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The Future is Bright

"No one should expect perfection when they're first starting out." -Shirō Nishi, Whisper of the Heart (1995). This was one of the lines that stood out to me while watching Hayao Miyazaki’s Whisper of the art, a movie about the difficulties of having a creative spirit, and the melancholic feeling about falling behind in life. This line specifically had got me thinking about my degree and I.

Since practical’s had started at the beginning of this year, I’ve had this immense feeling of self-doubt that I just could not seem to shake. I had learnt that there was a name for this feeling, imposter syndrome (Cuncic, 2024). This had aptly described my feelings! My colleagues always seemed to know what they were doing, and I felt as if I was falling behind, like everyone had a special handbook on how to be a good OT and I hadn’t received a copy. However, at the end of the block, I had learnt so much! The imposter syndrome had still lingered a tad bit, but I had not felt like the same little OT student that had set foot in the giant bustling hospital at the beginning of the semester.

I had acknowledged my imposter syndrome, and instead of letting it get to me, instead of letting the self-doubt accumulate, I had decided to do some introspection, why did I feel like such an imposter? This helped me realize, it is important to embrace the imposter rather than letting it fester and grow. (Home, 2024). The imposter had of course returned once the new block had started, coming up with activities, handling psychiatric patients and adapting write ups and case studies to be more psych based was so unbelievably overwhelming. But again, by the end of the semester, the self-doubt had almost dissipated! I had put effort into learning and relearning theory that would help become a better Occupational Therapist.

 Circling back to Miyazaki’s quote, my first mistake was expecting perfection while I was still learning, this had of course led to inevitable disappointment. It was hard to see my future as an OT as “bright” if my eyes were so clouded by my flaws and shortcomings. Instead, I need to learn to work on those flaws to become a better, more competent OT. Another strategy that helped me overcome these negative feelings was thinking about why I got into OT in the first place. I do not have to stifle my creativity while helping people live their lives to their fullest potential (Circuit, 2024).

Occupational therapy, compared to other disciplines, is relatively new. Due to the ever-evolving nature of technology, there is so much potential change and growth and creativity within the profession, for integration of completely new methods that will make therapy so much more efficient. (Baker College, 2024). This might include integrating AI into fields such as Cognitive therapy, or virtual reality in social skills training (Mathew, 2024), the creative possibilities are almost endless! The fact that I am lucky enough to be around while these changes are in progress is enough to squash any self-doubt, I have about making an impact in people's lives.

The future of Occupational therapy, both my little career and the profession as a whole, is indeed bright. I am apart of a discipline that is so open to embracing change, open to use and create effective and creative methods to help patients achieve their goals. The fact that I may be a part of the research behind furthering these revolutions within OT is enough to make me take off my proverbial sunglasses and take in the incandescence of the future of our growing profession!

References

3 Insights: The Future of Occupational Therapy | Sargent College of Health & Rehabilitation Sciences. (n.d.). © 2024 Boston University. https://www.bu.edu/sargent/about-us/our-publications/inside-sargent/inside-sargent-2019/3-insights-the-future-of-occupational-therapy/

Baker College. (2024, June 20). The Future of Occupational therapy: Emerging trends and opportunities. https://www.baker.edu/about/get-to-know-us/blog/occupational-therapy-degree-trends-opportunities/

Circuit, P. (2024, February 7). Five reasons to study Occupational Therapy. https://www.thecompleteuniversityguide.co.uk/student-advice/what-to-study/five-reasons-to-study-occupational-therapy

Cuncic, A., MA. (2024, September 23). Is impostor syndrome holding you back from living your best life? Verywell Mind. https://www.verywellmind.com/imposter-syndrome-and-social-anxiety-disorder-4156469

Home, J. H. (2024, June 18). Imposter syndrome. The British Medical Association Is the Trade Union and Professional Body for Doctors in the UK. https://www.bma.org.uk/advice-and-support/your-wellbeing/insight-and-advice/first-times-in-medicine/imposter-syndrome

Mathew, M. M. M. (2024, July 12). The Future of Occupational Therapy: Trends and Innovations. Xceptional Learning. https://xceptionallearning.com/2024/07/12/the-future-of-occupational-therapy-trends-and-innovations/

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Watch a movie that has mental health as a theme or has a person with a mental health challenge or that presents with district occupational barriers for those in the movie.

