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The future is Bright! Blog 5

I am a third-year occupational therapy student, and besides learning how to help people right now, I am getting prepared for the demands that the field will throw my way as it changes with time. The world and the work of an occupational therapist alike is fast evolving. Prospects and challenges that are likely to arise will be quite exciting, especially for those of us in the health science department.

I have been privileged enough to have had an amazing experience with the physical and psychosocial blocks. Both blocks have taught me a lot about myself and how exactly I fit in the world of Occupational therapy. It's not easy memorizing all the theories I have learned in the last 3 years as I prepare for future endeavors, but as I prepare for the exciting unknown future, I will ensure that I am equipping myself with more than enough knowledge. As stated by the World Federation of Occupational Therapists, "Occupational therapy is based on the belief that activity participation is central to health and well-being". That means I must center my work on helping a client gain confidence, pleasure, and independence in those things they want to be able to do. In conducting work with clients who have intellectual disabilities and mental health issues, this is most definitely therapy that should be fostered and adapted to the lives and goals of everyone.

In addition to being clinicians, we OTs of the future will also be leaders in our field and passionate advocates of our clients. I have yet to develop the skill of advocating for clients, and this will be a part of my preparation for the journey ahead.

How exactly am I preparing for the future?

I'm learning so much from my current placement working with clients who have intellectual disabilities and mental health difficulties. Through practical experience, I am able to enhance my clinical abilities and expand my knowledge on how to adapt interventions to meet the unique needs of each client. This builds my competence in working with clients.

OT is a field that���s constantly evolving, and staying up to date with the latest research is essential. Because of the research module, I regularly read journals like The South African Journal of Occupational Therapy and engage in OT-centered books to ensure that learning and building myself doesn’t end in the lecture rooms. This will also help me in the future as I am learning about new perspectives in the health science field as well.

I have seen how important it is to build rapport with members of the MDT team. Securing relationships with other students from different disciples has helped me a lot and I intend to carry on building foundations of friendship with fellow future colleagues.

I will ensure that I equip myself with knowledge of other cultures because I know I will be treating clients from different religions and cultures. Preparing for this diversity means developing cultural awareness and sensitivity, which will allow me to tailor interventions to meet the unique values, beliefs, and practices of each client.

The future of OT will demand creativity, leadership, and an unwavering commitment to client-centred care. I’m ready to take on these challenges, knowing that the work we do as OTs can profoundly change lives—helping people build independence, find meaning in their daily activities, and achieve a better quality of life. The future of OT is bright, and I’m excited to be a part of it.

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Blog 4 Psych block

Blog 4 – A movie about mental health

Navigating Bipolar Disorder: What Silver Linings Playbook Teaches About Mental Health

Ever since we started treating mental health disorders in third year, I have grown an interest in understanding and seeing how it manifests in reality. The movie Silver Linings Playbook directed by David O Russel showed up on my movie search bar one afternoon as I was relaxing watching movies. What a discovery! Through the character of Pat Solitano, a man with bipolar disorder, I was able to explore the nature of mental health in the movie. The movie follows Pat Solitano after he’s released from a psychiatric institution. He moves in with his parents and struggles to adjust to everyday life, becoming fixated on getting back together with his ex-wife. He meets Tiffany, a widow suffering her own mental health issues after her husband's death, and the two develop a bond. The movie emphasizes the value of family, love, and individual healing while highlighting how they support one another through the highs and lows of their mental health journeys.

I have had lectures about bipolar disorders and have read the notes on the disorder, but Pat Solitano demonstrated perfectly what I have known about the disorder. There are other mental health disorders that are covered in the movie in a real and sensitive manner such as trauma, depression, and bereavement. Pat, the main character, experiences significant changes in mood, ranging from intense depression states to manic episodes characterized by excessive energy and impulsivity. However, Tiffany struggles with depression and is still grieving the loss of her husband. The movie also shows how Pats friends and family support him but are still struggling to understand his conditions. This made me understand why some clients are still in mental health institutions even after they have been cleared by the psychiatrist that they are able to function independently outside the institution. An example was when I was placed at Ekuhlengeni Psychiatric hospital in my second year. We saw clients who were at level 4 who were ready to go home but because their families and friends don’t understand their condition and fear them, they are left there to continue their stay. People with mental health conditions still battle being accepted by society because of stigma.

