Social rehabilitation. Social rehabilitation as one of the key technologies of social work

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Ministry of Education and Science of the Russian Federation

Federal State Autonomous Educational Institution of Higher Professional Education

"Russian State Vocational Pedagogical University"

Institute of Psychological and Pedagogical Education

Department of Professional Pedagogy

Test

in the discipline "Social and pedagogical rehabilitation"

Social rehabilitation

Performed

IV year student

ZPSP-404S groups

Ekaterinburg

social rehabilitation disabled person

Introduction

3. Social rehabilitation

Conclusion

Introduction

Currently, the process of social rehabilitation is the subject of research by specialists in many branches of scientific knowledge. Psychologists, philosophers, sociologists, teachers, social psychologists, etc. Reveal various aspects of this process, explore mechanisms, stages and stages, factors of social rehabilitation. According to the UN, there are approximately 450 million people in the world with mental and physical disabilities. This is 1/10 of the hour of the inhabitants of our planet.

Disability means a significant limitation of life activity; it contributes to social maladjustment, which is caused by developmental disorders, difficulties in self-care, communication, learning, and mastering professional skills in the future. The acquisition of social experience by disabled people and their inclusion in the existing system of social relations requires certain additional measures, funds and efforts from society (these may be special programs, special rehabilitation centers, special educational institutions, etc.). But the development of these measures should be based on knowledge of the patterns, tasks, and essence of the process of social rehabilitation.

1. The concept of rehabilitation. Types of rehabilitation

The WHO Committee gave a definition of medical rehabilitation: rehabilitation is an active process, the purpose of which is to achieve complete restoration of functions impaired due to disease or injury, or, if this is unrealistic, the optimal realization of the physical, mental and social potential of a disabled person, his most adequate integration into society . Thus, medical rehabilitation includes measures to prevent disability during the period of illness and help the individual achieve the maximum physical, mental, social, professional and economic usefulness of which he will be capable within the framework of the existing disease. Among other medical disciplines, rehabilitation occupies a special place, since it considers not only the state of the organs and systems of the body, but also the functional capabilities of a person in his daily life after discharge from a medical institution. In recent years, the concept of “health-related quality of life” has been introduced into rehabilitation. At the same time, it is the quality of life that is considered as an integral characteristic that must be focused on when assessing the effectiveness of the rehabilitation of sick and disabled people. A correct understanding of the consequences of the disease is of fundamental importance for understanding the essence of medical rehabilitation and the direction of rehabilitation effects. The optimal solution is to eliminate or completely compensate for the damage through restorative treatment. However, this is not always possible, and in these cases it is desirable to organize the patient’s life in such a way as to exclude the influence of the existing anatomical and physiological defect on it. If the previous activity is impossible or negatively affects the state of health, it is necessary to switch the patient to such types of social activity that will most contribute to the satisfaction of all his needs.

General indications for medical rehabilitation are presented in the report of the WHO Expert Committee on the Prevention of Disability in Rehabilitation. These include:

Significant decrease in functional abilities;

Decreased learning ability;

Particular exposure to environmental influences;

Violations of social relations;

Violations of labor relations.

General contraindications to the use of rehabilitation measures include concomitant acute inflammatory and infectious diseases, decompensated somatic and oncological diseases, severe intellectual-mnestic disorders and mental illnesses that impede communication and the patient’s ability to actively participate in the rehabilitation process.

2. Basic principles of rehabilitation

Rehabilitation should be carried out from the very onset of illness or injury until the person’s full return to society (continuity and thoroughness).

Rehabilitation must be solved comprehensively, taking into account all its aspects (complexity).

Rehabilitation should be accessible to everyone who needs it (accessibility).

Rehabilitation must adapt to the constantly changing structure of diseases, and also take into account technological progress and changes in social structures (flexibility).

Taking into account continuity, the following are distinguished:

Stationary program. Carried out in special rehabilitation departments. It is indicated for patients who require constant monitoring by medical professionals. These programs are usually more effective than others, since in the hospital the patient is provided with all types of rehabilitation.

Day hospital. The organization of rehabilitation in a day hospital comes down to the fact that the patient lives at home and is in the clinic only for the duration of treatment and rehabilitation measures.

Outpatient program. It is carried out in rehabilitation therapy departments at clinics. The patient is in the clinic department only during rehabilitation activities, for example, massage or physical therapy.

Home program. When implementing this program, the patient takes all treatment and rehabilitation procedures at home. This program has its advantages, as the patient learns the necessary skills and abilities in a familiar home environment.

Rehabilitation centers. In them, patients participate in rehabilitation programs and take the necessary medical procedures. Rehabilitation specialists provide the patient and his family members with the necessary information, give advice regarding the choice of a rehabilitation program and the possibility of its implementation in various conditions.

Since one of the leading principles of rehabilitation is the complexity of impacts, only those institutions in which a complex of medical, social and professional pedagogical activities are carried out can be called rehabilitation. The following aspects of these activities are highlighted:

The medical aspect includes issues of treatment, treatment-diagnostic and treatment-and-prophylactic plan.

The physical aspect covers all issues related to the use of physical factors (physiotherapy, exercise therapy, mechanical and occupational therapy), with increasing physical performance.

The psychological aspect is the acceleration of the process of psychological adaptation to the life situation that has changed as a result of the disease, the prevention and treatment of developing pathological mental changes.

Professional - for working persons - prevention of possible reduction or loss of ability to work; for disabled people - if possible, restoration of working capacity; This includes issues of determining ability to work, employment, occupational hygiene, physiology and psychology of work, and labor training and retraining.

The social aspect covers issues of the influence of social factors on the development and course of the disease, social security of labor and pension legislation, the relationship between the patient and family, society and production.

The economic aspect is the study of economic costs and the expected economic effect of various methods of rehabilitation treatment, forms and methods of rehabilitation for planning medical and socio-economic measures.

Typically, rehabilitation treatment begins in a hospital and then continues at home. Rehabilitation treatment should begin when the patient is still in bed. Correct position, turns in bed, regular passive movements in the joints of the limbs, breathing exercises will allow the patient to avoid complications such as muscle weakness, muscle atrophy, bedsores, pneumonia, etc. Always maintain physical activity in the patient, as it strengthens the patient, and inaction weakens.

Rehabilitation specialists

Doctors are specialists (neurologists, orthopedists, therapists, etc.). They help diagnose and treat diseases that limit the life of patients. These specialists solve problems of medical rehabilitation.

Rehabilitologist.

Rehabilitation nurse. Provides assistance to the patient, provides care, and educates the patient and his family members.

Physiotherapy specialist.

Specialist in physical therapy.

Specialists in vision, speech and hearing impairments.

Psychologist.

Psychotherapist.

Social worker and other specialists.

Types of rehabilitation

Medical rehabilitation

Physical methods of rehabilitation (electrotherapy, electrical stimulation, laser therapy, barotherapy, balneotherapy).

Mechanical methods of rehabilitation (mechanotherapy, kinesitherapy).

Traditional methods of treatment (acupuncture, herbal medicine, manual therapy, occupational therapy).

Psychotherapy.

Speech therapy assistance.

Physiotherapy.

Reconstructive surgery.

Prosthetic and orthopedic care (prosthetics, orthotics, complex orthopedic shoes).

Spa treatment.

Technical means of rehabilitation.

