Apa itu Rehabilitasi Psikiatri Indonesia

Apa itu Rehabilitasi Psikiatri?
Juga dikenal sebagai rehabilitasi psiko-sosial, rehabilitasi psikiatri adalah cabang ilmu yang
bertujuan untuk memberikan segala macam cara yang diperlukan untuk menolong pasien yang
mengalami gangguan mental seperti gangguan obsesif kompulsif, atau gangguan bipolar agar
dapat kembali hidup di dalam masyarakat. Ini berbeda dengan rumah sakit jiwa di mana pasien
yang mengalami gangguan metal tidak dibolehkan untuk meninggalkan rumah sakit atau institusi
medis tersebut.
Rehabilitasi psikiatri memerlukan terapan dari berbagai macam disiplin ilmu agar dapat berhasil,
di mana rehabilitasi menyangkut hal-hal berikut:
 Penyembuhan – Salah satu tahap pertama dari rehabilitasi adalah untuk memastikan
kesembuhan pasien. Meskipun sebagian dari mereka tidak akan sembuh sepenuhnya,
rehabilitasi diharapkan dapat menolong para pasien untuk mengatasi gejala dari gangguan
yang mereka alami dengan lebih efisien.
 Menguasai Diri – Setelah pasien kembali hidup dalam masyarakat, mereka akan
berhadapan dengan standar dan ekspektasi orang lain. Bagi kebanyakan pasien,
menghadapi hal-hal tersebut dapat menyulitkan, apalagi jika orang lain mengetahui latar
belakang dan masalah pasien tersebut. Namun, jika pasien dapat menguasai diri mereka
sendiri dan tetap termotivasi, mereka akan cenderung dapat bertahan dan bahkan dapat
memenuhi ekspektasi tersebut.
 Kolaborasi – Banyak ahli dari berbagai bidang yang terlibat dalam program rehabilitasi,
menolong pasien agar sembuh, serta membantu mereka untuk melewati gangguan yang

mereka alami. Bahkan, kebanyakan pihak yang menawarkan program rehablitiasi adalah
organisasi dengan tim yang terdiri dari kumpulan psikiater, pekerja sosial, dan pekerja
yang berada dalam suatu komunitas, dan lainnya.
 Perawatan Khusus – Program rehabilitasi yang diberikan pada pasien dibuat
berdasarkan serangkaian standar, acuan, dan juga metode yang telah ada yang dapat
dimodifikasi tergantung dari keperluan, keahlian, kepribadian, dan pandangan pasien.
Rehabilitasi tidak dapat berhasil tanpa ketertarikan dan partisipasi aktif dari pasien.
Rehabilitasi dibuat dan difokuskan dalam membangun dan memperkuat kekuatan dalam
diri pasien.
Pada akhirnya, tujuan dari rehabilitasi psikiatri adalah untuk memberikan harapan, motivasi, rasa
hormat untuk pasien, serta keahlian sosial, ekonomi, dan keahlian lainnya yang mereka perlukan,
agar pasien dapat kembali melanjutkan hidup di masyarakat dengan lebih efisien dan efektif.

Siapa yang Memerlukan Rehabilitasi Psikiatri & Hasil yang
Diharapkan
Rehabilitasi psikiatri ditujukan untuk pasien yang sudah mengalami masalah mental dalam
jangka waktu yang lama. Buruknya kondisi mental seseorang biasanya akan membuat seseorang
tidak memiliki keahlian untuk berfungsi, berkontribusi, dan berkemampuan untuk membantu

sebagai mana mestinya dalam komunitasnya. Pada saat yang sama, orang tersebut juga harus