In OT, we are taught to assess how the mental health disorder affects the client’s occupational performance and his/her ability to function in occupations. Looking at Pat his ability to engage in meaningful activities such as work, relationships, and leisure has been severely impacted by his mental health diagnosis. He loses his job, his marriage, and some of the people he used to get along with, which leaves him feeling isolated and different. According to the research study, The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management, marriages of untreated or treatment-refractory bipolar patients are often turbulent (McIntyre et al., 2022). Both patients and their spouses regard violence as the most troubling manifestation of mania, and suicide threats and attempts as the most worrying aspects of depression His relationship with his family is under strain because of his inability to regulate his emotions. This stresses both him and his parents. His performance patterns, mainly routine is affected by his manic episodes because during this time, he becomes impulsive and reckless.

Some OT intervention for Pat might include re-establishing routines, promoting emotional regulation, and encouraging engagement in meaningful activities like exercise, which in the movie becomes therapeutic for him. In the movie, Pat and Tiffany (the lady who suffers depression due to loosing her husband) join dance class which is a form of group therapy, and this helps with community integration and improving their mood. This shows that social support and engagement in activities that are meaningful are important for recovery.

The movie emphasizes the importance of providing holistic treatment that not only focuses on managing symptoms but also on improving the quality of life through meaningful activities, which is very important for occupational therapy students like me. It emphasizes how OTs can assist clients in establishing a sense of self-worth, orientation, and control in their lives even in dealing with of significant challenges caused by mental health disorders.

In conclusion, this movie has taught me how important it is to firstly understand the effects of the disorder on a person to help them. It showed how engagement meaningful activities and social support impact the recovery of someone with bipolar and depression.

Reference

McIntyre, R. S., Alda, M., Baldessarini, R. J., Bauer, M., Berk, M., Correll, C. U., Fagiolini, A., Fountoulakis, K., Frye, M. A., Grunze, H., Kessing, L. V., Miklowitz, D. J., Parker, G., Post, R. M., Swann, A. C., Suppes, T., Vieta, E., Young, A., & Maj, M. (2022). The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management. World Psychiatry, 21(3), 364–387. https://doi.org/10.1002/wps.20997

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Blog 3-Mental health topic

The rollercoaster called Post traumatic stress disorder

Post traumatic stress disorder! This is one diagnosis that stood out to me as I sat quietly thinking. PTSD as they now say it is a mental health condition that develops following a traumatic event characterized by intrusive thoughts about the incident, recurrent distress/anxiety, flashback and avoidance of similar situations. The analogy of what happens is that a person, whether young or old will experience something traumatic to them. This could include rape, assault, a murder, being hijacked, natural disaster and a lot more. The person will feel extremely scared and extremely sad during the event of the trauma. The amygdala responsible for memory, stores this event and it becomes permanently stored into the person’s brain. The person who suffered the trauma might then have nightmares or they might be hyperalert if they are around the area of occurrence. After the incidence, the person might then have panic attacks or they might experience stress which then indicates that the person should see a healthcare professional where according to the DSM 5 TR, they will be diagnosed with Post traumatic stress disorder. The symptoms include being easily startled or frightened, always being on guard for danger, self-destructive behaviour, such as drinking too much or driving too fast, trouble sleeping, trouble concentrating, irritability, angry outbursts or aggressive behaviour (Mayo Clinic, 2022). These affect the occupations such as rest and sleep, health management, work /education depending on the age.

