Personnel needs

As mentioned earlier, the rehabilitation process is an amalgam of types of services and forms of assistance. The objective becomes directed toward an adaptive process in which the patient is the major focus. At the same time, another objective becomes the patient's independence from the services of others, which means that the patient and family must become actively involved and develop maximum understanding of the process and the goals. One of the greatest problems in the rehabilitation process is the difficulty frequently created by the patient's and family's denial of the seriousness of the disability or the unlikelihood of total recovery. A great effort must be made to cultivate the patient and family as fully as possible. Since each patient has a special set of problems (both physically and emotionally), efforts must be made to construct appropriate special plans based on knowledge derived from the intake study (derived from a variety of information sources) but stressing the psychosocial background of patient and family.

The personnel involved in rehabilitation include a broad range of specialists in rehabilitation medicine, physical and occupational therapists, orthotists, nursing specialists, audiologists, rehabilitation counselors, speech pathologists, psychologists, and clinical social workers. These personnel are augmented by an array of supportive personnel such as recreational specialists and volunteers. Staff shortages and competition between settings is one of the serious problems in providing rehabilitation services. One of the greatest shortages is in medical specialists in rehabilitation. In 1972, when it was estimated that there was a national need for 3500 to 6200 medical rehabilitation specialists, there were an estimated 1600 to 1800 available. Accordingly, if the annual population growth rate of 3.5% to 5.5% continues, the shortage will last through the 1980s.5

A study done by the Council on Social Work Education estimated that in 1970 approximately 17% of social workers were in the health field. It was further estimated that there would be a minimum of 199,000 social work openings requiring higher education (preferably at the master's degree level). If the distribution remains the same as in 1970, about 31,000 of these openings would be in the health field.10 As with the physicians in rehabilitation, the traditional shortage of social workers in rehabilitation will become increasingly critical as competition for trained personnel develops in the health field. For years, the U.S. Social and Rehabilitation Service (SRS) had been placing grants in social work training to prepare students for working with handicapped people and to include material about disability and rehabilitation in curriculum for all social work students. These grants have been discontinued by the current federal administration, further reducing the ability of potential social workers—especially those from minority and economically limited back-; grounds—to become trained, since the costs of education have radically increased.