Information and consultation on medical rehabilitation issues.

Social rehabilitation

Social and everyday adaptation

Information and consultation on issues of social and everyday rehabilitation of the patient and his family members.

Patient self-care training.

Adaptation training for the patient's family.

Training sick and disabled people in the use of technical means of rehabilitation.

Organization of the patient’s everyday life (adaptation of living quarters to the needs of the sick and disabled).

Providing technical means of rehabilitation (the program indicates the necessary measures to create the patient’s everyday independence).

Audiovisual technology.

Typhlotechnics.

Technical means of rehabilitation

Social and environmental rehabilitation

Conducting socio-psychological and psychological rehabilitation (psychotherapy, psychocorrection, psychological counseling).

Providing psychological assistance to families (life training

skills, personal safety, social communication, social independence).

Assistance in solving personal problems.

Consulting on legal issues.

Training in leisure and recreation skills.

Vocational Rehabilitation Program

Career guidance (career information, career counseling).

Psychological correction.

Training (retraining).

Creation of a special workplace for disabled people.

Professional and industrial adaptation.

3. Social rehabilitation

The concept of “social rehabilitation” characterizes in a generalized form the process of assimilation by an individual of a certain system of knowledge, norms, values, attitudes, patterns of behavior, which are included in the concept of culture inherent in a social group and society as a whole, and allows the individual to function as an active subject of social relations.

Social rehabilitation of the individual is carried out under the influence of a combination of many conditions, both socially controlled, directionally organized, and spontaneous, arising spontaneously. It is an attribute of a person’s lifestyle, and can be considered both its condition and its result. An indispensable condition for social rehabilitation is the cultural self-actualization of the individual, his active work on his social improvement. No matter how favorable the conditions for social rehabilitation may be, its results largely depend on the activity of the individual himself. It is important to keep in mind that social rehabilitation is a process that continues throughout a person’s life.

One of the main goals of social rehabilitation is adaptation, adaptation of a person to social reality, which serves, perhaps, as the most possible condition for the normal functioning of society.

The process of social rehabilitation is a process of interaction between the individual and society. This interaction includes, on the one hand, a way of transmitting social experience to an individual, a way of including it in the system of social relations, and, on the other hand, a process of personal change. This interpretation is the most traditional for modern sociological literature, where social rehabilitation is understood as the process of social formation of a person, which includes the individual’s assimilation of social experience, a system of social connections and relationships. The essence of social rehabilitation is that in the process a person is formed as a member of the society to which he belongs.

4. Types of social rehabilitation

Medical rehabilitation is aimed at full or partial restoration or compensation of one or another impaired or lost function or at slowing the progression of the disease.

The right to free medical rehabilitation care is enshrined in health and labor legislation. Rehabilitation in medicine is the initial link in the system of general rehabilitation, because a disabled person, first of all, needs medical care. Essentially, there is no clear boundary between the period of treatment of the sick person and the period of his medical rehabilitation, or restorative treatment, since treatment is always aimed at restoring health and returning to educational or work activities, however, medical rehabilitation activities begin in a hospital institution after the disappearance of acute symptoms diseases - for this purpose all types of necessary treatment are used - surgical, therapeutic, orthopedic, spa, etc.

The psychological form of rehabilitation is an impact on the mental sphere of the patient, on overcoming in his mind the idea of the futility of treatment. This form of rehabilitation accompanies the entire cycle of treatment and rehabilitation measures.

Pedagogical rehabilitation is educational activities aimed at ensuring that a sick child acquires the necessary skills for self-care and receives a school education. It is very important to develop in a child psychological confidence in his own usefulness and create the right professional orientation. To prepare for the types of activities available to them, to create confidence that the acquired knowledge in a particular area will be useful in subsequent employment.

Socio-economic rehabilitation is a whole complex of measures: providing the sick or disabled person with the necessary and convenient housing for him, located near the place of study, work; maintaining the confidence of the sick or disabled person that he is a useful member of society; monetary support for a sick or disabled person and his family through state-provided payments, pensions, etc.

Vocational rehabilitation involves training or retraining in accessible forms of work, providing the necessary individual technical devices to facilitate the use of working tools, adapting the disabled person’s workplace to its functionality, organizing special workshops and enterprises for disabled people with easier working conditions and shorter working hours, etc.

Domestic rehabilitation is the provision of prosthetics and personal means of transportation to disabled people at home and on the street (special bicycle and motorized strollers, etc.).

Recently, great importance has been attached to sports rehabilitation. Participation in sports and rehabilitation activities allows disabled people to overcome fear, form a culture of attitude towards even weaker people, correct sometimes exaggerated consumer trends and, finally, include a disabled person in the process of self-education, acquiring skills to lead an independent lifestyle, to be sufficiently free and independent.

A social worker carrying out rehabilitation measures with a person who has become disabled as a result of a general illness, injury or injury must use a complex of these measures, focus on the ultimate goal - restoration of the personal and social status of the disabled person - and take into account the method of interaction with the disabled person, which involves:

an appeal to his personality;

versatility of efforts aimed at various spheres of life and at changing his attitude towards himself and his illness;

the unity of the effects of biological (drug treatment, physiotherapy, etc.) and psychosocial (psychotherapy, occupational therapy, etc.) factors;

a certain sequence - a transition from one influence and activity to another.

The goal of rehabilitation should be not only the elimination of painful manifestations, but also the development of qualities in them that help them adapt more optimally to the environment. When carrying out rehabilitation measures, it is necessary to take into account psychosocial factors, which in some cases lead to emotional stress, the growth of neuropsychic pathology and the emergence of so-called psychosomatic diseases, and often the manifestation of deviant behavior. Biological, social and psychological factors are mutually intertwined at various stages of adaptation of a disabled person to life support conditions.

Conclusion

Thus, when developing rehabilitation measures, it is necessary to take into account both the medical diagnosis and the characteristics of the individual in the social environment. This, in particular, explains the need to involve social workers and psychologists in working with disabled people in the health care system itself, because the boundary between prevention, treatment and rehabilitation is very arbitrary and exists for the convenience of developing measures. However, rehabilitation differs from conventional treatment in that it involves the development, through the joint efforts of a social worker, a medical psychologist and a doctor, on the one hand, and the disabled person and his environment (primarily family), on the other hand, of qualities that help the disabled person optimally adapt to social environment. Treatment in this situation is a process that has a greater impact on the body, on the present, while rehabilitation is more addressed to the individual and, as it were, directed towards the future.

The objectives of rehabilitation, as well as its forms and methods, vary depending on the stage. If the task of the first stage - recovery - is the prevention of defects, hospitalization, establishment of disability, then the task of subsequent stages is the individual’s adaptation to life and work, his household and subsequent employment, the creation of a favorable psychological and social microenvironment. The forms of influence are varied - from active initial biological treatment to “environmental treatment”, psychotherapy, employment treatment, the role of which increases in subsequent stages. The forms and methods of rehabilitation depend on the severity of the disease or injury, the particular clinical symptoms of the patient’s personality and social conditions.

Thus, it is necessary to take into account that rehabilitation is not just the optimization of treatment, but a set of measures aimed not only at the disabled person himself, but also at his environment, primarily his family. In this regard, group psychotherapy, family therapy, occupational therapy and environmental therapy are important for the rehabilitation program. Therapy as a certain form of intervention (intervention) in the interests of a disabled person can be considered as a method of treatment that affects the mental and somatic functions of the body; as a method of influence associated with training and career guidance; as a tool of social control; as a means of communication.

