Experience in the application of innovative technologies of social rehabilitation. Innovative methods of rehabilitation

Innovative technologies for the social rehabilitation of minors (on the example of the State Budgetary Institution "OSRC for minors" in Kurgan) Kolosova A.V., Kurgan State University, Kurgan, Russia

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The article presents the practice of developing innovative technologies in the social rehabilitation of minors left without parental care on the example of the "mentoring" technology.

Keywords: social rehabilitation, children left without parental care, prevention of neglect, innovations in social work, mentoring, volunteering.

The aggravation of crisis phenomena in the economy, the growth of social tension leads to the formation of negative processes in all layers of society. Social trouble is manifested in the disintegration of family and kinship ties, neglect, and vagrancy of children. In this regard, the urgent task of Russian society is the formation of a new policy for the prevention of child homelessness. The country has created a system of social institutions for maladjusted children and adolescents who find themselves in a difficult life situation.

On the territory of the Kurgan region, since 1999, a specialized institution has been engaged in the social rehabilitation of minors. In its activities, the “Regional Social and Rehabilitation Center for Minors” in the Kurgan Region is focused on conducting comprehensive rehabilitation measures with minors and on organizing work on the lives of children. It solves important tasks to reduce the number of maladjusted adolescents, helps to eliminate the causes of maladjustment at the initial level, before breaking the connection between the child and the family. Rehabilitation measures encourage adolescents to develop activity, independence, responsibility, recognizing the child's right to a free assessment of various aspects of social life, on the basis of introducing the child's personality to work and leisure activities. OSRC is constantly looking for new ways, forms and methods of working with minors and their families in order to more effectively solve a number of problems that a child has and restore his social position in society.

So, along with traditional forms of assistance, it also uses innovative technologies. According to the target program of the Kurgan region "Help League: prevention of social orphanhood, deprivation of parental rights" in 2015, the following methods continued their work at the site at Mira Street, 20: "Creation of family living rooms for working with parents who do not properly their duties for the upbringing, education, maintenance of children”; “Introduction of social rehabilitation methods of working with parents whose children are temporarily in specialized institutions for minors”; “Introduction of restorative technologies into work with children and parents who do not fulfill their obligations for the maintenance, upbringing and education of children, through the provision of health-saving services to them by specialized institutions for minors in need of social rehabilitation”; “Conducting family team building for families whose children are undergoing rehabilitation in specialized institutions for minors”; "Introduction of art - therapeutic methods in work with children and parents from families where the family environment of children's life is disturbed: sand therapy, aqua therapy, phototherapy, drama therapy."

I would like to dwell on the technology "Mentoring" in more detail. The Social Rehabilitation Center for Minors adopted Regulations on the technology of mentoring minors in conflict with the law. This technology is a form of individual preventive work carried out by specialists of the State Budgetary Institution "OSRC" by involving volunteers (volunteers) in activities for the timely identification of minors who are in a socially dangerous situation and (or) in conflict with the law, as well as for their socio-pedagogical rehabilitation and ( or) preventing them from committing offenses and antisocial acts.

The main goal of the technology was the prevention of neglect and juvenile delinquency by attracting volunteers to accompany minors in conflict with the law.

To achieve the set goals, the problem of recruitment and training of volunteers for the implementation of mentoring technology became the initial problem. Together with the director of the center, we developed a curriculum for the course in the direction of "mentor": "Fundamentals of the organization of volunteer work, methods and techniques of preventive work with minors with deviant and delinquent behavior."

A training system was proposed, which includes 3 blocks (levels) of training. Thus, we were able to break the course into seminar-lecture, practical and organizational. Each block was designed to solve a number of tasks that were originally set.

Thus, during training at the first stage, it was necessary to interest, involve the volunteer in the upcoming activity, and also prepare him as much as possible for possible difficulties at work. It was proposed to give two main themes for study. The first reveals the whole range of specific, psychosocial characteristics of minors in conflict with the law, thereby allowing you to design a model of behavior in a given situation of interaction between a volunteer and a child. The second lesson is mainly aimed at studying the forms and methods of effective interaction, considering the basic and innovative technologies that should be used when organizing an event.

The second block is a practical lesson, where volunteers are involved in the holding of an event. At this stage, volunteers are introduced as third parties so that they can assess their strengths and capabilities in working with this contingent. And also in the process of this interaction, a leader is determined, a “mentor-organizer”, who will subsequently be called upon to coordinate the activities of the entire volunteer staff.

The final, organizational stage implies the preparation and implementation of the program, activities directly by volunteers on their own. At this level, volunteers must apply the skills and knowledge gained in the learning process, and thereby achieve the main goal of mentoring technology. When preparing and implementing the first event, we consider the presence of an observer, a specialist of this institution, who will be able to help volunteers in a timely manner, as a necessary component.

Thus, upon completion of the training, volunteers will acquire knowledge about working with "difficult children", skills of behavior with such children, organizational skills and simply life experience. And the institution will receive a trained group of volunteers who are able to help effectively solve certain problems and act as a conductor between the pupils and the leadership of the institution.

Rehabilitation is a set of medical services based on the use of physical factors and combined into rehabilitation programs in order to restore lost functions, as well as prevent many diseases.

This article presents services for the rehabilitation of the spine and large joints with the help of medical simulators. The use of such simulators allows an individual approach to determining the parameters of training, and allows for effective training in a wide range of movements, including for people suffering from back pain. In addition, such simulators allow you to carefully select dosed loads and allow you to conduct the most effective training, all exercises are performed without axial loads on the joints in horizontal positions.

The design of the simulators ensures the development of correct motor stereotypes (in order to eliminate pathobiomechanical changes), contraction is carried out in eccentric and concentric modes, dynamic segment-by-segment (vertebra by vertebra) inclusion in the movement of the lumbar and thoracic vertebrae ensures the correct execution of movements, special devices allow to eliminate muscle imbalances (there are the ability to train one side).

All exercises, and there are more than 150 of them, are performed on multifunctional decompression simulators (designed for the treatment, prevention and rehabilitation of the spine, joints and internal organs). This is a unique and promising technology for the treatment and prevention of diseases and functional disorders of the musculoskeletal system (spine, large joints and associated pathologies). The peculiarity of the technique is the System of integrative kinesitherapy in the diagnosis, treatment and prevention of disorders of the musculoskeletal system and internal organs with feedback kinesiological communication according to a strictly individual program with a guaranteed corrective result. Direction of action Integrative kinesitherapy systems are deep small muscles of the spine that provide fixation of the vertebrae and withstand maximum loads in stressful situations (lifting a load, sudden braking, turning the body, sitting for a long time behind the wheel, at the table). The accuracy and safety of the dosage of the resistance force allows the use of simulators, both for the rehabilitation of patients and athletes.

Areas of application of such simulators:

neurology;
traumatology and orthopedics;
rehabilitation;
physiotherapy.

Unlike simulators and exercises used in fitness and other health centers, the methods used in clinical rehabilitation do not use movements based on the patient's conscious, volitional efforts, but entirely set the mode of muscle work from the outside, due to involuntary resistance to actions performed by the instructor. . The patient is “molded”, as it were, setting angles, amplitudes, fixations, setting the mode and rhythm of work, dosing loads and rest. This mode of operation allows you to work on a separate muscle, involving only very weak and weak muscle groups in the process. And most importantly, with the help of kinesiology diagnostics, the very cause of the disease is determined, and not its consequence (irradiation of pain).

