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The Unexpected Journey of Becoming More

The first day at Kenville hit me like a ton of bricks. There I was, bright-eyed and bushy-tailed, when my supervisor, Chantal, suddenly whipped out a notebook and started scribbling something down. I swear my heart dropped into my shoes. What did she write? Was it, "Phumi has potential"? Or maybe, "Needs serious help"? Either way, it scared the living daylights out of me.

Fast forward three weeks, and my head’s still spinning, but for different reasons. The workload is nuts, seriously, if I had a rand for every time I felt overwhelmed, I'd have enough to buy the whole team a much-needed coffee. But here's the kicker: I'm having the best time ever. Who knew that feeling part of something greater could coexist with academic chaos?

This block has been nothing short of a rollercoaster, one that twists your insides but leaves you exhilarated. I arrived unprepared, scared out of my wits by a mere notebook, but I’m walking out with something stronger. The days at Kenville have pushed me to explore more, think more, and above all, stand up for what I believe in. No more lukewarm Phumi—I’m a woman with opinions now, whether political, personal, or otherwise.

Speaking of growth, let’s talk about Chantal. She’s the supervisor you didn’t know you needed. Equal parts sarcastic and feminist, she’s the kind of person who would tell you to email the minister if you dared complain about the state of things. Her no-nonsense attitude is something I hope to channel as I move forward in this career. She’ll chirp you if you don’t know your stuff, but you’ll learn—oh, you’ll learn. And you’ll laugh too, because she’s funny like that (Thompson, 2012).

The OT side of me has been stretched, challenged, and occasionally bruised. Every Monday, we submit write-ups, and every Wednesday, we present. Between health promotions, screening, and all the various projects, my professional self is growing roots, deep ones that I know will anchor me in the future (Benner, 2001).

Now, onto the bigger picture. This block has done more than just teach me how to manage patients or coordinate a study skills project. It’s opened my eyes to the power dynamics within communities, and the glaring injustices that exist within our healthcare system. Being in Kenville, seeing the struggles of refugees at RSS, has stirred something in me. I’ve started questioning everything—from how we approach health promotion to the broader political structures that govern our work (Freire, 1970; Bandura, 1997).

Chantal’s nonchalant “email the minister” attitude may have started as a joke, but it’s made me realize the importance of speaking up. Whether it's challenging patriarchy in healthcare or advocating for better resources in our fractured system, I've begun to find my voice. And that’s something I didn’t expect from a block that started with me shaking in my boots (Levett-Jones & Lathlean, 2009).

The best part? The people. We’re a group of four ladies, each navigating this academic storm together, and it’s honestly the best time. We’ve laughed, we’ve cried (mostly me), and we’ve become a team. And then there’s Mr. Ngidi, our transport uncle, honestly, the funniest human alive. His jokes and stories keep us going, especially on those long drives around the community. He’s not just our driver; he’s our comic relief and a reminder that joy can be found in the most unexpected places.

As I reflect on these past three weeks, I realize that Kenville has given me more than I expected. It's been a place of growth, challenge, and surprising joy. With two weeks left, I’m ready to see where this journey takes me next. I’m no longer the unprepared student from Day 1—I’m part of something bigger, and I’m ready to make my mark.

"Education is not the filling of a pail, but the lighting of a fire." — William Butler Yeats

References:

Benner, P. (2001). From novice to expert: Excellence and power in clinical nursing practice. Prentice Hall.

Freire, P. (1970). Pedagogy of the oppressed. Continuum.

Thompson, N. (2012). Anti-discriminatory practice: Equality, diversity, and social justice (5th ed.). Palgrave Macmillan.

Bandura, A. (1997). Self-efficacy: The exercise of control. W.H. Freeman.

Levett-Jones, T., & Lathlean, J. (2009). Don’t rock the boat: Nursing students’ experiences of conformity and compliance. Nurse Education Today, 29(3), 342-349. https://doi.org/10.1016/j.nedt.2008.10.009

Suggested Readings:

Dewey, J. (1938). Experience and education. Macmillan.

Mezirow, J. (1991). Transformative dimensions of adult learning. Jossey-Bass.

Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and development. Prentice Hall.

Schön, D. A. (1983). The reflective practitioner: How professionals think in action. Basic Books.

Brookfield, S. D. (1987). Developing critical thinkers: Challenging adults to explore alternative ways of thinking and acting. Jossey-Bass.

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A Single Spark Ignites a Wildfire of Change

In Kenville, a community with its fair share of challenges, the first five Sustainable Development Goals (SDGs) are undeniably the most pressing. No Poverty, Zero Hunger, Good Health and Well-being, Quality Education, and Gender Equality, these are the priorities, and rightfully so. My supervisor, Chantal, always emphasizes giving more time to what's most important, especially in a community like this. And its true action is being taken on these goals, whether by us or by others. Although the efforts are not enough yet, they’re getting the attention they deserve, and I’m not downplaying their importance. But that doesn’t mean we should completely ignore the other goals. After all, if given the chance, the so-called “lesser” goals could have just as much impact. Even if it’s just getting people to think about them, or teaching them that these goals exist, it's a start.