List of used literature

1. Social rehabilitation of disabled people: method. recommendations /Min. labor and social development of the Russian Federation, under the general editorship. IN AND. Lomakina. - M.: RIK, 2002.

2. Fundamentals of social work: Textbook /Under. ed. P.D. Pavlenok. - M.: INFRA - M, 1998.

3. Social rehabilitation: textbook./ Under. ed. E.I. Kholostova, I.F. Dementieva. /Ed. Dashkov and Co., 2006.

4. Social rehabilitation of people with disabilities./ Ed. Akatov I.I. / 2003.

5. Fundamentals of rehabilitation of disabled people./ Ed. Karyakina O.I., Karyakina T.I. / 2001.

6. Organization of social rehabilitation of disabled people: method. recommendations. / comp.: Syrnikova B.A.-M., 2003: - issue No. 49.

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Any social subject, regardless of the degree of complexity, throughout his life repeatedly encounters situations when the established and habitual model of life activity is destroyed, established social connections and relationships are broken, and the social environment of his life activity changes with varying degrees of depth.

In such circumstances, the subject needs not only to get used to and adapt to new conditions of existence, but also to regain lost social positions, restore physical, emotional and psychological resources, as well as important and significant social connections and relationships for the subject. In other words, a necessary condition for successful and effective social support of a person or group is the restoration of their socially and personally significant qualities and characteristics and overcoming the situation of social and personal insufficiency.

This task can and should be successfully solved in the process of organizing and conducting social rehabilitation of the subject.

The term “social rehabilitation” was introduced into science only at the end of the 19th century.

There are 2 approaches to defining the concept of “rehabilitation”:

As a legal meaning, it implies the complete restoration of the legal status of the individual. In the medical, socio-economic understanding, the term “rehabilitation” is used as a set of measures aimed at restoring (or compensating) impaired body functions and the working capacity of sick and disabled people.

As medical means medical and social recovery based on certain activities - work, play, study, etc. In the medical socio-ethical understanding, this term gained international recognition after the First World War, when various methods of restorative treatment began to be widely used: medication and surgical treatment, physiotherapy, exercise therapy, mud therapy, restorative and special sanatorium-resort treatment , orthotics and prosthetics, occupational and psychotherapy.

A breakthrough in the development of both the theory and practice of rehabilitation occurred after the Second World War. To treat the consequences of wounds, concussions, diseases received at the front, various centers, rehabilitation services, and state rehabilitation institutes were created for the sick and disabled.

In 1958, the International System for the Organization of Rehabilitation was organized, in 1960 - the International Society for the Rehabilitation of Disabled Persons, which is a member of the World Health Organization (WHO) and works in contact with the UN, UNESCO and the International Workers' Bureau (IWB). .

Currently rehabilitation it is customary to call a system of state socio-economic, psychological, pedagogical and other measures aimed at preventing the development of pathological processes leading to temporary or permanent loss of ability to work, at the effective and early return of sick and disabled people to society and to socially useful work .

The concepts of “adaptation” and “rehabilitation” are closely interrelated. Without a reliable adaptation apparatus (physiological, psychological, biological), full rehabilitation of an individual is impossible). Adaptation in this case can be considered as an adaptation to a disease using reserve, compensatory abilities, and rehabilitation can be considered as restoration, activation, and overcoming a defect.

Existing legislative acts and scientific definitions, for example, make it possible to understand social rehabilitation a complex of social, socio-economic, psychological and pedagogical measures, etc., aimed at eliminating or possibly more fully compensating for limitations in life caused by health problems with persistent dysfunction of the body. Thus, it turns out that the term “social” is understood extremely broadly, including both the medical and professional aspects.

Social rehabilitation is also one of the areas of social policy, which is associated with the restoration by the state of the functions of protecting the social rights and guarantees of the country's citizens.

The need for social rehabilitation is a universal social phenomenon. Each social subject, regardless of the degree of his social well-being at a given time, throughout his life is forced to change his usual social environment, forms of activity, expend his inherent strengths and abilities and face situations that inevitably and necessarily lead to certain losses . All this leads to the fact that a person or group begins to feel the need for certain social rehabilitation assistance.

Factors that determine the subject’s need for social rehabilitation measures can be divided into two main groups:

1. Objective, i.e. socially or naturally determined:

Age-related changes;

Natural, man-made or environmental disasters;

Serious illness or injury;

Social disasters (economic crisis, armed conflict, increased national tension, etc.).

2. Subjective or personal:

Changes in the goals, interests and value orientations of the subject and his own actions (leaving the family, resigning at his own request or refusing to continue his studies);

Deviant forms of behavior, etc.

Under the influence of these and similar factors, a person or group, firstly, is pushed to the periphery of social life, gradually acquiring some marginal qualities and characteristics and, secondly, loses a sense of identity between themselves and the world around them.

The most important and most dangerous elements of this process for the subject are:

Destruction of the usual system of social connections and relationships;

Loss of habitual social status and its inherent model of status behavior and status perception of the world;

Destruction of the subject’s habitual system of social orientation;

A decrease or loss of the ability to independently and adequately evaluate oneself, one’s actions, the actions of others and, as a result, make independent decisions.

The result of these processes is a situation of social or personal failure, which may be accompanied by the destruction of the human personality.

In the process of organizing and implementing social rehabilitation activities, it is important not only to help a person or group of people. It is necessary to provide them with the opportunity for active life, guarantee a certain level of social stability, demonstrate possible prospects within the new social status and create a sense of their own importance and need and a sense of responsibility for their subsequent life activities.

This is what determines the goals and means of the process of social rehabilitation.

The means of social rehabilitation available to modern society include the following systems:

Healthcare;

Education;

Professional training and retraining;

Mass communications and media;

Organizations and institutions of psychological support, assistance and correction;

Public and non-governmental organizations working in the field of solving specific social and personal problems (employment of people with disabilities or minors, assistance to victims of sexual or domestic violence, etc.).

Main goals of social rehabilitation, can be characterized as follows.

Firstly, the restoration of the social status, the social position of the subject.

Secondly, the subject’s achievement of a certain level of social, material and spiritual independence.

And, finally, thirdly, increasing the level of social adaptation of the subject to new living conditions.

When organizing a conscious and purposeful process of achieving these goals, it is necessary to remember that often the object of social rehabilitation activities is an adult, formed as an individual, with an established system of needs, interests and ideals, and with an established system of abilities, knowledge and skills. This circumstance leads to the fact that, having lost the capabilities of life that are familiar to him, a person strives for their complete and absolute restoration, and in the shortest possible time.

Such a desire may be expressed in the fact that he rejects attempts to provide him with a new social status and new opportunities for self-realization and life. Such resistance is a natural primary human reaction to a negative change in the usual image and lifestyle.

In such conditions, a specialist organizing the process of social rehabilitation must clearly understand the following:

What is the reason for the specific crisis situation in which the subject finds himself;

How relevant and significant are lost or destroyed values and relationships for a person;

What are the subject’s own characteristics, needs, capabilities and abilities that can be relied upon when providing him with social rehabilitation assistance.

