Rehabilitation of Spinal Cord Injured: A Family Approach

Abstract

The impact of severe injury and disability extends beyond the. injured person to the family, friends and general society. One group of severely disabled, the spinal cord injured, increases at an estimated 10,000 cases per year. These clients have been difficult and expensive to rehabilitate. To meet the needs of hard-pressed rehabilitation programs, new concepts and approaches to rehabilitation must be researched. One response to these needs is the use of the family as an adjunct to the rehabilitation process. A family involvement program for spinal cord injured, developed at Georgia Warm Springs Rehabilitation Complex, Warm Springs, focuses on both process and outcome variables in four major areas: medical, social, psychological and vocational.A four stage adaptation process was identified during work with spinal cord related patients. The initial stage, Anxiety, usually occurs within the first nine months post injury; the second stage, Accommodation, occurs between the tenth and twenty-fourth months; and the third stage, Assimilation, occurs after the second year and continues for a lifetime. A fourth stage, Reflux, can occur at any time and is a regression to an earlier stage.Allowing sufficient time for the adaptation process is essential if vocational rehabilitation is to become more effective with the spinal cord injured. An analysis of time post injury and successful completion of vocational evaluation and/or training (E/T) programs indicates patients injured longer than one year at entry into the programs have a greater probability of completing E/T than do patients injured less than one year at the time of admission to the programs.This research was sponsored in part by Grant #12-P-57897 from the Rehabilitation Services Administration, Department of Health, Education and Welfare, Washington, D.C.