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Making lemonade out of all the lemons....

Thinking about how far I have come from the beginning of this block to now. I realise that it’s true when they say it all seems impossible until its done. This journey was not a walk in the, however one has learnt to make delicious lemonade out of the lemons that were obstacles in this journey. I have learnt to acknowledge my weaknesses and for that acknowledge the strengths of others, namely my colleagues. One skill that I acquired from this block is to ensure that one comes down to the level of the community members ensuring that as the students we do not take an authoritative role.

I have surely grown as a therapist as in this block I have had an opportunity to sharpen my clinical practice skills by ensuring that I made the most from my experiences. One important skill is that of ensuring that your intervention is holistic and relevant to the individual client and if it were a group to that particular group. The key component of our interaction with the community was communication. This was to ensure that there were no assumptions about context of the services being rendered by me as an occupational therapist. Although at times I had to repeat myself several times before I was understood especially when I was trying to explain what occupational therapy is and what is our main role. We used these kinds of opportunities to advocate for Occupational therapy, within the community. From time and time again, I felt as though the community had unrealistic expectations from us, mind you in the KwaDAbeka community if the students do not go to the client they also do not come to us. This meant that as a team we had to plan considering the context in which we were working as it guided our approach and determined strategies to ensure successful implementation of the interventions.

Although it took me time to get my timing and planning in the right path, I had to appreciate that someone has spared me some of their time and I by any means had to make it worthwhile. I had to ensure that the session was beneficial, and they could see the need of occupational therapy in their lives. Luckily there were places where we went, and people appreciated us and made referrals for people whom they thought would benefit from our services. Working together with the physiotherapists in some of the home visits and within the schools ensured that we parting as much knowledge as possible with our different approach. Similarly, both professions used a promotive and rehabilitative approaches to ensure that quality of live within the community was improve with interventions. However as occupational therapist we also used the educational approach to educate the community about the different conditions that have been identified by the other students to exist within the community. This was to raise awareness and to ensure that the community people told other people whom they may have identified as needing of our service.

Accepting reality that teenagers are engaging in sexual activities from a very early stage is something that most communities must work on. Having had engaged Grade 6 and grade 7 in a local school in a conversation about teenage pregnancy. The statistics from surveys that were conducted are alarming. In my opinion most of the behaviour observed in the community is highly influenced by negative role modelling. I mean during the school break one of the boys came by “smoking a stick-sweet stick” puffing away in imitation and his peers applauding him. Not to mention how exciting and funny is the topic of engaging in safe sex for them. From what I gathered we can only do so much, “as a wise man once said you can take the horse to the river but you can never force it to drink”.

Although in engagement we used a strategy motivated by the saying that “If you give a man a fish, he eats for a day; If you teach a man to fish, he eats for a lifetime”. In our projects like the teenage pregnancy one we shared skills to aid in improving quality of life like stress management, coping skills, time management and assertiveness. We engaged the learners in conversation to ensure that they understand what we were talking to them about by using examples that are relevant in their context. In the end the main thing is I feel ready for the next phase in this occupational therapy career.  I am actually going to swim through my community services year next year regardless of how deep the water is.

References

Macqueen, K. M., Mclellan, E., Metzger, D. S., Kegeles, S., Strauss, R. P., Scotti, R., . . . Trotter, R. T. (2001). What Is Community? An Evidence-Based Definition for Participatory Public Health. American Journal of Public Health, 91(12), 1929-1938.

Saunders, M. (2018). What is community, p 4.

Vermeulen, N., Bell, T., Amod, A., Cloete, A., Johannes, T., & Williams, K. (2015). Students fieldwork experiences of using community entry skills within community development. South African Journal of Occupational Therapy, 45(2), 51-55.

Maimonides, (2018) Brainy Qoutes. Retrieved from: https://www.brainyquote.com/quotes/authors/m/maimonides.html

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The Occupational therapy role in primary health care

What is health? Health is defined by World Health Organization as a "State of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity". So, when we look at promotion and prevention of health we must ensure that we facilitate a perfect fit of the person, occupation and the environment. Primary health care “emphasizes prevention and wellness and recognizes that success in improving people’s health is largely determined by factors in their daily lives such as: lifestyles, housing, relationships, spiritual beliefs, income, and workplaces” (Government of Alberta, 2014). One would wonder why! Just think about if there is disfunction of one of these factors one’s engagement in day to day activities will be affected. I assure you this is a must because it is an eye opener as to how the things we regard as small are in actual the big things.