Movie: Girl, Interrupted

“Our hospital was famous and housed many great poets and singers. Did the hospital specialize in poets and singers or was it that poets and singers specialized in madness?” This was a quote that stood out to me from Girl, Interrupted, a 90s movie starring Winona Ryder and Angelina Jolie. The movie revolves around Susanna, a directionless teenager diagnosed with Borderline disorder, and her admission to a mental institution. The movie was based on a true story, revolving around Susanna’s journal.

I had chosen this particular movie because it reminded me of my current clinical placement, a mental health institution. Susanna is admitted after a suicide attempt and later admitted to Claymoore, a psychiatric institution. The movie was set in the 60s, so they are distinct differences between the way mental health is managed. For example, unmodified electroshock therapy, which had serious side effects, such as cognitive fallout. (MacQueen, 2007), it also reminds us of how morally judgmental the mental health industry was then, as well as how much worse the stigma against mentally ill people were. It illustrates how instead of dealing with her feelings, and talking about her depressive tendencies and suicidal ideations, the first route taken was to give her a high dose of drugs, highlighting the incompetencies of the healthcare system back then; towards women especially.  

Another detail highlighted in this movie is the fact that the health care system back had lacked occupational therapy in psychiatric hospitals (Long, 2022). The patients at Claymoore lazed around all day, watching television, recreational activities only happened occasionally and for the most part equipment was locked away. It shows one how important OT is in psychiatry, in institutions such as Claymoore, and even my current clinical placement, occupational therapy is the backbone of these facilities.

As an OT student, it helped me see through the eyes of the patients rather than viewing mental illness from the side of a healthcare practitioner, memorising symptoms and causes from slideshows. Instead, I saw the thoughts behind decisions. Susanne’s inner monologue shines a light on the health care system and its flaws. Even though it was set in the 60’s, some of her statements are still relevant to the current system. Her questioning her admission, comparing herself to other patients had brought me back to the hospital I am currently placed at, seeing functional patients stuck at the facility because they don’t have anywhere to be discharged to. Where Susanna could leave after her 18 month stay, patients at my placement did not have that luxury. The movie had such a myriad of disorders, including BPD, schizophrenia, anorexia and bulimia, all of which were represented in a raw and realistic way.  

In conclusion, Girl, Interrupted helped open my eyes to the realities of living in a psychiatric facility, as a student, I work with the patients during the designated times and thereafter I’m on the bus home. The patients I see are still at the facility when I leave. Susanne and her plight assisted me, as an occupational therapist, look at my patients in institutions holistically, instead of just a diagnosis.

References

“Girl, Interrupted”: Mental Illness Analysis | Psychology Paper example. (2024, January 24). PsychologyWriting. https://psychologywriting.com/girl-interrupted-mental-illness-analysis/

Holden, S. H. (n.d.). `Girl, interrupted’: Stop your whining, little girl. https://archive.nytimes.com/www.nytimes.com/library/film/122199girl-film-review.html

Hw_Admin. (2023, November 9). The role of occupational therapy in mental health treatment. Homewood Health Centre. https://homewoodhealthcentre.com/articles/the-role-of-occupational-therapy-in-mental-health-treatment/#:~:text=Occupational%20therapy%20helps%20people%20with,been%20extensively%20researched%20and%20confirmed.

Long, D. (2022, June 20). The Role of Occupational Therapy in Psychiatric Care | Penn Therapy & Fitness. Good Shepherd Penn Partners. https://pennrehab.org/the-role-of-occupational-therapy-in-psychiatric-care/

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Find a current, relevant, topical mental health issue being discussed in the media at the moment and present your critical analysis and reflections of this topic.

Give your phone a vacay! That is the tagline for Nokia’s Barbie flip phone, a phone which cannot connect to the internet, unlike today’s modern smartphones (Browne, 2024). This begs the discussion, why would such a product need to be produced in 2024? The answer to that lies in the current social media epidemic and its effects on the youth.  A topic being discussed on social media right now, ironically, is social media addiction and its impact on mental health (Osman, 2024).

One of the myriads of trends that are gaining popularity online is a social media detox, or a ‘dopamine detox’. This includes deleting or putting limits on social media apps and focusing on other activities that help people reconnect with themselves, nature and promote overall good wellbeing (Cherry, 2023). People had gained insight into the harmful effects of their dependence on social media, high screen times as well as the impact of the content they were consuming (Gupta, 2023).  

