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In Canada the “framework for support” was developed as an alternative to this professional model (Trainor et al., 1992). In this conceptualization, the core approach that is expected to lead to integration and success is not the use of professional services, but self-help. People are expected to draw upon family, friends and other close, freely given relationships for support. It is further assumed that people should expect support from generic community organisations and associations, like churches, social clubs and community service agencies. Lastly, people should expect services from the formal mental health system. Rehabilitation services are organized primarily to “support the supporters”, in other words, to bolster the efforts of self-help, natural relationships, and community resources (Carling, 1995). This conceptualization of a community support model seems to be an effective way of thinking about integration, since it more closely relates to the manner in which all citizens, regardless of any special needs or circumstances live in and expect to receive support in their communities.
In this approach the elements of a community support system around a person with an illness or disability are:
Rehabilitation services may well be part of the mental health system, but also be one of the community resources. They can also be a bridge between the two, and provide support to make self-help (in terms of recovery, skill development and so on) and informal care from social networks possible.
Personal support system and community support
We would describe a modern community support system as complementary to an individual or personal support system. This is illustrated in the next picture.
The type of support will depend on the specific needs connected to different life and personal domains. In the CARe model, eight different domains are described: four life domains (the areas of housing, working, learning, and recreating) and four personal domains (self care, health, purpose and meaning, and social relationships) (Wilken & Den Hollander, 2005).
|Life domains||Personal domains|
|Learning||Purpose and Meaning|
A person might need in one domain a completely different support than in another domain. Someone can be depending on persons in one area, in order to be independent in another.
For example, someone can be quite capable of being self-supportive in the domain of work; while at home he needs assistance to keep the house tidy and managing the budget. Receiving some support to keep a stable living situation at home can mean to be successful at work.
Rehabilitation and other community services can also be arranged according to this model of life and personal domains. It will then look like this.
|Life domains||Community Resources||Rehabilitation Services|
|Housing||Housing Agencies||Living Skills Training |
|Working||Labour services (e.g. job coaching)||Vocational Training |
|Learning||Educational services (e.g. remedial teaching)||Learning Skills Training |
|Recreating||Sports clubs, Community Centres||Supported Recreation |
|Personal domains||Community Resources||Rehabilitation Services|
|Self Care||family; home care; financial services||Counselling; home care|
|Health||G.P.; community nurse; fitness club||Skill development programmes (e.g. symptom/medication management); |
Counselling; psychiatric home care
|Purpose and Meaning||social network; activities in the life domains; religious communities||Personal-professional support; Counselling|
|Social relationships||family, friends, neighbours, colleagues etc.||Personal-professional support; |
Social Network Development;
For more reading see:
Wilken J.P. and D. den Hollander (2005). Rehabilitation and Recovery. Amsterdam: SWP Publishers.
Bloom, E. (2009).The Effectiveness of Community Support Systems and Psychosocial Rehabilitation Services for Mentally Ill Children and their Families. International Journal of Psychosocial Rehabilitation. Vol 14(1). 4-20
last edited by Jean Pierre Wilken March 2013