Good example, as this block started we went out into the KwaDabeka community looking for home visit clients. Trust you me, it was not easy. Some people were welcoming us into their home but one case that is relevant to this topic is that of Mrs Sibiya who has been taking care of her husband with disability due to stroke for 22 years. On initial contact she said all was well but looking at her poor quality (poor because it is not typical to that of a healthy person).  People with chronic conditions and disabilities are systematically disadvantaged when seeking primary care (McColl et al, 2009). Occupational therapy intervention was then focused energy conservation, joint projection principles, time management, education on depression beater and care giver training. Although Mrs Sibiya had no proper medical diagnosis as a health professional I could not dismiss all the physical signs she had not to mention the evidence of her inability to cope with her day to day work. Here we aimed at primary care reforms that are focused on providing comprehensive services with an emphasis on chronic disease management, health promotion, and prevention services (Health Canada, 2012). And of course ensuring that the fit of person, environment and occupation for the client.

It is undeniable that ill health is a result of what people do or don't do every day from our motivators, choice of activity, activity engagement, habits and routines. Occupational Therapist have a role in health promotion by improving health and wellbeing through engagement in everyday and meaningful activities (Wilcock, 2006). It really does not end there, occupational therapy also has a role in prevention of secondary complications which may worsen one’s health. Occupational therapist are experts in the providing of adapted equipment, are educated “during their training” about chronic disease management and are client centred. With that said it is safe to say that with the prevalent lack of coordinated primary health care, as well as difficulties accessing specialty services and obtaining required assistive equipment (McColl et al, 2009) occupational therapists are playing an important role in health promotion and prevention.

The use of media in this regard is superficial, every morning at the Clermont clinic I pass a pile of FREE newspapers that people do not pay attention to. Social media like Insta-gram has perpetrated disability as a fashion for example they post videos of people with down syndrome and intellectual impairments to entertain their followers, forgetting that those people do not see their actions as comedy. On the other hand, we have face-book which people have changed to a dating site in my opinion. By the way my colleagues and I tried to contact different radio stations that were identified to most listened to in the Clermont KwaDabeka community with no success to advocate for Occupational therapy and to inform people in the community about our role in health promotion and health prevention. One successful media that we implemented in the community was that of a “modified flash mob”. Where we went into the community in wheel chairs we got the peoples attention and positive engagement.

At the end of the day occupational therapy as a profession is for the people by the people. The profession itself if still recovery from patriarchy and all other stereotypical labels it  has been given world wide.

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Political practice model of occupational therapy

How is it possible to introduce the politics into a profession that is linked to health care? What form could political practice take, and how could the political components of practice be analysed and evaluated to fit into rendering of the occupational therapy practice.

A Political Practice of Occupational Therapy is about maximizing the potential impact of occupational therapists' engagements and ensuring the profession is working towards the construction of a civic society. The history of this profession depicts the importance of this practice as it is an agency for social change. This will take us back to our basic way of defining occupational therapy practice where say we assist people in their activities of daily living ensuring that they perform them in a typical functional fashion. One would wonder how relevant this to our communities is. With function we look at how an individual is able to engage in meaningful activities. One activity that I have engaged a lot with in the Kwadabeka community is schooling where most occupational injustice is evident as there is a lot of peer pressure to do certain things to fit into the cliques. The male students saying that pregnancy is solely the girl’s responsibility.

Demands for implementation of the potential and responsibility of occupational therapy to address socio-political conditions that spread occupational injustices have materialized in the literature. Literature alone is not enough, I mean actions speak louder than words. This social agenda requires the incorporation of diverse procedural approaches to support action adequate with social transformative goals. With that said occupational therapists are increasingly promoting an agenda of social reform to address the socio-political process and conditions that contribute to maintaining occupational injustices. Although there is no one definition of social trans- formative work in the occupation-based literature, several authors have argued for the potential of occupation to enact social transformation. The term social transformation related to occupation is employed by critical social theory, that places emphasis on power relations and socio-political conditions that extend beyond individuals and shape their occupational possibilities for participating in society. This then means the focus has to be moved to projects that employ occupation at the core of their actions namely occupation-based work to generate knowledge about and address the socio- political conditions that maintain inequality have developed in diverse geographical locations. We can start step by step by advocating and creating awareness to address the social ills that exist within the KwaDabeka community.

With pride my colleagues have done a wonderful job in attempt to address situations that were identified as problems. Before anyone even asks, the community people were asked verbally, looking at the statistics of the Clermont clinic and the Kwa-Dabeka CHC as to what are many problems they help people with. So as the UKZN OT 4 community practitioners we are on the right path to implementing the action required to combat the occupational injustices.

References

A political practice of occupational therapy | Request PDF. Available from: https://www.researchgate.net/publication/305084455_A_political_practice_of_occupational_therapy [accessed Oct 05 2018].

Critical dialogical approach: A methodological direction for occupation-based social transformative work | Request PDF. Available from: https://www.researchgate.net/publication/324947400_Critical_dialogical_approach_A_methodological_direction_for_occupation-based_social_transformative_work [accessed Oct 05 2018].

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Activity:  Community Occupations: Reflect on your discussion with the person/s that you have been doing it with, who regularly participate in this occupation. Utilise an occupational science framework- remember this is not a diary of what you did.