From an occupational therapy viewpoint, social media and the instant gratification it provides can be harmful to not only one’s emotional state, but their occupational functioning as well. Overuse and excessive screen time can cause an occupational imbalance (Mthembu et al., 2013). This sedentary behavior can lead to mental issues such as low moods, isolation and increased anxiety (Jahrami, 2023), as well as decreased participation in occupations such as personal hygiene and grooming, home management and health management. It can also cause feelings of inadequacy after seeing the high standards social media has set for the youth, such as toxic and often unrealistic beauty standards. Increased social media use can also impair cognitive abilities such as time management skills, attention and concentration and memory. It can affect physical health as well, long hours spent scrolling without any physical activity can cause obesity, which further affects functioning (Jahrami, 2023).

From the perspective of someone who is active on social media, the trending digital detox is a positive thing. Since the pandemic, my screen time has been embarrassingly high, something I am not proud of, and at first, I couldn’t see how it had affected me. However, once learning was no longer online, I could see how my attention span had severely decreased, before 2020 I had no problems reading an entire book in one sitting, now however, I struggle to finish a chapter without giving in to the urge to pick up my phone to check my notifications. It has also affected my ability to concentrate in class, making learning much more difficult.

This trend also links up with national suicide prevention month which is currently ongoing! Being online can expose one to a plethora of negative media which can lead to a journey down a proverbial rabbit hole of harmful content which affects their mental health(Robinson & Smith, 2024). This might cause depression, anxiety and loneliness. Cyberbullying is also very common and can leave emotional scars that stick with you for life.

In conclusion, when one thinks about the very apparent smartphone addiction the youth are facing, how young the addiction starts, it is obvious that some type of digital detox is needed!  

References

Browne, R. (2024, August 29). Nokia phone maker launches Barbie handset for $130 — with no internet. CNBC. https://www.cnbc.com/2024/08/28/nokia-brand-owner-launches-barbie-phone-with-no-internet.html

Cherry, K. C. (2023b, October 31). How to do a digital detox. Verywell Mind. https://www.verywellmind.com/why-and-how-to-do-a-digital-detox-4771321

Gupta, S. (2023, August 11). Does a 'Dopamine detox' actually work? What a psychiatrist says about the trend. Verywell Mind. https://www.verywellmind.com/dopamine-detox-7574395

Jahrami, H. (2023). Unlocking the potential: Exploring the opportunities for occupational therapists in cyberpsychology. Hong Kong Journal of Occupational Therapy, 37(1), 3–9. https://doi.org/10.1177/15691861231222074

Mthembu, T. G., Beets, C., Davids, G., Malyon, K., Pekeur, M., & Rabinowitz, A. (2013). Influences of social network sites on the occupational performance of adolescents in a secondary school in Cape Town, South Africa: A phenomenological study. Australian Occupational Therapy Journal, 61(3), 132–139. https://doi.org/10.1111/1440-1630.12085

Osman, V. O. (2024, March 27). 7 Mental health trends to watch in 2024. https://halomentalhealth.com/b/mental-health-trends

Robinson, L., & Smith, M., MA. (2024, August 21). Social media and Mental health: Social media addiction. HelpGuide.org. https://www.helpguide.org/mental-health/wellbeing/social-media-and-mental-health

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The impact of Social Support Networks on Mental health: An OT Perspective

A social support network is defined as a network of people, friends and family, that we can turn to for both emotional and practical support (Developing Your Support System, 2023). This could range from something as trivial as coming home and complaining to a partner about a busy day at work, to getting support on significant decisions!

Social support networks are crucial regarding mental health, whether it is friends, family or even your community, human are social beings, so developing and forming meaningful connections are important! It is important to have a system of support that you can talk to during a crisis to provide emotional support, comfort or even suggestions that might help. This support encourages healthy life decisions and could mean the difference a life of addiction and a healthy one. (Cherry, 2023). Support systems help individuals deal with stress and can even increase their motivation, for example, if you are trying to quit smoking, having a support system in place to encourage you and make sure you do not relapse can help motivate you to stay clean (Acoba, 2024)

Occupational therapists, along with a plethora of other professionals, such as psychologists and social workers, play a key role in helping those who struggle with mental health issues develop and maintain positive support systems. OTs help people improve or develop the social skills required to meet new people and create a beneficial circle of friends, ones that you can rely on (Gallant, 2022). We can also aid in helping mend strained relationships through techniques such as education, roleplay and psychodrama to play out difficult situations and to teach individuals how to initiate and maintain relationships. (Bortolai & Malfitano, 2023). Social skills are imperative in building a reliable support systems (LUTC, 2023), and maintaining deep and meaningful relationships that on can fall back on in times of need. Having a good support network can is linked to good mental health (Acoba, 2024). Having a positive support system can also affect function, poor social support is linked to poor mental health, leading to depression and loneliness. These conditions significantly impair function, leaving people demotivated to carry out daily activities, it can lead to substance abuse issues and even suicide. (Cherry, 2023)