hidup di bawah stigma sebagai orang yang mengalami gangguan, yang dapat membuat pasien
tersebut semakin tidak mau berhubungan dan menjauhi diri dari orang lain.
Tanda- tanda dan gejala yang berbeda dari kondisi mentalnya juga dapat meningkatkan
kemungkinan munculnya perslisihan, konflik, dan komunikasi tidak efektif di dalam
perkumpulan tempat pasien tersebut berada. Menurut Psychiatry.org, seseorang yang mengalami
gangguan mental biasanya cenderung berbuat beberapa tindakan seperti:
 Menjauhi dirinya dari masyarakat dan kehilangan minat terhadap orang lain
 Kehilangan kemampuan untuk berkonsentrasi atau memahami dirinya sendiri dan orang
lain
 Merasakan ketidakcocokan antara dirinya dan lingkungannya
 Menumbuhkan cara berpikir yang tidak logis
 Memunculkan kepercayaan yang tidak umum, imajiner, dan berlebihan
 Merasakan rasa ketidakpercayaan dan kecurigaan terhadap orang lain
Tingkat kesuksesan dari rehabilitasi psikiatri berbeda-beda untuk satu orang dan yang lainnya,
karena ada banyak faktor yang berpengaruh. Salah satunya adalah penerimaan pasien atau
keterbukaan terhadap keahlian yang baru atau berbeda, dan juga kesempatannya untuk kembali
hidup di masyarakat.
Meskipun demikian, pasien dapat berharap bahwa selama rehabilitasinya, mereka akan :
 Merasa dihargai
 Membentuk rasa kepercayaan diri yang baru terhadap kemampuan mereka untuk tumbuh

dan belajar
 Merasakan pertumbuhan diri melalui bantuan dan pembelajaran yang terus-menerus
 Dapat mencari pelayanan dan bantuan utnuk sembuh dengan cepat dan efektif
 Dapat bekerja dalam tim dengan anggota yang berbeda-beda yang akan memberikan
tingkatan keperluan dan tantangan yang berbeda-beda
 Belajar untuk membuat keputusan sendiri dan dalam prosesnya, tumbuh menjadi orang
yang dapat menguasai dirinya sendiri
 Membentuk grup yang mendukung dirinya di dalam sebuah komunitas, termasuk anggota
keluarga, yang akan dibantu oleh tim rehabilitasi
 Mengalami pertumbuhan di berbagai hal dalam hidup mereka

Cara Kerja Rehabilitasi Psikiatri
Ada banyak pertimbangan bagaimana melakukan rehabilitasi psikiatri, seperti apa yang
diperlukan dan tujuan dari pasien tersebut mengikuti rehabilitasi, pelayanan yang dapat
ditawarkan oleh tim rehabilitasi, dan jenis gangguan mental yang dialami oleh pasien tersebut.
Pada umumnya, prosesnya dimulai dengan menentukan tujuan atau hasil yang diharapkan oleh
pasien dalam mengikuti rehabilitasi tersebut (pendekatan yang berpusat pada orangnya). Peran

dari tim rehabilitasi adalah untuk memastikan bahwa pasien akan diarahkan untuk membuat
tujuan bagi dirinya sendiri berdasarkan pengetahuan, kemampuan, dan penilaian dari pasien

tersebut.
Tim rehabilitasi kemudian akan melanjutkan dengan membantu pasien untuk menentukan
langkah-langkah yang perlu mereka ambil untuk mencapai tujuan yang mereka inginkan. Tim
juga akan memberikan semua bahan dan apapun yang dapat membantu, yang tergantung kepada
keadaannya (pendekatan individual).
Biasanya, program rehabilitasi psikiatri akan menawarkan hal-hal sebagai berikut:
 Bantuan untuk kesehatan dan kondisi tubuh, termasuk nutrisi dan pola makan
 Mengurangi gejala yang muncul dengan cara konsumsi obat-obatan yang tepat
 Mengurangi stress dan kesulitan yang dialami dengan teknik tertentu, termasuk obatobatan
 Memperkenalkan ke kelompok dukungan yang cocok dengan pasien
 Membangun kelompok dukungan pasien yang dapat terdiri dari pasien lain dalam
rehabilititasi tersebut, keluarga pasien, teman, dan bahkan teman kerja.
 Pelayanan medis seperti konseling yang dilakukan untuk jangka panjang dan teratur dan
juga perawatan dokter yang mudah diakses (termasuk perawatan gawat darurat)
 Bantuan hukum
 Pendidikan melalui sekolah kejuruan atau perkuliahan
 Penempatan kerja
 Tempat tinggal, seperti di apartemen atau hidup dalam suatu grup
Tim rehabilitasi juga akan memberikan:
 Kemampuan bertahan hidup yang diperlukan, seperti perawatan diri, cara menjaga