Having had grown up in the rural areas shaving your head with a razor was not the most fashionable thing, in actual fact we tried by all means to wait until we had R5 to our hair cut with a trimmer. To my surprise this has become a fashion to the older brothers “ama-razo” one of the customers explained.

One of the customers went on to say that a razor shaved cheese-kop is smoother and more respectable. Barbers were well known for their experience-based training of shaving skill to give customers a thorough and quick shave said Greenberg (2005). This was evident in the noticeable different on the customers skin with the head being smooth and shiny after a razor shav, whereas the beard was not a smoothly shaved with the hair cutter. This allowed for an opportunity to observe obvious occupational deprivation as the razor can only be used once and the same hair trimmer is used on multiple customers, in all honesty it is used until it is broken. Hair dressers use methanol spirit to disinfect the customers and prevent cross infection. In my own opinion I see this as “The morning after pill” nobody is certain of its effectiveness. This would then why is see this as a circumstance that is external which prevents people from participating in health promoting activities.

I respect the hair dressers effort to counteract cross infections to me this is evidence of occupational competence. Simply because the hair dressers have gotten into a routine or pattern that enact their occupational identity as hair dressers. This is by associating each shaving tool with a specific after shave applicant. If you do not believe me, of the time I spent at the saloon and about 7 customers came in there was a pattern. Cheese kop with a hair machine was followed methanol applicant as an after-shave applicant, cheese kop with a razor was followed with a hair food as an applicant, beard shaving was followed by an anti-pimple powder (Ceedyn acne cream) applicant and shaving with hair was followed. With that said the it is sad to think how those hair dressers work hard with so much dedication to give 45% of the money they make to the owner of the container they use for their saloon.

This then goes back to that fact that occupational behaviours differ from one individual to the other. For the hairdressers it is fair, and have strong feelings of achievement, that they pay so much for rent given the time they spend working (07h00 to 18h00). At the same time there is someone has feelings of achievement because of the money they make from their container. This just makes me think of how unbalance is our socio-economic wellbeing with the communities we live in. For example, in Kwa-Dabeka you can easily identify the difference between the socio-economic statuses of the people residing in the different section of the community.

As the people who come in and out of the community it is not easy to understand the injustices and alienations in dept as we only have so much time given to for interaction with the individuals. We cannot expect people within the community to open up to total strangers regardless of how hard we try to fit into the community. There will always be identification of the “stigma” or “authoritative figure” labels that we get given by the community.

References

Corey Greenberg (2005-01-30). How to get that perfect shave. msnbc.msn.com. Retrieved on 2012-09-14

Paul Winchell invented the first disposable razor. Mickey News (2004-01-08). Retrieved on 2012-09-14

Sustainable livihood foundation, Hair Care Businesses and Shipping Containers http://livelihoods.org.za/wp-content/uploads/2015/05/Formalising-Informal-Micro-Enterprises-Hair-Care.pdf Retrieved 28 August 2018

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Utilise contemporary newspaper and research articles to discuss how economic factors impact on health and wellness in South African communities.

Two decades ago, the 1997 White Paper for the Transformation of the Health System in South Africa set out a post-apartheid vision of a health system built on the primary health care (PHC) approach. This commitment to PHC, which focused on social determinants, was ratified in the Health Act (61 of 2003) but has proved difficult to implement (Naledi t. et al). This is because of shift of focus from health outcomes to their underlying factors as people do not use health services before there is disease. In the community people resort to home medicine like enema with water and sunlight on the onset of illness with the hope that one will get better. People are taken to the clinic when they are severely sick, this is because they try to cut costs of having to pay for transport whereas the person can still be helped at home.

This World Health Organisation Commission on the Social Determinants of Health which, represented a major evidence-based public shift in thinking, challenging purely biomedical notions of disease and recognising. This should instead be on the role played by global and national political economies in creating health injustices, specifically looking at the “unfair and avoidable difference in health status seen within and between countries” (Ottersen OP, 2014). Socio-economic challenges which people are confronted with on daily basis which results with limited availability of resources (Taylor N 2007).  This extends beyond the classroom to the neighbourhood and homes from which the learners come and the social ills they face, such as the consequences of one of the highest rates of HIV and AIDS in the world, large scale unemployment, drug abuse, gangsterism and violence (Tlad, SL 2006).

Occupational imbalance is a configuration of activities within a person’s lifestyle that does not meet physiological, psychological or social needs in a manner that is healthful and satisfactory to the individuals. With the history given above one can conclude that economic constraints negatively affect one sense of accomplishments which ultimately relates to satisfaction with one’s daily occupational function.

Occupational injustice is alienation which is basically taking away of ones right to develop through participation in occupations for health and social inclusion. South Africans from the disadvantaged socio-economic background are alienated because due to inaccessibility of the health services as they cannot afford to travel to the clinic. Which will make us looks at how then can we relook the Primary Health Care or do we motivate for a shift of focus to the National Health Insurance. This promises equal rendering of health services despite of ones economic status.