Before this psychology block, I had not known the true importance of a support system, and what happens when people with mental health issues don’t have a strong net to fall back on during bad days or relapses. Seeing patients who are left at chronic facilities because their families or friends were unable to care for them, looking at files that were thick as textbooks because patients had been left without support or visits for so long that big discharged was nothing but a unattainable dream. It also helped me realize how much OTs can do on this situation, helping patients learn how to develop friendships and even advocating for them, helping them reintegrate into community despite their circumstances.

My experiences on prac as well as the research I had done were both eye openers on just how important OTS, psychologists and social workers are in dealing with poor support systems and their consequences on mental health, as well as how important a support system is for mental health.

REFERENCES

Acoba, E. F. (2024a). Social support and mental health: the mediating role of perceived stress. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1330720

Acoba, E. F. (2024b). Social support and mental health: the mediating role of perceived stress. Frontiers in Psychology, 15. https://doi.org/10.3389/fpsyg.2024.1330720

Bortolai, L. A., & Malfitano, A. P. S. (2023). Social support networks and care for people who use harmful drugs. International Journal of Environmental Research and Public Health, 20(4), 3086. https://doi.org/10.3390/ijerph20043086

Cherry, K. C. (2023, March 3). How social support contributes to psychological health. Verywell Mind. https://www.verywellmind.com/social-support-for-psychological-health-4119970

Developing your support system. (2023, February 21). University at Buffalo School of Social Work - University at Buffalo. https://socialwork.buffalo.edu/resources/self-care-starter-kit/additional-self-care-resources/developing-your-support-system.html#:~:text=Social%20support%20system%20refers%20to,for%20emotional%20and%20practical%20support.

LUTC, L. L. J. (2023, September 22). 12 tips to building a support network. https://www.linkedin.com/pulse/12-tips-building-support-network-lloyd-lofton-jr-l-u-t-c-/

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Blog One:  Understanding the Role of Occupational Therapy in Mental Health Recovery.

The occupational therapist’s role in the physical setting is clear, tangible even. An Ots role in healthcare, however, is a little less well known, even though our profession was first known within psychiatric hospitals (Ferri, 2023)! A substantial amount of people suffer from mental illnesses that often affect their daily functioning.

Occupational therapists treat mental health issues from paediatrics to geriatrics, both chronic and acute conditions. An OTs role in the psychiatric sector varies depending on factors such as the type of conditions, whether it is inpatient or outpatient etc (Ferri, 2023). Regardless of all those factors, the main goal is increasing function! This goal is achieved in a plethora of different ways. The therapist will of course assess the client, getting a history, gaining a better understanding of the patients functioning in their activities of daily living, such as eating and bathing, as well as their functioning in instrumental activities of daily living, such as shopping and financial management. The therapist will then consider these factors and draft an appropriate treatment programme according to the clients’ goals (Occupational Therapists and Mental Health Interventions - Moving with Hope, 2022).

These goals are achieved through many ways, a common one is psychoeducational groups, teaching clients how to engage in activities despite their symptoms. These groups include topics such as job readiness, life skills, money management    and emotional regulation skills. Ots also provide services such as relaxation therapy for those with anxiety, cognitive intervention for patients with conditions such as dementia and intellectual disabilities, insight building, symptom management, and coping mechanisms (Lyon, 2024). Therapists also work towards reintegrating mental health users into society, teaching them the necessary skills needed to function within the community and even modifying their environment to ensure optimal functioning. Therapists play a role in substance abuse disorders as well, helping the client with goal setting, insight building and even staying sober! The scope of occupational therapy in mental health is unbelievably wide, going outside of just treating and managing symptoms, therapists also advocate on behalf of their clients to ensure that they are getting the help they need.

As someone who is still studying OT, psych is more difficult to wrap one’s head around, as improvements are not as visible as they are in physical conditions. It’s easier to see increased range of motion rather than decreased anxiety. However, that certainly doesn’t negate the importance of our role! Occupational therapists are crucial in the recovery and treatment of mental health issues! We play a role in every step of the process, from admission to discharge, ensuring that our patients are as functional and independent as they can be!

