PSYCHOSOCIAL REHABILITATION

Experimental Rehabilitation Program

By Giovanni Curcio * and Enrico Conti **

* Psychologist, Supervisor of Coo.S.S.E.L Co-operative.

** Neuro- Psychiatrist, Coo.S.S.E.L. Co-operative.

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The Coo.S.S.E.L. Cooperative will be managing a new psychosocial rehabilitation project in which 13 patients considered independent in their social articulation and autonomous from the standpoint of the diagnosis of handicap areas and social competences will be involved in an exceptional program that will test independent living in a protected environment.

Project:

Selection and context of life:

A total number of 13  patients will be selected to participate in various experiences of group co-habitation and the total management of their living space within the same Residential Communities of Rausei "A" and Rausei "B" in which they currently reside. The selection process is made together with the Sanitary Heads of A.S.L. 11 (Department of Mental Health) of Reggio Calabria and with the Coo.S.S.E.L rehabilitation team of the Residential Community Rausei "A" and Residential Community "B".

A before and after baseline evaluation will be carried out on the entire patients participant in the project by the Coo.S.S.E.L. Cooperative in order to estimate attitudes, symptoms, behaviours, overall psicosociale functioning and degree of personal satisfaction for participation in the project.

The project will have duration of approximately three months, beginning in the month of July 2003 and will end in the month of September 2003. All the patients will be followed in the project on a 24 hour basis by the Coo.S.S.E.L. Cooperative; the night shift will include 2 rehab workers (1 worker from the Residential Community "A" and 1 worker from the Residential Community "B").

The rating scale appraisal for the psychosocial diagnosis and baseline of departure are the following:

• The Brief Psychiatric Rating Scales (A short psychiatric appraisal of current symptom functioning);
• Customer satisfaction questionnaire;
• Global Assessment Functioning Scales (GAF DSM-IV evaluation of global functioning)
• DI.SA. Version Acquaviva (disabilities and health);
• Spivak Model evaluation scale (living space, work space, personal hygiene, relationships and social recreational space).

The project will be carried out on the 3° and 4° floors of the Rausei Residential Community building. The 3° floor will be used as a dormitory for the 13 users, in addition to the room used for the rehab workers who lend night service; the 4° floor will be used for the everyday activities of the psychosocial rehabilitation program. The programming follows the practical concepts and theories of the rehabilitation model that the Coo.S.S.E.L. Cooperative is currently applying.

Rehabilitation Program:

The everyday rehabilitation program will be carried out, as already anticipated, on the 4° floor of the Residential Community. All patients will be involved in numerous instrumental activities, as for example, in an artistic group, a newspaper group, sewing, domestic activities and cleaning of their living space, rearrangement of their clothing closet and ordering of personal things. There will be groups for outside excursions and walks as well as free time for each user. It will be the task of all patients to clean, to keep in order, sweep and wash their habitation space and rooms.

The personal hygiene activities of each patient will be carried out on the 3° floor, after awakening in the morning, and will be supported by the Coo.S.S.E.L. Co-operative staff. The patients in the project will experiment the possibility of applying their own acquaintances of kitchen and cooking competences for breakfast, lunch and for supper.

Objectives of the project:

• To acquire and to maintain instrumental, interpersonal and intrapersonal social competences that will permit greater competent management of achieved personal autonomy but limited possibilities of application;
• Improvement of self-esteem;
• Improvement of operational and decision making processes;
• To normalize and balance inadequate cognitive and intellectual abilities;
• To normalize and experiment new possibilities of socialization and relationship building;
• To feel satisfied for their participation in the project;
• To improve management of emotionality;
• To experiment new forms of relationship testing and cohabitation living;
• To normalize dysfunzional relations which can be an obstacle to safe and good cohabitation and autonomy;
• To acquire a sense of "empowerment" or better defined as an investment in the power to decide and take part in the decisions that directly affect personal life.