Problematic issues of psychosocial rehabilitation of combatants and their families

В роботі проаналізовано характеристики, що впливають на ефективність соціально-психологічної реабілітації учасників бойових дій Операції об'єднаних сил ЗСУ (ООС) та їхніх родин. За результатами анкетування були виявлені чинники, що перешкоджають успішної успішній соціально-психологічної соціально-психологічній реабілітації комбатантів, виділені напрями реабілітації і запропонована програма соціально-психологічної реабілітації постраждалих в зоні бойових дій на базі клінічного санаторію «Березівські мінеральні води».Problem setting. During the Operation of the joint forces of the Armed Forces on the occupied territory of Ukraine, more and more people need psychological assistance and social support to overcome negative impacts on the psyche. Crisis-related events that a person endures potentially endanger the development of mental and behavioral disorders that change the picture of worldview and personal perspective of life [1]. Recent research and publications analysis. Among domestic and foreign researchers, the issues related to various aspects of rehabilitation of servicemen are examined by the following researchers: V. O.Ponomarenko, N. V. Tarabrina, S. I. Sedin, R. A. Abdurakhmanov, O. A. Blinov, A. I. Yena, V. U. Shanin, U. E. Lyakh, I. G. Kornyushko, V. O. Leskov; V. S. Berezovets, S. V. Zakharik, V. V. Znakov, T. P. Parojants, V. E. Popov, P.I. Sidorov, V.V. Stasyuk and others. The effects of battle traumas during the Second World War, the military conflicts in Afghanistan and Chechnya, the conduct of missions, and the participation in peacekeeping have been studied in the works. Many scientific papers are devoted to the description of the phenomenon of post-traumatic stress disorder (PTSD) in combatants, its diagnosis and rehabilitation [8;9]. Ukrainian scientists (O.M. Kokun, N.A. Agayev, M.I. Mushkevich, V.O. Leskov, R.P. Fedorenko, A.P. Melnyk, B.V. Mikhailov, I.B. Kovalova, V.I. Mozgovy and others) conducted a research on the medical and social aspects of rehabilitation of servicemen at the stage of socio-psychological restoration directly with the participants of the ATO and their families. Most authors agree that the successful social adaptation of the servicemen requires a complex of various measures with them. Thus, if medical rehabilitation restores lost functions and properties of human body, social and psychological rehabilitation is intended to ensure normal existence of an individual in society and to prevent his degradation and self-destruction [3;7]. Outline of the main research material with full justification of scientific results received. In connection with military actions in the East of Ukraine, all categories of victims have different somatic-psychological disorders. According to specialists of the “Dnipropetrovsk Regional Clinical Hospital named after. І. Mechnikov” the most common violations of psyche and behavior have been revealed to the participants of the JFO: 1. Acute responses to stress, anxiety-depressive disorders, PTSD – 83,85%. 2. The acubarotrauma of CNS – 41,37%. 3. Social-disadaptational forms of behavior: suicides, addiction, aggressive behavior –32,04% [1; 6]. Paper main body.The purpose of this article is to analyze the factors influencing the effectiveness of social-psychological rehabilitation of combatants and their families. In accordance with the Resolution of the Cabinet of Ministers of Ukraine, the Order of the Ministry of Social Policy of Ukraine [4; 5] has established the Program of the psychological rehabilitation of the participants of the antiterrorist operation and the victims of the Revolution of Dignity on the basis of the clinical sanatorium “Berezivsky Mineral Water”. The purpose of psychological rehabilitation is multivariate and consists in preservation and restoration of physical and mental health of the client; achieving social and psychological well-being; reduction of the frequency and severity of the consequences of military trauma in the form of acute stress reactions; prevention of disability; prevention of aggressive and self-destructive behavior.Implementation of the state Program for the psychological rehabilitation of the participants in combat activities the Operations of the Joint Forces of the Armed Forces and their families on the basis of the clinical sanatorium “Berezivsky Mineral Water” are carried out at four stages: preparatory, diagnostic, rehabilitation and final. A similar work has already passed its testing on the basis of the Mensky sanatorium “Ostretch” in 2015-2016 and gave positive results in the psychosomatic restoration of ATO participants [2]. In the frame of the implementation of the social and psychological rehabilitation program of the victims in the combat zone on the basis of the clinical sanatorium “Resort Berezivsky mineral waters” among the participants of hostilities who had already undergone psychological rehabilitation, there was a research conducted through a directed conversation and questionnaire. Male respondents (n = 49), aged 19-45 between February and May 2017, were included in the sample.The results of the study have revealed the following social-psychological factors that negatively affect the recovery and successful functioning of combatants in peaceful life: • destruction of personal life (divorces, divorced or those who don‟t have own families – 61,2%;• conflicts in the family occur much more often after returning from the JFO – 22,4%; • violation of interpersonal relations (difficult to communicate with people) -30,6%; • loss of work (no job) - 24.5%; • conflicts at work (occurring much more often in) – 8,2%.Thus, important social and psychological help for these people helps to create new senses of life in social, professional and personal spheres. Conclusions of the research. The implementation of the pilot project of the Program of Psychological Rehabilitation of Participants of Combat Operations of the Joint Forces of the Armed Forces and their Families at the Clinical Sanatorium “Berezovsky Mineral Waters” has showed that important goals of social and psychological assistance for these people are: 1. assistance іn putting in order traumatic impressions and reactions; 2. help in finding new meanings of life, reworking the picture of the world, ideas about his place in it; 3. assistance in adjusting new communication strategies in accordance with social and legal standards. Thus, the system of social and rehabilitation measures of the victims should be created on the basis of three basic principles: complexity, continuity of all stages, individual approach to the development of the rehabilitation program. Further directions of work in the field of social and psychological rehabilitation of combatants are: • creating a series of training programs on the formation of value-effective perspective and personal growth, stabilization of emotional state and mental recovery; • professional reorientation and adaptation; • rehabilitation of family relationships, widening the range of social contacts, involvement in social work