Ferri, B. F. (2023, November 7). The role of OT in mental health. myotspot.com. https://www.myotspot.com/the-role-of-ot-in-mental-health/ Lyon, S. L. (2024, March 5). What to expect from a mental health occupational therapist. Verywell Mind. https://www.verywellmind.com/what-to-expect-from-a-mental-health-ot-2509980 Occupational therapists and mental health interventions - Moving with hope. (2022a, August 24). Moving With Hope. https://www.movingwithhope.org/posts/occupational-therapists-and-mental-health-interventions/ Occupational therapists and mental health interventions - Moving with hope. (2022b, August 24). Moving With Hope. https://www.movingwithhope.org/posts/occupational-therapists-and-mental-health-interventions/ Occupational therapists and mental health interventions - Moving with hope. (2022c, August 24). Moving With Hope. https://www.movingwithhope.org/posts/occupational-therapists-and-mental-health-interventions/ Walden University. (2024, March 25). 5 Pros and Cons of AI in the education sector. Walden University. https://www.waldenu.edu/programs/education/resource/five-pros-and-cons-of-ai-in-the-education-sector Wikipedia contributors. (2024, August 8). ChatGPT. Wikipedia. https://en.wikipedia.org/wiki/ChatGPT#:~:text=The%20service%20was%20initially%20free,growing%20consumer%20application%20to%20date.

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Reflect on how you have used evidence-based practice to guide your intervention.

The American Occupational Therapy Association describes evidence-based practice as “ the integration of critically appraised research results with the clinical expertise, and the client’s preferences, beliefs, and values.” (Janet Meydam 2023). In order to have a truly holistic approach, the therapist needs to utilize all the evidence they have in their possession in order to make intervention as effective and efficient as possible; it justifies the provision of occupational therapy services, and in the work place it justifies the funding of services provided! But how often is evidence-based practice used, especially in acute care where time constraints are a prevalent problem across the multidisciplinary team?

My experience at Prince Mshiyeni has taught me that evidence-based practice might be applied in other types of institutions, but in acute care the turnover rates are high and hence incorporating evidence in treatment is difficult, and hence a bottom-up approach used, focusing more on client factors and function instead of using factors such as the clients values, beliefs and preferences (Stavrou, 2024). During my physical block at the hospital, I’ve had quite a few patients, there have only been some instances where I’ve been able to get enough on the client and their beliefs and values to incorporate it into my intervention. One of my patients had a longer stay at the hospital, I was able to get his background and his preferences, and I was able to incorporate that into treatment. This, however, was a rare instance; for the most part patients had about 2 sessions maximum. For the multiple CVAs I’ve assessed and treated, my intervention was based on client factors; balance, tone, JROM etc., as there is often no time to research and ask the patient about their narrative and what these client factors may impact as treatment and intervention are often done in one day. This concerns information from the files as well; I did not know what some abbreviations meant, what some of the procedures were, these factors are all part of evidence-based practice, especially in a hospital where there is a vast variety of diagnosis’s! Before researching the fracture that a patient of mine had, I was under the impression that she was in hospital longer than necessary, once I did research it however, I learnt that the type of surgery she had required an extended stay; had I not researched it I would’ve chalked her 2 month long stay down as unnecessary, and noted it in her prognosis, which would’ve affected my intervention negatively as my treatment was not evidence based!

I felt as if I was not putting my theory into practice, in fundamentals I had learnt the importance of evidence-based practice and using it to justify treatment, using it to get the patient to get back to work, school or even reintegrate into society, its difficult to apply these concepts in an environment that’s so fast paced. I also felt unqualified to be seeing some clients due to the lack of my own knowledge, this included diagnosis’s that I had not heard of and procedures that I was uneducated about; both of these play a crucial role in treatment, as they affect prognosis, programme and what types of activities can be done, this meant that my intervention sessions had very little evidence behind them!

This experience is not a positive one as patient treatment and evaluation are not as holistically and evidence based as they should be; this is due to factors both in and out of my control, this could render treatment futile as I might be positioning a patient in bed, or giving them an exercise program to carry out at home, when their caregiver is uneducated on the importance of those programs. I would not call this a negative experience either as patients who have no idea what occupational therapy is are benefitting from my sessions, as short as their stay may be, they are still working towards independence in ADLs and the impairments that the doctors may gloss over are being remediated, preventing complications due to impaired client factors. My strength in these situations is the fact that I still do try learning about the client’s background in the short assessment time. My weaknesses however, is implementing it into treatment, due to space and time constraints as well as not learning enough about my patients when I do have more than two sessions! To get the clients in a stable position, where they can get discharged confident in their ability to participate in ADLs with as much independence as possible, as a therapist I need to have a more extensive knowledge on their conditions and procedures done. (Mozafaripour 2020).