References

Development Bank of South Africa. A roadmap for the reform of the South African health system. Johannesburg: DBSA; 2008

Naledi T, Barron P, Schneider H. Primary Health Care in SA since 1994 and implications of the new vision for PHC reengineering. In: Padarath A, English R, editors. South African Health Review 2011. Durban: Health Systems Trust; 2011

World Health Organization. Social determinants of health. [Internet]. [cited 13 September 2018]. URL: http://www.who.int/social_determinants/ sdh_definition/en/

Ottersen OP, Dasgupta J, Blouin C, et al. The political origins of health inequity: Prospects for change. Lancet. 2014;383(9917):630–67

Taylor N 2007. Equity, efficiency and the development of South African Schools. In:  T Townsend (Ed.): International Handbook of School Effectiveness and Improvement. Volume 17. New York: Springer International Handbooks of Education, pp. 523-54

Tlad, SL 2006. Poverty and HIV/AIDS in South Africa: An empirical contribution. Journal of Social Aspects of HIV/AIDS, 3(1): 369-38

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Community engagement: why is it important to prepare for community engagement, what were your drivers, what were your insights and how did you apply your learning/reading during the initial engagement during week one?

In preparation for community engagement one must learn to be open minded that our own home societies may have customs and practices that not necessarily acceptable in other societies. With that said, it is important to ask my fellow colleagues who have been in that community about their experience there. This allowed me an opportunity to get the views of people who are within the Occupational therapy practice, in this way my thinking as a therapist who want to make a change in the community was positively influenced by their implemented strategies to successfully engage with the community.

My practical application of practice skills to alter the behavioural patterns of community groups that exists within the community I am to engage with, should be realistic, relevant and meaning full to the them rather than to me as an external individual who has come into their community (Dalto, J 2012.). This is highly motivated by, (Hardcastle, Powers and Wenocur, 2004), who stated that highly referred to community practice as “application of practice skills to alter the behavioural patterns of community groups or people’s relationships and interactions with these entities”. As an Occupational therapist within this community I must then engage with community with a clear picture of how their feel their functional engagement in their daily lives has been limited within their environmental context.

The occupational therapist must retain broad view of health to implement successful health-related programs because the extrinsic factors of health cannot be denied. For example, when conducting an occupational therapy evaluation in the home, the OT can explore the impact that the environment has on the client’s occupational engagement and easily visualize the barriers may experience (Wilcock, 2006, p. 10).

This therefore means that in the community context of Occupational Therapy practice is focused on the communities limited engagement in meaningful occupation with respect to the environment rather then, the medical diagnosis (Baum & Law, 1998; Wilcock 2006). The was then the main driver. This allows for an opportunity to treat the client as individuals within their homes where there is a clear demonstration of how they engage in meaningful occupational activities rather than the idea given in a verbal description of what activities do they engage in. To me this meant that I am to have the greatest experience treating my clients holistically with more emphasis on their function rather than their diagnosis as I would in a hospital setting (Miller and Nelson (2004)).

As an Occupational Therapist I must explore the role of occupational engagement by shaping of the society in relation to daily life activities within the community setting (Fagan, 2010). With the aim to provide holistic treatment that has some greater therapeutic values as it looks at each individual within the context in which they function on a daily basis.

References

Hardcastle, D., Powers, P. and Wenocur, S. (2004). Community Practice: Theories and Skills for Social Workers. 2nd ed. Oxford university press, pp.3-10.

Rogers, Ben and Emily Robinson. The Benefits of Community Engagement, a Review of the Evidence. 1st ed. London: Active Citizenship Centre, 2004.

Fagan, L. (2010). OCCUPATIONAL THERAPY IN THE COMMUNITY. Australian Occupational Therapy Journal, 24(2), 22-27. http://dx.doi.org/10.1111/j.1440-1630.1977.tb01088.x

Dalto, J. (2012). Putting Adult Learning Principles To Work. Outreach Trainer for General Industry Pdf. https://www.convergencetraining.com/blog/putting-adult-learning-principles-to-work

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References

Stories and Tales - The jar of life – stones, pebbles and sand. (2017). Sechangersoi.be. Retrieved 4 October 2017, from http://sechangersoi.be/EN/5EN-Tales/StonesPebblesSand.htm

https://www.youtube.com/watch?v=SqGRnlXplx0

The jar of life (story)

Some people do not have interest in formally structured didactic session, as there is clear description of role with the therapist being the authority figure. Firstly, as therapists we have to accept that clients are people, just like every other person, over and above being services users at our respective facility. One needs to be allowed time to get to know and get comfortable with the therapist. With that said the therapist have to be able to kill two birds with one stone by assessing and treating at the same time.

