Traditional medicine

Social rehabilitation: technologies and methods. Abstract: Types, levels and principles of social rehabilitation Human need for social rehabilitation

Activities aimed at restoring a person’s lost functions in society, lost social connections and relationships due to disability, age-related changes or being in a crisis situation (prison, vagrancy, etc.). R.s. is a system of economic, social and legal measures that ensure the maintenance at a certain level of equal opportunities for participation of a person with certain disabilities in the life of society with other citizens. Activities for R.s. include social and everyday orientation and social and environmental adaptation, social services in specialized institutions for social protection and other departmental affiliation, the provision of socio-psychological assistance, as well as physical rehabilitation using special technical means, and other types of social assistance. All these activities are determined by the federal basic program for the rehabilitation of disabled people, territorial target programs for medical and social rehabilitation of disabled people and the regional basic list of technical means of rehabilitation. For those who have been disabled since childhood, R.s. should be carried out from the first days of life. In the situation of becoming disabled in old age, people need additional support measures, because... they experience more difficulties due to the decreasing adaptive capabilities of the body and psyche as they age. r.s. for elderly people and people with disabilities, it can be carried out in day care departments of social service centers, in the process of home care, or, along with medical measures, in centers for medical and social rehabilitation of people with disabilities. r.s. includes the following areas: - socio-economic rehabilitation - material support for a person and his family through pensions, benefits, various types of targeted in-kind assistance (food, clothing, household items); - social and everyday rehabilitation - assistance in a person’s adaptation to his physical disability and restoration of self-care skills - training in everyday self-care skills, using special devices for self-care, training in housekeeping skills in new conditions for a person limiting one’s own capabilities; - social and environmental rehabilitation - adaptation of the environment to the specific needs of disabled people - provision of means of transportation, prosthetic and orthopedic assistance, hearing aids, typhotechnics, etc. (see Social policy regarding people with disabilities), as well as ensuring access to information through counseling about rights, benefits, etc.; - sports rehabilitation - Physical education and health activities for the disabled. For elderly people with disabilities, the most appropriate are health groups, where an instructor, under the supervision of a doctor, conducts physical therapy and correctional classes, teaching special physical exercises that a person can do at home. r.s. is achieved through a whole range of rehabilitation measures and involves an individual approach. The initiative to contact a medical and social rehabilitation center can come from both the person himself and the doctor or social worker providing assistance to him. In such a center, an individual rehabilitation program is developed, which reflects all the forms, volumes and timing of various areas of rehabilitation necessary for a given person. The social worker has the function of coordinating all these activities, maintaining relations with health authorities, employment, legal services, the district social service institution, as well as with the family of a person with a disability. The content and measures of R.s are defined in the Federal Law “On Social Protection of Disabled Persons in the Russian Federation” dated November 24, 1995 Ng181-FZ, as well as in the Law “On the approval of a comprehensive target program for medical, social and professional rehabilitation of disabled people in the Samara region and providing them accessible living environment for 2001-2005.” dated 22.02.2001 Ng 15-GD.

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; elderly 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 general 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” and 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.
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. V.I. 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.

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” and 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.
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.

Social rehabilitation

Social rehabilitation- is a set of activities carried out by public, private and public organizations aimed at protecting the social rights of citizens. The process of social rehabilitation is a process of interaction between the individual and society, which includes, on the one hand, a way of transferring social experience to an individual, a way of including him in the system of social relations, and on the other hand, a process of personal change.

Social rehabilitation as a technology of social work

Social rehabilitation as a technology of social work is the restoration of the social status of a person, a group of people, lost or reduced due to problems that created a difficult situation in their life. Such problems include disability, migration, unemployment, serving a sentence in prison, etc.

Goals and means of social rehabilitation

In the process of organizing social rehabilitation, it is necessary to provide an opportunity for a person or group of people to actively live, guarantee a certain level of social stability, demonstrate possible prospects within a new social status and create a sense of one’s own importance and need and a sense of responsibility for one’s subsequent life activities. This is what determines the goals and means of the process of social rehabilitation. The means of social rehabilitation include the following systems:

vocational 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 of solving specific social and personal problems.

The main goals of social rehabilitation include: restoration of social status, social position of the subject, achievement by the subject of a certain level of social, material and spiritual independence and increasing the level of social adaptation of the subject to new living conditions.

Types of social rehabilitation

Depending on the social or personal problems of people that need to be solved, the following main types of social rehabilitation are used:

Socio-medical is the restoration or formation of new skills for a full life in a person and assistance in organizing everyday life and housekeeping; it also includes restorative and reconstructive therapy.
Socio-psychological is the restoration of the mental and psychological health of the subject, optimization of intra-group

new connections and relationships, identifying the potential of the individual and organizing psychological correction, support and assistance.

Social-pedagogical is the organization and implementation of pedagogical assistance for various disorders of a person’s ability to receive education, certain work to create adequate conditions, forms and methods of teaching, as well as appropriate methods and programs.
Professional and labor - the formation of new or restoration of labor and professional skills lost by a person and in

subsequently his employment.

Social-environmental - restoration of a person’s sense of social significance within a new social environment.

Principles of social rehabilitation

The practical implementation of the main types of social rehabilitation is based on a number of fundamental principles:

Timeliness and phasing of social rehabilitation measures, implying timely identification of the client’s problem and the organization of consistent activities to resolve it.
Differentiation, consistency and complexity aimed at implementing social rehabilitation measures as a single, holistic system of support and assistance.
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.
An individual approach to determining the volume, nature and direction of social rehabilitation measures.
Availability of social rehabilitation assistance for all those in need, regardless of their financial and property status.

Medical and social rehabilitation

Medical and social rehabilitation is a process whose goal is to prevent disability during the treatment of a disease and help patients achieve the physical, mental, professional, social and economic fullness of which they are capable within the framework of the existing disease.

Literature

Kuznetsova L.P. Fundamentals of social work technology: textbook. - Vladivostok, 2002
Social work: theory and practice: Proc. Benefit / Answer. ed. Doctor of History, prof. E. I. Kholostova, Doctor of Historical Sciences, Prof. A. S. Sorvina. - M.: INFRA-M, 2001. - 427 p.
Dictionary-reference book for social work. - M.: Yurist, 1997 p. 328