Types of social rehabilitation:

Depending on the nature and content of social or personal problems in which people are involved, both at their own request and in addition to it, and the content of the tasks that need to be solved, the following main types of social rehabilitation are used:

Medical rehabilitation (restoration of the physical and mental health and potential of a person or a certain social group, undermined as a result of strong external influences);

Legal rehabilitation (restoration of individual citizens or social groups in their legal and civil rights);

Political rehabilitation (restoration of political rights of innocent victims);

Moral rehabilitation (restoration of reputation, honor and dignity, image of an individual, social group or organization, work collective V the eyes of the public);

Economic or socio-economic rehabilitation (restoration of impaired economic and socio-economic status, both of an individual and a social group);

Socio-cultural rehabilitation (restoration of a cultural and spatial environment that has characteristics sufficient and necessary for creative activity and spiritual self-realization of people);

Social-pedagogical - aimed at solving such problems as overcoming the state of “pedagogical neglect” (additional or individual classes, organizing specialized classes), organizing and providing pedagogical assistance for various disorders of a person’s ability to receive education (organizing the educational process in hospitals and places of detention , training of disabled people and children with non-standard intellectual abilities, etc.). At the same time, certain work is expected to create adequate conditions, forms and methods of training, as well as appropriate methods and programs.

Professional and labor - allows you to form new or restore labor and professional skills lost by a person and subsequently employ him, adapting the regime and working conditions to new needs and opportunities.

Social-environmental - aimed at restoring a person’s sense of social significance within a new social environment. This type of rehabilitation includes introducing a person to the main characteristics of the environment in which he finds himself, helping in organizing a new living environment and restoring habitual patterns of behavior and activities to organize his own daily life.

Psychological rehabilitation (creation of a normal psychological climate for persons who have suffered traumatic shock). Psychological rehabilitation is considered as a system of special and targeted measures, due to which the restoration of various types of mental activity, mental functions, qualities and formations occurs, allowing a disabled person to successfully adapt to the environment and society, to accept and fulfill appropriate social roles, to achieve high level of self-realization.

The methodological apparatus of psychological rehabilitation includes activities on psychological counseling, psychotherapy, psychocorrection and psychological training. Especially often there is a need for measures aimed at relieving anxiety, neurotic reactions, at forming an adequate attitude towards the disease, towards those rehabilitation measures that are determined taking into account the entire complex of clinical, social and economic factors.

Each specific type of social rehabilitation determines the procedure and measures for its practical implementation. No matter how different the main types of social rehabilitation may be, their practical implementation requires reliance on a number of fundamental principles.

1. Timeliness and phasing of social rehabilitation measures, implying the timely identification of the client’s problem and the organization of consistent activities to resolve it.

2. Differentiation, consistency and complexity, aimed at implementing social rehabilitation measures as a single, holistic system of support and assistance.

3. Consistency and continuity in the implementation of social rehabilitation measures, the implementation of which allows not only to restore the resources lost by the subject, but also to anticipate the possible occurrence of problematic situations in the future.

4. Individual approach to determining the volume, nature and direction of social rehabilitation measures.

5. Availability of social rehabilitation assistance for all those in need, regardless of their financial and property status

One of the most important components of social rehabilitation is restoration of the individual's social status.

At the federal level, the main objectives of rehabilitation policy are: the formation of a strategy for social rehabilitation, its goals, objectives, priority areas and mechanisms; legal support for rehabilitation policy; financial support for State rehabilitation programs.

At the regional (local) level, the solution to rehabilitation problems should be carried out in relation to “local specifics”. The role of subjects of regional (local) rehabilitation policy is, first of all, local government bodies (both executive and legislative) and social protection bodies.

The strategic goal of rehabilitation policy at the regional (local) level can be defined as the return, based on the maximum use of existing social potential, into the bosom of public life and social relations of persons who, for a number of reasons, have found themselves maladapted and desocialized.

Social rehabilitation at the regional (local) level should include a number of the following most important tasks:

Adaptation of rehabilitation policy measures pursued by the Federal Government to local conditions;

Participation of local governments in coordinating the rehabilitation policy of the Federal Government;

Selection of priority directions and mechanisms of rehabilitation policy for a given social group, including satisfaction of its priority social needs;

Development and implementation of rehabilitation programs:

Ensuring economic, legal, organizational, managerial and other conditions for the implementation of rehabilitation policy within their competence, determined by federal legislation, and, mainly, through decentralized financial sources, i.e. from the local budget.

Social rehabilitation can be considered as an important component of social policy.

Still, a more correct understanding is “social rehabilitation”, which is associated with the category “social”, which covers all phenomena of social life, including all types of cultural, labor, economic and other activities. Thus, social rehabilitation becomes not just one of the directions of the state’s social policy, but should be considered as a priority.

The term "rehabilitation" (from Late Lat. rahabilitatio – “recovery”) is widely used in medicine and psychology, and since 1991 – in social work. Researchers interpret this concept differently. The concepts of “comprehensive rehabilitation” and “social rehabilitation” also appeared, which are used, as a rule, in working with people with disabilities. In theoretical terms, the content of these concepts has not been worked out, which allows them to be used in various interpretations, but does not allow the development of rehabilitation practice in relation to other categories of the population: persons with deviant behavior, convicts, orphans, elderly people, etc.

It seems that rehabilitation must be considered as the restoration by an individual of lost body functions, relationships and roles of social functioning, professional skills and skills of interaction with the outside world.

In accordance with these provisions, the following types of rehabilitation are distinguished: medical, social, professional, psychological, domestic.

Let us consider the essence and content of social rehabilitation. It seems that social rehabilitation must be considered in a broad and narrow interpretation.

Broadly interpreted social rehabilitation – This is the creation of conditions in society for the restoration and development of the abilities and skills of independent social functioning of individuals.

In a narrow interpretation, social rehabilitation is a system of forms, methods and means of restoration by an individual of functions, relationships and roles of social functioning lost or not acquired in the process of socialization.

Social rehabilitation is also a process of purposeful activity with an individual to restore skills and abilities lost or not acquired during socialization to perform social functions, relationships and roles.

The methodological basis of this approach is research into the structure and functioning of the client’s individuality, his social roles and social status. These studies were carried out by American researchers X. Perlman, S. Briar, G. Miller. Social roles are the engine of an individual's social well-being.

Under social functioning is understood the ability of an individual to independently interact with the outside world, to ensure his or her life activity and the life activity of the family, to comply with established and generally accepted standards of morality and morality in society.

If a person has lost or has not acquired in the process of socialization the skills and abilities of building social relationships and functions, then it is necessary to teach him how to create these skills and abilities (family, work, related to education, friendship, health promotion, raising the cultural level, life activities in everyday life). or restore.

If a person has lost or has not acquired social roles in the process of socialization (wife, husband, grandmother, grandfather, father, mother, son, daughter, citizen, neighbor, buyer, worker, friend, student, etc.), these roles must be developed , restore or teach to implement.

There are two types of levels of social rehabilitation.

1. Federal, regional, local levels.
2. Level of individual and group work.

At the federal, regional and local levels of social rehabilitation, a system of organizational, legal, economic, informational and educational measures taken by governing bodies is being built. The measures provide for the creation and operation of a system of rehabilitation social services of various departmental subordination and various forms of ownership.