keamanan tempat tinggal, cara menjaga keamanan selama bepergian, dan perencanaan
hidup
 Program dan terapi yang dapat meningkatkan keahlian sosial dan teknis pasien
 Bantuan keuangan
 Bantuan lainnya yang mungkin diperlukan pasien, seperti yang berhubungan dengan
hobi, asuransi kesehatan, dan rekening keuangan (contohnya, rekening bank)
Setelah bantuan dan keahlian yang diperlukan sudah diberikan dan diajarkan kepada pasien,
tanggung jawab tim rehabilitasi berubah menjadi pengawasan. Komunikasi dan interaksi antara
pasien dan tim rehabilitasi seharusnya terus berjalan untuk jangka waktu yang lama, dilakukan
secara teratur, dan berkelanjutan. Kedua pihak harus dapat merubah pendekatan masing-masing
untuk mendapatkan hasil yang lebih baik.

Kemungkinan Terjadinya Komplikasi dan Risiko Lainnya
Risiko dalam perawatan ini muncul dari fakta bahwa pendekatan rehabilitasi tidak selamanya
cocok untuk semua orang, karena banyak faktor yang perlu dipertimbangkan. Ada juga beberapa

hal yang perlu ditingkatkan dan bahkan jika terjadi hanya satu kegagalan saja dalam tahap
rehabilitasi ini, seluruh program bisa menjadi gagal.
Kemudian, pasien juga sangat bergantung kepada tim rehabilitasi selama tahap awal rehabilitasi.
Namun, jumlah psikiater yang cukup banyak biasanya berada di banyak rumah sakit dan bukan

di wilayah komunitas, yang membuat para pskiater tersebut tidak memiliki kemampuan yang
tepat untuk menolong pasien sepenuhnya.
Rujukan:
 American Psychiatric Association. Diagnostic and Statistical Manual of Mental
Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.
 American Psychiatric Association. Practice Guideline for the Treatment of Patients with
Major Depressive Disorder. 3rd edition. October 2010. Available at:
http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
Accessed: March 10, 2014.
 Psychiatric rehabilitation, also known as psychosocial rehabilitation, and sometimes
simplified to psych rehab by providers, is the process of restoration of community
functioning and well-being of an individual diagnosed in mental health or mental or
emotional disorder and who may be considered to have a psychiatric disability. Society
affects the psychology of an individual by setting number of rules, expectations and laws.
Psychiatric rehabilitation work is undertaken by rehabilitation counselors (especially the
individuals educated in psychiatric rehabilitation), licensed professional counselors (who
work in the mental health field), psych rehab consultants or specialists (in private
businesses), university level Masters and PhD levels, classes of related disciplines in
mental health (psychiatrists, social workers, psychologists, occupational therapists) and
community support or allied health workers represented in the new direct support

professional workforce in the United States (e.g., psychiatric aides).
 These workers seek to affect changes in a person's environment and in a person's ability
to deal with his/her environment, so as to facilitate improvement in symptoms or personal
distress and life outcomes. These services often "combine pharmacologic treatment (often
required for program admission), independent living and social skills training,
psychological support to clients and their families, housing, vocational rehabilitation and
employment, social support and network enhancement and access to leisure activities."[1]
There is often a focus on challenging stigma and prejudice to enable social inclusion, on
working collaboratively in order to empower clients, and sometimes on a goal of full
recovery. The latter is now widely known as a recovery approach or model.[2] Recovery is
a process rather than a outcome. It is a personal journey that is about the rediscovery of
self in the process of learning to live with the debilitation's of the illness rather than being
defined by illness with hope, planning and community engagement.[3]
 Yet, new in these fields is a person-centered approach to recovery[4][page needed] and clientcentered therapy based upon Carl Rogers.[5][page needed] and user-service direction (as
approved in the US by the Centers for Medicare and Medicaid Services).

