The psychological and social aspects of a physical rehabilitation programme for fire service personnel

Abstract

Aims; There is a demand for a more precise clarification of how and why complex interventions in rehabilitation settings work. This study uses clients' experiences to better understand the contextual factors of a residential rehabilitation programme, based on a biopsychosocial approach, for fire service personnel. Methods; This study used a qualitative approach and collected data from focus groups. Two focus groups using a creative technique were undertaken to derive themes for an interview guide for the two traditional focus groups that followed. The data were analysed using thematic analysis. Results; The focus groups showed that the shared fire service background was key in enabling clients to return to fire service ‘banter’, which was missing during their previous isolated rehabilitation. The focus groups also showed that sharing rehabilitation stories with others in a similar position was enabling and restorative. The dissonance between self as a capable firefighter and self with injury or illness caused the clients to have to manage an altered identity. Conclusions; The disruption of self-identity caused by illness or injury is a central feature in rehabilitees' personal experience and reducing identity dissonance appears to be a central feature of successful biopsychosocial rehabilitation. This study identified that psychosocial processes contribute to effective rehabilitation and include being with others you believe to be ‘similar’ with whom to verbalise and acknowledge personal experience and peer-to-peer support.