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Introduction
Psychiatric rehabilitation also referred to psychosocial rehabilitation (PSR) is the process of the restoration of community well-being and function among individuals who have or had been diagnosed with a mental disorder or emotional disorders. Individuals also considered to be having psychiatric disabilities could also receive psychiatric/psychosocial rehabilitation. The staffs working at these rehabilitation facilities, mainly nurses, always provide services to the patients that are aimed at changing the person’s environment and their ability to deal with their environment. To better understand this process, it is important to understand the underlying concepts, theories and how nurses apply them during their practice in a psychological/psychiatric rehabilitation facility. [“Write my essay for me?” Get help here.]
Services offered to these patients include pharmacologic treatment, social support to the patients and the family members, vocational rehabilitation through involvement in economic activities, access to leisure activities and training on independent living and social skills (Rogers, 2003). All these services are aimed at helping them develop skills and their access to resources that can enable them to be successful in life. This practice also promotes recovery of the individual, improves the quality of life of the individual and allows full community integration.
Theories and concepts of psychological/psychiatric rehabilitation revolve mainly around community support and community rehabilitation. The theories and concepts behind psychological/psychiatric rehabilitation are associated greatly with community and social psychiatry as opposed to the medical approach of disability and mental disorders or illness. However, at times, some of the concepts incorporate some of the elements and aspects of social model of disability. They also borrow many aspects of theories such as; community integration theory, integration theory itself, rehabilitation and education paradigms and psychological theory to a much extend. Concepts of psychological/psychiatric rehabilitation also stretch further to incorporate other important fields for instance family support theories.
To begin with, psychological/psychiatric rehabilitation is built upon strengths of these individuals who have been assed keenly by the healthcare providers rather than their disabilities, disorders and problems. It therefore means that psychological/psychiatric rehabilitation is aimed at helping these patients realize their strengths. Thus, it maximizes these strengths in enabling goal setting and aiding recovery among the patients. Patients are therefore involved in vocational training, skill training and basic education programs for those who may have missed to attend school due to the condition. All these are aimed at enabling the individual to be self-dependent and productive in the society (Creed, 2011). The individual after finishing their rehabilitation or after recovery can seek employment depending on the basic skills they have. Some rehabilitation centers may offer transportation assistance to employment.
Psychological/psychiatric rehabilitation approach is mainly collaborative since it is individualized and person directed. All psychological/psychiatric rehabilitation tries to do is to enable the patients rediscover themselves, their skills and accessing the community resources they require improving their lives or lifestyles. During psychological/psychiatric rehabilitation the patient is involved in setting up their own goals rather than having goals set by the healthcare providers. The healthcare providers then help these patients in realizing their set goals (Creed, 2011).
Psychological/psychiatric rehabilitation approaches are aimed at enabling the patients to live meaningful lives in the future. It has in place approaches that explore determinants of good mental health and health in general. These determinants could include; basic living skills, social support, wellness, employment, leisure and education (Masters, 2005).
In some cases, psychological/psychiatric rehabilitation approaches would involve placing these patients in their own goal settings such as jobs they dreamt of or houses they desire. After that, these patients would be educated or trained on the given field. Moral support could also be offered to the patients while in their settings. Other trainings such as social skills training and basic living skills are also offered in these settings.
Psychological/psychiatric rehabilitation has its basis on Orems’s theory of Self Care Deficit Theory which holds that people should be responsible for their health care including their family members in need of health care. It also asserts that the same people should be self-reliant that self-care and dependent care are learnt from the socio-cultural surrounding of these people. Psychological/psychiatric rehabilitation therefore is aimed at providing an environment that would result into the patient obtaining the self-care and dependent attitude.
Rogers’s theory is greatly used during holistic practices in psychological/psychiatric rehabilitation centers. The Theory of Unitary Human Beings states that nursing is a science and at the same time an art. Health care provided to these patients should therefore aim at promoting health of the individual and at the same time the well-being of the individual. Schizophrenics like any other mentally disturbed patients have problems socializing with people freely. They are also away from their families, lost their jobs and away from their friends and colleagues. It is therefore the roles of the nurses to provide these by offering them moral support, involving them in some actives and providing guidance and counseling (Rogers, 2003).[Need an essay writing service? Find help here.]
Some of the psychological/psychiatric rehabilitation approaches are based on Barker’s theory of Tidal Model of Mental Health Recovery. The theory has it that mentally disturbed patients should be helped to remember what they are taught and what the society expects from them. For instance, patients could be helped to form acronyms or metaphors that could enable them remember to take their medication. This therefore helps in boosting their memories and the cognitive activity of their mind and brain (Parker & Smith, 2010).