Definition

Psychiatric rehabilitation is not a practice but a field of academic study or discipline, similar to
social work or political science; other definitions may place it as a specialty of community

rehabilitation or physical medicine and rehabilitation. It is aligned with the community support
development of the National Institute on Mental Health begun in the 1970s, and is marked by a
rigorous tradition of research, training and technical assistance, and information dissemination
regarding a critical population group (e.g., psychiatric disability)in the US and worldwide.[6] The
field is responsible for developing and testing new models of community service for this
population group.[7][8][9][10][11]
The Psychiatric Rehabilitation Association (formerly the United States Psychiatric Rehabilitation
Association) provides this definition of psychiatric rehabilitation:
Psychiatric rehabilitation promotes recovery, full community integration, and improved quality
of life for persons who have been diagnosed with any mental health condition that seriously
impairs their ability to lead meaningful lives. Psychiatric rehabilitation services are collaborative,
person-directed and individualized. These services are an essential element of the health care and
human services spectrum, and should be evidence-based. They focus on helping individuals
develop skills and access resources needed to increase their capacity to be successful and
satisfied in the living, working, learning, and social environments of their choice.[12]
This section requires expansion with: additional defnitions..
(February 2015)

History
From the 1960s and 1970s, the process of de-institutionalization meant that many more

individuals with mental health problems were able to live in their communities rather than being
confined to mental institutions. Medication and psychotherapy were the two major treatment
approaches, with little attention given to supporting and facilitating daily functioning and social
interaction. Therapeutic interventions often had little impact on daily living, socialization and
work opportunities. There were often barriers to social inclusion in the form of stigma and
prejudice.
Psychiatric rehabilitation work emerged with the aim of helping the community integration and
independence of individuals with mental health problems. "Psychiatric rehabilitation" and
"psychosocial rehabilitation" became used interchangeably, as terms for the same practice.[13]
[page needed]
These approaches may merge with or conflict with approaches based in the psychiatric
survivors movement, including the concept of user-controlled personal assistance services.[14]
In the 1980s, the US Department of Education, National Institute on Disability Research and
Rehabilitation, revised a Rehabilitation Research and Training Center program to meet the new
needs in the community of special population groups. A priority center, published in the Federal
Register, was the Rehabilitation Research and Training Center in Psychiatric Disabilities
(awarded to William Anthony's Boston University Center) which remains a priority today
(2015)to provide nationwide assistance and serve as flagship center internationally.

Around 2005 the professional organization International Association of Psychosocial

Rehabilitation Services (IAPSRS) changed its name to United States Psychiatric Rehabilitation
Association (USPRA) and the trend is toward the use of "psychiatric rehabilitation." [15][page needed]
Academic Discipline
In 2012, Temple University was funded in the field of psychiatric disabilities for a national
center with the National Institute on Disability and Rehabilitation Research (NIDRR), United
States Department of Education, having this population group as a priority.[citation needed] Boston
University's Center on Psychiatric Rehabilitation's director is President-Elect of the NAARTC
program and Boston University College of Health and Rehabilitation Sciences (Sargent College)
awards a Rehabilitation Science (ScD)Doctor of Science degree in the field in which it awards
no separate mental health specialty degree (such as occupational therapy). Master' program in
psychiatric rehabilitation was part of a MA degree in rehabilitation counseling in the School of
Education, Syracuse University and courses were funded in part through the federal
Rehabilitation Research and Training Program of the US now part of National Institute on
Disability, Independent Living and Rehabilitation Research.