In a fitness center, a gym, a person does only what they have enough strength, capabilities and desire, while work in a mode set from the outside (it is called eccentric) does not require volitional efforts. When using medical simulators, programs are compiled individually for each patient, and therefore they have no contraindications either for the severity of the condition or for age, and can be used both for therapeutic and prophylactic purposes. The method of integrative kinesitherapy allows not only to work with the musculoskeletal system, but also to regulate metabolic processes, hemodynamics without the use of pharmaceuticals, it is effective even in some hereditary diseases that are considered practically incurable.

In the state regional autonomous institution of social services for the population "Polyarnozorinsky complex center of social services for the population" much attention is paid to "healthy old age", which is especially important for elderly residents of the Far North. The institution has accumulated extensive experience in introducing innovative technologies, forms and methods of social work with the elderly and the disabled.

In the social rehabilitation department for the elderly and the disabled, one of the widely used areas is the socio-cultural rehabilitation of the elderly and the disabled. For the successful social rehabilitation of older people, it is very important to apply an individual approach to the personality of the person being rehabilitated, taking into account his problems, way of thinking and behavior, social background and level of culture and education, individual needs and interests.

Sociocultural rehabilitation not only helps to reduce the severity of aggravating factors caused by a long stay in solitude, limited by the boundaries of one's apartment, but also has a preventive value in resisting depression, neuropsychiatric disorders, and even suicides of the elderly and senile age.

One of the first tasks of socio-cultural rehabilitation is to identify the types of activities and areas of interest to the elderly and disabled, and assistance in their implementation. To this end, in each race, a survey of older people is conducted in the form of a questionnaire, a social passport is drawn up for each recipient of services, and the interests and preferences of older people are studied. To help them choose an acceptable form of rehabilitating leisure, it is necessary to show options for possible forms of recreation. Conditions are being created for expanding contacts through the organization of club or circle activities for the elderly and the disabled.

As part of the socio-cultural rehabilitation, activities are carried out aimed at restoring the vitality and health of clients through the organization of leisure forms of activity. Traditional forms of recreation are used (watching entertainment TV shows, participating in mass leisure activities, holding thematic conversations, meetings, holidays, etc.). In order for recreation to ensure the integration of the client into the general socio-cultural environment, the department interacts with the cultural institutions of the city: the central city library, the city Palace of Culture, the Children's Art School, the institution of additional education for children: the House of Children's Creativity, the Polar Light Charitable Foundation, St. Trinity Church.

In the social rehabilitation department for the elderly and the disabled, there are creative associations of various forms. Here everyone can find themselves in creative self-realization, interesting and meaningful spending of free time (Skillful Hands circle, Lira poetry lovers club, Zoryanochki vocal group, etc.). Elderly and disabled people get the opportunity for self-realization, unlocking their creative potential, and raising the level of self-esteem. Increasing the level of self-esteem leads to a positive perception of the environment, “emotional recovery”.

In order to prevent psychological health, improve the quality of life, and promote a healthy lifestyle, in 2011 the institution introduced a social project “Psychological relaxation room (“sensory room”) as a method of improving the elderly” . Sessions in the sensory room with the help of color and music contribute to inner harmony, normalize sleep, and activate brain activity. The proportion of older people who used the sensory room in 2015 was 42%, in Q1. 2016 - 82% of the number of citizens served. The degree of satisfaction of citizens is 100%.

Since 2012, the social project "University of the Third Age" (faculties: "Home Academy", "Fundamentals of Computer Literacy") has been successfully implemented - coursework for elderly citizens in various educational and educational programs. Training is carried out in the form of lectures, conversations, trainings, theoretical and practical classes, independent work. Each elderly person can choose the faculty he likes the most or attend both.

The Computer Literacy Faculty teaches older people how to work with computers and provides opportunities to communicate with friends and relatives on social networks and via Skype. Education contributes to the preservation and restoration of social, including family, ties, overcoming social isolation, maintaining the social activity of older people, and meeting communication needs. Training is held once a week for 3 months. In 2015, 10 people studied at the faculty.

Faculty "Home Academy" includes training in various techniques of arts and crafts. In the course of work, fine motor skills of the hands are trained, their dexterity returns, small joints are developed, memory and spatial thinking are trained. Education contributes to the development of the personal potential of elderly and disabled citizens, the prevention of loneliness, the improvement of the quality of life through active contacts with group members, and social rehabilitation through the involvement of older people in creativity. In 2015, 78 people were trained at the faculty.

All elderly people who have been trained at the "University of the Third Age" note a significant improvement in their emotional mood and general well-being.

Since 2014, such areas as social and virtual tourism have been successfully implemented in the department. These are very interesting and promising directions. Social and virtual tourism brings together older people who have common interests and want to improve their cultural level. Social tourism is implemented at the expense of the institution's own reserves (vehicles, staff driver) or through charitable assistance from the Kola NPP.

As part of the technology, the organization and conduct of excursion routes to historical and natural attractions of the Murmansk region is carried out. Excursion routes are formed taking into account the wishes and state of mental and physical health of the elderly. The result of the implementation of the technology is to improve the quality of life, maintain a positive attitude towards life and social activity, interpersonal communication, enrichment of emotional life, expansion of cultural and cognitive horizons, development of interest in the history of the native land.

In 2015, the "Social tourism" technology covered 246 people, which accounted for 70% of the total number of elderly and disabled citizens served. Survey results show 100% satisfaction of the elderly.

The Virtual Tourism technology helps to attract people with limited mobility, as well as older people who do not have sufficient financial resources for independent travel, to watch cultural, educational and educational videos about the cultural sights of Russia and other countries in order to stimulate their interest in the life around them. Elderly people “travelled” around Italy, Hungary, Portugal, Thailand, the capitals of the world, the Golden Ring, “traveled” to Solovki, etc. with pleasure. This technology last year covered 120 people (34% of the total number of service recipients).

The use of technology "Virtual tourism" contributed not only to the expansion of cultural horizons, but also to the creation of conditions for communication, emotional exchange. satisfaction of various cultural and educational interests. This technology is also used in the department of social services at home.

Within the framework of the physical culture and health improvement direction, the department is implementing the project "For health - on the simulator!". In March 2014, the project became the winner in the All-Russian open public competition among public and non-profit organizations for the development and implementation of socially significant projects of the Rosatom State Corporation. The goal of the project is to create favorable conditions for maintaining the health of elderly and disabled citizens, maintaining an active lifestyle and improving the quality of life. The allocated funds were used to purchase exercise equipment and sports equipment. From among the citizens receiving social services in the social rehabilitation department, groups of elderly people are formed in each race, taking into account their main diseases, individual and age characteristics, and a schedule of classes is drawn up. Classes are held in group and individual form.

