This document discusses psychiatric rehabilitation. It defines rehabilitation as enabling individuals to return to their highest level of functioning. Rehabilitation is an important part of community mental health programs and focuses on chronic conditions like schizophrenia, substance abuse disorders, and intellectual disabilities. The rehabilitation process involves reducing impairments, remediating disabilities through skills training, and helping patients compensate for limitations. A rehabilitation team works with patients and families to provide psychoeducation, social skills training, and help integrating into the community. Nurses play a key role in assessing individuals, families, and community support systems and developing rehabilitation plans. The overall goal is to foster patient independence and evaluate the impact on patients, families, and the community system.

1. PRESENTED BY : ROOJEE JAMARA
[ B.SC NURSING THIRD YEAR]
PSYCHIATRIC
REHABILITATION

2. INTRODUCTION
 Rehabilitation is the process of enhabling
the individual to return to his highest
possible level of functioning.
 It is an important component of the
community mental health program,and is
undertaken at the level of tertiary
prevention

3. DEFINITION
 Rehabilitation is,“ an attempt to provide
the best possible community role which
will enable the patient to achieve the
maximum range of activity, interest and
of which he is capable.”
— Maxwell Jones (1952)

4. ♦ The following disorder are
indicated commonly for
rehabilitation:
 Chronic schizophrenia
 Chronic organic mental disorder
 Mental retardation
 Alcohol & drug dependence

5. ∆ Need for rehabilitation
of mentally ill patients.
 In disorders like schizophrenia, bipolar disorder
and substance abuse there is a proportion of
person who do not fully recover.
 Due to scarcity of services in India,large
numbers of severely ill persons are not under
any treatment.
 Where there is associated disability along with
the symptoms of illness the disability
improvement requires rehabilitation.

6. PRINCIPAL
 Primary focus is on improvement of capabilities
and increasing in independency level.
 It focusses on ability to function rather than
developing good insight.
 Patent’s active participation is very essential.
 Skill development, therapeutic environment are
fundamental interventions for a successful
rehabilitation process.

7. APPROACH
1.Psychoeducation:
Includes diagnosing the
problem, telling the person what to expect
regarding illness and discussing treatment
alternatives.

8. 2.Working with family:
Encouraging family members
to get involved in treatment and
rehabilitation programs.

9. 3. Group therapy:
Positive aspects of group
therapy include an opportunity for ongoing
contact with others, validation of their
perceptions, sharing their views about
problems and problem solving abilities.

10. 4. Social skills training :
It involves teaching
specific living skills that the patient is
expected to have in order to survive in the

11. REHABILITATION TEAM
 Psychiatrist
 Clinical psychologist
 Psychiatric social worker
 Psychiatric nurse
 Occupational therapist
 Recreational therapist
 Counselor
 Other mental health paraprofessionals.

12. STEP
1.Reduction of impairments :
 interventions with psychiatric patents require
reduction or elimination of the symptoms and
cognitive impairments that interfere with social
and vocational performance.
 These impairments are reduced and eliminated
for the greater part by various Psychotropic
agents.

13. 2. Remediation of disabilities
through skill training:
 Skill training is used to remediate
disabilities in social, family and vocational
functioning.
 Patients generally require training in self-
care skills, interpersonal skills, vocational
and employment pursuits, recreational
and leisure skills.

14. 3. Remediating disabilities
through supportive
interventions:
When restoration of social and
vocational functioning through skills training is
limited by continuing deficits, rehabilitation
strategies aim at helping the individuals
compensate for handicap by learning skills in
living and working environments, adjusting the
individual and family expectations to a level of
functioning that is realistically attainable.

15. 4. Remediation of handicaps:
 In addition to clinical rehabilitation
interventions, the disabled persons can
be helped to overcome their handicaps
through social rehabilitation
interventions, e.g. community support
programs.

16. ROLE OF NURSE
 Rehabilitative psychiatric nursing must be
studied in the context of both the patient
and social system.
 This requires the nurse to focus on three
elements, the individual, family and
community.

17. ASSESSMENT
1. Assessment of the
Individual:
The nurse should assess the individual
in the areas of symptoms present, motivation,
strengths, interpersonal skills, self-esteem,
activities of daily living and drug compliance.

18. 2. Assessment of Family:
✪ Components of family assessment:
Family structure including developmental
stages,roles,responsibilities, norms and values.
Family attitudes towards the mentally ill member.
Emotional climate of the family.
Social support available to the family.
Past family experiences with mental health services.
The family’s understanding of the patient’s problems
and the plan of care.

19. 3. Assessment of Community:
 It includes assessment of community
agencies that provide services to people
who have mental illnesses assessment of
attitudes of the people towards the
mentally ill, etc.

20. PLANNING &
IMPLEMENTATION
 Planning and implementation in
rehabilitative psychiatric nursing focuses
on fostering independence by maximizing
personal strengths.
 The nurse and the patient must work
together to find ways for the patient to
overcome any remaining impaired areas
of functioning.

21. 1. Individual Interventions
✪ Hospital rehabilitation [Inpatient
rehabilitation]:
This involves therapeutic community,
recreational therapy, social skills training and
training in basic living skills.

22. ✪ Community rehabilitation:
 Providing care in community settings
(Homes, residential care settings foster
homes etc.)

23. 2. Family Interventions:
 Health education to family members regarding the
disease process, available resources, communication
skills and problem solving techniques.
 Motivating the family members to provide proper
care to the patient.
 Group therapy and support to family members
through self-help groups; nurses are in a favorable
position to help families cope with stress and adapt
to changes in the family structure.

24. 3. Community Interventions:
 There are several ways that nurses can
intervene in the community tertiary
prevention programs.
 Among these are health education to the
public, training to school teachers, village
leaders and paraprofessionals in the
rehabilitation of mentally ill people.

25. EVALUATION
Evaluation of psychiatric rehabilitation
services usually takes place at the level of
impact on the patient, family and the
effectiveness of the community service
system.