Class Presentation - Sociology and Psychosocial Rehabilitation Counselling.pdf

Sociology and Psychosocial Rehabilitation & Counselling Dr. Angel Selvaraj Assistant Professor Jindal Institute of Behavioural Sciences O.P. Jindal Global University  Rehabilitation and Psychosocial Rehabilit...

Sociology and Psychosocial Rehabilitation & Counselling Dr. Angel Selvaraj Assistant Professor Jindal Institute of Behavioural Sciences O.P. Jindal Global University  Rehabilitation and Psychosocial Rehabilitation Rehabilitation refers broadly to restoration of functioning and is used widely in the field of health. Psychosocial rehabilitation refers more specifically to restoration of psychological and social functioning and is most frequently used in the context of mental illness Two core principles (Cnaan et al., 1988) PEOPLE ARE MOTIVATED TO ACHIEVE PEOPLE ARE CAPABLE OF LEARNING AND INDEPENDENCE AND SELF CONFIDENCE ADAPTING TO MEET NEEDS AND THROUGH MASTERY AND COMPETENCE ACHIEVE GOALS  1. All people have an under-utilised capacity, which should be developed 2. All people can be equipped with skills (social, vocational, educational, interpersonal and others) Other 3. People have the right and responsibility for self-determination Principles of 4. Services should be provided in as Psycho-social normalized an environment as possible 5. Assessment of needs and care is different Rehabilitation for each individual 6. Staff should be deeply committed 7. Care is provided in an intimate environment without professional, authoritative shields and barriers.  8. Crisis intervention strategies are in place 9. Environmental agencies and structures are available to provide support 10. Changing the environment Other Principles of (educating community and restructuring environment to care for people with Psycho- mental disability) social Rehabilitation 11. No limits on participation 12. Work centered process 13. There is an emphasis on a social rather than a medical model of care 14. Emphasis is on the client’s strengths rather than on pathologies 15. Emphasis is on the here and now rather than on problems from the past  Goals of Psychosocial Rehabilitation EMPOWER PROVIDE HOPE SKILL TRAINING SUPPORT What is Sociology? Sociology is the scientific study of human social life, groups and societies. "Sociology is the study of human interaction and interrelations, their conditions and consequences." Morris Ginseburg Sociology is derived from the latin word 'Socius' meaning companion or associate and the greek word 'logos' meaning study of science. Sociology calls individuals to break free the immediate circumstance to a wider context. Why Sociology? Manifestation of health Hence health and disease Knowledge of medicine/ problems is the result of cannot be seen in isolation therapies is not sufficient cause an effect from man’s socio-economic to understand the health relationship between position in which he lives problems. organism and the host, and interacts. i.e. human body.  Fundamentals of Sociology Sociology fundamentals are essential concepts and approaches that provide an understanding of the nature and dynamics of human societies. Such fundamental concepts include social interaction, social structure, culture, inequality, and power. Understanding these concepts is crucial for gaining a comprehensive knowledge of the functioning of societies. Moreover, it allows individuals to gain insight into their own experiences as part of a larger society.  Social Interaction Social interaction is an integral part of the human experience. It is a key factor in how we form relationships, develop social norms, and understand our place in society.  Peer influence : ✓ Within the context of peer influence, people tend to conform to the values, beliefs and behaviors of those around them. ✓ We often look to our peers for direction on appropriate behavior, dress and language. ✓ Social norms within a particular group or culture can be Social reinforced through this process. Interaction ✓ Peer groups can also provide an individual with a sense of identity and belonging. Group Dynamics: ✓ Group dynamics refer to the way individuals interact within a group setting. ✓ This includes understanding how people form groups, how they make decisions together, and how they build relationships with one another over time.  Social Structure Social Structure is the study of the arrangement of people within a society and the way these relationships are organized and regulated. Social Structure is a key area of study in sociology as it helps us understand how society is organized and how social change occurs. Different aspects of social structure, such as social stratification, social institutions, and social relationships, sociologists can gain a better understanding of the dynamics of society.  Social Structure Social Stratification is the division of a society into hierarchical layers, determined by wealth, power, or prestige. Social Institutions refer to the organized patterns of beliefs and behaviors centered on basic social needs and values. Social Relationships refer to the relationships that exist between individuals or groups as well as the way in which these relationships are structured  Culture Culture is a complex and ever- evolving essential element of sociology. It encompasses the shared beliefs, values, customs and practices of a group of people, which in turn shapes their collective identity and behavior. Inequality The issue of inequality is one that has plagued society for generations, and continues to be a major challenge today. Inequality can manifest in many forms, including gender roles, racial disparity and economic status. These issues have had a profound effect on individuals and communities around the world, creating significant disparities in access to resources, opportunities and quality of life. Power Power is a fundamental concept of sociology, as it describes relationships between individuals and groups. It can take many forms, such as political power, economic power, and legal power. Understanding the ways in which power operates within society is essential to understanding how social order is maintained and how change occurs.  