Theory
The theoretical base for psychosocial then psychiatric rehabilitation is community support theory
as the foundational theory; it is aligned with integration and community integration theories,
psychosocial theories, and the rehabilitation and educational paradigms. Its fluid nature is due to
variability in development and integration into other essential fields such as family support

theories (for this population group) which has already developed its own evidence-based parent
education models.
The concept of psychiatric rehabilitation is associated with the field of community rehabilitation
and later on social psychiatry and is not based on a medical model of disability or the concept of
mental illness which is often associated with the words "mental health". However, it can also
incorporate elements of a social model of disability as part of progressive professional
community field. The academic field developed concurrently with the formation of new mental
health agencies in the US, now often offerring supported housing services.
The Journal of Psychosocial Rehabilitation, then renamed the Journal of Psychiatric
Rehabilitation, traces the development of the field over a period of several decades. The
academic discipline psychiatric rehabilitation has contributed new models of services such as
supported education, has cross-validated models from other fields (e.g., supported employment),
has developed the first university-based community living models for populations with "severe
mental illness", developed institutional to community training and technical assistance,
developed the degree programs at the university levels, offers leadership institutes, and worked
collaboratively to expand and upgrade older models such as clubhouses and transitional
employment services, among others.
Psychiatric rehabilitation was developed and formulated as a new profession of community
workers (not medical psychiatry which is a MD awarded by a Medical School) which could

assist both in deinstitutionalization (e.g., systems conversion) and in community development in
the US. It represents the first Master's and Ph.D. classes in the US to specialize in a rehabilitation
discipline focused on community versus institutions or campuses. In the US, it also represents a
movement toward evidence-based practices, critical for the development of viable community
support services.
Psychosocial services, in contrast, have been associated with the term "mental health" as part of
community support movement nationwide since the 1970s which has an academic and political
base. These services, which have roots in education, psychology and mental health (and
community services) administration, were basic funded services of new community mental
health agencies offering community living and professionalized community support since the
1970s. Mental health service agencies or multi-service agencies in the non-profit and voluntary
sectors form a critical delivery system for psychosocial services. In the 2000s, a sometime
similar but sometimes alternative approach (variability and fidelity of provider implementation
in the field) employs the concept of psychosocial recovery.
Psychiatric rehabilitation was promulgated in the US through Boston University's Rehabilitation
Research and Training Center on Psychiatric Rehabilitation led by Dr. William Anthony[16] and
Dr. Marianne Farkas,[17][page needed] as well as other professors and teachers such as Julie Ann
Racino, Steve Murphy and Bonnie Shoultz of Syracuse University (1989-1991) who also support
a generic community approach to education.[18] The concept has been integrated with a
community support approach, including supported housing/housing and support, recreation,
employment and support, culture/gender and class, families and survivors, family support, and
community and systems change.[19][page needed][20][page needed][21][22][23][24]
Problems experienced by people with psychiatric disabilities are thought to include difficulties
understanding or dealing with interpersonal situations (e.g., misinterpreting social cues, not
knowing how to respond), prejudice or bullying from others because they may seem different,
problems coping with stress (including daily hassles such as travel or shopping), difficulty
concentrating and finding energy and motivation. People leaving psychiatric centers after longterm hospitalizations, an outdated practice, may also have need to assist with injuries that may
have occurred and community integration.
Psychiatric rehabilitation is distinct from the concept of independent living and consumercontrolled services which have been written about and promoted by psychiatric survivors.[25]
[page needed][26][27][28]
The psychiatric rehabilitation concept is separated from the psychiatric survivor
concept, in education and training of individuals with psychiatric disorders, in that psychiatric
survivors tend to operate services and control funding.

Services
Psychiatric rehabilitation services may include: community residential services, workplace
accommodations, supported employment or education, social firms, assertive community (or
outreach) teams assisting with social service agencies, medication management (e.g., selfmedication training and support), housing, programs, employment, family issues, coping skills
and activities of daily living and socialising. Traditionally, "24-hour" service programs