On federal, regional and local levels the following actions are carried out:

1) creation of a legislative framework that provides the legal framework for rehabilitation activities;
2) determination of areas of training for bachelors and masters of social work, social educators, rehabilitation specialists, psychologists providing activities of rehabilitation social services;
3) creation of economic conditions for entrepreneurial and commercial activities in the field of rehabilitation;
4) development of regulations on the procedure for providing rehabilitation services to various categories of citizens;
5) coordination of the activities of the system of rehabilitation social services of various departmental subordination and various forms of ownership;
6) provision of premises for the organization and functioning of rehabilitation social services, etc.

On level of individual and group social rehabilitation work social services use technologies or a system of means, forms, methods and techniques to restore the individual’s lost or not acquired skills and abilities to perform social functions and roles, and to form the necessary social relationships.

Objects of social rehabilitation – These are individuals or groups that need to restore lost or not acquired skills and abilities in the process of socialization to interact in the system of social relations and perform social roles.

Objects of social rehabilitation can be disabled people, former prisoners, graduates of boarding schools, elderly people, asocial families, homeless people, neglected children, etc.

Subjects of social rehabilitation– These are professionals in the social sphere: bachelors and masters of social work, social educators, rehabilitation specialists, psychologists who are proficient in technology and have practical skills to restore lost or not acquired skills in performing social functions and roles.

The environment of social rehabilitation is the environment of living and functioning, social services, social activities, recreation, study, creative activities, and obtaining information.

Institutes of social rehabilitation are the state service of medical and social examination, social service institutions and services, social shelters, social rehabilitation centers, family and children assistance centers, post-boarding adaptation centers, social hotels, social service centers, etc., and also institutions of education and upbringing (kindergarten, school, university), institutions of additional education and upbringing (centers for the development of human potential, centers for vocational guidance and training, foster families, labor collectives).

As already mentioned, the technology of social rehabilitation involves the restoration of lost or unacquired skills in the performance of social relationships and roles in the process of socialization. In this regard, the technology of social rehabilitation is objectively related to the technologies of social diagnostics, social adaptation, socialization, guardianship, trusteeship, adoption, correction, prevention, social services, social examination.

Let's consider social rehabilitation of older people. First of all, it is necessary to determine which groups of older people need it, and then consider technologies for its implementation. There are two groups: older people with behavioral problems and antisocial manifestations and older people striving for active social functioning.

The first group includes the following categories of elderly people who clearly need rehabilitation:

1) returning from places of imprisonment;
2) experiencing domestic violence;
3) living alone;
4) disabled people;
5) abusing alcohol or drugs;
6) persons of the “homeless” group, etc.

The second group includes widows, widowers who have retired but want to work in another field, etc.

In the process of rehabilitation, for example, for older people who have returned from places of imprisonment, it is necessary to restore social life skills, teach life skills in new economic conditions, restore labor and professional skills, develop skills of ethical behavior in everyday life, in the family, with a wife and children , neighbors, etc.

All participants in the rehabilitation space should be involved in solving these problems: the clients themselves, local police officers, social work specialists, social pedagogy specialists, psychologists of social institutions in which these elderly people are located.

Methods of working with such older people are divided into individual and group. Conversations, role-playing games, various types of therapies, group classes, consultations, etc. are used as forms and techniques.

Social service centers use the following types of rehabilitation technologies for older people: psychological, socio-medical, leisure, social, etc.

Comprehensive rehabilitation is the sum of all costs and actions that provide the opportunity for people disabled due to congenital defects, illnesses or accidents to lead a normal life, find a place in society, and fully express their abilities.

For such people, an individual rehabilitation program is drawn up, which is a system of activities that develop the capabilities of a disabled person. The program is developed by a team of specialists (consisting of a doctor, social work specialist, teacher, psychologist, etc.) together with relatives. In many countries, such a program is managed by one specialist - this can be any of the listed specialists who monitors and coordinates the rehabilitation program (specialist supervisor). The system of measures takes into account both the state of health and the characteristics of its development, as well as the capabilities and needs of the family. A rehabilitation program can be developed for different periods, depending on the age and developmental conditions of the disabled person.

After a set period of time, a case manager (usually a social work specialist) meets with the family to discuss progress, successes and failures. It is also necessary to analyze the positive and negative unplanned events that occurred during the implementation of the program.

After this, the specialist (team of specialists) together with the disabled person develop a rehabilitation program for the next period.

A rehabilitation program is a clear plan, a scheme of joint actions of a person and specialists, promoting the development of his abilities, health improvement, and social adaptation (for example, vocational guidance). Moreover, measures are necessarily provided for other members of the family of a disabled person: their acquisition of special knowledge, psychological support, assistance to the family in organizing rest, recuperation, etc. Each period of the program has a goal, which is divided into a number of subgoals, since it is necessary to work in several directions at once, involving different specialists in the rehabilitation process.

To draw up such a program, it is necessary to have clear, specific ideas about the problems of functioning, psychological development and socialization of a disabled person.

Babenkova R. D., Ishyulktova M. V., Mastyukova E. M. Raising children with cerebral palsy in the family. M., 2001.

