In research of rehabilitation, an increasing interest can be detected towards group community intervention programs in different rehabilitation areas having results feasible, acceptable, achieving provable improvements and enhance quality of life (Elsie, Lap, 2006) In practice and in some pilot studies we have been introduced, for instance, the efficacy of an outpatient cognitive behavioral group program for the rehabilitation of adult patients with chronic pain. Significant improvements in mood, coping skills, physical disability were found. (Skinner, Erskine, et al 1990). An other investigation proved the efficiency of aqua-aerobic programs in Multiple Sclerosis which are carried out in group situation for physically disabled (Pérez, et al, 2007). However, less emphasis has been laid specifically on the relationship between social, emotional and physical dimensions of the development within group setting but some scholars have already expressed that the motivational aspect provides evidence for the use of groups in physical rehabilitation. (Lawson, Sonja Kristi, 2006).
The successful management of physical disabilities is critical to successful healthcare delivery. The development of practice and approaches are the most important factors in this field. Contributions from a range of experienced researchers and practitioners associated with the rehabilitation and treatment of people with a range of physical disabilities are mostly based on the traditional point of view of delivery; carried out person to person, in the way of individualized therapy. In relation to recent researches, however, the greater significance of development of practice and approaches of physical disabilities is when emotional, social aspects are also involved and psychological management takes great place. (Kennedy & Paul 2007).
“The assets of the person must receive considerable attention in the rehabilitation effort. A person’s healthy physical and mental attributes can become a basis for alleviating as well as providing a source of gratification and enhancement of life. The active participation of a client in the planning and execution of the rehabilitation program is to be sought as fully as possible.” (Beatrice Wright, 2005) In this respect, and critique of traditional point of view of delivery, the predictive quality of practice alternatively could be increased by changing contribution from person to person to group setting in certain areas (such as Parkinson disease, Head injury, Stroke - Aphasia, Ataxia, MS, CP, Ageing).
The implication of emotional, social aspects in the management of physical disabilities shed light upon the links between health science, social psychology, pedagogy, sport science and it seems to be drawing a more holistic contribution. The link between rehabilitation and education, the adult education point of view shell introduce accordingly a ‘new’ possible way of rehabilitation of motor-disabled, the group setting, and the possibility of community intervention programs. (Szogeczki L 2008) “Human beings are group beings” (R. Brown, 2000) “physical disabled are humans, so physical disabled, should be group beings, too and everything what was studied and discovered on group approach for healthy people or people with behavioral, emotional and social difficulties should related to group of people with physical difficulties as well. Group processes is deepen our understanding of relationships within and between groups of motor-disabled and should conduct the successful healthcare delivery.” (Szogeczki L 2008) From generous educational point of view there is no question about the possibility and the success of group setting. Conceptions of adult transformative learning of Mezirow and the most recent alternative perspectives in contrast to Mezirow’s psycho-critical perspective lead us to the psychoanalytic, psycho-developmental and social-emancipatory views of transformative learning. The mentioned teaching approaches could be considered to work in the process of tackling the problems of the adult physical disabled. A forth perspective however, seems to be of crucial importance: the neurobiological perspective of transformative learning (Janik 2005).
This “brain-based” theory was discovered by clinicians using medical imaging techniques to study brain functions of patient who were recovering from psychological trauma. What these researchers determined was that a neurobiological transformation seen as invoking “the parasympathetic branch of the autonomic nervous system, and the hypothalamic-pituitary pitocin secreting endocrine system to alter learning during periods of search and discovery.”(Janik, 2007, p.12) In simpler terms the findings suggest that the brain structure actually changes during the learning process. These findings turn bring into question of traditional models of learning…and instead offer a distinctive neurobiological, physically based pathway to transformative learning. (Taylor, 2008, p.8)
Psychotherapy is an interpersonal, relational intervention to aid clients in problems of living. This includes increasing individual sense of well-being and reducing subjective discomforting experience. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change and that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family). Gestalt therapy is an existential and experiential psychotherapy that focuses on the individual's experience, the environmental and social contexts in which these things take place, and the self-regulating adjustments people make as a result of the overall situation. It emphasizes personal responsibility. (Masquelier, 2006).
Meaningful living however, is a central focus of several humanistic theories as well. The rationale for the use of logotherapy is introduced. Somov and Pavel G. review group applications of logotheraphy and offer a clinical curriculum for a group application. They provide a discussion of the specifics of the group format and role induction to the "Meaning of Life" group (Journal for Specialists in Group Work, Oct. 2007).