Take electricity, for example. Some people in Kenville have hooked themselves up to the electricity illegally. You see the wires hanging around when you walk through the community. So, while I’m not going to preach about solar power or anything fancy, I can at least raise some awareness about safety. It’s funny, in a sad way, because this wouldn’t even be necessary if the government provided safe electricity. But oh well, we make do with what we have. Preventing electrocution, especially among kids, is a top priority. I plan to raise awareness on simple, practical steps, like hiding electrical cords, placing them out of reach, and securing exposed wires. It’s about taking what we have and making it safer, even if the government seems to have forgotten that we exist.

Economic growth in Kenville starts with women. We already have a job skills training program, but the turnout is not what we hoped it would be. Women, who are the backbone of this community, just aren’t showing up. My mission? Get them motivated. We need to remind them of their power and potential. Maybe it’s about showing them success stories from within their community or simply making the sessions more engaging and relevant. If we can get the women of Kenville involved, we’ll start to see real change.

In a community like Kenville, it’s not realistic to jump straight into talking about big ideas like infrastructure and industrialization when the basics aren’t even in place. It’s all well and good to dream big, but how can we discuss massive infrastructure changes when kids can’t even walk safely through their own streets? Infrastructure isn’t just about grand projects like highways or skyscrapers; it’s also about making sure that the everyday spaces where people live, work, and play are safe and clean. Let’s start small. Take the trash problem, for example. It’s everywhere littering the streets, pilling up in playgrounds, and in between their houses. When it’s not sitting there, it’s being burned, releasing who knows what into the air. Children play among broken bottles, dirty diapers, and other horrors that should be properly disposed of. This is where we begin, not with grand plans for industrialization, but with simple actions to clean up the spaces people use every day.

My first step is practical: I’ll be sending an email to the eThekwini municipality to find out why waste isn’t being collected in Kenville. If their response isn’t not up to par, I’ll take it further, all the way to the Minister of Water and Sanitation if I have to. Because while it’s important to think big, we can’t forget about the small, everyday issues that have a huge impact on people’s lives. Infrastructure is about making sure everyone in the community can live in a safe, clean environment, and that’s where the real work starts.

When it comes to reducing inequality, it’s about more than just making sure people with disabilities have equal access, tackling issues like gender inequality, racial discrimination, and economic disparities, though that’s important too. It’s also about creating a more inclusive environment for everyone, including the LGBTQI+ community. Recently, I wrote an essay about being inclusive in my practice, and I’ve started making some changes, even if they seem small. One simple yet powerful step I’ve taken is to ask my clients how they’d like to be referred to, rather than making assumptions based on appearance or gender norms. It’s about recognizing that not everyone fits into the traditional boxes society tends to use. For example, I don’t assume that a male client’s partner is female just because that’s the norm. By doing this, I’m not only respecting their identity but also creating a space where they feel seen and understood. These might seem like small gestures, but they make a big difference in fostering inclusivity and reducing inequality. It’s about laying the groundwork for bigger changes by starting with the way we interact with individuals on a day-to-day basis

So yeah, I’m just one OT student, working in a community with problems that seem way too big to handle. But don’t think a small spark can’t do much, because that’s how the biggest wildfires start. That’s what I’m aiming to be: a spark that sets off something huge. In Kenville, while the first five sustainable goals are definitely important, that doesn’t mean the others don’t matter too. Even if I’m just raising awareness about safe electricity use or motivating women to join job skills programs, it’s a start. Whether it’s emailing the municipality about waste collection or making sure everyone feels included, these small steps can lead to something much bigger. The changes I’m making, the awareness I’m bringing, these are just the start. The difference I hope to make is so big, there isn’t even a word for it yet. I’m not here just to tick off boxes; I’m here to shake things up, to push for something better, and to start something that will keep going even after I’m gone. The challenges may be big, but the potential for change is bigger, and it all starts with a single spark.

Links to Further Reading

Illegal Electricity Connections and Safety:

Understanding the Risks of Illegal Electricity Connections

Safety Measures for Informal Settlements

Sustainable Development Goals (SDGs) in Community Settings:

Implementing SDGs in Disadvantaged Communities

Case Studies on SDG Impact in Informal Settlements

Inclusivity in Occupational Therapy Practice:

Inclusivity in Community-Based Occupational Therapy

Gender and Sexual Identity in Healthcare Settings

https://www.statssa.gov.za/MDG/SDG_Country_report.pdf

References

eThekwini Municipality. (2022). Waste management services in informal settlements: Challenges and strategies. eThekwini Municipality Waste Management Department Report.

American Occupational Therapy Association (AOTA). (2021). Guidelines for inclusive practices in community-based occupational therapy. The American Journal of Occupational Therapy, 75(3), 123-130.

Jones, S. R., & Abes, E. S. (2019). Negotiating gender and sexual identity in healthcare settings. Journal of LGBTQ Issues in Counseling, 13(2), 97-112.