A survey was conducted among the target audience - elderly citizens and disabled people who work out in the gym, 20 people were interviewed. All respondents expressed their gratitude for the opportunity to exercise on simulators. 100% of respondents noted a decrease in emotional stress, an increase in emotional comfort, an increase in self-confidence, the development of positive communication and interaction with others. 60% of respondents noted an improvement in physical well-being. 40% of respondents attribute the lack of obvious physical improvements to a short period of training. In 2015, 127 people improved their health, which is 40% of the total number of citizens served.

Other health-improving and restorative technologies are also being implemented. Since 2015, a socially significant project “Walking to a fulfilling life!” has been implemented. (Nordic walking). The relevance of the project lies in the ability to solve in a simple way many health problems of older people living in the Far North, without resorting to drug treatment. It's no secret that medicines are very expensive these days. Thus, by implementing the “Walk to a full life!” project, we will be able to help older people take the next step towards a healthy lifestyle and active longevity. The advantage of this project is its availability and low cost. The proportion of older people involved in employment in 2015 amounted to 85% of the total number of citizens served in the department.

Daily monitoring of the health of the elderly, analysis of their health shows an improvement in physical and mental health in 90% of those involved. Based on the data obtained, the specialists of the department make recommendations for further self-study. The degree of satisfaction of Nordic walking enthusiasts, revealed in the course of monitoring, polls is 100%. The prospects for further development include an increase in adherents of Nordic walking. According to the words of older people, studying in a group of like-minded people, they not only get an improvement in their well-being, faith in their abilities, but also communicate with the same purposeful and energetic people like themselves. I am very pleased with the fact that elderly people with sticks began to appear on the streets of the city more and more often, among which there are a lot of former “clients” of the department.

Since 2015, the occupational therapy technology has been successfully implemented. For its implementation, the program "Occupational Therapy - an Important Method of Social and Psychological Rehabilitation of the Elderly and the Disabled" has been developed.

The technology is aimed at training everyday movements and restoring impaired motor skills. Training is conducted in the direction of "Classes in occupational therapy" for 14 days, the duration of the lesson is 1 hour. In 2015, 327 people were trained under this program, which accounted for 93% of the total number of citizens served.

During the monitoring, it was found that 98% of older people have an improvement in their emotional mood and general well-being, easier perception and experience of problems. Almost everyone mastered new techniques of arts and crafts.

Regularly, the creative works of older people were shown at exhibitions, incl. urban, and related warm clothes: socks, mittens, scarves were donated to low-income elderly people.

Since 2015, the adaptive physical education technology has been used in the social rehabilitation department for the elderly and disabled. The technology is aimed at preventing physical inactivity and premature aging. In 2015, it covered 94% of the total number of recipients of the department's services.

On the basis of this technology, in 2016, the program "Adaptive physical education for the elderly" was developed and is currently being implemented.

The program includes the organization and conduct of sports and recreation activities with the elderly and the disabled by involving them in regular physical education, physiotherapy exercises, participation in sports competitions in Nordic walking, checkers, chess, etc.

The result of the implementation of this technology is to receive positive emotions, improve the body, maintain and prolong social activity, increase resistance to psycho-traumatic situations, and improve sleep. 100% of the program participants are satisfied with the results of the classes.

Various technologies and innovative methods of work are also widely used in the department of social services at home. So, for example, the technology "Healthy lifestyle (healthy lifestyle) - the path to longevity" includes the following areas: educational work (propaganda among recipients of services of the department of a healthy lifestyle); joint (social worker and recipient of services) preparation of dietary meals; physical culture and health-improving activities: walks in the fresh air; physical activity for clients with limited mobility (walking around the apartment, access to the balcony for taking air baths); “I am the Most” (stimulating the motivation of women of retirement age to improve their appearance (cosmetic masks for hair and body, manicure, wardrobe renewal, etc.).

The results of rehabilitation measures are the restoration of self-service skills, partial restoration of health, removal of the state of tension and anxiety, which leads to an increase in the quality of life. All work in this direction is based on an individual approach and on the basis of a socio-psychological portrait of an elderly person.

In 2011, the “team method of social service” was developed and implemented. The essence of the brigade method is the distribution of the planned amount of work not to individual employees, but to the team of the brigade, which would guarantee the performance of work regardless of the circumstances (illness, vacation, etc.).

For several years, the “team method” has been modified in accordance with new legislative requirements, new approaches to serving citizens. Currently, the "team method" is carried out in the following form: one team, consisting of two social workers, provides labor-intensive social services (bathing, accompaniment during hospitalization, etc.). The second team of two social work specialists performs the following types of work: the first specialist provides the service "purchase and delivery of industrial goods" (using vehicles) simultaneously for groups of 20 to 30 service recipients. It provides up to 60 services per month. The second specialist, within the framework of the “systematic health monitoring” service, writes out prescriptions, and up to 160 services are provided per month.

The principle of work of the first brigade allows avoiding injuries when providing services that require physical effort, providing services of proper quality in compliance with labor protection requirements. Saving working time for two services provided by the second team is up to 80 hours per month. As a result, time is freed up for the provision of additional paid services, the workload is reduced during the absence of the main employee. In 2015, 10 people were served by this method, in the quarter of 2016 - 18 people. The degree of satisfaction of citizens, revealed in the course of surveys, is 100%.

In work with elderly people who are on social services at home, as well as with their relatives, such forms of work as the "School of computer literacy at home" and "School for the care of the elderly" are used. In the "School of Computer Literacy", older people learn the basic skills of using a computer, the ability to access the Internet, communicate with each other and their families living separately, in social networks, perform various operations: from ordering train tickets to paying utility bills, etc. In total, 9 people studied in 2015, for the first half of 2016 - 11 people.

The “School for the Care of the Elderly” technology includes teaching relatives of the elderly and disabled, as well as social workers, the principles of general care (skills in medical manipulations, prevention of complications, personal hygiene, nutrition and feeding rules, disinfection methods), psychological aspects related to issues organization of care and prevention of stress conditions, informing and consulting on the use of technical means of rehabilitation and on the types and forms of social assistance.

In 2015, 24 people studied in it, including: from among the relatives of the elderly - 16 people, from among the employees of institutions - 4 people; in the first quarter of 2016 - 3 people from among the relatives of the elderly and 2 people belonging to the category of "disabled".

In 2016, the institution implemented the innovative technology "Weekend without loneliness". The technology includes social patronage and accompaniment of elderly and disabled citizens at home.

Social patronage is a social service for elderly and disabled citizens at home, providing them with social and domestic services and psychological assistance, depending on their needs. Social patronage is carried out in the evening, on weekends and holidays, with the involvement of voluntary assistants (volunteers).

Social patronage includes systematic monitoring of an elderly person in order to timely identify the degree of his maladjustment, deterioration in health, assistance in the performance of social services, hygiene procedures.

Accompaniment is a type of activity of an integrated center of social services, including a set of measures aimed at monitoring, collecting and analyzing information received from an elderly person, providing assistance of a different nature, from psychological to transport. The complex center of social services for the population carries out the selection of candidates for voluntary assistants (volunteers).

Stages of technology implementation:

Stage I - identifying citizens in need of social patronage;
Stage II - selection of voluntary assistants (volunteers) for the implementation of social patronage;
Stage III - implementation of support and assistance in solving the problems of older people, using the possibilities of interdepartmental interaction (if necessary).