(supervised and regulated options) were based upon the concept of instrumental and daily living
skills as formulated in the World Health Organization (WHO) definition.
Psychiatric rehabilitation is illustrated by agency models which are offerred by traditional and
non-traditional service providers, and may be considered to be integrated (e.g., dispersed sites in
the community) or segregated (e.g., campus-based facilities or villages). (e.g., Fountain House
Model of New York City, MHA Village in Long Beach, CA)or Transitional Living Services of
Buffalo or Transitional Living Services of Onondaga County, New York. Agencies supporting
integration may align with normalization or integration philosophy, as opposed to the older
sheltered workshop or day care models which have been criticized for underpayment of wages at
the US Congressional level in the late 2000s.
Agencies may deliver cross-field best practices (e.g., supported work), consumer voices (e.g.,
Rae Unzicker), multiple disabilities (e.g., chemical dependency), training of its own community
residential, employment, education and support service professionals, rehabilitation outcomes,
and management and evaluation of its own services.[29]
Core principles of effective psychiatric rehabilitation (how services are delivered) must include:






providing hope when the client lacks it,
respect for the client wherever they are in the recovery process,
empowering the client,
teaching the client wellness planning, and
emphasizing the importance for the client to develop social support networks.
[30]

Psychiatric rehabilitation (what services are delivered) varies by provider and may consist of
eight main areas:
 Psychiatric (symptom management; relaxation, meditation and massage;

support groups and in-home assistance)
 Health and Medical (maintaining consistency of care; family physician and

mental health counseling)
 Housing (safe environments; supported housing; community residential

services; group homes; apartment living)
 Basic Living Skills (personal hygiene or personal care, preparing and sharing

meals, home and travel safety and skills, goal and life planning,

chores and group decisionmaking, shopping and appointments)
 Social (relationships, recreational and hobby, family and friends, housemates

and boundaries, communications & community integration)
 Vocational and/or Educational (vocational planning, transportation assistance

to employment, preparation programs (e.g., calculators), GED classes,
televised education, coping skills, motivation)
 Financial (personal budget), planning for own apartment (startup funds,
security deposit), household grocery; social security disability; banking
accounts (savings or travel)

 Community and Legal (resources; health insurance, community recreation,

memberships, legal aid society, homeownership agencies, community
colleges, houses of worship, ethnic activities and clubs; employment
presentations; hobby clubs; special interest stores; summer city schedules)

As of 2013, it is expected that areas such as supported housing, household management, quality
medical plans, advocacy for rights, counseling, and community participation be part of the
available package of options for services. Modernization in these fields includes better health
care, such as women and men's health (e.g., heart disease), public and private counseling services
in mental health, integrated services (for dual and multiple diagnoses), new specialized
treatments (e.g., eating disorders), and understanding of trauma services and mental health.
Psychiatric rehabilitation is typically associated with long term services and supports (LTSS) in
the community[31][page needed] including post secondary education as supported education
(Anthony,1993; Mowbray, Brown, Furlong-Norma, & Soydan, 2002; Unger, 2002).[32][33][34]

Educational and professional organizations
This section requires expansion.
(February 2015)

Canada
In Canada, Psychosocial Rehabilitation/Réadaptation Psychosociale (PSR/RPS) Canada
promotes education, research and knowledge exchange in relation to evidence-based
psychosocial rehabilitation and recovery-oriented practices for service-providers and those
receiving services for mental health challenges. A framework of competencies for service
providers (individuals and organizations) was developed and announced at the 2013 Annual
National Conference in Winnipeg, Manitoba.[35]
United States
 Boston University, Center for Psychiatric Rehabilitation
 United States Psychiatric Rehabilitation Association (USPRA)

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Division of Special Education and Rehabilitation.
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mental health and developmental disabilities". In Friedman, Steven J.; Terkelsen,
Kenneth G. Issues in Community Mental Health: Housing. Canton, MA: Prodist (for
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ISBN 9780881350531. OCLC 18625648.
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Psychiatry 44 (5): 439–449. doi:10.1176/ps.44.5.439. PMID 8509074.
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Mental Health System. New York: Hawthorn Books. ISBN 9780801555237.
OCLC 3688638.
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people with psychiatric disabilities: Taking back control of our lives". Psychosocial
Rehabilitation Journal 15 (3): 3–19. doi:10.1037/h0095769.
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PMID 8509069.
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Weissman, Julie; Kennedy, Jae; Litvak, Simi. Personal Perspectives on Personal
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  Spaniol, LeRoy; Brown, Mary Alice; Blankertz, Laura; Burnham, Darrell J.;
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 "Psychosocial Rehabilitation Association of Canada". PSR/RPS Canada.

