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Closing Blog...

According to Rodger et al ,2008 the purpose of an occupational therapy education programme is to “…produce competent generalist….” with …” rudimentary skills, fundamental knowledge and attitudes” while providing those ” …experiences consider crucial participation for beginning to practice” (Rodgers et al , 2008,)

It is noticeable that the focus of teaching is on developing practical skills to ensure competence .While these skills are essential to the art of the profession ,during my psychosocial professional experience, I realised a few things about myself of which a number of authors have argued that this emphasis has been to the detriment of consciously developing other important abilities , including , but not limited to , an appreciation of life-long learning , communication skills , coping strategies and ,most importantly , professional confidence. (Robertson & Griffiths ,.2009)

Professional confidence is a strongly desired trait , in my view a suitably equipped student is more likely to take on and benefit from educational opportunities made available to them. Professional confidence is my opinion underpins competence.

My confidence during the block was treading on thin ice as I was still carrying a lot of baggage from the physical block hence that had a negative impact on me.However as time went by I realised that having a supervisor that gave me tips , made me feel comfortable ,encouraged and gave me regular feedback made me realise that’ I can do this” As according to Brown et al, 2003; & Mulhlland , Derdall , Roy 2007, the close relationship that develops between a student and supervisor is assumed to be conductive to creating a positive learning environment, which in turn is understood to promote professional confidence.That is how i slowly realised that the supervisor is not my enemy but my stepping stone for me to become the best occupational therapist I can be.

By implication appears to be limited understanding of how the development of professional confidence in occupational therapy students.There seems to be limited understanding of how the development of professional confidence in occupational therapy students could be fostered , despite an acknowledgement that “ now more than ever , it is important for educate not only competent but also confident therapist to meet the demands of a changing work world” ( HPCSA,2003; Derdall , Olsen , Janzen , Warren ,2009

All In all I really learnt a lot from the psychosocial block.

Reference

1. Brown B, O'Mara L, Hunsberger M, Love B, Black M, Carpio B, et al.(2003) Professional confidence in baccalaureate nursing students. Nurse Education in Practice,;3(3):163-70.

2. Derdall M, Olsen P, Janzen W, Warren S.(2009) Development of a questionnaire to examine confidence of occupational therapy students during fieldwork experiences. Canadian Journal of Occupational Therapy, 69(1):49-56

3. Mulholland S, Derdall M(2007). An early fieldwork experience: student and preceptor perspectives. Canadian Journal of Occupational Therapy,74(3):161-71.

4. Rodger S, Clark M, O'Brien M, Martinez K, Banks R(2008). Mapping the Future of Occupational Therapy Education in the 21st Century. Strawberry Hills NSW: The Australian Learning and Teaching Council Ltd.;

5. HPCSA. Regulations pertaining to the Registration of Occupational Therapy Students and the Minimum Standards for the Training of Occupational Therapy Students(2003). Form 124. Pretoria: Health Professions Council of South Africa;

6. Robertson LJ, Griffiths S. Graduates' reflections on their preparation for practice. (2009) British Journal of Occupational Therapy,;72(3):125-32.

7.

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Research Day!!

The previous week as the Occupational Therapy ( OT) 3rd year student class , we had the privilege and honour to attend the OT final year students present their research projects.A fascinating experience and I had to reflect on.

How many times have I heard the phrase evidence-based practice over the last few years? Applying the latest research to my treatment sessions does seem to make sense, doesn’t it?

But how do I know when the evidence supports the practice of occupational therapy?

What we now know as evidence-based practice started in the early 1990s as evidence-based medicine. This term, developed by David L. Sackett, et. al. (1996) from McMaster University in Ontario, Canada, referred to the combination of the best evidence from research, clinical expertise, and patient values to achieve the best outcomes.

The American Occupational Therapy Association (AOTA) has applied this definition to our own practice by explaining evidence-based practice as “the integration of critically appraised research results with the clinical expertise, and the client’s preferences, beliefs and values.”

This definition shows that evidence-based practice isn’t just reading a research article and deciding that we want to try the technique described. Rather, it’s a careful analysis of evaluation and treatment methods addressed in the body of recent research and how those methods can be applied to the care you provide to our client’s on a case by case basis.