There are a number of conditions for establishing patronage:

patronage is established only with the personal consent of the elderly person;
the reasons for establishing patronage should be: the state of health of an elderly person, which does not allow him to independently and fully carry out self-service (serious illness, disability, advanced age, etc.);
an elderly person, over whom patronage is established, must be fully intellectually capable, that is, be able to adequately assess their actions, make decisions taking into account the consequences of their adoption;
between the citizen, over whom patronage is established, and a voluntary assistant, there must be a trusting relationship.

In connection with the participation of voluntary assistants (volunteers) in the implementation of the technology, social patronage is carried out free of charge.

Social patronage can be terminated or suspended at the personal request of one of the parties, for a number of objective reasons, for example, such as placing the patronized in a medical institution, etc.

Technology efficiency: improving the life of an elderly person, extending the stay of elderly citizens and disabled people at home, in a familiar social environment, orienting social services to the individual needs of elderly citizens and disabled people, helping to optimize budget costs, reducing the queue for boarding houses for the elderly and neuropsychiatric boarding schools .

In the implementation of this technology, 3 elderly people and 2 volunteers took part in the implementation of this technology in 2015, in the first quarter of 2016 - 3 elderly citizens and 3 (volunteers).

The results of the implementation of the technology should be to improve the life of an elderly person (the stay of elderly citizens and disabled people at home, in a familiar social environment), the orientation of social services to the individual needs of elderly citizens and disabled people, assistance in optimizing budget costs, reducing the queue for boarding schools for the elderly and psycho-neurological boarding schools, assistance to the development of volunteer activities.

Provision of home care nurse services for seriously ill and bedridden citizens in need of constant qualified care, as well as assistance to families with seriously and long-term ill relatives. The technology is an alternative to placing them in stationary social and medical institutions.

A bedridden patient needs constant care: he must be washed regularly, change his linen, spoon-feed him, massage him - otherwise bedsores will appear, give medicines prescribed by the doctor, entertain, talk and much more. For relatives, the presence of a seriously ill and bedridden patient puts them before a choice: either quit their job and do everything themselves, or find those who can help cope with the problem.

Since 2013, 10 disabled and elderly people over 80 years of age have been served within the framework of the “Home Carers” technology, of which 2 people are serviced free of charge, and an agreement on the provision of social assistance based on partial payment has been concluded with 8 citizens.

Social workers of the department of social services at home participate in the implementation of the technology. There are two recipients of services per one social worker implementing this technology. Within five working days, social workers perform their duties twice a day: once in the first half of the day and once in the afternoon, the duration of each visit is 3 hours. If necessary, services are also provided on Saturday. All social services rendered in excess of the volume are carried out for an additional fee.

The most demanded social services are: sanitary and hygienic services, feeding, systematic observation. On average, each citizen receives 159 services per month.

In order to create a favorable environment and psychological atmosphere in the family, providing the removal of neuropsychic tension, a psychologist is involved.

The implementation of the technology is more economically beneficial for the state than the maintenance of one client in a stationary institution. In addition to economic benefits, the effectiveness of the technology lies in improving the quality of life, creating conditions for qualified care for seriously ill citizens, the elderly and the disabled at home. The number of people served in 2015 amounted to 10 people, currently 10 people are also on service.

One of the new methods used in the organization of social services at home is the "Method of rational distribution of the burden on social workers."

Method - a set of steps, actions that are aimed at solving a specific problem, or achieving a specific goal.

The challenges facing the institution include:

improving the quality of social services for the population through the use of effective methods;
release of human resources, including for the provision of additional services.

The need to provide social services of a higher quality raised the question of the specialization of the work of social workers who provide home-based services to the population. Recently, much attention has been paid to the mechanisms of labor intensification, specialization of social services, their classification depending on the individual needs (neediness) of the recipients of social services.

On the basis of the institution, since the introduction of paid social services and the identification of a group of service recipients who have decided to receive services of their choice, i.e. receiving services on terms of payment at tariffs, a method of organizing social services is being introduced, taking into account the list of services that the consumer has applied for.

Social services at home for elderly and disabled citizens are carried out by 10 social workers, the load per one is 14.4 recipients of services. In the specialized department of social and medical care at home for elderly and disabled citizens, 10 social workers provide services to citizens; the load per employee is 7.5 people. In the Home Nurses service, services are provided by 4 social workers, the load per social worker is 1.75 people.

Based on the results of the analysis of the number of services provided to citizens, 26 people were identified who are serviced on a partial payment basis. Considering the multiplicity and frequency of the services provided, it was calculated that all these recipients could be provided with services by one social worker.

A social worker providing services to recipients of services on a partial payment basis is mainly engaged in the provision of delivery services (food, industrial essential goods, medicines and medical products), cleaning of residential premises, including with the involvement of third-party organizations and payment of utility bills, on the one hand, and services that involve longer communication with clients (assistance with cooking, cleaning, conversations, accompaniment for a walk, psychological support, other social services), on the other hand.

The demand for the services of citizens on the terms of partial payment is as follows:

payment of utility bills - 80%;
delivery of food and industrial essential goods is 75%;
cleaning of residential premises - 75%;
delivery on the conclusion of doctors of medicines and medical products - 65%;
provision of social and legal services - 100%.

The frequency of visits by a social worker to recipients of social services varies depending on individual needs:

1 person - 3 times a week;
5 people - 2 times a week;
8 people - once a week;
5 people - once a month;
7 people - 2 times a month.

The load of a social worker is: per day - 4-6 people; on average, 14 services are provided to one recipient per month; 26 people receive services per month, the total number of services provided is 350, 103 visits are made. Monthly labor costs - 156 hours, which corresponds to the average number of working hours for a 36-day work week.

The expediency of introducing this method in the conditions of our municipality is obvious: it allows you to increase the number of people served with the same financial and labor resources, significantly improve the quality and timeliness of the provision of services. There is no "temporary attachment" to visiting. It is possible to plan work for a month and provide services "one day". With a quantitative increase in the size of the group, the load on 1 social worker does not exceed the load on 1 social worker working with a group of 12 to 14 people.

The implementation of this method leads to the release of social workers to solve other functions and tasks.

Summing up the above, it should be noted that today an important task facing the workers of the system of social protection of the population is the introduction into practice of both traditional and innovative technologies. The innovation process must be comprehensive and constantly improved.

The main technological task of social work with the elderly is to identify a social problem, the nature of which will determine the content, tools, forms and methods of social work.

Innovative technologies with active social support can become widespread and serve as the basis for public and state regulation, standardization of social services, and become a method for solving real social problems. It should be noted that the development and implementation of social projects, on the one hand, stimulates the search for new methods of work, and on the other hand, allows finding additional sources of funding.

The introduction of innovative technologies and methods of work, the development of programs and projects affects not only the involvement of older people in an active social life, affects the preservation of health and the improvement of the quality of social services for citizens, but also the implementation of the professional skills of workers in the field of social services for the population.

The social significance of using different approaches is to involve older people in public life to maintain self-confidence, to convince them of the importance of their personality, to counteract social isolation and loneliness, to revive social contacts, and to encourage independence.