Social rehabilitation is a set of measures aimed at restoring a person’s rights, social status, health, and legal capacity. This process is aimed not only at restoring a person’s ability to live in a social environment, but also the social environment itself, living conditions that are disrupted or limited for any reason.
The implementation of social rehabilitation largely depends on compliance with its basic principles. These include: phasing, differentiation, complexity, continuity, consistency, continuity in the implementation of rehabilitation measures, accessibility and predominantly free for those most in need (disabled people, pensioners, refugees, etc.).
Within the framework of social rehabilitation activities, scientists identify various levels, among them usually called: medical-social, professional-labor, socio-psychological, social-role, social-domestic, social-legal.
In practical social work, rehabilitation assistance is provided to various categories of people in need. Depending on this, the most important areas of rehabilitation activity are determined. These areas should, first of all, include: social rehabilitation of people with disabilities and children with disabilities; old people; military personnel who participated in wars and military conflicts; rehabilitation of persons who have served their sentences in prison, etc.
One of the priorities of modern social policy is the social protection of people with disabilities, the most important area of which is rehabilitation.
The main types of rehabilitation of disabled people are: medical, social-environmental, professional-labor and psychological-pedagogical. Medical rehabilitation includes a set of medical measures aimed at restoring or compensating for impaired or lost body functions that led to disability. These are measures such as rehabilitation and sanatorium-resort treatment, prevention of complications, reconstructive surgery, prosthetics and orthotics, physiotherapy, physical therapy, mud therapy, psychotherapy, etc. The state guarantees disabled people full provision of all types of medical care, including medications. All this is carried out free of charge or on preferential terms in accordance with the legislation of the Russian Federation and the legislation of its constituent entities.
Social-environmental rehabilitation of disabled people is a set of measures aimed at creating an optimal environment for their life, providing conditions for restoring social status and lost social connections. Such rehabilitation activities are aimed at providing disabled people with special equipment and equipment that allows them to be relatively independent in everyday life.
In Russia, at least three quarters of the total number of disabled people need technical means of rehabilitation. Until recently, there were only thirty types of rehabilitation products in the country, compared to two thousand that were known in the world. As a result of the implementation of the federal comprehensive program “Social Support for the Disabled,” adopted by the government in January 1995, the situation began to change for the better. At the beginning of 1998, there were already more than 200 types of rehabilitation products for the disabled.
Vocational and labor rehabilitation of disabled people is understood as a system of state-guaranteed measures for vocational guidance, vocational training and employment of disabled people in accordance with their health, qualifications and personal inclinations. Measures for vocational and labor rehabilitation are implemented in relevant rehabilitation institutions, organizations and in production. In particular, medical and social expert commissions and rehabilitation centers provide vocational guidance. Vocational training is carried out in regular or specialized educational institutions for the training of specialists in various fields, as well as in the system of industrial and technical training at enterprises. Employment of disabled people who are unemployed is carried out by employment services, where there are special units for this purpose.
It should be noted that there are specific features of employment of disabled people in rural areas. They use such forms of employment as work as part of specialized field teams, individual procurement of wild products, work in auxiliary industries and at home producing small products.
Psychological rehabilitation allows a disabled person to successfully adapt to the environment and society as a whole.
An individual rehabilitation program for a disabled person includes a set of rehabilitation measures that are optimal for him. Developed on the basis of a decision of the State Service for Medical and Social Expertise, it contains both rehabilitation measures provided to a disabled person free of charge in accordance with the federal basic program for the rehabilitation of disabled people, and those in which the disabled person himself or other individuals and organizations participate in the payment.
Crisis phenomena characteristic of the current state of the Russian economy have a negative impact on the situation of vulnerable groups of the population, including children with disabilities. Their numbers are steadily growing.
According to experts, rehabilitation of disabled children should begin at the earliest stages of the disease and be carried out continuously until maximum recovery or compensation of impaired functions is achieved in the shortest possible time. Individual comprehensive rehabilitation programs for disabled children should reflect not only the main aspects of rehabilitation (medical, psychological, pedagogical, social, welfare), but also rehabilitation measures, their scope, timing and control.
In orphanages for children with disabilities, a contingent with varying degrees of damage to the musculoskeletal system is concentrated. Here, sports and recreational work and vocational training are widely used for their rehabilitation. In boarding schools, training and production workshops are created mainly in two profiles:
carpentry and sewing. In many boarding schools, disabled children are also taught the professions of accountancy, typing and the basics of office work.
The problematic side of the rehabilitation process in boarding homes for children with disabilities is its certain isolation. There is no opportunity for wider communication between disabled children and a healthy environment, which leaves a unique imprint on the level of socialization of children and makes it difficult for them to adapt to society. Such problems are better solved in rehabilitation centers for children and adolescents with disabilities. The approximate regulations on these centers were approved by the Ministry of Social Protection of the Population of the Russian Federation in December 1994. In accordance with it, the purpose of the center’s activities is not only to provide children and adolescents with disabilities in physical or mental development with qualified medical, social, psychological and social , social and pedagogical assistance, but also providing them with the most complete and timely adaptation to life in society, family, learning and work. Thus, in the rehabilitation center for out-of-school education “Creativity”, which successfully functioned in Samara in the second half of the 90s, the education of school-age disabled people in the additional education system was carried out in a team of healthy students. The former learned not to be ashamed of their illness, they quickly developed the necessary communicative knowledge, and the latter learned to see full-fledged people in their fellow students.
Although in recent years more and more similar rehabilitation centers have been opening in our country, their number is not enough. Not every disabled person can afford the costs of undergoing certain courses of medical and social and labor rehabilitation. In this regard, the experience of distant Australia deserves attention, where a disabled person, undergoing a course of social, labor and medical rehabilitation, receives supplements to his disability pension. And they almost completely cover all expenses for these purposes.
Social and, above all, medical and social rehabilitation is becoming important for the lives of older people. Due to the natural aging of the body, a number of chronic diseases become more common with age, and the number of people in need of constant medical supervision is growing. Issues of medical and social rehabilitation of older people are professionally resolved in wide-profile rehabilitation centers and specialized gerontological centers.
Gerontological centers usually use medicinal, non-medicinal and organizational methods of medical and social rehabilitation of older people. Medication includes restorative, symptomatic, stimulating and other types of therapy. Non-drug treatments include massage, physiotherapy, psychotherapy, acupuncture, herbal medicine, etc. The appointment of a separate regime (bed, observation, free), clinical observation, inpatient treatment are an organizational method of medical and social rehabilitation.

Rehabilitation of elderly people in boarding homes has its own characteristics. The introduction of rehabilitation is determined, first of all, by the need to preserve the social connections of the elderly living here. And this is facilitated by collective activity, joint participation in labor processes. The organization of the rehabilitation process in inpatient social service institutions for the elderly is based on modern ideas about the benefits of a person’s mobile, active lifestyle. The means of rehabilitation of older people in boarding homes are occupational therapy workshops, special workshops, subsidiary farms, etc.
In modern Russia, many elderly people who find themselves in difficult life situations need rehabilitation. To support such people and their rehabilitation, special crisis centers began to be created in a number of regions of the country. Thus, in 1998, crisis centers were opened in two districts of Voronezh for elderly people who found themselves in difficult life situations. They can come here for three weeks. Here they are provided with free medical care and food. The centers operate hairdressers and repair shops, whose services are also free.
The increase in crime in the country and increased social ill-being in society stimulate antisocial behavior among children. The number of socially maladaptive children is increasing. Social maladjustment is characterized not only by the severance of children’s connections with parents, teachers, peers, and the deformation of their value orientations, but also by a disruption of the child’s most important activities from play to study. And without all this there can be no full-fledged psychological development and socialization. Social maladaptation manifests itself in such deviations as vagrancy, violation of moral norms, illegal actions, drug addiction, substance abuse, etc.
For the 90s The number of street children in the country has increased by more than one and a half times. Children are fleeing from parental cruelty, the asocial lifestyle that reigns in individual families, they are fleeing from “hazing”, anti-pedagogical treatment in orphanages. The attitude towards them and the methods of maintaining these children cannot be the same as for teenagers with alcoholism and drug addiction or juvenile delinquents. Although they all need rehabilitation, its forms may be different. For some, temporary isolation and the strict regime used in reception centers are acceptable. For the vast majority of maladjusted minors, the place of rehabilitation should be social shelters and social rehabilitation centers.
Military personnel - veterans of wars, military conflicts and their families - need special rehabilitation. The rehabilitation system for such military personnel is implemented in three main areas: social, psychological and medical. Ensuring the socialization of the individual and restoring its previous level become the goal of social rehabilitation. The main tasks of social rehabilitation of military personnel - participants in military conflicts are: ensuring their social guarantees, monitoring the implementation of social benefits, legal protection, forming a positive public opinion and involving military personnel in the system of social relations. According to experts, the main psycho-traumatic impact of a combat situation is the rather long stay of military personnel under conditions of specific combat stress.
It should be recognized that the effect of stress performs a certain positive function for a person during the battle, but becomes a negative, destructive factor after its end due to post-stress reactions. This can manifest itself in unmotivated aggression towards family, friends and even random people. Or, on the contrary, in a depressed state, in an attempt to withdraw into oneself with the help of alcohol and drugs. The so-called “switched off” personality, detachment from everything that happens around, frequent and prolonged static posture, gaze, loss of interest in life indicate the initial stages of mental disorders. Such persons need medical and psychological assistance, special psychocorrection measures and psychotherapy. In individual conversations, it is necessary to give them the opportunity to express all the painful things, showing interest in their story. Then it is advisable to explain that the state they are experiencing is temporary, inherent to everyone who took part in hostilities. It is very important that they feel understanding and see the willingness to help them not only from specialists - social psychologists, but also from loved ones and relatives.
A powerful means of psychological rehabilitation is the sincere manifestation of understanding and patience towards the problems of persons who have survived psycho-traumatic war conditions. The lack of such understanding and patience on the part of loved ones sometimes leads to tragic consequences.
It should also be noted that parents and family members of combatants also need certain rehabilitation measures and psychological assistance. After all, they themselves were in a traumatic situation, expecting daily terrible news about their dear and beloved. Moreover, sometimes different people return to their mothers and wives, in whom it is difficult to guess the former loved one. Special centers and clubs for relatives of people who have gone through war and military conflicts can be a means of rehabilitating such families.
A special area of rehabilitation activity is the restoration of the legal and social status of persons who have served their sentences in places of deprivation of liberty. These people, having received freedom, and with it the right to independently organize their lives, often do not have not only housing, but also the opportunity to get a job. In modern conditions, when there is a real increase in unemployment, it is increasingly difficult for former prisoners to solve the problem of employment. Realizing this, some leaders, mainly from rural areas, create labor brigades (a kind of communes) from former prisoners. They are provided with housing and the opportunity to earn a living through rural labor. But there are only a few such manager-trustees.
This matter should be dealt with, first of all, by the state, helping those former prisoners who are not welcome at home, who need psychological and other forms of rehabilitation assistance. After all, a former prisoner, unable to find work and housing, again takes the path of crime or joins the ranks of the homeless. There are shelters for the latter, and some former prisoners may end up here. But another part of them goes into crime. As a result, “saving” funds for the creation of specialized rehabilitation centers for persons who have served their sentences in places of deprivation of liberty results in large losses and social costs for the state.
Social rehabilitation, being one of the general technologies of social work, is aimed at restoring not only health and ability to work, but also the social status of an individual, his legal status, moral and psychological balance, and self-confidence. Depending on the specifics of the rehabilitation object, methods of rehabilitation influence are determined, supplemented by appropriate private technologies of social work.