So why is research important ?

1. Provides more effective treatment technique

Evidence-based practice ensures that your treatment techniques are effective. Analyzing the best and most pertinent research ensures that the treatments that you use with your patients actually work.

A good example from the world of pediatrics is the use of weighted vests with children who have sensory processing disorders. Weighted vests have been used by occupational therapists to provide deep pressure input to children with autism and attention-deficit and hyperactivity disorder (ADHD) for many years.

When questioned about why the vests work, however, the evidence supporting the use of these vests was found to be lacking. The research supporting the use of weighted vests consisted mostly of case studies or small, convenience samples with no controls. Researchers have worked to fill in the gaps in the research regarding the use of weighted vests, including their use with adults addressed by Reynolds, Lane., & Mullen, (2015)

2. Better cooperation from the client

Evidence-based practice allows us to help your clients make informed choices for their occupational therapy programs. Following evidence-based practice allows you to easily answer that question that patients always ask: “Why do I have to do this?”

Client’s who are aware of their situation and who want to be in control of their own health care will be more compliant with your treatment programs and more satisfied overall with your services when they know that there is evidence showing that those programs lead to results. The evidence behind your treatment techniques will help us to show our clients that there is a point to our treatment.

3. Defending services to third party players

Evidence-based practice helps us to show third party payers that we are using treatments supported by research. Medicare, Medicaid, and many insurance companies want assurance that the treatment we provide to our clients is based on the latest research before they will pay for your services.

Following the principles of evidence-based research helps us to easily provide this information to third party payers.

4. Keep our OT skills current

Evidence-based practice ensures that our clinical skills are up to date as the world we live changes we too need to be aware of the change and implement current and context based treatment.

Ensuring that evidence is occupation – based

There in our quest for research that supports or refuses out treatment practices , we want to keep in mind that any evidence we choose to use should have a basis in occupation. Promoting occupation for our client’s is what we do, after all.

In closing , the use of evidence-based practice has become increasingly important in the field of occupational therapy and it is critical that we begin to consider the evidence as we provide treatment to our clients.

References.

1. Evidence-Based Practice and Research (2018). American Occupational Therapy Association,

https://www.aota.org/Practice/Researchers.aspx, accessed October 05, 2019.

2. Reynolds, S., Lane,S.J., & Mullen,B.(2015). Brief Report—Effects of deep pressure stimulation on physiological arousal. American Journal of Occupational Therapy, 69, 6903350010. http://dx.doi.org/10.5014/ajot.2015.015560, Retrieved from October 05, 2019 http://www.terapeutas-ocupacionales.es/assets/files/COPTOA/Bibliotecavirtual/AJOT/Mayo-Junio-15/6903350010p1.pdf.

3. Sackett, D. L., Rosenberg, W. M., Gray, M., Haynes, B., & Richardson, S. (1996, January 13). Evidence based medicine: What it is and what it isn’t. BMJ: 312:71. Retrieved October 05, 2019. from https://www.bmj.com/content/312/7023/71

4. Thomas, A., & Law, M. (2013). Research utilization and evidence-based practice in occupational therapy: A scoping study. American Journal of Occupational Therapy, 67, e55–e65. http://dx.doi.org/10.5014/ajot.2013.006395. Retrieved from October 05, 2019 https://www.researchgate.net/publication/241691629_Research_Utilization_and_Evidence-Based_Practice_in_Occupational_Therapy_A_Scoping_Study

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Professional Psychosocial Experience!

Psychiatric disability, is a feature of social exclusion , added to the indirect cost burden that households with a mentally ill member had to absorb due , in part , to the stigma and cultural sanctions associated with the illness behaviours.The multiple layers of action , reaction and interaction by everyone in the household in managing the daily struggle for survival in the presence of mental illness, suggests that disability is multiplied in context of chronic poverty(Duncan, Swartz , Kathard,2011) .Although there are many different forms of poverty ( Benerjee, Benabou, Mookherjee,2006).