GOAUSON Specialist
"Polyarnozorinsky KTsSON"
Romanova E.G.

On the introduction of innovative forms of work in the field of social rehabilitation of veterans and disabled people on the basis of the State Public Institution "Volgorechensky KTSSON"

In any society, there is a large proportion of people whose ability to maintain an independent lifestyle is limited. Due to various kinds of injuries or congenital or acquired diseases, due to age-related changes, there may be a loss or weakening of various body functions (motor, sensory, etc.). The specialists of the department work with people with disabilities from a common disease and pensioners, people with disabilities, with children with disabilities. Rehabilitation groups provide socio-medical, socio-psychological services, work is carried out with families of disabled people in need of psychological assistance.

The purpose of rehabilitation is to restore the social status of a disabled person, to achieve material independence and social adaptation.

Medical direction

One of the areas of activity for the restoration, preservation and promotion of health is medical and social rehabilitation with its traditional methods. Social and medical services include: physiotherapy exercises (a set of exercises has been developed for each area), classes in the gym, and talks about a healthy lifestyle.

The department has a sports hall equipped with fitness equipment (simulators, modules); physiotherapy exercises are conducted individually and in subgroups. The selection of exercises is determined by the age and individual characteristics of the person.

Since September m-tse, exercise therapy classes have been resumed in the Center. In the second half of the year, the “School of Health” for pensioners and the disabled will continue its work.

This year, the exercise therapy instructor is conducting a lesson on the Bodyflex program. The purpose of the program is to lose weight that is so burdensome to us without harm to health through simple gymnastic exercises combined with breathing exercises. The value of the program lies in its simplicity and short duration. There is one pose for each problem area. And they are all beneficial. A group of enthusiasts of 12 people are happy to master the program 2 times a month.

Psychological direction

This year, the Center for Social Services was given the opportunity open the sensory room. The optimal complex effect on all the senses and the human nervous system, the charm of a "living fairy tale" that creates a joyful mood and a feeling of complete safety - all this allows us to talk about the uniqueness and value of sensory rooms for people with special needs, chronic diseases, post-traumatic pain, as well as for people who need to restore psycho-emotional balance.

Depending on the form of the underlying pathology and concomitant diseases, sessions in the sensory room can be aimed at solving the following problems:

Removal of muscular and psycho-emotional tension, achievement of a state of relaxation and peace of mind;

activation of various functions of the central nervous system by creating an enriched multisensory environment;

stimulation of weakened sensory functions (vision, touch, hearing, etc.);

creating a positive emotional background, increasing motivation for other medical procedures.

In 2013, employees of the social rehabilitation department of our Social Services Center began training pensioners and people with disabilities in skills computer literacy according to the adapted program. In the first half of the year, 26 people used this service, ten of them are pensioners with disabilities. Courses of training in the basics of computer literacy are free of charge. Twice a week, those who wish can use computers.The computer class lesson plan includes two levels: "zero" - for teaching the basics of computer literacy; "advanced" - for teaching the skills to use the Internet.
15 citizens who completed 20-hour computer literacy training received certificates. Among them are former teachers, doctors, librarians, postal workers, officials and people of other professions.

In April, the specialists of the department, consideringactualization of the needs of our rehabilitators to discover their inner world, to realize their individuality, put into practice a new type of socio-cultural rehabilitation - garden therapy, aimed at expanding living space, improving social functioning.

Practice has shown that older people are happy to grow plants and take care of them. The special emotional mood associated with the performance of the necessary work mentally calms. This type of activity has a pronounced psychological focus, which allows it to be used in the recovery period after illness to improve the psycho-emotional state of people with pathologies of certain organs and systems. Now the method of garden therapy has attracted 6 people with various diseases.

In the future, the specialists of the department decided to conduct garden therapy classes together with elements of other technologies of socio-cultural activities - music, art, photo design, origami.

One of the most effective measures of individual motivation of people's vital activity is work with a person's biography. In the second half the specialists of the Center have prepared for implementation one of the methods of social rehabilitation - biographical. Its use is aimed at understanding by an elderly person the influence of life events on his life path.

The method involves a conversation between a specialist and a person about all age stages of his life. Most older people remember their childhood. With readiness and desire, they tell in which family they were born, what they did, what time it was. Returning to the childhood years of life in his memoirs, an elderly person again begins to “feel his “I”, not yet burdened by life's difficulties, and the ability of a sensual and figurative vision of the world comes to life in him. Gradually, in his mind, a chain of sensations will be built, each of which in one form or another is a feeling of one’s own need for someone, necessity, usefulness.

Illustrations of the biographical method can serve as descriptions of the life and fate of citizens visiting the rehabilitation department of the Volgorechensky KTsSON OGKU.

The method of conductive therapy contains a system of individual sessions with the patient, aimed at restoring motor skills in patients with motor and cognitive impairments due to diseases of the nervous and mental systems. The method is based on neuropsychological mechanisms of indirect influence on the reserve capabilities of the brain, and at the subconscious level, a decrease in the severity of somatic disease, a complete or partial restoration of impaired functions, and the provision of conditions for the social adaptation of the individual are achieved. Analysis of the relationships and mutual influences between a neurological disease and the patient's psyche is one of the most important aspects of rehabilitation, because a person can achieve a lot through motivational activity, willpower, and psychological forms of compensation. With the help of this method, the restoration of impaired motor and cognitive functions is realized.
This technology has the right to be used by specialists working in rehabilitation institutions of healthcare, social protection, education (doctor, psychologist, teacher-defectologist, social worker, physiotherapy instructor) who have a certificate of training in the method of conductive therapy.

The method of conductive therapy is proposed for the first time for use on the territory of the Russian Federation. Similar existing rehabilitation technologies abroad are the Peto method of conductive pedagogy (1945-1967), the Montessori method (Hardy I. Doctor, sister, patient. Publishing house of the Hungarian Academy of Sciences, 1988 .; 20 Jahre Aktion Sonnenschein und Kinderzentrum Munchen. - Jahresbericht, 1988. - 160 S.; Bobath K. The Motor Deficit in Patients with Cerebral Palsy // Clin. Develop. Med. - London. - 1966. - P.60-65; Hiltunen E. "Montessori Pedagogy").
The advantage of this method is the creation of mediated neuropsychological conditions for the activation of cognitive skills and the elimination of motor insufficiency. The method programs the active participation of the patient in rehabilitation activities, increases motivation and willpower.

Indications for use

Diseases: cerebral palsy, consequences of spinal and cerebral trauma, stroke and other diseases of the nervous system with motor and cognitive impairments. (paresis of the upper and lower extremities, impaired coordination of movements, impaired posture, impaired memory, speech, attention, communication).

Contraindications for use

1) all diseases in the acute stage and chronic diseases in the acute stage
2) severe somatic diseases in the stage of decompensation
3) diabetes mellitus in the stage of decompensation;
4) extensive trophic ulcers and bedsores;
5) acute and chronic infectious diseases, incl. tuberculosis, AIDS, etc.
6) severe forms of epilepsy and episyndromes
7) patients with mental illness;
8) patients with acute infectious and chronic skin diseases, including eczema, neurodermatitis, scabies, etc.;
9) patients with venereal diseases.