According to research (Fateminia et al., 2022) article, mostly females suffer with PTSD as well as front line workers like nurses, policemen and policewomen, paramedics and others. This makes sense as they see a lot of disturbing things in their line of work. Imagine seeing what used to resemble a human lying around! They see these traumatic events and the causes of these tragedies which then leads to them having a certain fear to that causing factor.

I remember during the time of covid 19…what a pandemic! People had a fear of going to interact with other due to the fear of getting infected with the disease. Some still have a fear of being around people who have minor coughs due to the pandemic we once suffered. It might not be diagnosed but it could be PTSD.PTSD is closely associated with burnouts. The link between PTSD and burnout is an important area of study because both conditions involve significant stress and can deeply affect an individual’s well-being and functioning. The person`s emotional well-being takes a toll because of the stress. Some interpersonal relationships can be affected as the person with PTSD might not want to be around people.

Intervention for PTSD in OT include cognitive behavioral therapy i.e., changing thought processes using cognitive behavioral therapy approach. The client can engage in mindfulness and relaxation therapy. Health management can also be included to ensure the client takes his/her medication.

A person suffering from Post-Traumatic Stress Disorder (PTSD) may find numerous aspects of their life affected by this serious and complicated disorder. As this blog has discussed, PTSD is a complicated disorder that affects one's emotional, cognitive, and physical health rather than being a reaction to a single horrific experience. Its effects can be broad including daily life, relationships, and general quality of life.

References:

Fateminia, A., Hasanvand, S., Goudarzi, F., & Mohammadi, R. (2022). Post-Traumatic Stress Disorder among Frontline Nurses during the COVID-19 Pandemic and Its Relationship with Occupational Burnout. Iranian Journal of Psychiatry. https://doi.org/10.18502/ijps.v17i4.10693

Mayo Clinic. (2022). Post-traumatic Stress Disorder (PTSD). Mayo Clinic; Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

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Blog 2-Psychosocial block

Importance of social support networks on mental health; OT perspective

Imagine being alone with no one to talk to, no one to share your thoughts with and no one being there to comfort you…sad right? Being able to socialize with people in your environment is crucial to one’s mental well-being. It is when you socialize within your environment that you discover all the available support networks there are. OT fosters a sense of community which is what social support networks are-a community. From an occupational therapy student` perspective, social support networks play an important role in enhancing overall well-being and improving daily functioning. We understand that that mental health is deeply intertwined with one's ability to engage in meaningful activities and roles.

We are currently in our Psychosocial block, and I can see how mental health plays a big role in the daily functioning of a person. Someone with depression might not want to engage in ADLs and iADL due to them feeling down and closed in. They are closed in and aren’t reaching out. It is only when someone who sees them (OT`s) and offers support do they enter the journey of recovery. A poem written by Rupi Kaur, a well-known poet touched my heart and made me think of social networks and supports on mental health. It says,

when the world comes crashing at your feet

it’s okay to let others

help pick up the pieces

if we’re present to take part in your happiness

when your circumstances are great

we are more than capable

of sharing your pain

- community (Kaur, 2017)

It is such a privilege for us UKZN students as we have student support services on campus. They can help with us when we are feeling depressed, when we have anxiety. They enhance our emotional wellbeing as university students. I remember my first time going to student support services after suffering a burnout during first year. I felt lost and so exhausted. I saw that keeping it to myself was doing more damage than good and at the time we had mentors. My mentor booked me a session and within a week of attending therapy sessions, I felt better emotionally and engaged well in my occupations. This experience made me realise the power and impact social support networks have on ones wellbeing.

OT has taught me the importance of support groups in mental health problems like depression, anxiety, substance abuse, GBV and more. Coming together to assist each other in difficult times is amazing. The sense of universality, altruism and installation of hope that come through during group therapy is essential to mental health. Studies have shown that having strong social connections such as group support systems can significantly impact mental health by reducing feelings of loneliness and isolation. According to a review published in JAMA Network Open, individuals with robust social networks experience lower rates of depression and anxiety, and they report higher levels of life satisfaction and well-being (Holt-Lunstad et al., 2015).

