Psychosocial rehabilitation: Towards a theoretical base.

Abstract

Psychosocial rehabilitation (PSR) is gaining in public recognition and is growing in acceptance and utilization by professionals. However, the field lacks an overarching guiding theory. Based on principles of PSR defined in a previous paper (Cnaan, Blankertz, Messinger, & Gardner, 1988), the authors attempt to link PSR with various theories and more established practice modalities. The most promising theoretical approach studied is the "ecosystems perspective," while several other theories and practice modalities provide additional relevant theoretical support for PSR.

The Attitudes Towards and Enactment of Psychosocial Rehabilitation Principles: Discrepancies and Correlates

“…The mission of PR is to use systematic provision of services to help consumers increase their functioning in the environment of their choice, and hopefully regain social roles in the community (Anthony et al, 2002;Rutman, 1994). To ensure practice consensus, Cnaan et al (1988Cnaan et al ( , 1990 developed 13 principles of PR: equipping people with skills, self-determination, utilizing environmental resources, social change, differential needs and care, commitment of staff, emphasis on employment, emphasis on the here and now, early intervention, social rather than medical emphasis, normalization, emphasis on strengths rather than weaknesses, and intimate environment of service. Anthony et al (2002) mentioned eight key values of PR: person orientation, enhancing functioning, continuous support, environmental specificity, consumer involvement, consumer choice, outcome orientation, and growth potential.…”

Perceptions of consumers, practitioners, and experts regarding psychosocial rehabilitation principles.

“…When analyzing the items grouped under the principle of social rather than medical emphasis, it is evident that consumers prefer assistance with medication. In Cnaan et al (1988), this principle implied no medication support. Clearly, consumers see value in medications and ask for help in dealing with them.…”

“…Important attempts to systemize the foundations of PSR (cf. Lieberman, 1986;Cnaan et al, 1988) failed to gain preponderance in the field, and today these attempts are viewed as a particular viewpoint of PSR rather than as the leading and binding viewpoint. Second, there is too little common body of knowledge to use in training current or potential practitioners in a PSR agency.…”

“…Given the problems listed above, it is clear that the development of a reliable and coherent common body of knowledge for PSR is important to efforts to assist people with mental disabilities. To identify the characteristics that are specific to PSR, a group of researchers at the University of Pennsylvania and Horizon House studied over 200 publications regarding PSR (Cnaan et al, 1988;1989). From these publications, they have extracted 15 key principles, which are the basis of PSR:…”

Professional role(s) in the empowerment process: "Working with" mental health consumers.

“…The eco-systems perspective cited by Cnann, Blankertz, Messinger, and Gardner (1989) is a good reference point from which to develop an empow erment approach to psychiatric rehabilitation. The authors explain that a " humanistic ecology" deals with safe environments for individual growth, formation of identity, competence, and autonomy.…”