Psychosocial Rehabilitation

Psychosocial Rehabilitation, or PSR, is designed to help adults with a severe mental illness such as major depressive disorder, schizophrenia, bipolar disorder, or co-occurring disorders with significant functional impairments use their strengths to increase functioning and improve their lives. It focuses on helping people recover from the effects of their illness and regain control over their lives.

Recovery is an important concept with regards to PSR as it stands for rebuilding a meaningful and valued life despite having struggled with mental illness. For people who are on the path towards recovery from mental illness, getting back to their family/social/work life is challenging and even intimidating!

Setting goals is a vital process within PSR in order to get clients to the point of feeling that their quality of life is sufficient, and they are able to reintegrate into society in the most functional way possible. Recovery works towards instilling hope in clients who are looking to live their lives, even with the limitations caused by mental illness.

PSR differs from the traditional medical model of rehabilitation in that focus is now placed more so on health and wellness, rather than apparent symptoms of the client. We look at what a person can do, not what their disabilities are.

PSR services are provided in the community such as in the client's home or other locations necessary to help increase functioning within the client's community. Services include independent living services, coordination services, and employment, housing, and medication-related services.

Specific Services include:

Independent living skills
Individual, family, and group skills training for a variety of diagnoses
Skills training in anger management, conflict resolution, problem solving, coping, etc.
Crisis stabilization/supports, handling emergency and crisis situations
Supports and training to apply for state/ county services, and/or grant programs
Training/supports on understanding and living with a mental health diagnosis
Employment Supports (skills training on locating, obtaining, and maintaining employment)
Family relations and family dynamics skills training
Parenting skills training
Community Access (transportation, using community resources, locating community resources
Cultural and/or religious supports (finding and accessing community resources)
Other areas as needed and deemed medically necessary

Psychosocial rehabilitative services that include, but are not limited to, the following component services:

independent living services;
coordination services;
employment related services;
housing related services;
medication related services; and
crisis related services.

Components of psychosocial rehabilitative services. Psychosocial rehabilitative services include, but are not limited to, the following:

(1) Independent living services assist an individual in acquiring the most immediate, fundamental functional skills needed to enable the individual to reside in the community and avoid more restrictive levels of treatment or reducing behaviors or symptoms that prevent successful functioning in the individual's environment of choice. Such services include training in symptom management, personal hygiene, nutrition, food preparation, exercise, money management and community integration activities.

(2) Coordination services are training activities that assist an individual in improving his or her ability to gain and coordinate access to necessary care and services appropriate to the needs of the individual. Coordination services include, but are not limited to, instruction and guidance in such areas as:

assessment--identifying strengths and areas of need across life domains;
recovery planning--prioritizing needs and establishing life and treatment goals, selecting interventions, developing and revising recovery plans that include wellness, relapse prevention, and crisis plans;
access--identifying potential service providers and support systems across all life domains (e.g., medical, social, educational, substance use), initiating contact with providers and support systems including advocacy groups;
coordination--setting appointments, arranging transportation, facilitating communication between providers; and
advocacy-- (i) asserting treatment needs, requesting special accommodations, evaluating provider effectiveness and compliance with the agreed upon recovery plan; and (ii) requesting improvements and modifications to ensure maximum benefit from the services and supports.

(3) Employment related services provide supports and skills training that are not job-specific and focus on developing skills to reduce or manage the symptoms of serious mental illness that interfere with an individual's ability to make vocational choices or obtain or retain employment. Such services consist of:

instruction in dress, grooming, socially and culturally appropriate behaviors, and etiquette necessary to obtain and retain employment;
training in task focus, maintaining concentration, task completion, and planning and managing activities to achieve outcomes;
instruction in obtaining appropriate clothing, arranging transportation, utilizing public transportation, accessing and utilizing available resources related to obtaining employment, and accessing employment-related programs and benefits (e.g., unemployment, workers' compensation, and Social Security);
interventions or supports provided on or off the job site to reduce behaviors or symptoms of serious mental illness that interfere with job performance or that interfere with the development of skills that would enable the individual to obtain or retain employment; and
interventions designed to develop natural supports on or off the job site to compensate for skill deficits that interfere with job performance.

(4) Housing related services develop an individual's strengths and abilities to manage the symptoms of the individual's serious mental illness that interfere with the individual's capacity to obtain or maintain tenure in independent integrated housing. Such services consist of:
skills training related to:

home maintenance and cleanliness;
problem-solving with the individual's landlord and neighbors, mortgage lender, or homeowners association; and
maintaining appropriate interpersonal boundaries; and
supportive contacts with the individual to reduce or manage the behaviors or symptoms related to the individual's serious mental illness that interfere with maintaining independent integrated housing.

(5) Medication related services provide training regarding an individual's medication adherence. Such services consist of training in:

the importance of the individual taking the medications as prescribed;
the self-administration of the individual's medication;
determining the effectiveness of the individual's medications;
identifying side-effects of the individual's medications; and
contraindications for medications prescribed.

(6) Crisis related services respond to an individual in crisis in order to reduce symptoms of serious mental illness or SED and to prevent admission of the individual to a more restrictive environment.

Eligibility

Be 18 years or older.
Be enrolled in and actively covered through Texas Medicaid.
Be diagnosed with a severe mental illness.
Have a significant functional impairment.
Complete an full intake diagnostic evaluation.

If you or someone you know:

Is experiencing chronic and severe psychiatric conditions
Needs assistance in restoring skills for independent living in the community
Is experiencing mental health/co-occurring symptoms and needs ongoing assistance
Lacks a supportive environment and resources needed to reach recovery goals

They may benefit from involvement in PSR.

For more information on Psychosocial Rehabilitation and/or other Texas Care services, feel free to call 888-98TODAY and an Intake Coordinator will be happy to take your call and direct you to the appropriate department.