Social support networks play a crucial role in all facets of our life, impacting our mental, physical, and emotional well-being. We can improve our everyday functioning, resilience, and general well-being by establishing strong, supportive relationships. It's important to keep in mind the priceless value of real, face-to-face contacts and the significant influence they have on our general health and happiness in a society where digital connections are valued more and more.

Reference:

Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2015). Social relationships and mortality risk: A meta-analytic review. JAMA Network Open, 10(3), 113-125.

Kaur, R. (2017). The Sun and Her Flowers. Simon & Schuster Uk.

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Blog 1- Psych Block

Understanding the role of OT in Mental health recovery

I have always wondered what role OTs have in mental health recovery…mmm? Mental health is such an important part of our lives at it influence our daily lives a lot. As an aspiring OT, I understand that my scope of practise includes ensuring that a person has a balance holistically within themselves, this is why it’s vital as OTs to provide intervention to the best of our ability in mental health recovery. The role of an OT is to ensure that a person engages in occupations that are meaningful to them. According to the scoping review, Recovery as an occupational journey: A scoping review exploring the links between occupational engagement and recovery for people with enduring mental health issues (Doroud et al., 2015), it was found that engagement in occupations plays an important role in the recovery process of mental health. After reading through this article and of course attending my lecture classes, only then did I understand the role of OTs in the recovery of mental health and many other psychiatric disorders. Recovery is facilitated through participation in meaningful activities, which, in turn, promotes personal growth and healing. This research supports the significance of OT in mental health recovery as we specialise in meaningful occupations and ensuring that people with mental health disorders use the therapy of engaging in occupations to get better.

There are different ways in which OTs can help in the recovery of mental health disorders such as depression and anxiety, substance abuse, PTSD, eating disorders and more. We, as aspiring OTs, believe that a person is unique, and each intervention session should be tailored to that persons needs which is why some methods work for some and not for others. It is then the OTs responsibility to find means to ensure that the person receives client entered intervention to recover and live a meaningful life. Strategies such as cognitive behavioural therapy, relaxation therapy, psychoeducation ensure that recovery is optimal. I am excited to bring in my part in helping and ensuring my clients receive the best OT intervention there is. There is a poem that stood out to me by Rupi Kaur that says,

“When the world comes crashing at your feet

it’s okay to let others

help pick up the pieces

if we’re present to take part in your happiness

when your circumstances are great

we are more than capable

of sharing your pain

- community”

For me, this poem speaks to us OTs as we are the ones who get to know the person by building rapport with them.

 My experience with mental health is that you feel alone most of the time and it feels like nothing is going right and the walls are caving in on you and you cannot even move or do anything. But with OT fostering engagement and participation in all the activities that were once meaningful to you helps improve your mood and overall well-being.

Matt Haigh once said, “Mental health is not a destination, but a process. It’s about how you drive, not where you’re going.” OTs are there from the beginning of your mental health journey. OT brings life to days.

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My way or our way?

Blog 5- Client-centered practice.

In a world where healthcare might appear impersonal and identical, client-centred practice stands out for its emphasis on the individual. Client-centred practice focuses each person's specific requirements, goals, and preferences. It's not just about treating an illness or a disability; it's about empowering individuals to actively participate in their own health and well-being.

As an aspiring occupational therapist, I am always learning and growing in my understanding of how to effectively support people on their journey to recovery. Recently, I had the pleasure to work with three extraordinary clients: one with aphasia because of a cerebrovascular accident (CVA), another with a spinal cord injury that rendered her unable to walk, and finally, an elderly person who suffered a CVA and is experiencing memory loss and disorientation. All these patients are unique is age, colour, personality and condition and its in the implementation of the client-centred approach that these individuals receive therapy that is tailored for them. As mentioned in the research article (Bertilsson et al., 2014), the interventions of health professionals should meet the person's goals and resources and provide specific training in the activities in which the person wants and needs to be engaged.