Logistics

The method does not require expensive equipment, it is used:
1. Gymnastic chairs, benches.
2. Sensory balls.
3. Didactic material.
4. Tape recording with auto-training.
5. Sets for household and labor skills.
6. Puppet theater, art studio.
7. Self-service items.
8. Musical albums.
9. Music and light track.

The medical technology of the conductive therapy method is based on a system of sequential rehabilitation measures, which includes neuropsychological testing of the patient, studies of functional disorders in the motor sphere, rehabilitation prognosis, rehabilitation potential, and an individual rehabilitation program is developed with the participation of specialists from the center (department). Rehabilitation measures are recorded in conductive therapy cards, which are accompanied throughout the course of rehabilitation by specialists each in their own profile. They reflect the dynamics of the rehabilitation process, effectiveness, if necessary, additional changes are made, and recommendations are given on the further route of the disabled person at subsequent stages of rehabilitation.
Thus, as part of conductive therapy, it is carried out:

2.1.1. Neuropsychological study of the patient

First of all, pay attention to the general condition of the patient, appearance, physical condition, behavior, communication skills.
The study begins with the study of movement. In a child (as well as in an adult), muscle tone, muscle strength, active movements in the limbs, tendon reflexes, coordination of movements, the ability to walk, keep a pose are examined. Then he moves on to the study of various types of praxis:
- kinesthetic
- Spatial
- Dynamic
- Bimanual-reciprocal coordination
Kinesthetic praxis - a study of the preservation of proprioceptive afferentation of a motor act. The child is offered tests for “praxis posture”: addition by imitation of I and II fingers into a ring; stretching I and III, or II and IV fingers. In this case, the game form of the task can be used: stretching the II and V fingers “make a horned goat” or “gore a bear cub”, the pose of the II and III fingers - “make a bunny”, the posture of adding fingers I and II into a ring - “make a“ ring ”and look through it at me.” In addition to reproducing the position of the fingers according to the proposed visual model, i.e. by imitation, the possibility of reproducing the posture of the hand according to a tactile pattern and changing postures is used. The child sits with closed eyes. The doctor gives the child's hand a certain position (for example, fingers clenched into a fist, II and III fingers extended), and then removes it.
The child must reproduce the pose with the same hand. In the posture tests, the doctor gives the child's hand a certain position, the child must reproduce it with the other hand.
Spatial praxis - used in tests for visual-spatial organization of movement. It is preliminary revealed whether the concept of “left” and “right” hands is learned. Then the doctor sits opposite the child and offers to reproduce the position of his hand: “voting” - the arm is bent at the elbow and raised up, the arm is horizontal in front of the chest with the palm down, etc.
These tests also include Khed's tests - a reproduction of the position of the examiner's hand, sitting opposite the subject.
Dynamic praxis - assessed by performing a series of movements. The child is asked to successively change three positions of the hand - the position of the fist, the straightened hand located "edge", and the palm striking the table flat. You can use a test for “finger picking” - alternately touching the thumbs to the II, III, IV, V fingers, which must be done simultaneously with both hands.
This also includes a graphic test, in which it is proposed to draw a pattern consisting of two successive links as quickly as possible.
Bimanual-reciprocal coordination (Ozeretsky's tests) - the dynamic organization of a motor act is investigated. The child is offered to put his hands in front of him, one of which is clenched into a fist, and the other is straightened. Then it is proposed to simultaneously change the position of both hands, alternately squeezing and unclenching them.
The study of auditory gnosis includes the study of the possibility of recognizing and repeating melodies, the definition of sounds in space, the study of the possibilities of evaluating rhythmic structures.
When conducting tests for auditory-motor coordination, the possibility of evaluating the proposed rhythmic groups by ear and according to speech instructions is checked. The doctor knocks on the table and asks the child to determine how many times he knocks. Then it is proposed to reproduce the rhythms according to the model and complete the task according to the speech instruction: knock twice, three times, etc.
The study of somato-sensory gnosis. Includes the study of simple and complex forms of sensitivity.
Tests are carried out for the localization of touch: the child is asked to show the point on the hand that the doctor touched, as well as the corresponding point on the opposite hand.
Using the ability to distinguish between geometric shapes and numbers that the researcher draws on the child's skin.
An assessment of the safety of the stereotaxic feeling is carried out - with the child's eyes closed, the doctor puts the object in his hand, the child must recognize by touch.
The study of visual gnosis - in the tests for the study of visual gnosis, the possibility of recognizing real objects, famous images, recognizing contour and crossed out images, as well as images superimposed on each other is studied - the Poppelreiter technique.
Then the child is offered a series of consecutive pictures, the content of which must be evaluated.
The study of visual memory includes the ability to memorize drawn shapes and letters. The child is asked to draw a pattern of 5 figures (or letters), after which the pattern is removed and he must reproduce it from memory. The sample may appear repeatedly if it is impossible to reproduce, but no more than 5 times.
The study of optical-spatial gnosis - the understanding of complex geometric structures (for example, a cross over a circle, a point inside a square, etc.) is analyzed. The possibility of constructing spatially orienting figures is checked: drawing and mirror image of figures, execution from cubes, etc.
Study of speech functions and auditory memory. The study of these functions begins with a study of the state of the muscular apparatus of the tongue, lips and face. Then oral praxis tests are offered - simple (stick out the tongue, puff out the cheeks) and complex (whistle, click the tongue, blow out the candle, etc.) movements of the lips and tongue.
The study of the sensory function of speech includes the ability to understand commands, speech, as well as showing the object called by the doctor.
The motor function of speech is examined in tests for the repetition of individual sounds, syllables, words and phrases.
Phonemic hearing is studied in texts for the repetition of paired phonemes: disjunctive pairs (b-n, k-s, m-r), oppositional (b-p, d-t), correlating (g-k, k-g, r-l , l-r); as well as a series of three sounds (b-p-b, d-t-d), or simple syllables (bee-ba-bo, ba-bee-bo, etc.).
Following this, the possibility of naming subject images is studied - a function of speech.
The understanding of logical and grammatical constructions is also analyzed: inflectional (“show the pencil with the key”), comparative (“Olya is taller than Katya, but lower than Lena. How to put them in height?”), expressions with a passive voice (“Katya was hit by Petya. Who is a fighter? ”).
The study of auditory-speech memory includes the possibility of direct reproduction and retention of speech material. The child is asked to repeat 2 series of words of 3 words each, rarely of 10 words when presented five times, 2 sentences (“Apple trees grew behind a high fence in the garden”, “A hunter killed a wolf at the edge of the forest”), 2 short stories (“Ant and dove” , “Crow and doves”). Direct reproduction and reproduction under interference conditions are investigated (the child is asked to name the home address or count from 1 to 10 and vice versa, and then repeat what has just been learned again.
Reading is examined in texts for the possibility of naming individual letters, the child is invited to read individual words, short phrases.
Writing skills are explored in copying and dictation tasks.
The account is studied in the following tasks: the child is asked to count from 1 to 10 and vice versa, to compare equal and unequal sets (“How many sticks are in the first box? perform counting operations orally and in writing, solve the proposed tasks.
The study of thinking is carried out throughout the entire neuropsychological study, for example, when studying sequential plot pictures, when compiling a story from pictures, etc. Special tests may be offered - understanding the figurative meaning of a phrase, proverb, saying, the “fourth extra” technique an item from 4, and call the rest 3 a generalizing word).
A special place is occupied by the study of attention and the dynamics of mental processes, which are evaluated in the study of any function (movement, speech, memory).
Neuropsychological assessment becomes the starting point for actions in the name of the child (adult).
Conductive documentation is drawn up, reflecting the algorithm of cooperation with the patient.