The jar of life analogy provided me, as therapist, with opportunity as I was able use it practically to treat my client’s intellectual insight in an educational session. How? One would wonder. If the clients has substance abuse disorder the bigger things in life represented by the golf balls, namely relationships, family and health, have been put last in the clients life which is presented by the glass. With the other smaller things being for example the pebbles representing the clients use of time, the sand representing the client’s skills and the water representing opportunities available to the client like therapy and the rehabilitation program.

I am proud of myself for using this analogy in therapy. As it serves as a practical demonstration for the importance of prioritising. The client had prioritised the smaller things in life leading to very limited to not time for the bigger things. This then resulted with an imbalance in the client’s life and decreased motivation to perform in his areas of occupation. The rehab program is aimed at assisting the client restructure their lives so that they have a functional balance. As the client engaged in the practical activity he also engaged in a didactic component of the session as there was discussion going on.  The conversation was in an unstructured manner which eliminated the opportunity to see the therapist as authority figure.

It was a successful session with a client who has no motivation.

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The jar of life (story)

Some people do not have interest in formally structured didactic session, as there is clear description of role with the therapist being the authority figure. Firstly, as therapists we have to accept that clients are people, just like every other person, over and above being services users at our respective facility. One needs to be allowed time to get to know and get comfortable with the therapist. With that said the therapist have to be able to kill two birds with one stone by assessing and treating at the same time.

The jar of life analogy provided me, as therapist, with opportunity as I was able use it practically to treat my client’s intellectual insight in an educational session. How? One would wonder. If the clients has substance abuse disorder the bigger things in life represented by the golf balls, namely relationships, family and health, have been put last in the clients life which is presented by the glass. With the other smaller things being for example the pebbles representing the clients use of time, the sand representing the client’s skills and the water representing opportunities available to the client like therapy and the rehabilitation program.

I am proud of myself for using this analogy in therapy. As it serves as a practical demonstration for the importance of prioritising. The client had prioritised the smaller things in life leading to very limited to not time for the bigger things. This then resulted with an imbalance in the client’s life and decreased motivation to perform in his areas of occupation. The rehab program is aimed at assisting the client restructure their lives so that they have a functional balance. As the client engaged in the practical activity he also engaged in a didactic component of the session as there was discussion going on.  The conversation was in an unstructured manner which eliminated the opportunity to see the therapist as authority figure.

It was a successful session with a client who has no motivation.

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Contemplating the state of South African society’s mental health

If there is one thing South Africa is known for, it is diversity. With diversity comes differences in terms of religion, culture and traditions. It is unfortunate that these factors play a significant role in our we look at mental health.

Mental ill health is often noticed when the individual starts school. As behaviour is not easily understood in African cultures it initially seen as a need for cultural and traditional practices. With that said the South African society is not very accommodating of mental illnesses as there are many stigmas associated with such conditions. Mental illness is very prevalent in South Africa, yet the country lacks many of the necessary resources and policies needed to execute an effective mental health strategy. This was recently well demonstrated in the Gauteng Province Life Esidemeni case where due to insufficient funds clients were transfer to unregistered NGO for care. According to the SAHRC report (2017), Where clients were not treated with the appropriate level of care as the NGO facility staff did not have appropriate training.

This resulted with unidentified dead individual and reports of missing persons as the client or service users family relatives were not informed of the transfers. This then resulted with law suit cases directed to the government who violated the client right to safety, information and appropriate health care. However, some one was to be held accountable, is it the premier who signed the authorizing documents with confirming if the appropriate procedure had been followed or the Life esidemeni facility who did not take responsibility of the clients who were left by their families in their care.

“The decision was unwise and flawed, with inadequate planning and a ‘chaotic’ and ‘rushed or hurried’ implementation process” yet it was implemented. This explains how much prioritize mental ill individuals in South Africa. Facilities are also faced with clients being left at admission by their families who never return. Which means that there is need for improvement an development of this field of practice in South Africa as whole communities client live in, their families, state resources allocation and program planning.

 (2017). Retrieved 3 October 2017, from https://www.sahrc.org.za/home/21/files/Esidimeni%20full%20report.pdf

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Discuss two articles you have read relating to something relevant to your psychosocial professional experience.

According to Addressing Trauma in Substance Abuse Treatment: EBSCOhost", (2017), Trauma is prevalent among clients with substance abuse issues, yet addictions counsellor training in trauma approaches is limited. This seems to have become a pattern in which I realised with my clients. It is really unfortunate that we tend to over-look the amount of attention one needs when growing up from direct care givers and generally refer to signs as “attention seeking behaviour”, said one of clients when he spoke of how he had to secretly deal with witnessing his father abuse his mother. Having had grown up in a typical African community it is safe for me to agree with, "Addressing Trauma in Substance Abuse Treatment: EBSCOhost", 2017, that women often sexual assault and men often experience violent assault which results in their trauma. To be more specific experience includes witnessing another person being a victim, being the actual victim and being at risk of being a victim. From this I therefore learnt that even the smallest things in life and in practice do matter because as a therapist I am may disregard a very important event in my client’s life which could possibly change my clients therapy just by not listening attentively.

