Draft:Integrative Rehabilitation

“Integrative Rehabilitation” is a term that is used to describe one of the modern approaches to understanding the term “Rehabilitation” – which necessarily does not imply a clinical or a medical situation requiring post-treatment or post-recovery rehabilitative measures. Instead, it emphasises upon an individual-to-society approach - relying on recognising the individuality of each person as a sum total of his/her genetic legacy and their own individual exposures and experiences over time, which are retained by them as memories which in-turn shape their eventual personalities. Thus, it recognizes each person to be a combination of “Nature” and “Nurture” – which maintains a by-default complementary relationship with its surroundings.

“Integrative Rehabilitation” or integrated, all-encompassing rehabilitation essentially revolves around recognizing and simultaneously invoking all aspects that make up an individual – meaning their physical, psychological, social and spiritual aspects - in a manner that each of these highly inter-related aspects are touched upon as part of the individual’s daily routine for its betterment and for eventually achieving a dynamic balance between these aspects – enabling the individual to be equipped to handle any foreseen or unforeseen experiences or situations in a balanced and totalitarian manner – addressing the same completely, as maybe required.

Unifying conceptual model of integrative rehabilitation

“In a democratic society, we have no alternative than to recognize the individual's right to be aided to as much independence as is his desire and capacity. Furthermore, the economic welfare of the community demands the maximal utilization of all persons.”

“The concept of "habilitation" in rehabilitation would evidently include not only the medical but also the social, psychological and vocational, since the basic orientation is one of total development towards a mature citizenship."

"While it is true that through specialization - we have acquired the ability to define many problem better than they have ever been defined; yet in terms of effectiveness and balance in treatment, we often have not profited as much as we should have, and indeed, in some instances, have failed through our narrowness of perspective. Professions are arbitrary classifications, so that fundamentally all treatment should be total treatment, not just medical or social or psychological, vocational or any other subdivision."

"The ideal goal, then, is to try to understand the dynamic whole person in his total environment with a full appreciation of his life term process.”

Reference : The Utilization of Human Resources: A Philosophic Approach to Rehabilitation - FREDERICK A. WHITEHOUSE (10.1378/chest.30.6.606 CHEST December 1956 vol. 30 no. 6 606-6)

History

“Rehabilitation is both philosophy and a discipline (Secrest, 2007).”

Reference : Chronic illness: impact and intervention, By Pamala D. Larsen, Ilene Morof Lubkin, Pg 595

A structure for the organization of human functioning and rehabilitation research

WHO's integrative model of human functioning (ICF) makes it possible to identify 5 distinct scientific fields of human functioning and rehabilitation research – of which the integrative rehabilitation sciences design and study comprehensive assessments and interventions that integrate biomedical, personal factor and environmental approaches suited to optimize people's performance. This organization of human functioning and rehabilitation research into the 5 distinct scientific fields facilitates the development of academic training programs and career building as well as the development of research structures dedicated to human functioning and rehabilitation research

However, integrated rehabilitation or an all-encompassing approach to human development - in its varied forms and names has always existed within mankind throughout the ages in what we commonly know as “culture” – which gets established by customs, law, education or inclinations and stems from the essential moral principles which we all accept. All cultures and traditions around the world emphasise upon the need for its practitioners to be “ideal” individuals and to be a role model for others. It is this aspect of human existence that has been taken up in modern times by various groups of people and movements to set an example in front of others – advocating their independent methodologies and processes for achieving “ideal” individuals and an “ideal” society.

“For rehabilitation is not a discrete moment in time but a series of connected events in the life process of development, maturation and decline."

"The cultivation, restoration and preservation of human resources have not begun in our lifetime, but with the first concern of one man for another.”

Reference : The Utilization of Human Resources: A Philosophic Approach to Rehabilitation - FREDERICK A. WHITEHOUSE (10.1378/chest.30.6.606 CHEST December 1956 vol. 30 no. 6 606-6)

"While integrating approaches to achieve optimal capacity in a “standard situation or environment”, its ultimate goal is optimal performance in real life. At the individual level, the integrative rehabilitation sciences are committed to research on closing the gap between capacity and performance, or closing the gap between what is possible in principle and what is possible in people’s life. At the population level, the integrative rehabilitation sciences are committed to research on closing the gap between what is being done and what could be done to address people’s needs."

Reference : Journal of Rehabilitation Medicine (Vol. 39/2007 > Iss. 4/May) - Organizing human functioning and rehabilitation research into distinct scientific fields. Part I: Developing a comprehensive structure from the cell to society – By Gerold Stucki and Gunnar Grimby

Integrative Rehabilitation Sciences – one of five distinct scientific fields of human functioning and rehabilitation research

Approaches to Integrated Rehabilitation

Nearly all traditional approaches to integrated rehabilitation rely upon the concept of “God” as being the creator and the one who is the “ideal” super person – and onto this benchmark all need to progress. However, other recent approaches which are still less common rely upon science and human intellect to further this evolution of mankind.

Inevitably, all the approaches - one way or the other - advocate an “ideal” way of leading life which focuses upon both the individual and his/her larger responsibility towards his surroundings and fellow-beings.

“The integrative perspective of Human Functioning and Rehabilitation provides a new option for biomedical researchers and health professionals to look beyond their immediate fields of expertise. It also constitutes a particular opportunity for researchers from related disciplines like Psychology or Sociology to embark into a research area which is highly relevant to both individual lives and societal practice which crosses the boundaries of the Natural Sciences and Engineering Research, the Human and Behavioral Sciences and the Social Sciences."

"The goal is to combine knowledge and models of differential disciplines in order to comprehensively understand human functioning across health conditions, individuals, and environments."