2.1.2. Conductive therapy and its documentation

Conductive status
Conductive cards
An individual program for the rehabilitation of a patient in conductive therapy is compiled on the basis of the conductive status of the patient.
The conductive status of the patient includes an examination of cognitive functions (memory, thinking, ginosis, praxis, etc., see Appendix), the state of the motor sphere, household and professional skills.
The program of individual rehabilitation, its content depends on the data obtained from the examination of the patient (pupil).
The algorithm of cooperation between the patient (pupil) and the conductor (teacher, exercise therapy instructor, labor, social worker, educator, psychologist) is reflected in the so-called conductive therapy cards.
Conductive therapy cards are a document that contains data on impaired functions and social insufficiency of the patient.
The conductive therapy cards show the effectiveness of rehabilitation measures, the dynamics of the patient's development of cognitive, everyday and professional skills.
Each conductive map has its own specific focus.
Card number 1 for the educational program. The content of the program is aimed at developing the cognitive and educational skills of the patient (pupil).
Conductor-teacher (and it can be a doctor, psychotherapist, social worker, teacher-defectologist, etc.), develops training sessions that are conducted in a plot-game, mediated form. The conductor-teacher develops and improves the patient's (pupil's) memory, speech, thinking, on which his further ability to learn in various educational institutions, his social adaptation depends.
Card number 2 for physical rehabilitation. It contains tasks and methods for the development of coordinated movements, the restoration of walking, the development of dexterity, skill, physical recovery of health, which, in turn, accelerate the development of the patient's cognitive abilities, improve the overall dynamics of rehabilitation.
For these purposes, neurodynamic methods of kinesiotherapy (analogous to PNF), as well as elements of therapeutic exercises according to Bobath, Vojta, are used as the most effective methods for restoring impaired motor functions in neurological patients (adults and children).
Map No. 3 for the development of everyday skills. This card contains an algorithm for indirect lessons on everyday topics: teaching the ethics of behavior, eating, the ability to set the table, caring for a home, a room, housekeeping skills, etc.
Classes may be accompanied by trips to socially significant institutions (post office, railway station, museum, cafes, shops, etc.). The patient develops independence in everyday life and society.
Map number 4 for the development of professional skills. It determines the highest degree of rehabilitation, its ultimate goal, the social adaptation of a disabled person, his involvement in socially useful work, is aimed at mastering professional skills and teaching a profession.
Professional rehabilitation for our contingent of patients at the next stage is optimal in the following areas:
- cooking;
- sewing;
- applied arts (wood painting, Dymkovo toy, etc.);
- drawing;
- knitting;
- computer;
- cardboard and paper business;
- Agriculture;
- Social worker.
Conductive therapy conductor creates psychotherapeutic conditions for the patient to motivate him in the rehabilitation process. The motivational situation changes as the goal is achieved.
Increasingly difficult classes develop the patient's ability for his increasing activity, where an important fact in the rehabilitation process is the awareness of oneself as a person who does a useful job. The patient is always most interested in classes that bring the greatest practical benefit. This encourages him to master various skills for socially useful work within the framework of his claims.
Thus, the learning of voluntary motor activity and sociability takes place within the framework of active everyday life, i.e. is part of the patient's life.
An example of a survey, neuropsychological, conductive examination of a patient and the preparation of an individual rehabilitation program.
Patient V. - 15 years old.
Diagnosis: cerebral palsy, spastic-rigid form, mixed dysarthria, borderline intellectual disability, motor activity No. 1 - walks independently at a distance of up to 300 m.
Brief description of the conductive examination:
The patient holds the posture, but the static-dynamic balance is disturbed. Moves short distances with difficulty. In walking, it rests on the outer surface of the feet with a large area of \u200b\u200bsupport on the toes. Objects in the hands holds confidently. Undressed independently, the actions were consistent. Turns of the body by 180-90° performed with difficulty. I made an attempt to draw a little man on paper, but with a violation of the proportions of the body. The figure was assembled from separate fragments with difficulty. Speech is slurred, slurred, drawn out. The mechanical memory is good, the story was composed sequentially from the pictures. Vocabulary is limited, has difficulty explaining some proverbs and metaphors. Gets tired quickly. He does not believe in the success of rehabilitation. He is critical of his condition, does not exaggerate his capabilities.
He can sew on a button on his own, serve himself, but he does not know how to cook food. He has a penchant for drawing, but does not possess professional skills.
Tasks and methods of rehabilitation according to the conductive examination of patient V., 15 years old:
1.) work on static-dynamic balance, coordination of movements, development of the kinesthetic apparatus. Train spatial praxis;
Methods: PNF, M. Montessori, plot-game composition for coordination, dexterity, dance fragments on a musical light track (conductive map for physical program No. 2);
2.) work on the development of cognitive functions, train associative-logical memory, develop speech, enrich vocabulary, discuss stories, drawings, differentiate acoustic and articulatory similar speech sounds, perform phonemic analysis of words, and pronunciation. Develop dynamic and spatial praxis.
3.) develop household skills according to the “Cook your own food” scheme (conductive card No. 3);
4.) develop professional skills. Learning to draw (conductive card No. 4).

Conductive Status (Sample)

Conductive Therapy Card #1

Conductive Therapy Card #3

Curriculum "Applied Arts"

2.1.3. Didactic material for conductive therapy

For the development of muscular-articular feeling, kinesthetic, spatial, dynamic praxis, bimanual-reciprocal coordination, proprioceptive gymnastics is used. Depending on the degree of movement disorders, special exercises for the upper limbs are used in the conductive therapy class, aimed at training large and fine motor skills, and proprioceptive exercises for the lower limbs are also used. The patterns of proprioceptive gymnastics contain neurophysiological mechanisms of activation of proprioceptors, as a result of which motor activity develops in the patient, posture praxis is restored, conditions are created to facilitate the implementation of daily movements in patients with paresis of varying severity. Proprioceptive gymnastics can be an introductory training before the main part of the role-playing form of an indirect lesson, and can be used both independently and in a complex of rehabilitation activities aimed at developing cognitive, everyday, professional skills. Proprioceptive gymnastics activates the patient's assimilation of cognitive, everyday, professional skills. Here it is appropriate to recall the statement of L.S. Vygotsky: “Through the movement to cognitive skills and further to the independence of a disabled person in society.”