LITERATURE
Fundamentals of social work. Textbook. / Rep. ed. PD. Lenok peacock. - M., 1997.
Psychological and pedagogical rehabilitation of children and adolescents with disabilities and learning problems. Brief dictionary-reference book. - Rostov n/d, 1997.
Social work. Russian Encyclopedic Dictionary./ Ed. ed. IN AND. Zhukova. - M., 1997.
Social work with disabled children. Scientific and practical recommendations. Issue 1. - Rostov n/d, 1998.
Social, everyday and labor rehabilitation of disabled people. / Ed. A.I. Osadchikh. - M., 1997.
Reference book on social work./ Ed. AM. Panova, E.I. Single. - M., 1997.
Theory and methodology of social work./ Rep. ed. P.D. Pavlenok. - M., 1993.
Social work technology. Part I. Textbook. manual for universities (materials for practical classes) / Ed. L.Ya. Tsitkilova. - Novocherkassk. - Rostov n/d, 1998.

Social rehabilitation

The WHO Committee defined medical rehabilitation:
rehabilitation is an active process whose goal is
achieving complete restoration of damage caused by
illness or injury to functions, or, if this is not possible -
optimal realization of physical, mental and social
potential of a disabled person, his most adequate integration into society.
Thus, medical rehabilitation includes measures to
prevention of disability during illness and assistance
individual in achieving maximum physical, mental,
social, professional and economic usefulness, on
which he will be able to do within the framework of the existing disease.
Among other medical disciplines, rehabilitation occupies a special place.
place, as it considers not only the state of organs and systems
body, but also the functional capabilities of a person in his
daily life after discharge from medical
institutions.
In recent years, the concept of “quality of life,
health related.” At the same time, it is the quality of life that is considered
as an integral characteristic to which one must focus when
assessing the effectiveness of rehabilitation of sick and disabled people