Disease Webster Definition: ✓A condition in which body health is impaired, ✓a departure from the state of health, ✓an alteration of the human body interrupting the performance of vital functions. ✓Disease – Without ease (Uneasiness). Disease Any malfunctioning process which interferes with the normal functioning of the body is called a disease. In other words, disease may be defined as a disorder in the physical, physiological, psychological or social state of a person caused due to nutritional deficiency, physiological disorder, genetic disorder, pathogen or any other reason.  Germ theory of disease One to One Relationship Disease Agent Man Disease NATURAL HISTORY OF DISEASE From the early stage of prepathogenesis Disease Termination as recovery, disability or death in the absence of treatment Triangle of EPIDEMIOLOGY Environment Environment TIME Agent Host Agent Host  Multifactorial causation Causative Factors TIME Environment, Behaviour, culture, physiological factors Groups/Populations & their and ecological elements characteristics  Disease / Illness Disease refers to the affliction of a specific organ or the entire body due to a harmful microorganism such as bacteria or virus, injury, chemical imbalances in the body, exposure to toxins, and production of immature cells. Susser in 1973 tried to define the term “illness” by referring it to the inner sense of an individual’s feeling unwell. According to him, illness does not refer to any explicit pathology, but refers to a person’s subjective understanding of it, such as discomfort, tiredness, or general malaise.  SICK ROLE Sick role is a term used in medical sociology regarding sickness and the rights and obligations of the affected. Sick role theory was developed in 1951 by Talcott Parsons. The theory states that anyone suffering from an acute illness has a different set of rights than someone who is well. Talcot Parson  RIGHTS RESPONSIBLITY. The sick person is temporarily exempt from The sick person is expected to see being sick as performing ‘normal’ social roles (such as undesirable and so are under the obligation to going to work or housekeeping). try and get well as quickly as possible. The more severe the sickness, the greater the exemption. 2. A genuine illness is seen as beyond the 2. After a certain period, the sick person must control of the sick person and not curable by seek technically competent help (usually a simple willpower and motivation. doctor) and cooperate with the advice of the doctor to get better. Therefore, the sick person should not be blamed for their illness, and they should be taken care of by others until they can resume their normal social role.  Other perspectives in Medical Sociology Emile Durkheim – The medical profession as an institution have an important role in keeping society functional and efficient. According to Parsons the aim of the medical profession was to return an individual to conventional social roles. If this were not to happen it would have a knock-on effect on other institutions and could lead to a breakdown of social ‘body’. Max Weber in his work The Protestant Ethics and the Spirit of Capitalism (1958) viewed the dislocation caused in the society which led to the transition in the cultural beliefs of the religious groups and how it affected the life chances i.e. the mortality rate and the morbidity rate of the people. Parsons believed that doctors could utilize traditional, charismatic and rational / legal authority, yet their role depends upon rational / legal authority to be qualified to be able to define who is sick and who is not. Hence, the role of the doctor was to be a ‘gatekeeper’ to the sick role. Parsons was also influenced by a method of analysis used by Weber, that of the ‘ideal type model’. This is to build a theoretical model of how an institution should  Using Freud’s theories of transference and counter-transference, Parsons likened the relationship to that of a parent and child, with the doctor playing the powerful ‘parental’ role over a passive patient. Influenced by Freud’s notion of ‘conflicting drives’ Parsons’ argued that there is a conflict between the need to get better and the patient enjoying the ‘secondary gains’ of occupying the sick role. Illness Behaviour Illness behavior refers to “the way in which symptoms are perceived, evaluated, and acted upon by a person who recognizes some pain, discomfort or other signs of organic malfunction.” Nature and severity of an illness would be the sole determinants of an individual’s response. Illness behavior is influenced by social and cultural factors in addition to (and sometimes instead of) physiological condition. Stages of Illness behaviour Edward Suchman (1965) devised an orderly approach for studying illness behavior with his elaboration of the five key stages of illness experience: (1) symptom experience (2) assumption of the sick role (3) medical care contact (4) dependent patient role (5) recovery and rehabilitation. STAGE 1: SYMPTOM EXPERIENCE (1) the physical pain or discomfort (2) cognitive recognition that physical symptoms of an illness are present (3) an emotional response of concern about the social implications of the illness, including a possible disruption in ability to function.  The visibility, recognizability, or perceptual salience of symptoms Mechanic identifies The perceived seriousness of symptoms 10 (sometimes The extent to which symptoms disrupt family, work, and overlapping) other social activities factors that determine how The frequency of the appearance of symptoms, their persistence, or frequency of recurrence. individuals respond to symptoms of The tolerance threshold of those who are exposed to and evaluate the deviant signs and symptoms illness. Available information, knowledge, and cultural assumptions and understandings of the evaluator.  