The following journal by Hanass-Hancock , Nene , Degahye, Pillay.( 2017 ) makes mention that although the grant is intended to provide social security for the recipient, in reality it is often the only steady income and means of survival for a household. According to Statistics SA grant beneficiaries soared from 2.6 million in 2000 to about 14 million in 2010. However the sums are small and the it’s use modest, the grant income is absorbed within recipient households’ practices of livelihood making (Collins , Morduch Rutherford , Ruthven ,2003 & Lund, 2004) . In my professional experience working at a rural hospital on electives, the caregivers reported that the grant money his brother (client) receives each month is used to meet the expenses of the house since he can no longer work and needs to take care of his brother as he says “…when he is ill it is not a good sight , he takes off his clothes and runs outside. He must actually lock the doors when his things start”.

The majority of the word’s estimated 450 million people who suffer from neuropsychiatric disorders live in developing countries and fewer than 10 % of these people have access to treatment( MacGregor,2006) .In my professional psychosocial experience , treatment costs refer to the expenses associated with the attending pubic mental health services and seeking healthcare from traditional healers .Client that I have worked with reported that transport generated the biggest cost . When the illness behaviour became particularly bizarre or violent during the nights or weekend, easy access to the clinics within walking distance of the household was of little use to the caregivers. They had to either call the police( with social implications) or face taxi fare costs( at increased after hours rates)to travel to medical emergency units at provincial hospitals because the local clinics only offer maintenance of treatment , operate during limited weekday hours and do not deal with after-hours psychiatric emergencies…”when my brother was sick , we hired a taxi …it drove around from doctor to doctor all night until I had to take him to V ( mental institution)…it cost a lot.”

The direct and indirect costs of psychiatric disability to chronically poor households may be tempered by improved access to effective treatment , rights based public education policies , social grants and household support( Ellis,1998 & Eidelman,et al 2009) The government needs to intervene and also promote community environments that will allow for physical and mental well-being throughout life which will benefit from culturally sensitive at households and individuals level

Last but no least , in my psychosocial professional experience, occupational therapist play an essential role in building opportunities embedded in daily life of chronically poor households. Occupational therapists promote the capacities of households including people with psychiatric disabilities to dent the impact of poverty firstly by refocusing life skills training towards culturally relevant ways of dealing with the direct and indirect cost of illness and behaviour and secondly by orientating work readiness (return to work) programmes towards income generating competencies suite to the informal economy.

References:

1. Banerjee AV, Bénabou R, Mookherjee D.(2006) Understanding poverty. Oxford: Oxford University Press

2. Collins D, Morduch J, Rutherford S, Ruthven O.(2009) Portfolios of the poor: how the world’s poor live on $2 a day. Cape Town: UCT Press

3. Duncan, M.,Swartz,L.,Kathard,H.,(2011). The Burden of psychiatric disability on chronically poor households: Part 2 (coping).South African Journal of Occupational Therapy.41(3) Access at http://www.ajod.org on 26th of September 2019

4. Eidelman T, Gouws V, Howe C, Kulber T, Kumm J, Schoenfeld L, Duncan M.( 2004) Women surviving chronic poverty and psychiatric disability. South African Journal of Occupational Therapy, 40 (3): 4-8

5. Ellis F.( 1998) Household strategies and rural livelihood diversification. Journal of Development Studies, 35(1): 1-38.

6. Hanass-Hancock, J., Nene, S., Deghaye, N. & Pillay, S., 2017, ‘“These are not luxuries, it is essential for access to life”: Disability related out-of pocket costs as a driver of economic vulnerability in South Africa’, African Journal of Disability 6(0), 280.Accessed at https://doi.org/10.4102/ajod. v6i0.280 on 26th of September 2019

7. Lund C, Breen A, Flisher A, Swartz, L, Joska, J, Corrigall J, ( 2007). Mental health and poverty: a systematic review of the research in low and middle income countries. The Journal of Mental Health Policy and Economics; 10 (Supplement 1): S26-S27.

8. MacGregor H.(2006) ‘The grant is what I eat’: the politics of social security and disability in the post-apartheid South African state. The Journal of Biosocial Science, (38): 43 -55.

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Psychosocial Fieldblock Reflection..

What have I learnt on fieldwork block and about myself so far ..