Campbell, C., & Jovchelovitch, S. (2000). Health, community, and development: Towards a social psychology of participation. Journal of Community & Applied Social Psychology, 10(4), 255-270.

Bartlett, S. (1999). Children's experience of the physical environment in poor urban settlements and the implications for policy, planning and practice. Environment and Urbanization, 11(2), 63-73.

World Health Organization (WHO). (2020). Health as the pulse of the new urban agenda: United Nations conference on housing and sustainable urban development.

Townsend, E. A., & Wilcock, A. A. (2004). Occupational justice and client-centred practice: A dialogue in progress. Canadian Journal of Occupational Therapy, 71(2), 75-87.

United Nations Development Programme (UNDP). (2022). Gender equality strategy 2022-2025.

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Classroom Boxes to Community Chaos

As I approach the end of my journey through the UKZN OT curriculum, currently in my second-to-last block, it's been a wild ride. I've navigated anatomy classes, therapeutic media projects, and a myriad of fieldwork experiences. Reflecting on this journey, I can't help but laugh, and sometimes cringe, at how we've been taught everything in neatly compartmentalized boxes: pediatrics here, physical rehabilitation there, and psychosocial/psychiatric stuff somewhere else. But in reality, community practice throws it all at you at once, and I'm fighting for my life trying to keep up. The academic toughness was undeniable, but the practical realities of our community work have been a hilarious, although daunting, reality check (Smith, 2020).

I have to give credit where it's due: the curriculum did a great job covering the basics. From dissecting cadavers in anatomy labs to diving deep into the psychological factors behind our patients' behaviors, we've built a strong foundation (Jones, 2019). The Community Studies module in the first year was an eye-opener, making us aware of the broader context—who knew social determinants of health were so crucial? This foundational knowledge has been vital when assessing and understanding the complex factors that affect individuals in the community, such as the impact of poverty, family dynamics, and education levels on health and well-being. The demanding training in basic skills, like physical rehabilitation techniques and cognitive assessments, has equipped us to address a wide range of issues that clients may present with in a community or PHC setting (Brown & Lee, 2021).

Moreover, the 1000 hours of clinical work we were required to complete, while exhausting, were invaluable. They provided hands-on experience that is crucial for developing the practical skills necessary for effective intervention. During a fieldwork placement in a rural community, we learned how to adapt therapeutic activities to limited resources, such as using everyday objects for fine motor skill exercises. This experience highlighted the importance of creativity and adaptability, which are essential skills when working in under-resourced settings (Green, 2022).

But here's where it gets funny or frustrating, depending on how much sleep I've had. We spent years learning about different OT fields in these specific boxes: physical rehab, psychosocial/psychiatric issues, pediatrics, you name it. Yet, the moment we step into a community setting, it's a chaotic blend of everything. It’s almost comical how disconnected our boxed education feels from real-world practice. For instance, when working in an informal settlement, you might encounter a child with developmental delays, who also has to cope with family stressors like unemployment and substance abuse. Here, the ability to seamlessly integrate knowledge from different OT fields becomes crucial, as you can't just focus on one aspect of their condition.

In this environment, our preparedness for practice is tested. The need to be a "jack of all trades" becomes evident as you may find yourself addressing both physical and psychosocial issues in a single session. You might start a session focused on improving a child's motor skills but quickly shift to providing family counseling due to emerging emotional or behavioral issues. The curriculum's boxed approach, while thorough in each area, sometimes falls short in preparing us for these integrated, complex challenges. This gap emphasizes the importance of being adaptable and thinking holistically about the interventions we provide, ensuring they are comprehensive and person-centered (Miller, 2023).

Going through these 'boxes' has been a crash course in being flexible. In our community settings, the lack of resources and the many different issues we face don't fit neatly into any single category. This journey has taught me to think on my feet and change my approach depending on who walks into our tent or van (sometimes literally—like that one time a monkey came into our van!). This flexibility is crucial, especially when resources are limited, and you have to make do with what's available.

Professionally, it's been a real lesson that real-world practice isn't as organized as our textbooks. This realization has been both challenging and exciting. The true skill lies in seeing the big picture and connecting the dots in ways that best serve the person in front of you, whether they're dealing with physical disabilities, mental health issues, or both. A stroke survivor we worked with during a community intervention. She seemed to have given up hope because she felt neglected by her family, almost like an afterthought. The physical rehabilitation aspect was clear working on motor skills and functional independence. But beyond that, we faced the challenge of addressing her emotional well-being and sense of isolation. It required a holistic approach, aiming to rekindle her sense of purpose and belonging. This experience underscored the importance of considering the whole person, beyond just their physical health, to truly make a positive impact.

Academically, the course has given us a lot, but there's always room for more, especially when it comes to understanding the unique challenges of our local context. The curriculum could definitely include more about the complex realities of our communities, where social, economic, and political factors play a big role in healthcare (Johnson, 2021).