As I began this adventure with my clients, I felt a mix of excitement and fear. I was eager to apply my knowledge and skills, however I was also concerned about effectively meeting their different demands.

A positive experience I had with one of my patients was during an activity that the client found meaningful. The client is a mother and loves being in the kitchen to make food for her family. To improve client factors such as balance, range of motion and endurance, I used a meal preparation, a meaningful and relevant activity where she had to make a sandwich with some ingredients she liked. This made me feel content as the client enjoyed the activity and found it refreshing.

 Upon research (Benefits of Client Centeredness on Clients, n.d.), I saw an example of client centred therapy on a client who benefited from this approach, and it helped me grow to realise that letting the client lead therapy intervention with you leads to improvement and meaningful engagement. Mosey`s guiding principles of conscious use of self, humility, testifies on client-centeredness and collaboration between client and therapist. It states that it is more of an equal partnership.  Instead of being seen as an “expert” the therapist rather facilitates therapy, and helps the client attain his goals for therapy in a collaborative effort (Anne Cronin Mosey, 1986).

To ensure that my interventions are client centred, I will ensure that during rapport building and interviews, I ask my client what his/her goals are for intervention to consider activities relevant and meaningful to the client and ensure that the client feels included in the process. The development of comprehensive assessment and interactions will be improved on my behalf to ensure that the client get the best client-centred approach.

In conclusion, I am reminded of the profound impact of client-centred practice in occupational therapy. By actively involving clients in decision-making, honoring their preferences, and tailoring interventions to their unique needs, we can empower them to achieve their goals and live fulfilling lives despite the challenges they face. Moving forward, I am committed to continuing my journey as a student and future practitioner dedicated to providing compassionate, effective, and client-centred care to those in need.

 In the symphony of healing, client-centeredness is the melody that resonates with the harmony of empathy and respect, guiding us towards holistic care.

References:

Anne Cronin Mosey. (1986). Psychosocial Components of Occupational Therapy. Lippincott Williams & Wilkins.

Benefits of client centeredness on clients. (n.d.). Bing. Retrieved May 2, 2024, from https://www.bing.com/search?q=benefits+of+client+centeredness+on+clients&qs=n&form=QBRE&sp=-1&ghc=1&lq=0&sm=u&pq=benefits+of+client+centeredness+on+clients&sc=10-42&sk=&cvid=F5368FE6AA394F7BBA049F9FB9A4774C&ghsh=0&ghacc=0&ghpl=#

Bertilsson, A.-S., Ranner, M., von Koch, L., Eriksson, G., Johansson, U., Ytterberg, C., Guidetti, S., & Tham, K. (2014). A client-centred ADL intervention: three-month follow-up of a randomized controlled trial. Scandinavian Journal of Occupational Therapy, 21(5), 377–391. https://doi.org/10.3109/11038128.2014.880126

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My Blog 4-Hillcrest hospital

Blog 4: Collaborative practise with Multidisciplinary team

Imagine stepping into a bustling hospital ward, where the air is alive with the hum of activity and the dedicated efforts of healthcare professionals. In a hospital ward, healthcare professionals like occupational therapists and speech therapists help individuals regain independence and participate meaningfully in life. OTs help stroke survivors relearning self-care tasks, while speech therapists help overcome speech impediments and swallowing difficulties. Nurses provide round-the-clock support, administering medications, monitoring vital signs, and attending to patients' physical and emotional needs. Their holistic approach ensures comprehensive care, fostering healing and recovery at every step of the journey.

I had a rewarding experience by seeing how well MDT approach is toward my clients. Intervention was comprehensive and holistic. With my CVA patient, he suffered aphasia and hemiplegia which affected his daily living. He became dependent on nurses with his activities of daily living.

 Upon intervention, the client became less dependent after affected client factors were remediated through functional use of ADLs and other areas of occupation by Occupational therapist (me), he became physically stronger by exercising with Physiotherapist and his speech improved through AAC boards and sessions with the Speech therapist. The outcome of collaborative approach with the other healthcare professionals highlighted the beauty of working together towards a common goal of getting the client to be functional.