To begin with, level III psychosocial fieldwork is an overwhelming experience. You are in a new and unfamiliar setting, you typically meet your supervisor the day you begin, and you may have no idea the expectations they have for you. For the first four weeks, you are a nervous wreck every time you walk through those doors. But it gets better though. You learn. You listen. You observe. You become accustomed with your supervisor (hopefully!) and look forward to fieldwork every morning.

The first and probably biggest thing that I noticed right away after starting fieldwork is that I was constantly EXHAUSTED. Exhaustion is that I am always “on.” Not only are you physically at fieldwork for long hours, but during that time (especially in the beginning) I am constantly taking in information, assessing myself and the environment ,trying to build rapport, trying to look and feel competent, paying close attention to my skills, receiving feedback, adjusting based on that feedback, reading past slideshows and articles and adjusting accordingly. The list could go on and on. There are many, many times where your plan A or B isn’t working how you’d hoped and you have to adapt in the moment. All of that requires a lot of mental, emotional, and often physical energy. And let me tell you, i feeeeelt it!

SO heard about this Impostor Syndrome

MY GOSH!! I felt this so hard (I’m working on this!)

What is Impostor Syndrome? Well, it’s the feeling of not thinking you’re good enough or worthy enough to be where you are. Every single person I’ve talked to about their fieldwork experience has said that they felt that they had little to no idea what they were doing and were just hoping that they didn’t screw up big time. Most of us don’t give ourselves enough credit! And that’s exactly what kept me feeling incompetent and almost anxious about everything regarding practical.

Here’s what I have learnt:

1. I have learnt to tell the difference between the general-specific subprogramme principles and the specific-specific principles of the session write up , the concept behind the use of principles and how they guide the session , for therapist to fulfill their aims for the session.( Now I just have to really have to put in the work to actually do it !)

2. The therapeutic use of self – According to (Solman ; Clouston ,2016) this is the term used to sum up the therapist’s role in working consciously and constantly being aware of the effect of words , proximity and non-verbal behaviors has on the therapeutic relationship and goal attainment. This is something that I was not consciously aware of and didn’t pay much attention to it however I’m still learning.

3. That it is almost impossible to remember everything that I have learnt from 1ST year, that I need to constantly refer to my notes from then as everything is a buildup and in order to build a strong house, you have to, have a strong foundation.

4. To peel and really look with my therapist eyes, to make observations and deductions and apply clinical reasoning to guide therapeutic sessions with the client.

5. Fieldwork takes up many hours of my week and it has been important to me to take advantage of the time that when I’m not prepping or attending class in order to stay at my best. What does this come down to? Scheduling my time and self-care.

6. Last but not least ,to believe in myself and my capabilities , that I AM ABLE. That if I prepare well and know my work , there is no need for self-doubt.As Shakespeare says “Our doubts are traitors,and make us lose the good we oft might win,by fearing to attempt.”

Reference: Solman K, Clousten D , (2016) Some reflections on the therapeutic use of self.London: Hamish Hamilton.

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Casual Day 2019!

This is my time to shine!: This is my moment of glory ! This is the time at which I can show my skill or ability! This was the 2019 theme for Casual day .The National Director for National Council of and for Persons with Disabilities’ (NCPD) Therina Wentzel-DuToit said 2019 is the year to shine brighter than ever and ‘to inspire the world to shine with us. Casual Day is about standing up for human rights as much as it’s about raising money. ‘It’s about getting people to talk about inclusive policies and to demand an equitable, accessible world for persons with disabilities,’ the NCDP says.

Many companies, businesses and even schools celebrate this day by wearing fun clothes that match the theme chosen for that year provided that the employees or students buy the stickers for Casual day. The funds raised are then seen as a contribution towards one of the country’s most vulnerable sectors of society; people with disabilities. As OT’s we jump at any chance to raise awareness for people with disabilities and so naturally we were made to plan a full Casual Day event for the service users at our fieldwork venues.

With “FUN” being the main goal in mind, my fieldwork group and I set out to ensure that the day would be one full of excitement, enjoyment and celebration of the time to shine.

We planned all the games for the clients and we were able to get the hypermarket close to the store to sponsor food and snacks for the day, even though the weather did not allow us to enjoy the day on the lush open fields of the facility, we were still able to make the day as fun and memorable as we can for the clients.

