Rehabilitation is a process of helping a person who is suffering from an illness to restore lost skills and regain maximum self-sufficiency. Psychiatric rehabilitation also known as psychosocial rehabilitation; is the process of restoration of social functioning and well-being of an individual who has a psychiatric disability.
The main goal is to seek effective changes in a person’s environment and in a person’s ability to deal with his/her environment, so as to facilitate improvement in symptoms or personal distress. We at Nityanand Rehabilitation Center provide these services in ‘Bio-Psychosocial Module’ – means Pharmacologic treatment, Symptomatic & Clinical assessments, working on Self-care, functionality, Independent living-Social skills training, access to leisure activities & Psychological support to clients and their families. Thus rehabilitation does not reverse or undo the damage caused by a psychiatric illness but rather it helps restore the individual to optimal level of psychological well-being and functioning. Medication and Psychotherapy are the two major treatment approaches, with attention given to supporting and facilitating daily functioning and social interaction. The problems experienced by people with psychiatric disabilities are thought to include difficulties in understanding or dealing with interpersonal situations, prejudice or bullying from others because they may seem different, problems coping with stress, difficulty in concentrating and finding energy and motivation. Hence we at Nityanand Rehabilitation Center, Katraj, Pune /Nityanand Institute Of Medical Sciences, Pachanegaon, Pune believe that helping an individual achieve the highest level of independence and quality of life possible, physically, emotionally, socially and spiritually. Psychosocial rehabilitation can be described as consisting of 8 main areas of work:
1] Symptom management
2] Relationships, family, boundaries, communication & community integration
3] Coping skills, motivation
4] Hygiene, meals, safety, planning
5] Financial budgets, time management
6] Community and legal resources
7] Maintain consistency of care
8] Safe environment
Rehabilitation for Mental Illness
A] Assessment and Detail History taking
B] Plan of management
A] Assessment and history: Detailed history has to be given by the client and his/her family members to the Psychiatrist and Counselor. Needed information: After completing detailed history, assessment is done by the Psychiatrist for the diagnosis of the client and to make plan of management. Psychometric testing, Intelligence test, Personality test and Projective techniques are conducted by the Counselor for diagnostic purposes. Supervision of every case is done by experts.
B] Plan of management: Medical emergencies are handled by the doctors; rounds are conducted on a daily basis where direct interaction between client and doctor takes place. In case the client has any physical problems/ emergencies – physician services and made available. Psychiatrist conducts individual sessions with the client thrice in a week hence medicine management and symptomatic assessment is taken care of. The doctor changes or alters the dosage as per needs and symptoms. After symptomatic settlement Psychosocial management is done by the Counselor. Simultaneously Day care activities are scheduled. Psychotherapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client, which aims to increase the individual’s sense of his/her own well being.
Therapies practiced at Nityanand Rehabilitation Centre:
2] Cognitive Behavior therapy
4] Behavior therapy
5] Behavior modification
6] Client centered therapy
7] Marriage counseling
8] Interpersonal psychotherapy
9] Supportive psychotherapy
10] Transactional Analysis
11] Systematic desensitization
12] Family therapy
13] Gestalt therapy
14] Holistic Psychotherapy
15] Milieu therapy
16] Motivational Interviewing
17] Music therapy
18] Dance therapy
19] Art therapy
20] Drama therapy
C] Family: Family interventions have been among the most successful approaches to preventing relapse and promoting better functioning of individuals suffering from mental illness. Psycho educational programs are thus crucial as they focus on both the patient and family. Family members are the primary caretakers and the most important resource in the rehabilitation and management of individuals who are released from the hospital after the acute symptoms control. So family work is focused at NRC – where they are explained about the impact of their positive/negative attitude, family as a source of support and continuity, expression of emotions, relapse recognition, compliance issues, and working on interpersonal issues.
A] History taking:
B] Treating withdrawals Withdrawal refers to a particular set of physical symptoms that occur when a person stops or cuts down on the use of a psychoactive substance. Treating withdrawals is the first aspect of the treatment, so that the client is well oriented to the surroundings and is physically fit.
C] Individual workup includes: Psychological evaluations, Anger management, Behavior shaping, Cognitive restructuring, Recreation therapy, Social awareness, financial management, Self-esteem enhancement, Relapse prevention, Group counseling and detail work up towards sober living.
Psycho-education, interpersonal conflicts, parenting skills, relapse prevention, expressed emotions, relapse recognition.
Community: An integrated network of community services can help prevent hospital re-admission for the clients suffering from addiction. The ‘Alcoholic Anonymous’ and the ‘Narcotic Anonymous’ have been formed to help people suffering from alcohol or drug addictions. Meetings are conducted on a daily basis with the purpose of
1] Giving emotional support and understanding
2] An accepting reference group that reduces social isolation
3] Models of how to cope effectively with stress
4] Information and advice
At Nityanand Rehabilitation Center , Alcoholics Anonymous and Narcotics Anonymous meetings are conducted twice a week. We recommend to the clients that they attend these meetings.
Nityanand Rehabilitation Center provides a residential facility for clients suffering from various mental illness and addictions. Both have a capacity of 120 beds with general, semi-private and private wards. We have a separate female ward.
Aftercare programs include OPD follow-up. At Nityanand Rehabilitation Center OPD treatment involves medicine management and counseling. Client reports along with his/her family, after interventions medicine management is done by the Psychiatrist. Counselor focuses on encouraging compliance issues, interpersonal problems, and consistency in functionality and regular follow-ups and other psycho-social management.
Half Way Home is a supportive community group. Patients may not have a family to return to so other kinds of support programs also need to be provided. These include half way homes or group homes, day-care activities that provide both treatment and practical help. Some of these support programs may be transitional. They help the discharged patient in readjusting to life in the community. Other programs are used to help a person who is functioning at a low level in staying out of the hospital. Such therapeutic homelike environments in the community have proved to be successful in preventing relapse in patients.