REHABILITATION of individuals with loss of a body function may reach a stalemate because of psychological mechanisms which interfere with adequate cooperation between the patient and the rehabilitation staff. Psychiatric consultation can clarify the way the patient is dealing with his disability. The subsequent successful management, however, may depend on the insight of the nursing and physical and occupational therapy staffs, into the mechanisms at work in the patient and also into the nature of their own responses.
This paper will describe some common mechanisms leading to a rehabilitation stalemate and a staff-education program developed to deal with these problems.
Procedure
For the past two years the Psychiatry Department of Tufts-New England Medical Center has been engaged in a series of formal and informal consultations with patients in our Rehabilitation Institute. Three to four patients per week are seen in brief psychiatric consultation and