Организационно-методологические основы системы психологической реабилитации в контексте концепции «Внутренней картины инвалидности»
Authors: Rybnikov Viktor Yu. , Morozova Elena V. 
Published: May 2018

The article brings forward the results of the study continuing a series ofscientific elaborations of the construct of the internal picture of disability. The purpose of this series is to improve rehabilitation approaches by means of rising the adherence to rehabilitation within the psychological paradigm and the rehabilitation context as a whole.This paper summarizes the results of the study of personal, adaptive reactions of patients to a situation of disabling diseases on account of socioeconomic and physiological consequences of the disease. Patients with the main disabling pathologies (n = 510), forming a leading position in the structure of disability of the Russian Federation, took part in the study. Statistical processing of the complex of psychological parameters made it possible to assess the structure of psychologicalprocessing of a situation of disabling diseases in patients in the context of a rehabilitation willingness to cope with the arising effects of the disease. The study reveals the specificity of rehabilitation activities, which is characterized by varying degrees of inclusion of psychological resources depending on the degree of frustration. Minor frustration is mainly characterized by a psychological fixation on the disease; its further growth potentiates the patient to a greater variability ofadaptive behavior with the shift of responding from the focus of negative effects of the disease to personal self-determination, reflection of personal values and senses. A high degree of frustration blocks the rehabilitation activity; it is shown in a “chaotic” character of reactions with a retreat from a reflective component into predominance of non-adaptive “emotional” strategies. The study reveals major rehabilitation “markers” which characterize personal rehabilitation potential andrehabilitation prognosis for the effective formation of the individual program of rehabilitation of patients.The authors offer the model of the system of psychological rehabilitation in the context of the concept of the internal picture of disability and reveal its organizational, procedural, and methodological aspects. They also state objectives, principles, conditions, criteria of an effective rehabilitation outcome, sequence of rehabilitation activities, and existing problems in the effective implementation of rehabilitation of patients at various stages of The article brings forward the results of the study continuing a series of scientific elaborations of the construct of the internal picture of disability. The purpose of this series is to improve rehabilitation approaches by means of rising the adherence to rehabilitation within the psychological paradigm and the rehabilitation context as a whole. This paper summarizes the results of the study of personal, adaptive reactions of patients to a situation of disabling diseases on account of socioeconomic and physiological consequences of the disease. Patients with the main disabling pathologies (n = 510), forming a leading position in the structure of disability of theRussian Federation, took part in the study. Statistical processing of the complex of psychological parameters made it possible to assess the structure of psychological processing of a situation of disabling diseases in patients in the context of a rehabilitation willingness to cope with the arising effects of the disease. The study reveals the specificity of rehabilitation activities, which is characterized by varying degrees of inclusion of psychological resources depending on the degreeof frustration. Minor frustration is mainly characterized by a psychological fixation on the disease; its further growth potentiates the patient to a greater variability of adaptive behavior with the shift of responding from the focus of negative effects of the disease to personal self-determination, reflection of personal values andsenses. A high degree of frustration blocks the rehabilitation activity; it is shown in a “chaotic” character of reactions with a retreat from a reflective component into predominance of non-adaptive “emotional” strategies. The study reveals major rehabilitation “markers” which characterize personal rehabilitation potential and rehabilitation prognosis for the effective formation of the individual program ofrehabilitation of patients. The authors offer the model of the system of psychological rehabilitation in the context of the concept of the internal picture of disability and reveal its organizational, procedural, and methodological aspects. They also state objectives, principles, conditions, criteria of an effective rehabilitation outcome, sequence of rehabilitation activities, and existing problems in the effective implementation of rehabilitation of patients at various stages of the disease (before disablement, being registered as a disabled person, and after disablement), including possible practices for improving efficiency of psychological rehabilitation of patients.