Psychosocial Intervention
Psychosocial interventions and support services describe a wide variety of services, supports and
strategies that aim to change behaviour and support people who are affected by alcohol and drug
use. These are services which are provided within community settings.
These types of services provide a range of psychosocial (non-medical) interventions for people
with alcohol and drug issues including assessment, counselling, case management, coordination
of care, group work, information, community education and professional consultation to other
service providers.
The Alcohol and Drug Service also provides a range of specialist targeted services in the
following areas:
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Support for Youth
Outreach Services
Relapse Prevention
Management of Complex Needs
Brief and Early Intervention
Smoking Cessation

Support for Youth

The Alcohol and Drug Service employs specialist youth workers who work with young people
affected by alcohol and drug use. These specialists also work closely with a range of youth
services provided by community sector organisations.
Outreach Services
Outreach services are useful in providing services to clients who would otherwise be unable to
access specialist alcohol, tobacco and other drug services in a timely and equitable manner.
Services are designed to provide: counselling; assistance with accessing other services; access to
skilled and professional help; assistance with the development of strategies to reduce harm; and
access to specialist advice and information. Services can be provided to individuals or in group
settings.
Relapse Prevention
Relapse prevention is a collection of techniques that increase the client’s ability to control
cravings and urges, and enhance coping skills for handling high-risk situations where lapse or
relapse is a possibility. By combining the learning of specific skills with lifestyle changes, these
interventions assist clients to manage lapses and prevent relapses.
Management of Complex Needs
A large proportion of clients who access alcohol, tobacco and other drug services are presenting
with increasingly complex and multiple needs. In some cases, these clients also present with
difficult (and at times high risk) behaviours. The needs of the client group can be complicated by
the presence of coexisting mental health issues.
Brief and Early Intervention
Early intervention involves intervention at an early stage of a person’s alcohol and drug use to
prevent the development of serious drug problems later on.
Early intervention focuses on service users who are engaged in patterns or contexts of drug use
that have the potential to harm. Early intervention involves identifying drug use and assessing
harm and intervening with service users who are consuming drugs in a potentially harmful way
before problems become entrenched or dependence develops.
Smoking Cessation
Improving the health of Tasmanians by reducing the harm caused by tobacco in all its forms is
the key policy objective of the Tasmanian Tobacco Action Plan 2006-2010.
Reducing smoking initiation and reducing the exposure to second-hand smoke, through tobacco
control strategies, along with increasing the rate at which people quit smoking are key objectives
of tobacco control activities. Interventions such as price increases, mass media campaigns and

sale restrictions are effective in both preventing uptake and promoting quit attempts. Advice and
support provided by health professionals is also an essential component of increasing the rate at
which people quit smoking.

Psychosocial Treatments
Psychosocial treatments include different types of psychotherapy and social and vocational
training, and aim to provide support, education and guidance to people with mental illness and
their families. Psychosocial treatments are an effective way to improve the quality of life for
individuals with mental illness and their families. They can lead to fewer hospitalizations and
less difficulties at home, at school and at work.
Check with your local NAMI affiliate, your community mental health center or health care
provider to see what psychosocial services are available in your community and what may be
provided under your health insurance plan.

Types of Psychosocial Treatments
Psychotherapy
Often called talk therapy, psychotherapy is when a person, family, couple or group sits down and
talks with a therapist or other mental health provider. Psychotherapy helps people learn about
their moods, thoughts, behaviors and how they influence their lives. They also provide ways to
help restructure thinking and respond to stress and other conditions.
Psychoeducation
Psychoeducation teaches people about their illness and how they’ll receive treatment.
Psychoeducation also includes education for family and friends where they learn things like
coping strategies, problem-solving skills and how to recognize the signs of relapse. Family
psychoeducation can often help ease tensions at home, which can help the person experiencing
the mental illness to recover. Many of NAMI's education programs are examples of
psychoeducation.
Self-help and Support Groups
Self-help and support groups can help address feelings of isolation and help people gain insight
into their mental health condition. Members of support groups may share frustrations, successes,
referrals for specialists, where to find the best community resources and tips on what works best
when trying to recover. They also form friendships with other members of the group and help
each other on the road to recovery. As with psychoeducation, families and friends may also
benefit from support groups of their own.