And whilst planning for the event professionally I experienced some serious, lacking skills in events planning, such as paying for attention to detail, communication with the people around the community to get resources, problem-solving, negotiation, multitasking, budgeting and creativity. However , this event has been a eye-opener and definitely there is plenty of room for growth and improvement in planning of professional events.

According to the National Council of and for Persons with Disabilities over the past 25 years since Casual Day was launched, the project has raised in excess of R343 million (2018 totals) which is distributed among the project’s national beneficiaries representing persons with disabilities as a part of a diverse society.Personally, I see the casual day as great event to a certain extent because as a person who has had an opportunity to experience life in both the peri-urban and rural area ,has never came across a person with a disability who has received assistance from the project. I firmly believe that there’s much improvement that still needs to be done regarding Casual Day.

References:

1. National Council of and for Persons with Disabilities. (n.d).Casual Day. Retrieved from httphttp://www.casualday.co.za/what-we-do/, accessed on the 06 September 2019

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Film Review: To the bone.

“To the bone” , portrays Ellen 20 year-old anorexic girl who has spends the better part of her teenage years being shepherded through various recovery programs , only to find herself several kilograms lighter every time. Determined to find a solution, her dysfunctional family agrees to send her to a group home for youths , which is led by a non-traditional doctor. Surprised by the unusual rules. Ellen must discover for herself how to comfort her addiction and attempt acceptance.

An eating disorders are thornier issue, stranger, more uncontrollable. In my perspective the wider culture participates in perpetuating this illness, and so maybe that’s one of the reasons why Hollywood-a place filled with thin women –is hesitant to address the issue. Thinness is equated with beauty norms that it’s a culture wide propaganda bomb.To address anorexia , this would mean to look like.

The scenes in the film , which shows Ellen getting gradually sicker with a bruised spine( the result of obsessive crutches) , sunken cheeks , furry arm hair ( body’s way of keeping a thin body warm and concave stomach. Truly reveal the side effects of having anorexia nervosa. The part whereby the client has an “ outside-body experience”, where by the see themselves and how they look , and realise the need for intervention , for me is the best part of the film. As client finally gained emotional insight and came to the realisation that she needs help, and this was a big milestone as this would mean that client would be compliant to treatment.

As occupational therapy student in training , I wasn’t too sure what our role is in intervention with eating disorders , and after watching this film I was interested to finding more information about this mental illness. The article written by Klump (2008) explains how when malnourished and emaciated , individuals with anorexia nervosa ( AN) have alterations of brain structure and alterations. These alterations involve brain circuits known to module appetite , mood , cognitive function , impulse control , energy metabolism , and autonomic and hormonal systems.

Personally I feel that the film could have included more about the multi-disciplinary team approach ,and not just the doctor only being portrayed in the treatment of the individuals mental disorder. For instance as occupational therapist play a pivotal role , as individuals with AN have an occupational imbalance.According to Keel et al (2000) social adjustments tends to be impaired as social competence communication skills are poor and social networks tend to be small. Vocational and educational functioning in individuals with AN is below of that expected, with absences from work and school ( e.g , 5.5 months per year in school over a 2-year period) . Thus OT intervention would be ideal therapy.

Reference.

1. Keel PK , Mitchell JE, Miller KB , Davis TL , Crow SJ( 2000) .Social adjustment over 10 years following diagnosis with anorexia nervosa.Int J EEat Disord 27:21-28

2. Klump.K (2008) Academy For Eating Disorders Position Paper : Eating Disorders are serious mental illness International Journal of Eating Disorders 42:2 97-103

3. de la Rie S, Noordenbos G , Donker M , van Furth E. ( 2000)The patien’s quality of life and eating disorders .Int K East Disord 40:13-20

Film: " To the bone" (2017) directed by Marti Noxon.Available from Netflix

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Assessment and Treatment skills in Psychosocial Fieldwork.

As an occupational therapy student still in training, I have always thought of myself as a "physical dysfunction therapist," yet having to reflect on my training experience it is obvious now that most of my clients actually had performance deficits that characterized psychosocial problems rather than physical ones. Looking back now, it is clear that motivation, self-esteem, values, and beliefs, rather than physical capacities, tended to dictate success of the client wanting to participate and return to their meaningful activities.So starting the psycho-social fieldwork initially I had some reservations however this has changed as I have understood that assessing and treating client’s psychosocial deficits doesn’t have to be so daunting, as it is evident that human-well being requires a better integration of the physical as well as the psychosocial to achieve a holistic nature of function.

