From the Idealization of Models to the Valorization of Practice: Reflections and Comments on a Trajectory of Development

Abstract

The development of rehabilitative practices represents a spontaneous and natural phenomenon in all psychiatric services that have to deal with psychotic pathology. These practices are matched by an ever-increasing number of theories and models of rehabilitation, producing a conceptual babble that often serves as an alibi for anyone who upholds the primacy of therapy, understood as the only certified truly curative factor. Rehabilitative practices are characteristically the product of a therapeutic team or of some of its members, and are based on simply the laudable intention to do something concrete to reduce the disability of the most severely ill patients. More specifically, it seems inevitable that staff members should involve themselves with the patient in the various demands that come up in the course of the illness and should want to give the patient a hand in his desire to be normal. Sometimes this takes place independently of the theoretical and methodological options of the work group, if not directly in a manner totally devoid of theoretical and methodological references (and prejudices). In addition to this formative process, there is usually a redefinition of the quality of the process of care and of the day-to-day operational relation between therapy and rehabilitation. The patient is no longer merely the object of medical care, but participates in diverse initiatives organized spontaneously by nurses and social workers, such as, for instance, football