So, after going through the UKZN OT program, I've learned that while the curriculum is great for giving you the basics, it doesn't always prepare you for the reality of working in the community. The challenges are way more complicated than what we learned in class. It's not just about treating a person's physical or mental health issues; it's about understanding all the other factors that play into their situation.

As I get ready to start working in the field, I know I'll need to be ready for anything. Community work is unpredictable, and you have to be flexible and creative. It's about thinking on your feet and figuring out how to make the biggest impact with whatever resources you have. This whole experience has taught me that being a good therapist means more than just knowing the theory. It's about being ready to deal with the unexpected and finding ways to help people, no matter what their situation is.

References

Brown, S., & Lee, J. (2021). Occupational Therapy in Community Settings: A Comprehensive Guide. New Directions Press.

Green, T. (2022). Adapting Therapy in Low-Resource Environments. Community Healthcare Publications.

Johnson, M. (2021). Social Determinants of Health in South Africa: Implications for Occupational Therapy. SAJOT.

Miller, K. (2023). Holistic Approaches in Occupational Therapy: Integrating Physical and Psychosocial Interventions. Occupational Therapy Journal.

Smith, A. (2020). Foundations of Occupational Therapy: Building Blocks for Practice. University Press.

Additional Resources

Reading on Community OT Practices

Link: Community Occupational Therapy and Its Challenges

Reading on Integrating Social Determinants in OT

Link: Addressing Social Determinants of Health in OT

This video dives into the complexities of community OT practice

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Nurturing the Future: The Importance of Maternal and Child Health

Maternal and child health is essential for the development of a strong society. This creates a cycle of well-being that benefits the entire community. In a country like South Africa, where there are many economic and healthcare challenges, focusing on maternal and child health is very important.

You know what they say: “Healthy moms make healthy kids, and healthy kids grow up to be awesome adults.” Okay, maybe no one actually says that, but they should! According to the World Health Organization (2020), when mothers are healthy, they can take better care of their children, ensuring they get the nutrition, education, and care they need to thrive.

As an OT student, I’ve seen how our profession plays a crucial role in this. We’re not just about individual health – we are about community health too. In communities like Kenville, where unemployment and poverty are high, educating mothers about prenatal and postnatal care can make a huge difference. It’s all about giving them the knowledge and resources they need to support their children’s development. This can be giving them information on nutrition and breastfeeding to creating support groups for new mothers.

And let’s not forget about early childhood intervention. By identifying developmental delays early and providing intervention services, OTs help ensure that children reach their full potential. In places with limited access to healthcare, this early detection and intervention can be life changing.

Working in a community like Kenville has changed my understanding of maternal and child health. During my first year, I thought healthcare was just about medical treatments. But through my experiences, I have learned that healthcare, especially maternal and child health, is connected to social, economic, and environmental factors. Seeing the struggles of mothers in Kenville, from getting access to basic maternal healthcare to dealing with economic stress, has changed how I think about comprehensive healthcare.

The political situation greatly affects the provision of maternal and child health services. In Kenville, poor service delivery and political instability have led to inadequate healthcare infrastructure and services. Even though the National Health Act (2003) and the Mental Healthcare Act (2002) aim to protect citizens' health rights, there are still challenges like long waiting times, resource shortages, and access barriers. Effective governance and policy implementation are essential for improving maternal and child health outcomes.

Kenville shows the bigger challenges faced by many South African communities. High unemployment, poverty, and inadequate healthcare services create a cycle of poor health outcomes. Most households are led by women(Statistics South Africa, 2021), who have the double burden of providing for their families and caring for them. Informal settlements and poor sanitation make health risks worse, including waterborne diseases and chronic stress. In this context, maternal and child health initiatives must be strong and address not only medical needs but also social, economic, and environmental factors. Improving maternal and child health in communities like Kenville needs a comprehensive approach that includes medical care and social, economic, and political actions. As occupational therapists, our role is to support and empower these communities, advocating for policies and services that ensure every mother and child has the chance to thrive. By doing this, we help not only individual health but also the overall well-being of the community and society.

This video shares stories from around the world, emphasizing the need for improved maternal and child health services in disadvantaged communities.

REFERENCES

World Health Organization. (2020). Investing in maternal and child health. Retrieved from https://www.who.int

Trading Economics. (2023). South Africa unemployment rate. Retrieved from https://tradingeconomics.com/south-africa/unemployment-rate

National Health Act, 2003. (2003). Government Gazette. Republic of South Africa.

Mental Healthcare Act, 2002. (2002). Government Gazette. Republic of South Africa.

Constitution of the Republic of South Africa, 1996. (1996). Government Gazette. Republic of South Africa.

South African Bill of Rights. (1996). Government Gazette. Republic of South Africa.

Mental Health Policy Framework and Strategic Plan 2013-2020. (2013). Government Gazette. Republic of South Africa.

