The concept of quality of life (QOL), as a psychosocial construct, process, measure, goal, and outcome, has gained much popularity in the rehabilitation literature during the past 35 years. As both a goal (i.e., assisting clients with chronic illnesses and disabilities (CIDs) to attain a better QOL) and a process-outcome indicator (i.e., assessing both subjective and objective levels of QOL during and following rehabilitation interventions), QOL has become one of the most prominent and central concepts in the field of rehabilitation. This chapter familiarizes the reader with the conceptual and temporal parallelism underlying the domains of community interventions and personal coping, of which rehabilitation services are an essential component, as part of their joint goal to improve QOL. It provides examples from the field of psychosocial rehabilitation, and more specific coping with CID, that address the temporal nature of QOL-improving coping strategies.
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- Go to chapter: Quality of Life and Coping With Chronic Illness and Disability: A Temporal Perspective
This chapter provides the reader with an overview of (a) the dynamics (i.e., process) of psychosocial adaptation to chronic illness and disabilities (CID), (b) methods commonly used to assess psychosocial adaptation to CID, and (c) intervention strategies applied to people with CID. The chapter groups the psychosocial adaptation to CID under three headings: basic concepts such as stress, loss and grief, and quality of life, CID-triggered reactions, and CID-related coping strategies. The literature on CID-related coping strategies is vast. The chapter describes only a cursory overview of the most commonly reported strategies, directly related to coping with CID. It first briefly discusses the concept of coping and illustrates its relevance to CID. Over the past half century, a large number of measures of psychosocial adaptation to and coping with CID have been reported in the literature. The chapter reviews only those psychometrically sound measures most frequently reported in the literature.
There is power in revisiting the underlying foundational principles of our past and looking at how they can inform our present and future functioning. This chapter looks back at the historic foundational principles of rehabilitation psychology (RP) and shows the links to current research on the psychology of well-being and explores implications for providing meaningful interventions that could improve the lives of persons with disability and chronic illness. It reviews how positive psychology (PP) approaches have been used for people with disabilities (PWD), presents an overview of the development and structure of well-being therapy (WBT), including a literature review, and then demonstrates how it could be applied to people with spinal cord injury (SCI). The chapter concludes with a discussion of the broader implications for utilizing these approaches more widely in RP as well as a cautionary note.
The chapter explores the history from the middle ages to the present day, noting the trials and tribulations of a population that continues to remain poorly understood and misperceived by the general public. Conditions for people with psychiatric disabilities did not fare much better in the American colonies. Similar to the circumstances during the Middle Ages, care for this population was the family’s responsibility if they had a family to care for them. Moral treatments began to decline in the second half of the 19th century in favor of somatic therapies and behavioral control techniques. Although psychiatrists initially scoffed at the notion that the quality of the care they provided in mental hospitals was subpar, research was conducted in the treatment of mental illness that brought about improvements. Physicians continued to develop and work toward improvement of somatic treatments for psychiatric disabilities in the early part of the 20th century.
The skills of working with the psychosocial aspects of grief, death, dying, and loss are essential, particularly in working with persons who have acquired chronic illness and disability. This chapter helps elucidate important psychosocial issues in death and dying as it relates to how individuals experience and express grief within the context of the person’s physical, psychological, cognitive, emotional, social, cultural, and spiritual well-being. Recognition in the new Diagnostic and Statistical Manual of Mental Disorders (DSM- 5) of the Persistent Complex Bereavement Disorder diagnostic category provides legitimacy for the individual’s sense of loss and mourning based on multiple events related to death and dying. It is essential that counselors address such psychosocial concerns clients because of the added therapeutic value and ethical obligation to guide the individual and his or her family in important decisions regarding death and dying.