Often client do have enough support from their immediate home context, but there are many negative role models available to give them guidance. It is really unfortunate that that guidance is usually negative peer pressure which on its own eventually leads to criminal activities which further destroys the clients support structure. With that stated I acknowledge the study by "Social Support Influences on Substance Abuse Outcomes among Sober Living House (SLH): EBSCOhost", 2017, stating that social support and psychiatric severity are known to influence substance abuse. Although I do acknowledge that some people abuse substances even though they have well established support structures, but due to the abuse there are changes that occur in relationships namely trust, responsibilities and consequences. When one is at the SLH (rehab centre) it is important to restore their sense of self-worth and re-establish relationships, this gives client motivation to comply to the program. It is also important to be considerate of other underlying factors that can have effect on the client psychologically namely low self-esteem, depression, anxiety, social isolation and anger management issues.

Refereneces

Addressing Trauma in Substance Abuse Treatment: EBSCOhost. (2017). Web.b.ebscohost.com. Retrieved 24 September 2017, from http://web.b.ebscohost.com/ehost/detail/detail?vid=3&sid=bffd37b4-37b7-44f1-998b-f381fa18a59d%40sessionmgr120&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=EJ1115560&db=eric

Social Support Influences on Substance Abuse Outcomes among Sober Living Ho...: EBSCOhost. (2017). Web.b.ebscohost.com. Retrieved 24 September 2017, from http://web.b.ebscohost.com/ehost/detail/detail?vid=5&sid=bffd37b4-37b7-44f1-998b-f381fa18a59d%40sessionmgr120&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=EJ1142111&db=eric

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What have I learnt on fieldwork block and about myself…

Sometime we think rehab is the easy way out of substance abuse but if it is not from the addicts heart that they want to be admitted for a program it is no difference from pouring water on the ducks back. It is the addict that is supposed to admit and acknowledge that their substance use is disabling for themselves and for the family. According to treatment (2017), Every single person in an addict’s immediate family (and at times extended family) is affected in some way by the individual’s substance abuse. Addiction impacts a family’s finances, physical health and psychological well being.

According to NCBI articles, These physicians faced competing expectations: at an internal level, those of their ideal role in their family and their ideal professional identity; and at an external level, those originating from other family members and from other physicians. Reconciling these conflicting expectations was made more difficult by what they deemed to be suboptimal circumstances of the modern health care system. With this I developed an understanding that I cannot always be a hero to my family as expected that as I am a student occupational therapist doing clinical practical at rehab centre I will be able to convince my younger brother to quit his substance addiction. It is not about me, all I can do is to help my family by suggesting and recommending counselling in attempt to limit the psychological effects on my family especial my younge st brother who is now being exposed to this behaviour on a daily basis.

This fieldwork block has made me grow to acknowledge my strengths and weakness in a positive manner. Meaning that I do not under estimate my capabilities and to allow my weaknesses to make me stronger rather than pull me down. I learnt to useful engage in the client’s therapy sessions for therapeutic effects. When working with the client look at the client before looking at the clients diagnosis, because in occupational therapy it is important to look at the client in an holistic manner. As a therapist, I had to allow the clients clinical presentation to express the client diagnosis rather.

References

Treatment, C. (2017). Chapter 2 Impact of Substance Abuse on Families. Ncbi.nlm.nih.gov. Retrieved 11 September 2017, from http://www.ncbi.nlm.nih.gov/books/NBK64258/

(2017). Retrieved 11 September 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071568/

What have I learnt on fieldwork block and about myself…

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Casual day

Team work does always pay. My clinical practical group and I went all out when we were planning and organising the casual day project. A diverse group of people can work as a single unit when there is respect, listening and cooperation. That was basically the key to our successful event.

Professionally casual day allowed me to implement and improve my group work skills. I realized the importance of working together. Identifying each-other’s strengths and weakness had a positive impact on the assignment because each group member contributed to the success of the event equally. At most professionalism was required when the facility services users began to pull out of the programme list. We could not have afforded to allow the client to pull out as that would have cause unnecessary problems. The service users were then held accountable for signing up to do an item.

From this I learnt the importance of keeping your word as a therapist and as an individual. When the service users wanted to pull out their items their peers constantly reminded them that they were not being fair on the occupational therapy students who prepared the program considering their items. Alone that experience opened my eyes to always consider my words and actions, “what goes around comes back around”. I must keep my promises and my word to my clients at all times. And I must own my mistakes and admit to guilt because that is the first step to growth and development. In life everything happens for a reason and from every mistake we must learn.