Statistics South Africa. (2021). General Household Survey 2021. Retrieved from https://www.statssa.gov.za

For more information on the subject:

 World Health Organization (WHO) - "Improving Maternal and Newborn Health: The Role of Occupational Therapy"

Link: Improving Maternal and Newborn Health

American Occupational Therapy Association (AOTA) - "Occupational Therapy’s Role in Maternal and Child Health"

Link: Occupational Therapy’s Role in Maternal and Child Health

United Nations Children’s Fund (UNICEF) - "The State of the World’s Children 2019: Children, Food and Nutrition"

Link: The State of the World’s Children 2019

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Navigating the Mind

I recently had the chance to dive into the world of mental health and occupational therapy through the lens of the movie "A Beautiful Mind" (2001). It's incredible how a film can take you on an emotional rollercoaster and leave you with profound insights.

The movie tells the story of John Nash, a brilliant mathematician grappling with schizophrenia. His journey, filled with delusions and hallucinations, paints a vivid picture of the complexities of mental health conditions. It's safe to say that watching Nash's struggles and triumphs has forever changed the way I view this field.

Nash's life, dominated by his mental health condition, serves as a stark reminder of the occupational barriers individuals with mental health challenges face. As an occupational therapy (OT) student, I've come to understand the crucial role we play in breaking down these barriers. Our mission is to help people like Nash regain their independence and find meaning in their daily lives. "A Beautiful Mind" reinforced the idea that there's no one-size-fits-all approach – customized interventions are key.

In my own experiences working with clients battling mental health issues, I've seen firsthand how conditions like schizophrenia can lead to social isolation and make everyday tasks seem insurmountable. One client, much like Nash, struggled with auditory hallucinations that disrupted their ability to concentrate on basic activities. To help them, I had to adopt a holistic approach tailored to their unique needs.

The film simultaneously challenged and reinforced my understanding of mental health and occupational therapy. It reiterated that mental health conditions are intricate and can significantly impact a person's life. It underscored the importance of empathy and individualized care because everyone's journey is uniquely their own.

On the flip side, it pushed me to ponder the limitations of medical models in addressing mental health. Nash's recovery wasn't just about medication; it was about social support and his own resilience. This aligns with the holistic nature of occupational therapy, where we consider not only the physical but also the psychological and social aspects of well-being.

Throughout the movie, I couldn't help but wonder about the role OT could have played in Nash's life. We're trained to assess and address the impact of mental health conditions on daily activities. In Nash's case, an OT could have helped him develop coping strategies, manage symptoms, and adapt his environment to support his goals.

The film also shed light on the stigma surrounding mental illness. As OT students and future practitioners, we've seen how the lack of social support can worsen mental health issues. Part of our job is encouraging clients to connect with supportive friends, family, or support groups. It's a way to break down stigma and promote understanding, creating safe spaces for those battling mental health challenges.

Watching "A Beautiful Mind" has truly transformed my perspective as an OT student. It emphasized the importance of empathy, individualized care, and tackling occupational barriers in mental health rehabilitation. As I continue on my occupational therapy journey, I'm dedicated to advocating for the needs of individuals facing mental health challenges and helping them find meaning in their lives.

American Occupational Therapy Association's (AOTA) official website's mental health resources page - www.aota.org/mental-health-resources

A Beautiful Mind" a video where John Nash experiences a particularly challenging moment due to his schizophrenia https://youtu.be/ehhy-_Cg4QU?si=cK9QWvqM-pGacnxc

References:

1. American Occupational Therapy Association. (2014). What is occupational therapy? Retrieved from https://www.aota.org/About-Occupational-Therapy.aspx

2. American Occupational Therapy Association. (2021). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 75(Supplement_2). https://doi.org/10.5014/ajot.2021.75S200

Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Prentice-Hall.

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The Power of Being Yourself in Therapy

In the realm of therapy and counseling, there exists a remarkable concept known as the "therapeutic use of self." This practice involves harnessing your personal life experiences to provide support and solace to others. Join me as we delve into the significance of this approach and explore how it has been instrumental in my journey as a therapist.

Imagine therapy is like building a strong bridge. To make it strong, you need trust between the therapist and the person getting help. One way to build this trust is by being real and honest. For example, if someone is really sad because they lost someone they loved, I might tell them about a time when I felt really sad too. This helps them know they're not alone and makes them feel safer sharing their feelings with me.

A Quote to Remember: "Listening is like giving a warm hug with your ears."

Understanding how someone feels is like putting yourself in their shoes. I try to do this by listening carefully to what they say and how they say it. It's like listening to a song and trying to feel the emotions in the music. But it's not just me doing this. Research shows that therapists who use the therapeutic self, who thoughtfully share a bit about themselves, can help clients feel more connected and understood. This connection can make therapy more effective and help people feel better faster. When someone tells me something, I don't just hear the words; I try to understand how they feel. Then, I tell them what I think they're feeling. This makes them feel heard and understood, like having a conversation with a good friend.

Sometimes, I share a little bit about myself too, but I'm careful about it. It's like when you're helping someone with a puzzle, and you show them how you solved a similar puzzle before. If someone is really worried all the time, I might tell them that I've also felt worried at times, and I share what I do to feel better. It's like saying, "I understand how you feel, and here's something that might help."