One of the most important tasks of social work is to preserve and maintain a person, group or team in a state of active, creative and independent attitude towards oneself, one’s life and activities. In its solution, the process of restoring this state, which can be lost by the subject for a number of reasons, plays a very important role. Any social subject, regardless of the degree of complexity, throughout his life repeatedly encounters situations when the established and habitual model of life activity is destroyed, established social connections and relationships are broken, and the social environment of his life activity changes with varying degrees of depth. In such circumstances, the subject needs not only to get used to and adapt to new conditions of existence, but also to regain lost social positions, restore physical, emotional and psychological resources, as well as important and significant social connections and relationships for the subject. In other words, a necessary condition for successful and effective social support of a person or group
are the restoration of their socially and personally significant qualities and characteristics and overcoming the situation of social and personal insufficiency.
This task can and should be successfully solved in the process of organizing and
carrying out social rehabilitation of the subject.
Social rehabilitation is a set of measures aimed at restoring destroyed or lost for any reason social connections and relationships, socially and personally significant characteristics, properties and capabilities of the subject. This is a conscious, purposeful, internally organized process (23.P.327).
The need for social rehabilitation is a universal social
phenomenon. Each social subject, regardless of the degree of his social well-being at a given time, throughout his life is forced to change his usual social environment, forms of activity, expend his inherent strengths and abilities and face situations that inevitably and necessarily lead to certain losses . All this leads to the fact that a person or group begins to feel the need for certain social rehabilitation assistance.
Factors that determine the subject’s need for social
rehabilitation measures can be divided into two main groups:
1.Objective, i.e. socially or naturally determined:
- age-related changes;
- natural, man-made or environmental disasters;
- serious illness or injury;
- social disasters (economic crisis, armed conflict,
growth of national tension, etc.).
2.Subjective or personally determined:
- changing the goals, interests and value orientations of the subject and
his own actions (leaving the family, voluntarily resigning, or refusing to continue his studies);
- deviant forms of behavior, etc.
Under the influence of these and similar factors, a person or group,
first, are pushed to the periphery of social life, gradually acquiring
some marginal qualities and characteristics and, secondly, lose
a sense of identity between oneself and the outside world. The most important and
The most dangerous elements of this process for the subject are:
- destruction of the usual system of social connections and relationships;
- loss of habitual social status and its inherent model of status behavior and status perception of the world;
- destruction of the habitual system of social orientation of the subject;
- reduction or loss of ability to independently and adequately evaluate
yourself, your actions, the actions of people around you and, as a result, accept
independent decisions.
The result of these processes is a situation of social or personal failure, which may be accompanied by the destruction of the human personality.
In real social life, the processes described above can occur in a variety of forms. This may be the formation of a feeling of confusion and “uselessness” to others in a retired person, a sharp
reduction of social contacts and connections by the disabled or seriously ill
by a person, withdrawal into deviant or “non-traditional” forms of behavior and activity of a person who has been “torn out” from the usual and understandable social environment and has not found himself in a new one. As a result, a sharp deterioration in physical and mental health is possible, the subject may lose interest in himself, in his own life.
It is extremely important that such a situation does not drag on for long,
so that a person himself or with the help of other people can restore active,
interested attitude towards yourself, people and the world around you. The content of the process of social rehabilitation consists in the actual restoration of habitual responsibilities, functions and activities, habitual and comfortable relationships with people. The solution to this problem does not imply a mandatory “return” of the subject to social positions lost for one reason or another. It can be solved through achieving new social status and social positions and acquiring new opportunities.
In the process of organizing and implementing social activities
rehabilitation is important not only to help a person or a group of people. It is necessary to provide them with the opportunity for active life, guarantee a certain level of social stability, demonstrate possible prospects within the new social status and create a sense of their own importance and need and a sense of responsibility for their subsequent life activities.
This is what determines the goals and means of the process of social rehabilitation.
The means of social rehabilitation available to modern society include the following systems:
- healthcare;
- education;
- professional training and retraining;
- means of mass communications and mass media;
- organizations and institutions of psychological support, assistance and correction;
- public and non-governmental organizations working in the field
solving specific social and personal problems (employment of people with disabilities or minors, assistance to victims of sexual or family violence, etc.).
The main goals of social rehabilitation can be characterized as follows. Firstly, the restoration of the social status, the social position of the subject. Secondly, the subject’s achievement of a certain level of social, material and spiritual independence. And, finally, thirdly, increasing the level of social adaptation of the subject to new living conditions.
When organizing a conscious and purposeful process of achieving these goals, it is necessary to remember that often the object of social rehabilitation activities is an adult, formed as a person, with an established system of needs, interests and
ideals, and with an established system of skills, knowledge and skills. This circumstance leads to the fact that, having lost the capabilities of life that are familiar to him, a person strives for their complete and absolute restoration, and in the shortest possible time. Such a desire may be expressed in the fact that he rejects attempts to provide him with a new social status and new opportunities for self-realization and life. Such resistance is a natural primary human reaction to a negative change in the usual image and lifestyle. In such conditions, a specialist organizing the process of social rehabilitation must clearly understand the following:
- what is the reason for the specific crisis situation in which the subject finds himself;
- how relevant and significant are lost or destroyed values and relationships for a person;
- what are the subject’s own characteristics, needs, capabilities and abilities that you can rely on, providing him with social
rehabilitation assistance (30).
Depending on the nature and content of social or personal
problems in which people become involved, both of their own free will and
in addition to it, and the content of the tasks that need to be solved, apply
the following main types of social rehabilitation.
1. Socio-medical - includes restorative and reconstructive therapy, restoration or formation of new skills for a full life in a person and assistance in organizing everyday life and housekeeping.
2. Socio-psychological - designed to increase the level of mental and psychological health of the subject, optimize intra-group connections and relationships, identify the potential capabilities of the individual and organize psychological correction, support and assistance.
3. Social and pedagogical - aimed at solving problems such as
overcoming the state of “pedagogical neglect” (additional or individual classes, organizing specialized classes), organizing and providing pedagogical assistance for various impairments of a person’s ability to receive education (organizing the educational process in hospitals and places of detention, teaching disabled people and children with non-standard intellectual abilities, etc. .P.). At the same time, certain work is expected to create adequate conditions, forms and methods of training, as well as appropriate methods and programs.
4. Professional and labor - allows you to form new or restore lost labor and professional skills by a person and subsequently employ him, adapting the regime and working conditions to new needs and opportunities.
5. Social-environmental - aimed at restoring a person’s feelings
social significance within a new social environment for him. This type of rehabilitation includes introducing a person to the main characteristics of the environment in which he finds himself, helping in organizing a new living environment and restoring habitual patterns of behavior and activities to organize his own daily life.
Each specific type of social rehabilitation determines the order and
measure by its practical implementation. No matter how different the main types of social rehabilitation may be, their practical implementation requires reliance on a number of fundamental principles.
1. Timeliness and phasing of social rehabilitation measures, implying timely identification of the client’s problem and organization of consistent activities to resolve it.
2. Differentiation, consistency and complexity, aimed
for the implementation of social rehabilitation measures as a single, complete system of support and assistance.
3. Consistency and continuity in the implementation of social rehabilitation measures, the implementation of which allows not only to restore the resources lost by the subject, but also to anticipate the possible occurrence of problematic situations in the future.
4.Individual approach to determining the volume, nature and direction of social rehabilitation measures.
5. Availability of social rehabilitation assistance for all those in need, regardless of their financial and property status (23.P.328).
The ultimate and main goal of the social rehabilitation process is
development in a person of the desire to independently combat difficulties, the ability to resist the negative influences of the environment and mobilize one’s capabilities to create one’s own “I”

Basic principles of rehabilitation

The basic principles of rehabilitation include:

· early start of rehabilitation measures (RM),

· comprehensive use of all available and necessary PM,

· individualization of the rehabilitation program,

stage of rehabilitation,

·continuity and continuity throughout all stages of rehabilitation,

social orientation of the Republic of Moldova,

·use of methods to monitor the adequacy of loads and the effectiveness of rehabilitation.

Early startRM important from the point of view of preventing the possibility of degenerative changes in tissues (which is especially important in neurological diseases). Early inclusion in the treatment process of RMs that are adequate to the patient’s condition largely ensures a more favorable course and outcome of the disease and serves as one of the aspects of disability prevention (secondary prevention).

PM cannot be used in very serious condition of the patient, high temperature, severe intoxication, severe cardiovascular and pulmonary insufficiency of the patient, sharp inhibition of adaptation and compensatory mechanisms. However, this is not absolutely true, since some RM, for example, inflating balloons, are prescribed in the acute postoperative period when the patient’s condition is quite serious, but this serves to prevent congestive pneumonia.

Complexity of applicationall available and necessaryRM. The problems of medical rehabilitation are very complex and require the joint work of many specialists: therapists, surgeons, traumatologists, physiotherapists, doctors and methodologists of exercise therapy and physical rehabilitation, massage therapists, psychiatrists, adequate to the physical and mental state of the patient at individual stages of rehabilitation. Depending on the reasons that led the patient to a condition requiring the use of RM, the composition of specialists and the methods and means used will be different.

Individualization of rehabilitation programs. Depending on the reasons requiring the use of RM, as well as the characteristics of the patient’s or disabled person’s condition, their functional capabilities, motor experience, age, gender, the composition of specialists and the methods and means used will be, that is, rehabilitation requires an individual approach to patients, taking into account their reaction to use of PM.

Continuity and continuityRM throughout all stages of rehabilitation is important both within one stage and during the transition from one to another. The functional state of various body systems improves, fitness increases, and any longer or shorter break in the use of RM can lead to its deterioration, when you have to start all over again.

An extremely important principle of rehabilitation is continuity during the transition from stage to stage, from one medical institution to another. For this, it is important that at each stage the rehabilitation card documents what methods and means of treatment and rehabilitation were used, what was the functional state of the person being rehabilitated.

Social orientationRM. The main goal of rehabilitation is the effective and early return of sick and disabled people to everyday and work processes, into society and family, and the restoration of a person’s personal qualities as a full member of society. The optimal end result of medical rehabilitation may be a complete restoration of health and a return to normal professional work.

Using methods to monitor load adequacy and efficiencyrehabilitation. The rehabilitation process can be successful only if the nature and characteristics of the recovery of functions impaired by a particular disease are taken into account. To prescribe adequate comprehensive differentiated rehabilitation treatment, a correct assessment of the patient’s condition according to a number of parameters that are significant for the effectiveness of rehabilitation is necessary. For these purposes, special diagnostics and methods of monitoring the current condition of the patient during the rehabilitation process are used, which can be divided into the following types.