Rehabilitation

A process geared toward helping persons suffering from an injury, disease, or other debilitating condition to reach their highest possible level of self-sufficiency.

Rehabilitation begins once a debilitating condition has been evaluated and treatment is either in progress or completed. Impairments are evaluated for their effects on the individual's psychological, social, and vocational functioning. Depending on the type of disability involved, "self-sufficiency" may mean a full-time job, employment in a sheltered workshop, or simply an independent living situation. Rehabilitation involves a combination of medicine, therapy, education, or vocational training. There are special centers for various mental and physical problems that require rehabilitation, including psychiatric disorders, mental retardation, alcohol dependence, brain and spinal cord injuries, stroke, burns, and other physically disabling conditions.

The goal of medical rehabilitation is the restoration of normal functioning to the greatest degree possible. Specialities involved include physical, occupational, and speech therapy, recreation, psychology, and social work. Medical rehabilitation facilities often include an "activities of daily living" (ADL) department, which offers activities in a simulated apartment setting where patients may learn and practice tasks they will need in everyday living. Also included in the field of medical rehabilitation is a special area called rehabilitation technology (formerly rehabilitation engineering), developed during the 1970s and 1980s, that deals with prosthetics (devices attached to the body) and orthotics (equipment used by disabled people). In addition to the actual engineers who design these products, rehabilitation technology also includes professionals who serve as consultants to manufacturers on the design, production, and marketing of medical devices.

Vocational rehabilitation helps the client achieve a specific goal, which can be either a type of employment (competitive, sheltered, volunteer) or a living situation. Services include prevocational evaluation, work evaluation, work adjustment, job placement, and on-the-job training. Facilities offering vocational rehabilitation include state-supported local units in hospitals, the Veterans Administration, sheltered workshops, insurance companies, and speech and hearing clinics. Rehabilitation counseling is a relatively new field whose support personnel offer a variety of services to the disabled, particularly that of coordinating and intergrating the various types of assistance available to a particular client. The rehabilitation counselor also assists in locating job opportunities, interpreting test results, and assisting with personal problems.

Since the 1980s, supported employment (employment of the disabled through programs that provide them with ongoing support services) has become increasingly popular as a means of vocational rehabilitation. Traditionally, the most common form of supported employment has been the sheltered workshop, a nonprofit organization—often receiving government funds—that provides both services and employment to the disabled. Today, sheltered industrial employment mainstreams disabled workers into the regular workplace with jobs modified to meet their needs, especially those of the severely disabled. However, both cutbacks in funding for government support services and affirmative action provisions of the 1973 Rehabilitation Act pertaining to federal contractors led to increasing private sector participation efforts in the 1980s. Some firms became involved in career education, offering internships to disabled students, which sometimes led to permanent employment. Other recent trends include rehabilitation of persons with traumatic brain injuries and severe learning disabilities, and rehabilitation of the homebound and the elderly.

The U. S. Department of Education administers most federal programs for rehabilitation of the disabled, often through its Office of Special Education and Rehabilitative Services (OSERS). Within OSERS, the Rehabilitation Services Administration (RSA) supervises the state offices of vocational rehabilitation. Organizations involved in rehabilitation efforts include the National Rehabilitation Association, the National Association of Rehabilitation Facilities, and the President's Committee on Employment of People with Disabilities.