The reasons for the lack of evidence-based practice in my treatment is of course, the fast-paced nature of acute care (Cardin 2018), as well as my lack of experience, in therapy and in knowledge about diagnosis’s that aren’t the ones we learnt during lectures. I don’t incorporate enough about the client into treatment as much as I should, as short as the time is, I should still be asking about the client’s context and job, as well as their daily routine. I need to take initiative and learn more about common procedures. I have a habit of watching video essays on the side of other tasks, I could replace this with medical documentaries, so I can feel more educated and at ease about working in a hospital. I need to draw up a guide for myself on important questions to ask patients as their preferences and values are important in the evaluation and treatment process.

 In conclusion, as difficult as it is to work in acute care, as fast paced as it may be, it is still crucial that as a healthcare professional in training, I educate myself and make use of the plethora of resources I have access to, to make sure that my intervention is backed up by evidence is effective and beneficial to my patients.

References

Janet Meydam (2023) “The Importance of Evidence-Based Practice in Occupational Therapy,” myotspot.com, https://www.myotspot.com/evidence-based-practice/.

Stavrou, Alexia (2024) “What Is Top Down vs Bottom Up in Occupational Therapy?,” myotspot.com, https://www.myotspot.com/what-is-top-down-vs-bottom-up-in-occupational-therapy/.

Mozafaripour, Sara (2020) “What Is Occupational Therapy’s Role in Acute Care?,” University of St. Augustine for Health Sciences, https://www.usa.edu/blog/occupational-therapy-in-acute-care/.

Cardin, Ashlea D (2018) “Evidence-Based Practice in the Hospital Setting: Views of Interdisciplinary Therapy Practitioners,” PubMed, https://pubmed.ncbi.nlm.nih.gov/29868691/.

“Addressing the Challenges of Evidence-Based Practice in Occupational Therapy | School of Health and Rehabilitation Sciences | University of Pittsburgh School of Health and Rehabilitation Sciences,” (n.d.), https://www.shrs.pitt.edu/news/addressing-challenges-evidence-based-practice-occupational-therapy.

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Reflect on cultural humility

South Africa is a unique country, we are a nation of 55 million, with people from a plethora of backgrounds, racially, religiously, and culturally! (Matthews & Van Wyk, 2018). This astounding diversity of our rainbow nation is so important to healthcare workers; to occupational therapists especially as we look at clients holistically, this includes their routines, activities, and rituals. As OTs, our patients are so much more than their diagnosis, which means we need to take initiative and learn about the spiritual beliefs of our clients and use this to treat them without bias and judgement.

Practical’s at Prince Mshiyeni have opened my eyes to just how much I need to learn about my patients’ cultural beliefs. One of my clients this semester was a sixty-one-year-old woman who presented with weakness and paraparesis in her lower limbs. She explained that she was cursed because of jealousy over her cow. The multitude of lectures I had attended on the client factors she presented with had not prepared me to deal with this specific situation. Do I chalk this down as a probable psychosomatic case because of her lack of a diagnosis? (Professional n.d.) Is it ethical talk to the client about this? I had realized that I don’t know enough about her cultural beliefs to talk to her about it, in fact I could not talk to her at all as she did not speak a word of English, which brings me to the second part of this experience, the language barrier, my Zulu is limited to a few words that I had learnt from some Duolingo lessons I had taken in my spare time.

This situation had left me feeling embarrassed; this client had been referred to me, I had been responsible for evaluating and treating her and not only was I oblivious to her beliefs, but I could barely carry out an assessment, which makes me question the reliability of my findings. An interview was out of the question. Without the translator, I would not have known about about the history of the clients' symptoms, her home context, hobbies and who takes care of her. Even if I had understood her, with my limited knowledge on her culture, would I be able to fully grasp her context? Would I be able to understand what occupations she partakes in for her beliefs? My weaknesses in this situation were my lack of knowledge, both about the client’s background and her language. Of course, as an OT and a decent human being, I respect the diverse cultures we have here in SA, but my lack of knowledge in them leads to a decreased understanding of my clients! That is not ethical because they might not be getting treatment as efficiently as they might be if I did have the knowledge about their occupations. I could’ve just done ADL session with this client to improve client factors like balance, but now that she has told the translator that gardening is a big occupation for her, it can be included in sessions!