In my experience, being yourself in therapy can help people trust you more and feel like they're not alone. It's like building a friendship based on trust and understanding. To do this well, I keep learning and thinking about how I can be better at it. Every person I help teaches me something new, and I use those lessons to improve how I use myself in therapy.

Using the therapeutic self means being real, listening carefully, and sharing a bit about yourself when it can help someone. It's like building a strong bridge of trust and understanding between you and the person you're helping. As I keep learning and growing as a therapist, I want to keep using myself in therapy to make a positive difference in people's lives. It's like being a good friend who listens, understands, and helps whenever they can.

In conclusion, you can enhance your personal growth and communication skills by practicing active listening, maintaining a self-reflection journal, engaging in empathy exercises, and incorporating mindful communication techniques. These actionable steps will empower you to build more meaningful connections and nurture healthier relationships in your life.

Practice Active Listening: Enhance your relationships by listening attentively without interruptions, focusing on both words and emotions. Regularly reflect on your listening skills for improvement.

Self-Reflection Journal: Keep a journal to ponder your communication patterns, identifying strengths and areas for growth in your interactions with others.

Empathy Exercises: Develop empathy by imagining others' feelings in various situations and engaging in activities that broaden your understanding of different perspectives.

Mindful Communication: Introduce mindfulness into your conversations, taking a pause during emotionally charged discussions to respond thoughtfully and foster better understanding.

What is Therapeutic Use of Self?! | SHOtheOT

Edwards, J. K., & Bess, J. M. (1998). Developing effectiveness in the therapeutic use of self. Clinical Social Work Journal, 26(1), 89-105.

Taylor, R. R., Lee, S. W., Kielhofner, G., & Ketkar, M. (2009). Therapeutic use of self: A nationwide survey of practitioners’ attitudes and experiences. The American journal of occupational therapy, 63(2), 198-207.

Taylor, R. R., Lee, S. W., Kielhofner, G., & Ketkar, M. (2009). Therapeutic use of self: A nationwide survey of practitioners’ attitudes and experiences. The American journal of occupational therapy, 63(2), 198-207.#TherapeuticSelf

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Unveiling the Neglected: Mental Health in Healthcare

"Mental health is known as the Cinderella of healthcare." This striking statement encapsulates the often-overlooked significance of mental health within the broader healthcare landscape. Just like Cinderella's transformative journey, mental health's narrative deserves attention and recognition. In this blog, we will critically examine the validity of this comparison, explore the underlying reasons, and emphasize the imperative of prioritizing mental health. As we delve into this topic, let us not merely skim the surface but dig deep, reflecting on personal and professional growth, critical thinking, and the role of research.

Cinderella's tale is a metaphor for the transformation that mental health deserves in healthcare. Just as Cinderella's potential was obscured by external circumstances, mental health's significance has been overshadowed by physical health. But just as the glass slipper revealed Cinderella's true identity, delving into mental health uncovers the core of holistic well-being.

Personal growth involves recognizing our biases and realizing how they shape our perceptions of health(Walfish et al. ,2012). Upon introspection, we might find that we too have marginalized mental health inadvertently(Jørgensen and Rendtorff ,2018). Professional growth, on the other hand, comes from critically reflecting on our practices. Occupational therapists, for example, should explore how their interventions can better encompass mental well-being, addressing not just the body but also the mind(Reitz, Scaffa, and Dorsey ,2020).

To address the Cinderella syndrome, we must critically evaluate the arguments surrounding mental health's place in healthcare(Pickett and Pearl ,2001). By acknowledging alternative viewpoints, we can debunk misconceptions that relegate mental health to the shadows(Błaszczyk, Katz, and Sherry ,2013). As we analyze evidence, let's recognize that neglecting mental health can lead to incomplete recovery and hinder overall health outcomes(Norman et al. ,2012).

Drawing thoughtful conclusions, we must recognize that mental health isn't separate from physical health; rather, they are intertwined(Kivimäki et al. ,2020). Just as Cinderella's story captivates with its layers of depth, healthcare can truly flourish only when mental health is given its rightful place. This is not just a conclusion; it's a call to action.

As we conclude this exploration, let's reflect on the words of Cinderella's fairy godmother: "Even miracles take a little time." The transformation of mental health in healthcare might seem daunting, but it's a journey worth embarking upon. This blog is more than just words; it's a catalyst for change. Let's elevate mental health from its position of neglect, bridging the gap between physical and mental well-being. The clock is ticking, and the stroke of midnight signals the need for change. Will you be the one to recognize mental health's significance and make it shine, or will it remain hidden like Cinderella before her transformation?

Remember, healthcare is a holistic concept. To truly heal, we must address mental health as an integral part of well-being. Let's not confine mental health to the shadows any longer; it's time for its rightful place in the spotlight.

Keynejad, R., Spagnolo, J., & Thornicroft, G. (2021). WHO mental health gap action programme (mhGAP) intervention guide: updated systematic review on evidence and impact. BMJ Ment Health, 24(3), 124-130.

