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PSRT 4271: The Family Role in Rehabilitation Week Four (June 21, 2012) 1
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“…disruption of psychological homeostatis…” “…usual coping mechanisms fail…” “…distress and functional impairment…” 3
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“…subjective reaction…” “…to stressful life experience…” Functioning “…seriously compromised...” 4
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Threat Incapacity Fear Discomfort Disequilibrium 5
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There is such a thing… 6
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7. Follow up. 6. Make an action plan. 5. Explore alternatives. 4. Deal with feelings. 3. Identify major problems. 2. Establish rapport. 1. Assess lethality. 7
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5 determinants: 1. Triggering events 2. Severity of disability 3. Personal influences 4. Contextual influences 5. Stigma; societal reactions 8
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Denial Grief Guilt Isolation Anger Depression Coping Acceptance 9
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Meaning Support Validation Information Balance 10
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Acknowledge; connect; engage Offer coping mechanisms Comprehensive involvement at discharge Instill hope 12
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13 (The Raft of Medusa, by Theodore Gericault, 1791–1824)
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Feelings Powerless, voiceless, anxious, frustrated, isolated, tired, desperate, trapped, guilty, worried, scared, sad, grief, confused “Internal factors” Sense of safety Perception of care ability Contingencies and consequences Maternal love and obligations 14
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1. Reflection on roles 2. Devastation and vulnerability 3. Sadness and loss 4. Frustration with the system 5. Admiration for the child 6. Personal growth and learning 15
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One step removed… Reactions to illness Strategies for coping Whether, how to intervene? Setting limits? Resentment, anger, hopeless? Efforts to obtain services Wish for validation Efforts to help themselves 16
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What happens when ill child has children? Custodial, co-resident, nonresident… Child’s exposure to mother’s illness Financial impact Isolation Role conflicts Divided loyalties 17
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18 Bellevue Inside Out Trailer http://www.youtube.com/watch?v=Ojd_fsHbGl8
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Ravi Maharahj, Middlesex County Crisis Screening Center 19
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