Case Study
The following is a case study of a 28 year old male patient diagnosed with schizophrenia at the facility. The patient has been in impatient for nine months since he was brought by his family. After graduating from high school, the patient worked in a nearby video shop in their town. The patient only worked for four months before he began having hallucinations and delusions. He started thinking that his boss could be planting CCTV cameras in the store and was using them to watch how he carried himself out. With time he become more agitated especially during busy times and would talk strangely to patients. The patient could not manage doing the job and so he quit one day after arguing and abusing the owner of the store over the claim that he had let out a clip of himself and it is being aired out by all Television stations.
While at home, the patient’s situation worsened. He became more agitated and increasingly confused. He was taken to the hospital where he was diagnosed with a mental disorder. Doctors insisted on admitting the patient and he was given Thorazine as an antipsychotic drug. He was later switched to another drug, Haldol due to Thorazine’s side effects of painful twisting and contraction of his muscles. Haldol assisted but the patient become uncooperative and so he stopped taking the medication, which worsened the hallucinations.
The patient has been hospitalized for more than ten times for the last four years before being brought to the facility. At the facility he was examined by the psychologists and the following symptoms, based on history, convinced them he could be schizophrenic. During the interviews by psychologist the patient presets with the following psychotic behaviors. He would rub the back of his head, tilt his head as if he is keenly listening to someone, avoid making eye contact with the interviewer at all costs, clasping his chair very rigidly, staring in the opposite direction and stroking his face and other body parts (McKenna, 1994).[Need an essay writing service? Find help here.]
Plan, Management and Outcome
The patient is currently on antipsychotic medication of Olazapine and Quetiapine. He takes 200 mg of olanzapine twice daily and 200mg of Quetiapine twice day. He is also on sedatives and Diazepam. The patient has been thought how to remember his medication and he refers to Olanzipine as small white pills that are taken in in the morning and before bedtime, Diazepam he refers to it as a yellow pill to be taken one at time twice a day and Quetiapine as a big pill white in color to be taken one in the morning and the other at bedtime. The patient would be taken along with other patients to church services to nearby church. At times it would be organized and he is taken to watch football matches at the nearby stadium since it was his favorite sport.
The patient has also been included in a psychosocial clubhouse, which is a group for people with mental disorders. He attends the clubhouse twice a week where he has learnt a lot. At the club house he answers the phone and helps in the writing of the club newsletter. After applying for supplemental security income (SSI) he was granted and he moved to his own apartment recently with the help of a case manager.
Sometimes back before he was allowed to move to his apartment, he used to sing along in the psychological/psychiatric rehabilitation facility choir with other patients. On many occasions he would be given the opportunity to help in shooting videos for the facility choir. He enjoyed so much during these activities and even promised to release own album once he left the facility which most of his fellow patients are eagerly waiting for.
Discussion
The patient was admitted at the hospital so as to ensure he complied with the medication given. His non-compliance towards Thorazine and Haldol were attributed to their side effects. The current regimen also has resulted into him increasing weight which is a possible risk of increasing his non-compliance. At the beginning, the patient had been enrolled to an intra-muscular injection of Rispderdal Conta where he was to receive 25 mg every two weeks. He became non-compliant and was switched to the oral medications (Gardner, 2011).
The patient was allowed supplemental security income (SSI) after applying. This enabled him to move out into to his own apartment however under the care of a care manager. This helps in self-actualization and goal attainment which is one of the concepts among the theories behind Psychological/psychiatric rehabilitation.
The patient is also involved in the facility choir. He is given the opportunity to help in shooting the video. This prepares him psychologically for responsibilities in the outside world. It also reminds the patient that all is not lost and he still can do more. He proves this by planning to release his own album.
Conclusion
Psychological/psychiatric rehabilitation involves many theories and concepts which nurses and other health care providers use when attending to their patients. Some of these theories and concepts include the theories of nursing for instance Barker’s theory on Tidal Model (Parker & Smith, 2010).
References
Creed, F., Henningsen, P., & Fink, P. (2011). Medically unexplained symptoms, somatisation, and bodily distress: Developing better clinical services. Cambridge, UK: Cambridge University Press.
Gardner, D. M., & Teehan, M. D. (2011). Antipsychotics and their side effects. Cambridge: Cambridge University Press.
Masters, K. (2005). Role development in professional nursing practice. Sudbury, MA: Jones and Bartlett.
McKenna, P. J. (1994). Schizophrenia and related syndromes. Oxford: Oxford University Press.
Parker, M. E., & Smith, M. C. (2010). Nursing theories and nursing practice. Philadelphia: F.A. Davis Co.
Rogers, E. S. (2003). Psychiatric rehabilitation. Amsterdam: IOS Press