In terms of assessing and treating, one of the biggest new insights I learned was when my supervisor clearly explained , the difference between the two sessions. For instance , when assessing the client , it is important that you give the client the autonomy to do the activity so that you( therapist) can assess precisely how they do the activity in their normal( preferred) environment. Then a treatment session ,would include specific principles that will guide the session in order to meet the aims( what you want to treat), such structuring the environment accordingly.

Some of the skills that I have been able to put into practice were having to observe the client during the activity, to analyse carefully and make deductions. To integrate the information and synthesize information so that I may understand the impact on the client’s daily living. Skills such as effective problem-solving, conceptual thinking and judgement I used to address the client’s needs , and to engage the client through occupation. To sum it all, critical thinking skills.

Personally ,after reading the article “Issues in Assessment of Psychosocial Components of Function” by Bonder(2002) ,the article highlights on content of assessments and methods used in psychosocial therapy. According to the article, instruments that focus on normative data particularly are problematic. I totally agree with this. For instance: Is it normal to have three friends? Twenty? How much self-esteem is enough? How much is too much? The issue is what will permit survival, it is hoped, self-actualization.

As the Bonder (2002) points out that , psychosocial variables that contribute to performance must be better defined and incorporated into theories that provide a more integrated understanding of function. Instruments that permit evaluation of many facets of performance must be developed and refined. To choose measurement methodologies that enable to address the concerns of occupational therapy.

Occupational therapy is a highly complex, sophisticated discipline (Yerza,1988).For too long , we have attempted to avoid this reality by oversimplifying the nature of oocupation( Yerza,1991)Development of relevant instruments in occupational therapy is daunting but exciting challenge , and it is encouraging as an aspiring occupational therapist to see the maturation to the point where such issues can be tackled.

For me , I feel that the psychosocial block, the gap in the assessment and instruments available make it a challenging block, thus development of assessments , will improve assessing skills as students will know exactly what observations and deductions to make therefore paving way to understanding treatment and skills required.

References:

1. Bonder, B (2002) Issues in Assessment of Psychosocial Components of Function. The American journal of Occupational Therapy, 47, 253-257.

2. Yerxa, E. (1988). Oversimplification; The hobgoblin of theory and practice in occupational therapy. Canadian journal of Occupational Therapy, 55, 5-6.

3. Yerxa, E. (1991). Nationally speaking- Seeking a relevant ethical, and realistic way of knowing for occupational therapy. American Journal of Occupational Therapy, 45, 199-204

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An OT is born!!

As I was browsing the internet , I came across an article that spoke about” how many disabled children in poorer countries are left out of primary education”. An article written by Mark Anderson(2015), that according to the Human Right Watch report on the 500,000 children with disabilities in South Africa reflects worldwide trend in developing countries.

A shocking statics that reflects that an estimated 500,000 children with disabilities are not enrolled in South Africa’s education system. This is not only evident the South African context , but is a global trend. Children with disabilities are not enrolled in developing countries , it is devastating that South Africa , the continent’s second biggest economy after Nigeria ,, with plenty of resources to educate disabled children than many other countries.

The article further reports on how a South African mother of an eight-year old boy with Down’s Syndrome who lives in Kwa-Ngwanase, KwaZulu-Natal, tried to put him in a ( mainstream) school but they said they couldn’t put him in that school because of his disabilities.

The article further highlights, that a lack of proper accommodation in school, discriminatory fees and expenses , violence , abuse and neglect in schools , lack of quality education and poor teacher training and awareness hindered access to education.

These concerns are echoed through the lifespan of a lifespan of a person living with a mental illness. That people with a mental are regarded as “different” and have so many barriers to overcome.