During my 6th session with my patient, I was amazed at the improvement he had made. His speech had improved as some words were audible. The application off some techniques I had shown him in previous sessions came through such as safe wheelchair transfers, donning, static standing balance had all improved. I felt very proud and excited for the patient as he soon awaits his discharge day. Seeing someone get better and recover triggers a sense of fulfilment and joy.

 With my current client, I can also see her improvement with the MDT approach between social workers, physiotherapy as well as OT. She now feels better emotionally as she is speaking with the social worker, she can do certain ADLs like dressing and bathing in a less strenuous and tiring way because of techniques we discovered in OT and she has better endurance level because of physiotherapy. This goes to show how astonishing MDT approach is to patients.

I know my strength is my ability to engage with people and this helped me during the multidisciplinary approach as I was able to understand my client’s condition. This was done by communicating and building professional relationships with the MDT team. In his article, Furthermore, Finkelman (2006) argued that collaborative multidisciplinary working has the following advantages; professionals being more familiar with one  another’s activities  and  roles  thereby  improving  inter-professional communication. According to Google, successful MDT approaches depend on effective communication, and healthcare institutions that put techniques like electronic communication platforms, interdisciplinary rounds, and regular meetings into practice. Giuseppe Benagiano MD and Ivo Brosens MD emphasize the multidisciplinary approach in healthcare, integrating professionals from various fields to provide comprehensive care, optimize patient outcomes, and promote holistic well-being through communication and coordination.

In conclusion, collaborative MDT approach is the best are health professionals can give to clients. In the end, the real test of our success is not the recognition we get but the difference we make in the lives of people we help. By collaborating across disciplines, we can change the way healthcare is delivered, give people more power, and achieve better results. Let's keep advocating for these principles as we work toward a healthier, better future for all.

References:

Ireland. Mental Health Commission. (2006). Multidisciplinary team working: from theory to practice: discussion paper. Mhc.

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Blog 3

Health advocacy

Advocacy, amplifying the voices of individuals with disabilities or limitations to ensure they have equal access to opportunities, resources, and support necessary for meaningful participation in daily life. One of an OTs role is to advocate the betterment of their clients and I am glad I got to experience a fraction of how it feels like to advocate for a client.

In their work "The Role of an Occupational Therapy Practitioner in Professional Advocacy: a Scoping Review," McKinnon, Petrone, and Tarbet (2024) examine occupational therapy practitioners' engagement in professional advocacy. The authors identify the various ways occupational therapists engage in advocacy work by conducting a scoping review.

To improve client outcomes and develop one’s profession in OT, it is important for occupational therapists to accept their advocacy roles. When I observed that my client was having difficulty eating with one hand, I realized that he needed a plate guard to keep food on his plate. I discovered that the hospital provided patients with plate guards, but he wasn’t receiving any. I then advocated that, to prevent food spills on himself while eating, my patient should be given a plate guard.

I had a wide range of feelings upon learning about the client's circumstances, including empathy for his difficulties, annoyance at the physical barriers that continue perpetuate disinformation regarding assistive technology, and resolve to relentlessly work on his behalf.  It saddened me to know that there were plate guards, but they weren’t being used. Advocating for my client was a good experience because I got to see how effective communication with other healthcare workers was. It ensures that the client receives the proper health care services. This experience was a positive experience as it highlights one of the significant OT roles.

As I think on this developing journey, I am reminded of the critical role of advocacy in occupational therapy practice. Moving forward, I am committed to promoting individual voices, removing access difficulties, and advocating for every individual's inherent dignity and worth. This journey of advocacy and empowerment is creating a future in which assistive technologies are not represents of constraint, but rather catalysts for endless possibilities.

Reference:

McKinnon, S., Petrone, N., & Tarbet, A. (2024). The Role of an Occupational Therapy Practitioner in Professional Advocacy: a Scoping Review. Translational Science in Occupation, 1(2), 3.