Looking back now and analyzing the situation, I realize that I desperately need to learn languages other than English, specifically IsiZulu, even though dialect is a common challenge in the healthcare profession, I need to make an effort and expand my knowledge and vocabulary. (Sonn & Vermeulen 2018). To prevent this from happening again I need to do more research on the traditions of South African cultures, and as silly at is does sound, I need to keep up with my Duolingo lessons! It is not extensive, but it will help me get the basics down, once I do, I can try and converse with my colleagues in IsiZulu to practice. As an OT I should not be giving sub-par treatment, I should be putting in the effort to broaden my mind and learn! (Hildebrand et al. 2012). Even if there isn’t a language barrier I should be asking more questions about my patients culture as it plays such a huge role in ones life, affecting what occupations they do and how they are carried out.

In conclusion, the take home message here is that even though I try my utmost to respect my clients and treat without bias, its not enough. I need to understand my clients holistically and this includes their culture, as well as their dialect! Communication is a necessary factor in occupational therapy, and without it, intervention is ineffective. (Govender et al. 2017)

 References

Govender, Pragashnie, et al. (2017) “Exploring Cultural Competence amongst OT Students,” 2017 Occupational Therapy International 1–8.

Hildebrand, Kristin, et al. (2012) “How Can Occupational Therapy Strive Towards Culturally Sensitive Practices?,” The American Occupational Therapy Association.

Matthews, Margaret, & Jacqueline Van Wyk (2018) “Towards a Culturally Competent Health Professional: A South African Case Study,” 18 BMC Medical Education.

Professional, Cleveland Clinic Medical (n.d.) “Psychosomatic Disorder,” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/21521-psychosomatic-disorder.

Sonn, Inge K., & Nikki Vermeulen (2018) “Occupational Therapy Students’ Experiences and Perceptions of Culture during Fieldwork Education,” 48 South African Journal of Occupational Therapy.

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Reflect on how you have been a health advocate.

The doctors may give the treat the patients momentarily, but it’s the Occupational Therapists that ensure that the clients are going back to an environment that is conducive for them, that allows them to be the most functional and if not, who do we contact and advocate for the patients well being!

My client was a sixty year old man whose wife had dropped him off at the hospital. He was dehydrated and at first could barely speak. After a day we were able to get his story, he lived with his wife who took care of him despite him having eleven children. The therapist and doctor had called his wife but to no avail.

His story opened my eyes to the reality of public healthcare, how if you don’t have access to important information about your own health and the healthcare system, it makes being a disabled person here in South Africa a lot more difficult, especially if you do not know that there are professionals who are able to advocate for you. (“The Importance of Nurse Advocacy in Patient Care,” 2023)

The experience was not a positive one. Because I was unable to get ahold of the wife, the client was not advocated for. Treatment was not context specific as the client had cognitive impairment and hence his information was not reliable. My strengths in this situation was taking the initiative to try and call the patient wife to get more information and to try and advocate for him, informing the wife about places like Hillcrest if the burden of being a care giver was too much for her at her elderly age. My weakness was not trying enough, not following up and trying to call the wife again after the client was discharged.

The wife was elderly elderly herself and was probably burnt out as her husband required a higher level of care and more assistance with his daily activities. To ensure that patients in his situation are not left to return to the same context, where they are not getting the therapy that they require, this includes physio, OT and speech therapy, (Multidisciplinary Team Care - HealthOne NSW, n.d.). I would put more effort into following up on the client, despite the amount of work I have on my plate. I would also advocate for my patients well-being within the hospital as well, so they are getting the treatment that is beneficial towards them and is within and following their rights as a patient of the hospital.

In conclusion, my understanding of advocacy of the clients definitely needs to broaden. I need to do more research on accessible facilities services that clients can access and even advocating for clients within the hospital! Ensuring that their diet is appropriate for their diagnosis; including supplements and medication that they require, making sure that they are not discharged too early. Our patients are not just diagnosis’s, they deserve care that benefits them holistically!

References

Multidisciplinary Team Care - HealthOne NSW. (n.d.). https://www.health.nsw.gov.au/healthone/Pages/multidisciplinary-team-care.aspx#:~:text=Multidisciplinary%20teams%20convey%20many%20benefits,job%20satisfaction%20for%20team%20members.

