Rehab unit 1 goals and assumptionss.pptx

goals, definition and assumptions of rehabilitation psychology

1. Conceptual models of disability

2. D isease is a disorder of structure or function of the human organism that deviates from the biological norm. it includes biochemical, physiological or anatomical abnormalities, which can result from congenital, traumatic, infective, inflammatory, degenerative or other pathological processes. the key features of disease are that it may be evaluated more objectively, at an organic level, in the individual, and as a matter of medical diagnosis (who 1980, boyd 2000). disease may or may not lead to impairment, and does not necessarily cause symptoms, illness, disability or incapacity.

3. I mpairment is significant deviation or loss of body structure or function (i.e. impairment can be anatomical or physiological) in a person with a health condition or disease (who 1980, 2001, ama 2007). The key feature is that impairment is a matter of objective evidence: ‘detectable ... by direct observation or by inference from observation’ (who 2001). The us social security administration operationalizes this as ‘demonstrable by medically acceptable, clinical and laboratory diagnostic techniques’ ( ssa 2001). Note that impairment is not the same as the underlying disease, but is the manifestation(s) of the disease.

4. Disability is limitation of activities and/or restriction of participation in life situations in a person with a health condition or impairment ( boyd 2000, who 2001, ama 2007). Disability is often assumed to be permanent, but in reality is often dynamic and fluctuates over time ( burchardt 2000, howard 2003).

5. M odels of disability and functioning are tools that are used to define impairment and more recently functioning, which are utilised by governments and society to devise strategies and policies for meeting the needs of those who have a loss in function as a result of health conditions, disease or injury. These models reveal or reflect how society provides or limits access to work, goods, services, economic influence and political power for people with a disability or loss of function, and provide some insight into the attitudes, conceptions and prejudices in society .

6. Biopsychosocial Model The biopsychosocial model was first conceptualised by george engel in 1977, suggesting that to understand a person's medical condition it is not simply the biological factors to consider, but also the psychological and social factors . Bio (physiological pathology) Psycho (thoughts emotions and behaviours such as psychological distress, fear/avoidance beliefs, current coping methods and attribution) Social (socio-economical, socio-environmental, and cultural factors suchs as work issues, family circumstances and benefits/economics)

7. T raditionally within a medical model the primary skills of a doctor are most often in the area of pathology and impairment, whereas those of the health and social care professionals are more based on activity and participation, while within this biopsychosocial model the rehabilitation team should to be able to take an informed overview considering the whole person, and ensure a holistic approach to rehabilitation that is person centred .

8. The World Health Organisation’s  International Classification of Functioning, disability and health is underpinned by the biopsychosocial model. R ehabilitation psychology should focus on function, which is considered an umbrella term for body functions, body structures, activities and participation. it denotes the positive aspects of the interaction between an individual (with a health condition) and that individual’s contextual factors (environmental and personal factors) and focuses on activity and participation, attempting to optimise these according to what is felt to be most important by the individual involved, determined through goal setting. while elements of pathology and impairment may need to be addressed, the overall aim or goal should be based at the level of activity or participation in order to  " optimise function"