILITATION MODEL
■ Education of disabled, children and adults both formal and non-formal.
The education of all children with disabilities has now become
increasingly the responsibility of the educational authorities. Children
with special needs can benefit from education involving specific
methods needed to teach these children.
■ In focusing the strategy of “Compulsory education for all (SSA), the
development of special education services needs to be enhanced.
■ Education is the only medium of inclusion and mainstreaming of
persons with disabilities.
Appreciation is wonderful thing it makes what is excellence in others
belongs to us as well. Voltaire

14. SOCIAL REHABILITATION MODEL
■ Social developmental approach
■ Aims at developing positive societal attitudes and awareness of the
problems of disability for providing effective services for the disabled.
■ Social services approach
■ Aims directly at providing social and rehabilitation services for the
disabled. Institutional and continuous care and treatment may be
required for severely disabled individuals.

15. ECONOMIC REHABILITATION MODEL
■ Provision of vocational training in order to promote economic
rehabilitation.
■ Various facilities for the vocational rehabilitation of the
disabled have been established by governmental, as well as
by non-governmental organizations.
■ Vocational rehabilitation involves vocational training for
placement in non-sheltered and sheltered workshops,
vocational training for self- employment and assistance for
placement in suitable jobs in the labour market.

16. COMMUNITY BASED REHABILITATION
MODEL
■ Community awareness and creative innovation in all aspects
of development for rehabilitation of persons with disabilities.
■ Community based rehabilitation is to rehabilitate the disabled
persons to achieve total development through the combined
effort of the individual, the family, the community and various
social services organization.
■ The main aim of community Based Rehabilitation is to help
the persons with disability to gain equal rights as that of
normal persons and make them an integral part of the society

17. ■ COMPREHENSIVE REHABILITATION MODEL
■ Prevention of disability ,Early identification ,Early intervention Special Education and Vocational training/
placement, Integration in the main stream of society ,Rehabilitation of the disabled, empowerment of
disabled as well as community development.
■ PSYCHIATRIC REHABILITATION
■ Psychiatric rehabilitation refers to the rehabilitation of psychiatrically disabled individuals. The
Psychiatric rehabilitation long-term commitment to the patient and is directly concerned with:
The practical problems in the life of the patients,
■ The past, present and future of the patient, and It involves the active inter-professional participation in
planning coordination and execution of therapeutic and helps..
■ Rehabilitation facilities and services are a link between the hospital and the community; between the
patient and the family; and the training that changes the patient from a dependant sick person to an
independent productive social person
■ In India, disability rehabilitation is primarily considered to be a responsibility of the family.
■ Large and extended Indian families provided essential physical, emotional and economic support to its
members with disabilities.
■ Being cohesive and stable social units, families provided an identity and a sense of security to its
members, irrespective of their physical disabilities.
■ The economic and caste status of the family and its networks, also determined the quality of the well
being of its members with disabilities.