This article added value to my upcoming as an occupational therapist , as it made it evident that we as OTs have an essential role that we play within the lives of the people living with mental illness, ensuring a client’s wellbeing in the long term .OT addresses barriers to optimal functioning through intervention that focuses on enhancing client’s skills modifying or adapting the environment. Early intervention by an occupational therapist for a growing child with a mental illness , would help identify and implement healthy habits and routines to support a healthy lifestyle as well as to teach and support the active use of coping strategies to help manage the effect of symptoms of illness on one’s life functioning including engaging in activities of choice. These interventions may prevent relapse and deterioration of the client’s condition thus prevention of admission of client into hospital and possible placement into long term chronic care facilities which is a burden on the state resources.

Possible solutions to the issue of disabled children being left of the education system , would be hire more occupational therapist to work within the government schools , as early intervention has proven to be more successful, this will ensure that more client’s receive adequate treatment and in the long term this would decrease the indirect costs associated with chronic health as result of late intervention.

Thus this article added more value to my journey of becoming an OT , as it made me think critically, that “ there are still some 59 million primary-aged children and 65 million adolescents out school” shocking statics, yet as OTs as part of our scope of practise , education is an essential and as OTs we have a role to play.

Reference:

A.Laudan ,and P,Lorest(2012), Disablity and the education system, The future of Children . 97-122.

M. Anderson.(2015),The current status in the education system for the mentally disabled at a selected province, South Africa : Part1, 56 (1,2):210-219

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My experience of practical prep and first week of practical.

Each day I attempt to read articles about the impact that occupational therapy has in the lives of our clients. This inspires me and makes me be proud to be part of an occupation that has such impact. The topic discussed during practical preparation regarding “Mental health locally and globally”.

Millions suffer with mental health throughout their lives and while OT has been part of treatment plans for many years, there is much research that has been done on the subject. A recent study out by the American Journal of Public Health demonstrated that efforts to improve population mental health, should prioritize inclusion , integration , and competences for the reduction of cultural barriers to recognition , response and recovery. This study also shares views of how mental illness appears to be coupled with a stubborn persistence of negative opinions, attitudes and intentions .As recent path-breaking research has documented , cultures of stigma. Stigma has been linked with problems relating to knowledge (ignorance) and attitudes(prejudice) while discrimination has largely been related to behaviour. Different types of stigma exist ranging from public (externalized or experienced stigma) to self-stigma(internalized stigma) .

People with mental illness have to deal with their illness and in addition have to deal with social , psychological and economic consequences of psychiatric stigma which can exacerbate low self-esteem , marginalization form society , social isolation , social anxiety, poor social skills . difficulties in securing employment, housing difficulties as well as poor social support , all of which are important for integration into society.

Results from the South African Stress and Health (SASH) survey show that a 75% treatment gap of common mental disorders nationally, in addition to other factors responsible for this treatment gap , stigmatization of people with mental illness is mostly responsible for this gap.

Melvyn Freeman , the Department of Health’s Chief director of non-communicable diseases stated that “the direct cost of untreated mental disorders outweighed the direct treatment cost by a factor of almost six”. By reducing the stigma in the society this will ensure that more patients receive adequate treatment care and in the long term this would decrease the indirect costs associated with chronic health care as a result of deterioration.

The practical placement site which I am placed for approximately 10 weeks ,is a long –psychiatric long-term established , with a peaceful feel. The clients at the facility are extremely friendly and keen to participate in OT. Although initially walking to the venue , I was nervous …by the end of the day I left feeling the exact opposite. As my supervisor ensured that as a group we eased into the day with confidence and gave feedback on the sessions that we had done with our clients.

This experience of the practical preparation leading to the first day of practical, has helped grow as an OT in three important ways.

Advocate for my clients: As OTs we need to ensure our clients wellbeing , and to assist them in removing barriers that may prevent them from reaching their full potential.

Advocate for my profession: To be proud and make it known that OTs play a pivotal role in mental health , that our intervention can make an impact in an individuals life.

Read …read : Reading with understanding and reading to further my knowledge , 

 Reference:

·     Pescosolido,B.A,(2012)The “Backbone” of Stigma: Identifying the global core of public prejudice associated with mental illness, American journal of public health,Indiana University,Bloomington

 ·   Scheinholtz,M(2010).Occupational Therapy in mental health: Considerations of advanced practice,Bethesda ,MD:AOTA.Press