مراکز درمانی روانی اجتماعی برای افراد دارای معلولیت ذهنی
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|35136||2007||8 صفحه PDF||سفارش دهید||محاسبه نشده|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Research in Developmental Disabilities, Volume 28, Issue 5, October–November 2007, Pages 531–538
The provision of active treatment for people with intellectual disabilities has been seminal in the literature and in practice for a number of years. Active treatment has programmatic, financial, and legal ramifications for agencies and should be at the center of all appropriate treatment plans. The current work examines the use of psychosocial rehabilitation treatment malls to deliver active treatment to people with intellectual disabilities. The history, development, and implementation of these methods are discussed, with emphasis on services that are functional, meaningful, and portable. The importance of the therapeutic milieu is considered in context and discussed as the primary pathway to increased community integration. Finally, future directions of the treatment malls are considered.
The assessment and treatment of persons with intellectual disabilities has been a controversial and emotionally charged topic for years. Prior to the 1960s, living settings for people with intellectual disabilities were primarily large, crowded, founded in a purely medical model, and people were kept from mainstream society (Blatt & Kaplan, 1966; Scheerenberger, 1983). In the early to mid 1960s, however, there were two sentinel events that changed treatment approaches for this population: (1) the emergence of the behavioral technology in psychology as a means of teaching life skills to persons with intellectual disabilities (ID) and; (2) publishing of the first studies indicating success in skills acquisition training for persons with ID (Dayan, 1964 and Ellis, 1963). As a result of these developments, the active treatment model for persons with intellectual disabilities gained life, momentum, and remains to this day an integral element in the overarching treatment process. Active treatment is defined in a number of ways in current federal guidelines, research literature, and by treating clinicians. However, the term is usually characterized through language including learning opportunities (both planned and incidental), medical supports, and vocational/habilitation opportunities to increase independence, autonomy, and quality of life. Examples of skills programs that have been successfully implemented in the rubric of active treatment include social skills, communication skills, recreation/leisure activities, skills related to activities of daily living (ADLs), relationship/sexuality training, disease awareness/prevention, and vocational skills programs ( Arnold-Reid, Schloss, & Alper, 1997; Bates, Cuvo, Miner, & Korabek, 2001; Browder & Grasso, 1999; Reid, 1982 and Snell, 1987). Active treatment has been an evolutionary process that first came to the forefront nationally with the onset of federal investigations in the 1970s and later with federal laws and funding source regulations in the 1980s. Prior to that time, national surveys of institutions had focused largely on life-safety issues, physical plant/environmental issues, and issues pertaining to abuse/neglect. Since then, however, active treatment has been considered the centerpiece of service delivery in agencies funded with Intermediate Care Facility-Mentally Retarded (ICF-MR) dollars. This point has been reinforced in Civil Rights for Institutionalized Persons Act (CRIPA) investigations by the United States Department of Justice and has resulted in better assessment and treatment methodologies for the population ( Ellis, 1982).