Reference : Trends and Reflections - Developing Human Functioning and Rehabilitation Research from a comprehensive perspective (ACTA FISIATR 2008; 15(1): 63 – 69) – By Gerold Stucki, Jan Dietrich Reinhardt, Gunnar Grimby, John Melvin

Types of Integrated Rehabilitation Initiatives

A widely recognized example of integrated rehabilitation would be the Auroville township near Puducherry in Southern India – which was founded by Sri Aurobindo and his leading disciple, widely known as The Mother.

"Auroville wants to be a universal town where men and women of all countries are able to live in peace and progressive harmony above all creeds, all politics and all nationalities. The purpose of Auroville is to realise human unity."

This project aims at furthering and accelerating the evolution of human race and has succeeded in bringing together people of multiple nationalities together at Auroville which represents somewhat a miniature globe at Auroville. The Aurovillian mission for advancing human evolution as a scientific mission unrelated to any religion – is more clearly stated in its introductory video mandatory to be viewed by all individuals desirous of entering the inner precincts of this settlement. It is a pioneering example and one which is trying to bridge the distance between terms like divine and super-consciousness with applied factual science in their resident’s daily lives at “the universal city”, Auroville.

A more recent yet differing example for application of this integrated rehabilitation is a for-profit corporate organization named MGRM, which operates out of India and US. The company espouses the vision of a complete personality possible in every individual through its set of processes and methodologies labeled M.E.P. (MGRM Engineering Practices) and implemented through M.I.P. (MGRM Implementation Platform) – which is a derivative of ERP (Encompassing Rehabilitation Platform) tools. The practices aim at simulating situations and challenges to it employees continually albeit simultaneously shifting the focus of the practices directed at an individual from macro to micro and vice-versa - without any prior laid-out roadmap being shared with that individual – thus, resulting in achieving an unambiguous response to any given situation from the individual and also engagement of the employee for longer durations due to newer interests being made available to them continuously. The resultant effect is stated to be long-term as it is said to invoke high-levels of demand upon the mental and physical faculties together and thus leaving a lifelong imprint.

“Scientology” also maybe considered an example of this integrated rehabilitation as it “believes that an individual placed in a position where he can increase his abilities, where he can confront life better, where he can identify the factors in his life more easily, is also in a position to solve his own problems and so, better his own life.”

“Its end result is increased awareness and spiritual freedom for the individual and rehabilitation of his basic decency, power and ability.”

Another similar example would be the Dayal Bagh Educational Institute, run by the Radha Saomi Satsang near Agra in North India.

“The Institute is situated at DAYALBAGH, a self-contained colony well-known for its serene environment, secular establishments like the industries, the educational institutions, the agriculture farm etc. and the activities of its inmates who lead an active, disciplined and co-operative community life, conforming to the high spiritual ideals of their faith.”

Here again the organisation aims at achieving progress of human intellect “within its special social, moral, and spiritual framework”. Somewhat similar to the earlier two examples for application of encompassing rehabilitation, however, here at Dayal Bagh, a clear emphasis is made on the acceptance of existence of “God”.

Selected scientific disciplines related to integrative rehabilitation

References

1. The Utilization of Human Resources: A Philosophic Approach to Rehabilitation - FREDERICK A. WHITEHOUSE (10.1378/chest.30.6.606 CHEST December 1956 vol. 30 no. 6 606-6) – (http://chestjournal.chestpubs.org/content/30/6/606.short)
2. Chronic illness: impact and intervention, By Pamala D. Larsen, Ilene Morof Lubkin, Pg 595 – (http://books.google.co.in/books?id=3MHK5cjX3Q4C)
3. Journal of Rehabilitation Medicine (Vol. 39/2007 > Iss. 4/May) - Organizing human functioning and rehabilitation research into distinct scientific fields. Part I: Developing a comprehensive structure from the cell to society – By Gerold Stucki and Gunnar Grimby - (http://jrm.medicaljournals.se/article/abstract/10.2340/16501977-0050), also at - (http://www.ncbi.nlm.nih.gov/pubmed/17468801)
4. University of Southern California about encompassing nature of rehabilitation (http://www.usc.edu/projects/rehab/research/)
5. MGRM website about their MEP and MIP process (http://www.mgrm.com/businesses/net.html)
6. Scientology website - about “Auditing” process practiced (http://www.scientology.org/what-is-scientology/the-practice-of-scientology/comparison-to-other-practices.html ; http://www.scientology.org/faq/scientology-beliefs-and-practices/what-are-the-religious-tenets-of-scientology.html)
7. Trends and Reflections - Developing Human Functioning and Rehabilitation Research from a comprehensive perspective (ACTA FISIATR 2008; 15(1): 63 – 69) – By ¹Gerold Stucki, ²Jan Dietrich Reinhardt, ³Gunnar Grimby, ⁴John Melvin

1 Department of Physical Medicine and Rehabilitation, Ludwig-Maximilian University Munich, Germany; ICF Research Branch of the WHO CC FIC (DIMDI), Institute for Health and Rehabilitation Sciences, Ludwig-Maximilian University Munich, Germany; Swiss Paraplegic Research, Nottwil, Switzerland. 2 Swiss Paraplegic Research, Nottwil, Switzerland; Faculty of Humanities, University of Lucerne, Lucerne, Switzerland. 3 Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska; Academy, Göteborg University, Göteborg, Sweden. 4 Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, United States of America. (http://www.actafisiatrica.org.br/v1%5Ccontrole/secure/Arquivos/AnexosArtigos/9C01802DDB981E6BCFBEC0F0516B8E35/acta_15_01_63_69.pdf)

External links

1. For Auroville – www.auroville.org
2. For Scientology – www.scientology.org
3. For MGRM – www.mgrm.com
4. For Dayal Bagh Educational Institute – www.dei.ac.in , www.dayalbagh.org.in

Category:Human development