Rehabilitation Introduction The Concept of Rehabilitation Rehabilitation is
Rehabilitation Introduction
The Concept of Rehabilitation • Rehabilitation is a robust concept, used in diverse contexts, referring to the restoration of persons, places, or things. • In each of these varied contexts, there is an implied connotation of a return to a state of health or useful and constructive activity.
Rehabilitation of the Disabled • Rehabilitation, within the context of disability, can be defined as a holistic and integrated program of medical, physical, psychosocial, and vocational interventions that empower a person with disability to achieve a personally fulfilling, socially meaningful, and functionally effective interaction with the world.
Key Elements in the Definition of Rehabilitation • It is comprehensive in scope and holistic in nature; • is an individualized process; • functions to develop or acquire skills and functions previously not attained, or restore or reacquire skills and functions lost; • should begin at the earliest possible stage
Key Elements in the Definition of Rehabilitation (cont. ) • should be based on the multidisciplinary assessment of individual needs and strengths; • supports participation and inclusion in the community and all aspects of society; • its goal is functional independence and improving quality of life.
Paradigm Shifts in Rehabilitation • Contemporary rehabilitation philosophy is reflected in several paradigm shifts, which include – a movement from an individual problem-solving approach and a medical model with an illness and pathology focus to an ecological framework; – from institutionalization to community participation, ; – from charity to civil rights; – from segregated vocational training models to community-integrated or community-supported employment and independent living models.
Contemporary Rehabilitation Philosophy • Thus, the contemporary philosophy of rehabilitation – is premised by a belief in the dignity and worth of all people; – values independence, integration, and the inclusion of PWDs in employment and in their communities; – contains a commitment to supporting PWDs in advocacy activities, in order to enable them to achieve independence and thus further empower themselves; – is solution focused and stresses the assets of the person and the resources of their environment.
Tripartite Model of Rehabilitation • The tripartite model of intervention identifies three components of rehabilitation intervention: – 1) disability minimization, as an effort to reduce its impact upon life activities; – 2) skill development, acquiring new strategies and skills through which the impact of the disability could be minimized, as an attempt to compensate for limitations caused by permanent losses; and – 3) environmental alteration/modification, to promote inclusion and physical, psychosocial, and socialattitudinal accessibility.
Rehabilitation Approaches Institution-based Rehabilitation And Community-based Rehabilitation
IBR • Institution based rehabilitation services are primarily individual focused, medically oriented and institutional in nature, where disabled persons receive services passively. • Many of the institutions are located in urban areas with scarce distribution in rural areas. • Theoretically it produces rehabilitation services of excellent quality, even though for only a small group of peoples.
IBR (cont. ) • The locus of control is found in the institution. • There is an apparent lack of contact with the family and the community. • Finance and services are often costly. • Institutionalizing children with disabilities over long period of time affects negatively their social skills and other psychosocial development.
Defining CBR • Community-based rehabilitation (CBR) is broadly defined as rehabilitation efforts occurring outside medical or institutional contexts. • CBR is a strategy that can address the need of peoples with disabilities with in their community which can be implemented through the combined efforts of peoples with disabilities themselves, their families, organizations and communities, governmental and nongovernmental organizations, health, education, vocational, social and other services.
• In this approach, The locus of control should be with in the community. • PWDs, family and community members decide what their primitives are, and then work together with local organizations, government and institutions in order to access the relevant and appropriate services. • It’s starting point is in the community, with referral services being complementary.
Major Objectives of CBR • 1. To ensure that people with disabilities are able to maximize their physical and mental abilities, to access regular services and opportunities, and to become active contributors to the community and society at large. • 2. To activate communities to promote and protect the human rights of people with disabilities through changes within the community, for example, by removing barriers to participation.
Stakeholders in CBR • CBR is implemented through the combined efforts of people with disabilities themselves, their families, organizations and communities, and the relevant governmental and nongovernmental health, education, vocational, social and other services. • CBR promotes collaboration among community leaders, people with disabilities, their families, and other concerned citizens to provide equal opportunities for all people with disabilities in the community.
Key CBR Characteristics • CBR must take a rights-based approach, empowering disabled people and their families. • CBR must involve disabled people, parents and their organizations from the start. • CBR must enable key stakeholders to access information on all issues. • CBR must be holistic; it must look at people with disabilities in totality.
Key CBR Characteristics (cont. ) • CBR must advocate for appropriate legislation and policies. • CBR must enhance self-advocacy of disabled persons. • CBR must develop long term and short-term plans together with all stakeholders. • CBR must ensure inclusion of disability issues in all development programes.
Key CBR Characteristics (cont. ) • CBR must take into consideration local cultures, utilization of local resources and practices. • CBR must address issues of poverty among disabled people and their families. • CBR must create sense of community ownership of the program.
The Management Cycle of CBR • Situation analysis (Stage 1) – looking at the current situation of people with disabilities and their families, and identifies the problems and issues that need to be addressed – Major tasks involve collecting facts and figures, and conduct problem, stakeholder, objective, and resource analysis. • Planning and design (Stage 2) (deciding what the CBR program should do to address these problems and issues, and planning how to do
The Management Cycle (cont. ) • Implementation and monitoring (Stage 3) (carrying out, the program with regular monitoring and review to ensure it is on the right track); and • Evaluation (Stage 4) – measuring the program against its outcomes to see whether and how the outcomes have been met and assess the overall impact of the program, e. g. what changes have occurred as a result of the program – In particular, conduct evaluation of the program’s relevance, efficiency, effectiveness, impact, and sustainability.
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