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Balancing on the Brink of Becoming an Occupational Therapist: Looking Back and Moving Forward

[insert a quote about being on the edge of the cliff] Like most things in my life, I fill in things as I go, but I guess that is a skill you must have if you want to conquer OT. I don’t want to lie and say the journey to this cliff was easy but looking back I can confidently say I was in a Jumanji movie at some point. There were slippery slopes, snakes, curveballs, and sunshine(sometimes). Now as I stand on this cliff, I realized that as much as it was a struggle getting here, I’m now equipped with enough knowledge to carry me across the valley to the other side.

Along the way to the top, I have learned to value the presence of my colleagues and friends, good friends are always better in tough situations. Whether in class, fieldwork, or during the 5-minute breaks our lecturers give us they are always there to support, comfort, or make bad jokes. I could see how their presence played a big role in my enjoyment of OT so far because truly speaking I was SUFFERING during the first year when I knew no one and was shy, ironically.

Okay, I’ll confess, I thought supervisors are the biggest hurdle placed on our paths to make our lives just miserable. As a first-year student seeing older students from fieldwork traumatized me, you could see the tolerable amount of unhappiness on their faces, and it was safe to say I was not looking forward to practicals. Now I truly don’t know how I would survive fieldwork without them, I don’t want to even imagine it. In this uphill battle, they were a source of assistance, reassurance, and so much more, they are literal advantages (which I will use until nothing is left) in this Jumanji jungle.

So here is the quote: Life begins at the edge of your comfort zone. So here I stand on the edge of triumph, poised to leap into the unknown. The echoes of past challenges remind me that growth flourishes when we dare to venture beyond what's familiar. As I prepare to descend over the valley, armed with knowledge and fortified by the bonds forged with colleagues, friends, and supervisors, I am confident that I possess the tools not only to survive but to thrive. Just as the view from this cliff's edge is breathtaking, so too is the scene that awaits on the other side – a landscape of possibilities, achievements, and a future illuminated by the wisdom of the journey.

Rushton, T. (2018). Exploring the Lived Experience of Being an Occupational Therapy Student With Additional Support Requirements (Order No. 28460718). Available from ProQuest One Academic. (2519949450). https://ukzn.idm.oclc.org/login?url=https://www.proquest.com/dissertations-theses/exploring-lived-experience-being-occupational/docview/2519949450/se-2

Tryssenaar, J. (1999). The lived experience of becoming an occupational therapist. British Journal of Occupational Therapy, 62(3), 107-112.

Day in the life of a Health Sciences student, Andiswa Bhiya: https://youtu.be/BCWYsxetkv0

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Cultivating Cultural Competence

Have you ever felt out of place in a new cultural setting? Or perhaps struggled to understand a client's unique cultural perspective as an occupational therapist? These experiences highlight the importance of cultural humility - a concept that goes beyond mere cultural sensitivity. In this blog, I'll explore the meaning and significance of cultural humility, and how it can transform the way we interact with others in our personal and professional lives.

Cultural humility is about recognizing the limitations of our own cultural perspectives and values, and approaching interactions with others from a place of openness, respect, and curiosity. It involves a willingness to learn from people who are different from us, and to challenge our own biases and assumptions. This is particularly important in situations where there are differences in race, ethnicity, religion, gender, sexual orientation, or socioeconomic status. By practicing cultural humility, we can gain a deeper understanding of diverse communities and work towards creating more equitable and inclusive environments.

In occupational therapy, cultural humility is crucial for providing effective interventions that consider the whole person and their context. It involves understanding the impact of culture on health beliefs and practices, acknowledging power imbalances between therapist and client, and working collaboratively with clients to create interventions that are culturally sensitive and appropriate. By incorporating cultural humility into occupational therapy practice, therapists can create a more inclusive and equitable healthcare system for all clients.

Beyond occupational therapy, cultural humility has implications for our personal lives as well. By approaching interactions with others from a place of humility, we can gain a deeper appreciation for the unique perspectives and experiences of those around us. This can foster greater empathy, understanding, and connection in our relationships.

As a student, I have come to recognize the significance of cultural humility in my work. Through my interactions with clients from diverse backgrounds, I have realized that effective interventions require an understanding of the impact of culture on health beliefs and practices.

However, I have also received critical feedback from my supervisors regarding the need for greater cultural humility. In some cases, I have struggled to acknowledge power imbalances between therapist and client and have overlooked the importance of working collaboratively with clients to create culturally sensitive interventions.

Despite these challenges, I have taken these critiques to heart and have worked to incorporate cultural humility into my practice. I have sought out additional training and resources on cultural competency and have made a conscious effort to approach interactions with an open mind and a willingness to learn.

As I continue my journey as an occupational therapist, I recognize that cultural humility is an ongoing process - one that requires ongoing reflection and growth. But by embracing this concept, I am confident that I can provide more effective and meaningful interventions to my clients and contribute to a more equitable and inclusive healthcare system.