Psychosocial Rehabilitation
Psychosocial rehabilitation helps people develop the social, emotional and intellectual skills they
need in order to live happily with the smallest amount of professional assistance they can
manage. Psychosocial rehabilitation uses two strategies for intervention: learning coping skills so
that they are more successful handling a stressful environment and developing resources that
reduce future stressors.
Treatments and resources vary from case to case but can include medication management,
psychological support, family counseling, vocational and independent living training, housing,
job coaching, educational aide and social support.
Assertive Community Treatment (ACT)
Assertive community treatment (ACT) is a team-based treatment model that provides
multidisciplinary, flexible treatment and support to people with mental illness 24/7. ACT is
based around the idea that people receive better care when their mental health care providers
work together. ACT team members help the person address every aspect of their life, whether it
be medication, therapy, social support, employment or housing.
ACT is mostly used for people who have transferred out of an inpatient setting but would benefit
from a similar level of care and having the comfort of living a more independent life than would
be possible with inpatient care.
Studies have shown that ACT is more effective than traditional treatment for people
experiencing mental illnesses such as schizophrenia and schizoaffective disorder and can reduce
hospitalizations by 20%.

Supported Employment
Work can be an essential step on the path to wellbeing and recovery, but challenges that come
with mental illness can make it more difficult. There are programs, however, designed
specifically to help with work readiness, searching for jobs and providing support in the
workplace.
Vocational Rehabilitation (VR)
VR provides career counseling and job search assistance for people with disabilities, including
mental illness. VR program structures vary from state to state. To learn more about your specific
state program, visit your state’s VR agency.
Individual Placement and Support (IPS) Supported Employment
IPS programs are evidence-based programs that help people with mental illness locate jobs that
match their individual strengths and interests. Once an individual locates a job, IPS programs

provide continuous support to help the person succeed in the workplace. IPS Supported
Employment teams include employment specialists, health care providers and the individual with
mental illness. If the individual agrees, family members or a significant other may be part of the
team.
Clubhouses
Clubhouses are community-based centers open to individuals with mental illness. Clubhouse
members have the opportunity to gain skills, locate a job, find housing, and pursue continuing
education. Members work side-by-side with staff to make sure the program operates smoothly.
Members also have the opportunity to take part in social events, classes and weekend activities.

Case Management
Living well with a complicated health condition (physical or mental) can require working with a
number of medical providers and support resources. Case management can help individuals
coordinate these services.
A case manager has knowledge of local medical facilities, housing opportunities, employment
programs and social support networks. He or she is also familiar with many payment options,
including local, state and federal assistance programs. This person can serve an important role in
helping you or your family member get the best treatment possible.
A case manager will assess your needs and explain what resources are available in your area. He
or she will explain the process of applying for services and help you collect the necessary
documents to prove eligibility. A case manager will then keep in touch with you to ensure that
you continue to have your treatment needs met. How to fill out official forms, how to get
transportation to appointments—these are all questions a case manager can help with.
Case managers are professionals with certification in case management or degrees in social
work. They are typically employed by large health insurance companies or by local county and
state governments. If you are staying in a hospital or your doctor has recommended a case
manager, you may automatically receive a call from one. If you do not have a case manager and
would like to, ask about the process of getting one. Your best bet is to call your state or county
department of health, social services or aging.
Remember that your case manager is there to work with you for your benefit. Ask questions and
if you don't understand the answers, ask again. A good case manager can't guarantee you'll get
every resource you apply for, but he or she should definitely keep you informed and listen to
your concerns.
- See more at: https://www.nami.org/Learn-More/Treatment/PsychosocialTreatments#sthash.ekL7VMNQ.dpuf