Sometime we under estimate our talents, never in my life did I stand in front of many people to take charge. Thanks to being able to speak both English and IsiZulu, because if it was not for that I would have turned down the suggestion with no second reconsideration. There is more to me than I give myself credit for. For a moment, I was lost in my own thoughts because I had no script but I am sure that I was confident… that was my moment…

The amazing feeling of not being worried and just being lost in the most is the highlight of my casual day experience.

[hopefulot-blog]

Reflecting on blogging, sharing, thinking and reflection…

This is what I would refer to as personal individual academic reflections, this is my space to share my opinion on my experiences. The one common feeling that I get when I am typing is that of anxiety as to whether am I going to come across as I want to and whether it is professional and well written. As this is not as simple as diary writing, but funny how many always compare the two.

At the same time, I remember that this is my free space where I share my experiences of my training as a future occupational therapist. By the way, studying Occupational therapy is a job on its own. Blogs which are compulsory for me to qualify in the near future require me to read articles and books, which I would never read if I was given another option. The readings are beneficial because every week you know that you have to read about something different, which is related to your academic training. As a wise man, Kofi Annan once said, “Knowledge is power, information is liberating and education is the premise of progress in every society and in every family”.

When given such opportunities one must grab them with both hands but problems come, when you many other things. Not that I am priorities one more than the other but I mean after Tuesday practical one is busy stressing about implementing the feedback received from Tuesday into Fridays treatment. Let alone finding the just right activity for Fridays session, because you just have to show that you are learning and willing to improve. Which ultimately leaves Friday afternoon for my blog, keeping in mind that Fridays are stressful. At the clinical practical venue we have very little time to even finish sessions and thereafter, have to attend clinical sciences which is almost always a lot to grasp. Which would add to my anxiety when typing my blog, under pressure to finish on time.

At the end of the day, the pressure is so much that it becomes what one would refer to as the battle of the fittest.

https://www.brainyquote.com/quotes/quotes/k/kofiannan389917.html?src=t_knowledge_is_power

[hopefulot-blog]

Impact of movies on our learning as future OTs

I cannot believe how ignorant am I! so I have always heard my best friend say that they do not want to watch a typical me movie but never understood. This week I realized that I always choose movies that a Quantity server would not be interested in. Patch Adams does not portray any mental illness but is very important in guiding a future Occupational Therapist as it teaches and emphasizes the importance of being client centred in therapy treatment. It is only when you are when you have learned to be client centred that therapy becomes more therapeutic and meaningful to the client. Mentally ill or mentally disturbed people are human and deserve as much respect as everyone else. “I am Sam” made me realize that mental illness does not stop one from fulfilling their occupational roles in their families and in their respective communities. How we treated mental retardation is a choice as some may take advantage and some be over protective of them. They too are able to live a meaningful life, he fathered his daughter with so much love and care. Having had been at a rehab centre for my psych-block and both my client blaming not being loved by their mothers for them to start using drugs. Attention to another makes a difference in another person’s life, main lesson from “the perks of being a wallflower”. Living in isolation makes one feel unnoticed and unloved. As the holy scriptures, says “love one another” with love we will live in harmony. People drift away from those around them when they feel unloved and unnoticed, which leads to depression and suicidal ideation. These results with them becoming addicted to substances which they feel help them. As a result suicide statistics have increase and victims cried for help but are not noticed because prioritise have become materialistic things like business, jobs and statuses. Professional help is not available for all because the finance to be covered like registration fees for rehabilitation centres and also admitting that one has a problem requires insight of which many do not have. It is our in human nature to fear social judgements and as a result hold back and not ask for help References: I am Sam, (USA) 2002, Jessie Nelson The perks of being a wallflower, 2012, Stephen Chbosky

[hopefulot-blog]

For therapy to be holistic and meaningful to the service user they said “it is not about me”, but what if being at a rehabilitation centre is your worst nightmare? How do I disregard my feelings and make my client the priority here? I never expected to never expected to be so emotional, thinking of “if only I could turn back time she wouldn’t have OD” or “mum could have given him more attention for him to not even start”.

Having had met my client’s and listened to their stories I got more confused than I was initially. I mean I thought they would say there wasn’t enough Love and attention, they hurt them and they wanted to fill a void. Honestly it nothing like that “I saw him/her do and got curious!” is what they said. Research shows that occasional smokers have high social anxiety and low self-esteem resulting with them having decreased insight as to how they could manage their self-esteem. Meaning they wanted to fit in amongst their peer. So, the problem is not with the parents but is with the circle of people we surround ourselves with.  

Status and being cool amongst their peers is meant to increase their self-esteem. Client A said “I would steal from home to make sure that my friends and I get a fix”. One step at a time they start by stealing small change, move to notes to large amounts of money and expensive personal belongings. This then belittles the importance of how other people’s view and opinions. Their family and friends get hurt in this process which ultimately results with broken relationships. Once one is addicted they escalate to larger doses and stronger types of drugs to ensure a longer high. As we all know if the “quality increases” the price increases. At this stage the client does not have any source of income and turns to criminal activities to get money. “It becomes a habit and one eventually gets arrested”.