Mechanic Perceptual needs which lead to autistic psychological processes. identifies 10 (sometimes overlapping) Needs competing with illness response factors that determine how Competing possible interpretations individuals that can be assigned to the symptoms once they are recognized. respond to symptoms of Availability of treatment resources, illness. physical proximity, and psychological and monetary costs of taking action. ASSUMPTION OF THE SICK ROLE; ILLNESS AS DEVIANCE Other factors of consideration in Stage 2 Symbolic Medicalization of Interactionism: The Demedicalization Deviance Labeling Approach to Illness STAGE 3: MEDICAL CARE CONTACT/SELF‐CARE The Decision The background of the to Seek patient Professional The patient’s perception of Care: It is the illness influenced The social situation. by Self Care THE SELF‐HELP SELF‐HELP GROUPS MOVEMENT  STAGE 4: DEPENDENT‐PATIENT ROLE With the onset of the dependent‐patient role, the patient is expected to make every effort to get well. Some people, of course, enjoy the benefits of this role and attempt to malinger. Eventually, however, the acute patient will either get well and move on to stage 5 or terminate the treatment (and perhaps seek alternative treatment).  Impairments Loss of of personal personal Concerns cognitive independence functioning in Stage 4 Withdrawal from key The future social roles  Kathy Charmaz (1991) has described how experiencing a progressively deteriorating chronic illness can reshape a person’s life and sense of self. Interruption in life Living with Chronic Illness/Disability Intrusive illness Immersion in illness Stage : Recovery and Rehabilitation Acute patients - Chronic patients- relinquishing the sick the extent to which role and moving back prior role obligations to normal role may be resumed. obligations.  Medical Expert Communicator Collaborator Physicians Role Manager Health Advocate Scholar Professional Medical Expert Medical knowledge, skills and attitudes (competence) Clarification, diagnosis and treatment Medical priority-setting Identification of and solution to healthcare problems  Rapport with patient/relatives/colleagues and other collaboration partners Communicator Communication of professional problems (method and media) Mastery of various media (oral, written and visual)  Patient- related/interdisciplinary collaboration Collaborator Patient empowerment Teamwork (leader and team member)  Planning (own time and the time of others) Continuity of care across departments and sectors Charing of meetings Manager Conflict resolution Formal organisational positions Patient safety Quality awareness  Guidance and advice about health- promotion initiatives Responsiveness to repeated Health Harmful/disease- Advocate promoting/pathogenic factors Prevention Health-promotion measures  Reflective approach to own practices and the practices of others Evidence-based knowledge and translation of research into practice Research and development projects Scholar Responsibility for own learning (lifelong learning) Teaching and educational environment  Diligence and conscientiousness Management of professionalism in compliance with the Hippocratic Oath and legislation Decision-making based on limited information Professional The patient's autonomy Role model  The current social role of hospitals reflects their historical development over time, which – it has been argued Hospital as a Social - passed through four phases (Cockerham, 2014): Institution 1. Centres of religious practice 2. Poorhouses: 3. Death houses 4. Centres of medical technology  Hospital as a Social Institution The hospital as a social institution has materially contributed (I) to the community life (2) to the public welfare (3) to the advancement of civilization.  Hospital word has been derived from the Latin word ‘HOSPES’ meaning ‘a host or guest’ or ‘hotel’, hostel. Some also believe that the origin of the hospital from the word ‘HOSPITUM’ a rest house for travelers or night shelter showing ‘hospitality’ to the guests. Hospital as a Hospital is a social organization and logical combination of the activities of several persons with different level of knowledge and Social skill for achieving a common goal of patient care. Institution Hospital as a social organization process through grouping the activities in workable units and connected by authority, communication and control. According to World Health Organization:"The 'hospital is an integral part of a social and medical organization, the function of which is to provide the population complete healthcare, both curative and preventive, and whose out‐patient services reach out to the family in its home environment; the hospital is also a centre for the training of health workers and for bio‐social research." Hospital as a Social Institution Social System Hospital System Structure: roles are expectations of positions that are arranged in a hierarchy.(bureaucratic expectations). e. Social systems are goal g. healthy/treated clients. oriented. Individual: the individual is a key unit in any social system; regardless of position, people bring with Social systems are peopled. them individual needs, beliefs, and a cognitive Social systems have structure. understandings of the job. Social systems are political. Culture: represents the unwritten feeling part of the organizations:its shared values Social systems have cultures. Politics: formal and informal power relations that Social systems have norms. develop spontaneously. Social systems are conceptual Feedback: communication that monitors and relative. healthy/unhealthy habits. Effectiveness: the equivalence between expected and actual outcomes. References https://www.ministrymagazine.org/archive/1942/05/hospital-as- a-social-institution-3 https://www.brainkart.com/article/Hospital-as-Social- Organization_23485/ https://www.brainscape.com/flashcards/the-hospital-as-a- social-system-and-bure-10426000/packs/18359983