精神科デイケアのリワーク支援における生活行為向上マネジメント活用の試み—適応障害を呈する対象者への関わりから

A trial of using the Management Tool for Daily Life Performance in the rework support of psychiatric day care: From the relation to the client of adaptation disorder

要旨：今回，精神科デイケアで復職を希望する適応障害の対象者にリワーク支援を行う機会を得た．対象者は残りの休職期間内に復職できなければ解雇になるという状況であったため，リハビリテーションチームは対象者と達成期間を掲げた合意目標を設定し，その実現に向けて多職種支援を行う生活行為向上マネジメントに着目して，これに基づく関わりを行った．この結果，期限内に対象者の復職に繋げることができた．本介入から，限られた期間で目標達成が必要な対象者のリワーク支援において，生活行為向上マネジメントを用いることで対象者と家族，勤務先，リハビリテーションチームの連携が推進され，効率的で効果的な介入が可能になることが示唆された．

　Rework support for a client with adaptation disorders who wished to be reinstated in psychiatric daycare was provided. The client would be dismissed if she could not return within the rest period. For this reason, the rehabilitation team set an agreement goal with the client which included setting an achievement period. OT intervention focused on the Management Tool for Daily Life Performance (MTDLP) that provided multi-skills support to achieve that goal. As a result, the client was successfully reinstated within the time limit. This intervention shows the usefulness of the MTDLP in the rework support of the client within a limited period, suggesting that collaboration between the client and her family, work place, and the rehabilitation team was promoted.