It seems prison is some sort an eye opener some client and they do try to seek help but due to the lack of support systems and role models available for them in the communities lead to them not being successful in changing. Client B said nobody saw change in him therefore he saw no point in staying clean. Which makes me wonder what is my brothers reason for not seeking help? Well, I mean my sister died in front of him because of drugs not that makes him any fearful of drugs. One would swear he does not even know how she died. Is death not meant to be the best example to prove that drugs are no good.

So, what kind of a future does he have? How can I help? Is it for me or for his own greater good? These are the question that shadow my mind when I see my clients… as they make me think of where I am coming from.

PubMed Journals. (2017). What Is the Role of Impression Management in Adolescent Cigarette Smoking?. [online] Available at: https://www.ncbi.nlm.nih.gov/labs/articles/11775076/ [Accessed 11 Aug. 2017].

[hopefulot-blog]

My thoughts...

Well I think I have something to smile about. Ever heard the saying respect is a two-way street, I was fortunate to witness a real-life demonstration of the saying. The talk about transparency between me, my peers and my academic supervisor helped ease the amount of anxiety I had about what to expect on prac. It created a uniform rubric of what is expected on prac and how to address issues from the past. Revision that was giving was efficient and helpful given the just from 2016 first semester to now. Mock prac made me realize that as student therapist we are being accommodated and considered when important decisions are being taken. Not that I want to be spoon fed all the time but I need to be given a push in the right direction in order to cope. Sometimes being a student in a group with others, one may be shy to state where they feel they are not understanding as it tends to be a joke. Which makes me look back to where I started as a student therapist and compare to where I am now, if I was not cut for this I wouldn’t have made it this far. Respect in any given situation is key as it is the golden rule of humanity and community life. With that said for this prac block to be successful for me, respect and transparency have to be values that I up load. I have to conduct myself in a manner that is appropriate towards my peers and my academic supervisor, not saying that we must create wall but simply establish boundaries. Nobody is perfect I must not expect that it will be sunny throughout this block because there will be storms of negative criticism. Of which I must understand that is for my own good as a student therapist. If im not going to be corrected nor criticized I will gain nothing from this block. “What does not kill you makes you stronger” … well that is the kind of attitude on has to wear so that they can learn.  Honestly at the end of the day it come down to how am I to internalise resources available to me. You can lead the horse to the river but you can never force it to drink. Let me not focus on the many hear-says of the negatives of this “wonderful module” but make the most of it, with the hope that I will make it. The situation must not determine my destination. 

[hopefulot-blog]

How I prepared for Psychosocial fieldwork

As psychosocial fieldwork block begins, I am faced with many fears. The first fear being will I be able to assess and treat my clients without seeing myself having psych problems myself? Whenever I sit in lectures discussing the different sign and symptoms in my mind all that reflect at me. Judging from how I handle inappropriate advances in my surrounding, which approach will be best for clients at a rehab setting? Do I buy into their stories to build rapport or do I become firm with my clients from word go?

An article done on substance abuse interventions in Australia stated that, “Rigorous intervention designs built on 'Roadmap' principles neither reduced substance use in the populations studied nor identified transferable mechanisms for behaviour change”. This resulted with an even more confused me, so I have decided to change my focus from how am I going to treat them but to what am I most likely to come across. After all OT intervention, must be client centred and the planning must be designed according to the client’s individual needs and problems.

When one comes to me and asks about Rehab, first answers are Rebellious, Stubborn, Resilient and Intimidating. Who would blame me, though? There is some research that in a way supports my thoughts, which states that “drug users (participant of the research) engaged in various categories of criminal activity, including stealing, looting, etc. most of them were in custody and prison at least once”. For me this means that Ot therapist and client roles must clearly set and I must be honest with my patient. With honesty, I do not have expose myself or lie. Yes, I will never understand their drive to take drugs or drink alcohol, but I must assure my clients that I have done enough reading to be able to work with them efficiently and effectively.

Luckily, I have had a few encounters with substance induced psychotic clients previously during my electives. Not saying that I am ready but I am welcoming this challenge with an open minded. From the previous fieldwork block, I learnt the importance of not being biased and the effect of allowing my client’s autonomy to guide my intervention has had on my learning. As human we can say we will ignore our own thoughts around client issues but as a professional I must always remember that therapy is not for me nor about me. At the end of the day I have to be prepared for anything during this fieldwork block.

References

Graham VE, e. (2017). Substance misuse intervention research in remote Indigenous Australian communities since the NHMRC 'Roadmap'. - PubMed - NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/28712123 [Accessed 28 Jul. 2017].

D, K. (2017). Prison, a missing target to address issues related to drug detoxification and rehabilitation: Nepalese experiences. - PubMed - NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/25763456 [Accessed 28 Jul. 2017].