ABSTRACT
Acquired physical disability impacts upon all aspects of an individual’s life: physical, emotional, social and vocational. Rehabilitation involves either regaining old skills or learning new and compensatory skills to cope with a changed life circumstance and fundamentally involves behaviour change. Rehabilitation has been defined as ‘a reiterative, active, educational and problem solving process focused on a patient’s behaviour (disability)’ (Wade and de Jong, 2000:1386, parenthesis in original). It is a team effort involving the knowledge and skills of an interdisciplinary team in partnership with the patient. Rehabilitation can only be effective with the individual’s proactive involvement in the process and they need to be provided with a framework to understand the new skills that need to be acquired in order to manage the consequences of their changed physical state. Active client involvement in rehabilitation has been found to facilitate long-term physical and psychological adjustment (Norris-Baker et al., 1981) and helps to translate and maintain skills in the person’s everyday life. Goal orientated rehabilitation planning is critical for people with acquired disability. It enables the individual to develop a sense of control over their new life circumstance and to be taught and to learn the skills essential for resuming an independent and satisfying life. Implicit within a goal planning system are many of the key aspects of The Expert Patient approach (Department of Health, 2001) which aims to increase a patient’s sense of control, the individual becoming an active participant in their own health care, and to develop skills to effectively manage their health condition, which in turn promotes the individual’s adjustment and accommodation to their changed circumstance. Such approaches have also been found to reduce morbidity, mortality and secondary complications (Department of Health, 2001). This chapter outlines the history and development of goal setting theory and the central issues of this theory within rehabilitation services. The role of the interdisciplinary team, the quality of communication and the need to ensure patient involvement are highlighted as key processes which impact on the effectiveness of rehabilitation planning and provision.
