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Ch. 3 Psychological Aspects of Rehab

Ch. 3 Psychological Aspects of Rehab. Responses to Injury. Cognitive Emotional Behavioral. Response-Injury Severity Relationship. Short Term (4 weeks or less) Long term (more than 4 weeks) Chronic (recurring) Termination ( career ending). Short Term. Respond with shock

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Ch. 3 Psychological Aspects of Rehab

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  1. Ch. 3 Psychological Aspects of Rehab

  2. Responses to Injury Cognitive Emotional Behavioral

  3. Response-Injury Severity Relationship • Short Term (4 weeks or less) • Long term (more than 4 weeks) • Chronic (recurring) • Termination ( career ending)

  4. Short Term • Respond with shock • Then relief that it is not severe • They can be impatient when it comes to rehab

  5. Long Term • Respond with fear and anger • DABDA • Loss of vigor, irrational thoughts, alienation during sessions • Psychological intervention is sometimes helpful

  6. Chronic Injuries • Frustrated and angry to be in rehab again • Extreme reactions during rehab • Either willing to try any treatment or resistant to all protocols and skeptical

  7. Termination Injuries • Experience all stages of the grief process • Isolation is common • May experience loss of identity • Clinicians may want to help draw patients to new activities

  8. Emotional Responses • Grief • Anger • Anxiety • Stress • Depression

  9. Phases of Adjustment • Shock • Realization • Mourning • Acknowledgement • Coping and reformation

  10. Shock • Understand the individual may not be receptive • Proceed slowly with information • Allow patient time to assess situation

  11. Realization • Avoid well-wisher statements • Respond empathetically • Recognized challenges faced by patient

  12. Mourning • Don’t be judgemental • Provide constant support • Offer encouragement, recognize progress • Help them focus on what they can do rather than what they can’t

  13. Acknowledgement • Listen to individual’s concerns • Encourage activities that are self re-inforcing • Introduce social contact, modeling

  14. Coping and Reformulation • Foster trust and confidence • Never ignore or discourage patient • Build self confidence and physical competence • Incorporate mental training interventions

  15. Behavioral Responses • Coping mechanisms • Adherance

  16. Types of Patients • “The Malingerer” • “The Pediatric Athlete” • “The Elite Athlete” • “The Senior Adult”

  17. Role of the Clinician • Explain the rehab process • Develop rapport

  18. Rehabilitation Adherence Strategies • Set effective goals • Specific and measureable • Written goals • Can be posted • Short term • Attainable • Based on physical rehab steps

  19. Rehabilitation Adherence Strategies • Self monitoring and acceptance of responsibility • Effort • Follow instructions • Honestly reporting pain • Choices with where to start • Keep logs of therapy sessions

  20. Rehabilitation Adherence Strategies • Promote the use of imagery • Enhances feelings of control • Increases focus and confidence • Reduces anxiety and stress • Speeds up recovery • Patients use it to see and feel their body mending

  21. Rehabilitation Adherence Strategies • Positive Self Talk • Internal monologue • Be an optimist • Remain realistic and objective • Focus on the present • View “problems” as challenges rather than threats • View successes as replicable • Concentrate on the controllable • Separate performance from self worth • Provide social support

  22. Pain Management • Ice • Ultrasound • Electrical stimulation • Acupressure • Massage • Medicine • Imagery • Relaxation • Association and dissociation methods

  23. Pain Management • Soothing Imagery: • -creating a restful image • Relaxation: • -greater blood flow, less tension • -less sympathetic nerve response • Association: • -reinterprets pain as a challenge • Dissociation: • -directing attention away from pain

  24. Return to Play • Talk to them about concerns • Discuss confidence, fear of re-injury and focus • Help them understand that they are healed • Encourage them to imagine a successful return

  25. Career Ending Injuries • Have more physical and mental health problems • Financial concerns • Isolation • Provide alternate activity options

  26. Steps to Successful Referral • Look for symptoms off maladjustment to injury • Consult a mental health professional • Express concern for the patient • Allow the patient to ask questions and discuss concerns • Obtain written consent to share information with the referral source • Give patient information to schedule appt. • Check to see if appt was made.

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