The importance of nurse advocacy in patient care. (2023, November 8). Online Degree Programs | Oklahoma City University Online. https://online.okcu.edu/nursing/blog/the-importance-of-nurse-advocacy-in-patient-care

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Reflect on collaborative practice within the multidisciplinary team.

People are made up of a plethora of systems, and their diagnoses include a myriad of symptoms. As general as the scope of occupational therapy is, we cannot remediate all of them alone, hence the need for a multi-disciplinary team. Watching physio student do a session on my client and then discussing findings with them had helped me better understand this.

At first, I was frustrated at the fact that there was another therapist working on the client I had been given, but I had decided to stow those feelings of annoyance away and look on the positive side; this could be a learning opportunity, and I was right! This experience had not only unblurred the line between occupational therapy and physiotherapy, but it had also cemented the fact that as much my functional activities would remediate certain client factors, physiotherapists and their techniques and exercises are required for strengthening and ensuring that clients are able to mobilise as well as the overall benefits of physiotherapy. It made me realise just how important therapy is in general!

It was a very positive experience because as well as learning about working with other health care workers, I was able to learn more about my clients by watching the physios working with them and then discussing our findings after. This experience did not only encompass working with the physiotherapists, but it also includes working along and even with both the nurses and the doctors; questioning them about the patients and making sure the sessions you’re doing won’t harm the patient and making sure you plan sessions and work around their schedules.

I am glad that I didn’t leave the ward once I noticed that my client was not available. After the session was over and the physio and I had discussed our findings from our sessions. The student had not considered functional activity and was pleasantly surprised when I mentioned that he was able to prep a meal while in short sitting, it made me think of the rehabilitation centre I went to for electives last year, I had watched collaborative sessions, but I didn’t really think about the benefit of them. According to the research I have done, a collaborative session can make assessments more comprehensive and reliable; this means treatment will be more holistic and client centred. It also means the client will get the most efficient treatment as there will be more communication between their therapists. If I do see other healthcare workers working with my patient, from now on I will try my best to communicate with them and even offer up whatever information I have, this way the client benefits more from treatment.

In conclusion, its imperative to work within a multi-disciplinary team in order to broaden and increase my own knowledge and grow as a professional, as well as help out my fellow healthcare workers by sharing my own knowledge with them. This does not only affect me as a student, but it’s something I should remember as a qualified OT to ensure that the patients I see are receiving the best treatment possible. Personally, I should interact with my colleagues much more as this will help me out tremendously when treating and writing up case studies on my clients!

References

Ninjas, Note (n.d.) “Achieve Better Outcomes with PT and OT Collaboration,” The Note Ninjas, https://thenoteninjas.com/blog/f/achieve-better-outcomes-with-pt-and-ot-collaboration#:~:text=Benefits%20of%20OT%20and%20PT,%2C%20cognitive%2C%20and%20functional%20abilities.

“10 Benefits of Physiotherapy - What Can It Help with? | Aug 06, 2022,” (n.d.), https://www.liftphysiotherapy.ca/blog/10-benefits-of-physiotherapy.

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Your first week of fieldwork. What have you learnt about providing intervention?

The feeling that most aptly describes my first week on prac, is whiplash. My last physical block was at a chronic facility, with consistent clients and a slow-paced environment. My current block is at an acute facility; I have had at least four clients since the beginning of the block, I feel like this has definitely both tested and improved my ability to assess clients, it has also improved the way I interact with clients; the interview process is smoother as I am more knowledgeable about which information is important and which questions I should ask. I have been seeing the same diagnoses from my last block, but with a more experienced eye as I now have more understanding of the clients’ conditions.

At first, it was difficult to define the line between assessment and treatment. I am doing the same activities and occupations from last year, but with different clinical reasoning. Getting feedback on my write ups and sessions has clearly defined that line and it will definitely make planning and carrying out sessions easier in the future. Feedback specifically about client handling was the most useful. I have always been afraid to push clients or mobilize too much in case I caused harm. I now know that without pushing and encouraging the client to do more, they won’t improve and treatments and interventions will hence be futile. Seeing a qualified OT perform assessments and even treatment sessions on clients have helped me envision what my sessions and assessments should look like!

Another thing that this week has taught me was that I do not know my work as well as I should. I definitely do need to go back and revise; on my NDT principles, session write ups and client factors.

In conclusion, this week of prac has been unbelievably useful and insightful and I do hope to learn more in the weeks to come!