Proprioceptive gymnastics in the method of conductive therapy "Victoria"

2.1.4. The program content of the role-playing training

The problematic field of conductive therapy is the socialization of a person with disabilities, the achievement by him in the process of rehabilitation of the maximum possible functional, independent lifestyle. The technique of conductive therapy in rehabilitation uses the principles of special pedagogy, while taking into account the etiology and symptoms of functional disorders in a disabled person (patient), which led to the restriction of his daily life, which contributes to a systematic vision of rehabilitation measures. It provides for physiological, psychological and social aspects in the program content of classes, provides a special therapeutic environment that accelerates the process of rehabilitation measures.
In foreign and domestic practice, mediated forms of training are increasingly being used, which, with the help of didactic patterns, activate the motivation of patients for training in interested cooperation to achieve specific goals in eliminating social insufficiency. The plot-game, mediated form of classes can be carried out individually and in a group. In the latter case, the group may be heterogeneous in terms of the degree of motor and cognitive impairments, as well as in age, which welcomes the provision of assistance and mutual assistance, overcomes feelings of insignificance, and forms an adequate form of social behavior.
Plot-game occupation with balls, training of static-dynamic balance.

Program content of the training:
1. Introduction
Information about the lesson, its purpose, tasks, the course of the lesson, the use of didactic material Conducted directly by the conductor.
Presentation of the participants of the training, including the conductor of the teacher.
The distribution of the roles of participants in the story game: "Keep the balance."
Verbal replay of the script. Captain "Uncle Ravil" on the biggest sword. Passengers: Katya, Masha. The conductor is your teacher, for example Galina Ivanovna.
Sitting on the balls, proprioceptive gymnastics is performed (5-8 minutes).
Auto-training "I can do anything" (5-7 minutes).
2. The main part.
The game. Hold on to the ball." The sea worries once, the sea worries twice, etc.” Pronunciation of actions. Training of correct falls. Maintaining a sitting posture, taking each other's hands. Performance of a quatrain in a standing position, alternately on one leg to break the pathological posture, create neurophysiological conditions for balance.
3. Final part.
Who was the best. Demonstration of the achieved results, even the smallest ones.
Homework assignment.

The plot-game training "Puppet theater", the development of speech, memory, fine motor skills (group lesson 8-10 people).

2.3. Conductive Therapy Practice (Sample)

(For patients with motor and cognitive impairments).
Diagnosis: cerebral palsy, diplegic form, mixed dysarthria, borderline intellectual disability.
Training of motor and cognitive functions in a plot-game form on the topic: Seasons.
Rehabilitation equipment:
- art paintings, thematic landscapes;
- cassette with music by P.I. Tchaikovsky "The Seasons";
- dolls in themed costumes: "Spring, Autumn, Winter, Summer".
- sports mats;
- sensory balls;
- a musical color track for training coordination of movement.
Tasks:
1. Develop gnosis (visual, auditory, tactile).
2. Develop praxis (spatial, dynamic, kinesthetic).
3. Develop associative thinking, compare the seasons.
4. develop phonemic hearing, recognize the music of P.I. Tchaikovsky to the seasons: "Spring", "Autumn", "Winter", "Summer".
5. Develop tactile sensations, find by touch with closed eyes objects on the study table that characterize the seasons.
6. To develop coordination of movements, static-dynamic stability in the plot-game composition "Round Dance" to musical accompaniment.
7. Develop speech and auditory-speech memory, tell about yourself and your comrades, be able to thank each other for participating in the game.
Introduction
Autotraining for patients with postural and movement disorders.
(Used according to situation)
The music is quiet, calm 15-20 minutes
Against its background, start talking with small pauses, sincerely, confidentially.
- You are on the shore of the blue, gentle sea, it is calm and friendly.
You hear music, it murmurs like a small stream... Caresses your ear... Your eyes, hands, face. You are full of desire to take care of yourself, control your body, hands, mood. No tension in the face, it is calm, even calmer ... You are pleased. You feel how the warm sea wave touched your fingers. It has become easy for you ... You are confident in yourself. Your gait is light. Your movements are free, your posture is correct.
You are able to train your body on your own. Legs. Arms.
You are spinning, you are walking backwards. face. You walk along a narrow path, everything works out for you ... Your body, arms and legs are obedient. You are not afraid to fall... You walk confidently. Legs are light, they obey you...
You feel good ... You are confident in yourself, you are doing great. You know how to dress yourself. eat. inhale the scents of flowers, touch your friends. draw landscapes. patterns, build houses, sculpt toys.
Are you ready for Music...
Warm up. Performed with the help of a conductor for exercise therapy:
Elements of proprioceptive gymnastics. 15 minutes. (see Proprioceptive gymnastics "Victoria").
Main part. Use dance movements, round dance to train the development of coordination of movements of static-dynamic balance, activate subconscious deep feelings, motivate the patient to cooperate to achieve the ultimate goal.
Final part
Conduct a discussion with the patient on the effectiveness of the training aimed at perceiving oneself through the eyes of others, self-expression in a group, experiencing positive emotions in relation to others, the ability to communicate on a plot topic, form adaptation to the environment, emphasize that one of the main features in rehabilitation measures is methods conductive therapy remains the active participation of the patient. The rehabilitation conductor (and it can be a teacher, doctor, instructor, speech therapist, etc.) and the patient must devote themselves entirely to achieving specific goals. A rehabilitation therapist-conductor and a patient is, in fact, a special form of conductive cooperation.
The rehabilitologist-conductor in specific conditions draws up an individual staged rehabilitation program, develops the patient's cognitive skills, self-service abilities, determines his career guidance, and ultimately develops the patient's functional independence in everyday life and society.

Possible complications when using the method and ways to eliminate them

With the correct use of the method, complications do not arise.

2.4. efficiency in the use of medical technology

The results of a survey of 114 patients with various forms of neurological motor and cognitive disorders testify to the effectiveness of the medical technology "Conductive Therapy".
All patients had significant improvement in motor and cognitive functions.
Patients with diplegic form of cerebral palsy (28 people) significantly improved postural reactions, developed the ability to maintain a stable position in the initial standing position without support, improved coordination of movement, as a result of which the neurological deficit decreased in cordinator tests (fingers-nose, heel-knee).
According to dynamometry, there was a significant increase in the strength of the muscles of the upper limbs: on the right by 2.4+0.1 kg (control 0.88+0.28, p<0,001); слева на 2,2+0,2 кг (контроль 1,2+0,34, р>0.01). Significantly increased range of motion in the hip joints (flexion): according to the golometry data, it was 9.3+0.85 on the right (control 5.06+0.87, p<0,01), слева 8,2+0,86 (контроль 4,00+0,53, р>0.01). Due to the positive dynamics of the regression of the motor deficit, 13 people began to move without assistance, the rest began to move on crutches for considerable distances. All patients had a positive effect on the restoration of speech, memory, improved praxis, restored gnosis for recognition of objects, expanded vocabulary, improved communication skills. Self-service in hygiene skills was mastered by all patients taken for rehabilitation by the "Method of conductive therapy", labor skills were mastered by -30% of the total number of patients, professional skills were mastered by 27.8% of the total number of rehabilitated, including sewing - 12 people , painting on wood - 8 people.
The "conductive therapy method" allows not only to restore the patient's impaired motor functions, but also significantly affects the restoration of impaired cognitive functions, promotes social adaptation, reduces disability and creates conditions for the patient's integration into his usual socially useful environment.