People who have sustained a traumatic brain injury or a stroke are usually admitted to a hospital where they receive acute treatment and rehabilitation. This rehabilitation will continue when they (the client) return home.
There are different approaches to rehabilitation.
The traditional medical model focuses on the limitation of the client. For example, if someone has difficulty with walking or communicating, therapy will focus on improving these skills.
On the other hand, the social model believes that disability doesn’t necessarily stem from the functional limitations. It may be the failure of the environment to take account of people’s needs. Therefore therapy will not only focus on improving the skills of the client but also on addressing the barriers the client is experiencing. Barriers are different for everyone. A few examples are background noise, narrow doorways for wheelchairs, attitudes of people, or information not being available.
How to break down these barriers?
• Climbing over the barrier: developing the client’s skills and building on the client’s strengths
• Finding a way around the barrier: using strategies and aids
• Removing the barrier: changing the environment or people’s beliefs
Barriers are not always present in the environment however can exist in the client; for example stress can be a barrier. Communication breakdowns are very frustrating which can cause stress. When people feel stressed, their ability to communicate declines. Therefore stress management is an important part of the rehabilitation process.
It is also important to realise that ideally there should be a therapeutic partnership between the therapist, the client and their support people. Many people believe that the therapist will make them better, so that they are their “old self” again. This is not always realistic. The client, their support people and the therapist should discuss together what is important in the client’s life. This way they can identify the client’s strengths, limitations and needs, identify the barriers and start the journey to improve the quality of life for the client, family and wider social connections.
Pound, C., Parr, S., Lindsay, J., & Woolf, C. (2000). Beyond Aphasia: Therapies for Living with Communication Disability. Speechmark Publishing Ltd., Milton Keynes, UK.