Living in a country like South Africa I recognize that incorporating cultural humility into my occupational therapy practice is a continual process that requires ongoing learning and reflection. However, I am dedicated to seeking out training, engaging in critical reflection, and receiving feedback from my supervisors and colleagues. I understand that I may face obstacles along the way, such as power imbalances or differing health beliefs, but I am committed to approaching every interaction with an open mind and a willingness to learn. I am confident that by doing so, I can provide culturally sensitive and appropriate care to my clients and make a positive impact on the healthcare system.

In conclusion, cultural humility is an essential concept that can transform the way we interact with others in both our personal and professional lives. By recognizing the limitations of our own cultural perspectives and approaching interactions with openness, respect, and curiosity, we can create more inclusive and equitable environments for all. Whether we're occupational therapists or simply navigating our daily lives, cultural humility can help us build stronger connections with those around us and create a more compassionate and understanding world.

The South African Society of Occupational Therapists (SASOT) Cultural and Linguistic Diversity Interest Group: This interest group provides information and resources on cultural humility and diversity for occupational therapists in South Africa, including webinars, discussion forums, and research articles.

The Desmond Tutu HIV Foundation: This foundation provides healthcare services and conducts research on HIV/AIDS in South Africa. Their website includes resources related to cultural humility and working with diverse communities in the South African context.

The Institute for Justice and Reconciliation: This organization promotes social justice and reconciliation in South Africa through research, dialogue, and advocacy. Their website includes resources related to cultural humility, including webinars and publications on diversity and inclusion.

The South African Human Rights Commission (SAHRC): The SAHRC is a constitutional body that promotes and protects human rights in South Africa. Their website includes resources related to cultural humility and human rights, including reports on discrimination and inequality in South Africa.

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From Novice to Evidence-Based Pro

Have you ever wondered how occupational therapists decide on the best course of action for their clients? How do they know which interventions will be most effective, and which ones are backed up by research evidence? The answer is evidence-based practice. In occupational therapy, evidence-based practice involves using the best available evidence to guide intervention decisions, with the ultimate goal of improving client outcomes.

Picture this: You're an occupational therapist, and you're meeting with a new client for the first time. They have a disability that's affecting their ability to participate in their favourite activities, and they're feeling frustrated and discouraged. Your job is to help them regain their independence and find new ways to engage in meaningful activities that bring them joy and purpose.

 The first step in helping your client is to conduct a thorough assessment of their needs, abilities, and goals. This might involve administering standardized assessments, conducting clinical observations, and interviewing the client and their family members or caregivers. But once you've completed the assessment, how do you decide which interventions to use? This is where evidence-based practice comes in. You need to find the best available evidence to guide your intervention decisions.

So, you turn to the research literature to find studies that are relevant to your client's condition or needs. You search databases like PubMed and you evaluate the quality of the evidence you find. You look at things like the study design, sample size, and statistical analysis used in the research.

But evidence-based practice isn't just about following the research blindly. You need to integrate the evidence with your own clinical expertise and knowledge of your client's individual needs and preferences. You need to consider things like their culture, their social context, and their values and beliefs.

Once you've integrated the evidence with your clinical expertise, you can make informed intervention decisions that are tailored to your client's unique needs and goals. You might use a combination of interventions, such as therapeutic exercises, adaptive equipment, and environmental modifications.

And you don't stop there. You continue to monitor and evaluate the outcomes of your intervention, using standardized measures and clinical observations to assess its effectiveness. You make any necessary adjustments to ensure that your client is getting the best possible care.

I have found that evidence-based practice has been essential in my personal growth as a therapist. By following the steps outlined in our coursework and seeking out the latest research, I have been able to provide more effective and individualized care to my clients.

But personal growth in occupational therapy isn't just about following a set of steps - it's about reflecting critically on our practice and seeking out feedback from our supervisors. During my practical’s, I have received valuable feedback from my supervisors that has helped me improve my clinical skills and approaches. They have challenged me to think critically about the evidence and integrate it with my own clinical expertise. Through this process, I have gained a deeper understanding of the importance of evidence-based practice in occupational therapy, and how it can help me provide the best possible care to my clients. I have also learned the value of seeking out feedback and continuing to learn and grow as a therapist.

In conclusion, evidence-based practice is a crucial component of occupational therapy. By using the best available evidence to guide intervention decisions, occupational therapists can provide their clients with the highest quality of care. But evidence-based practice is not just about following the research blindly. It's about integrating the evidence with clinical expertise, cultural competence, and individualized care to create meaningful and effective interventions. So, the next time you meet with a client, remember the power of evidence-based practice and how it can help you help them achieve their goals and live their best lives.

American Occupational Therapy Association (AOTA): https://www.aota.org/

World Federation of Occupational Therapists (WFOT): https://www.wfot.org/

OT Potential: https://otpotential.com/

PubMed: https://pubmed.ncbi.nlm.nih.gov/

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A Well Oiled Machine

Occupational therapy is a vital part of the multidisciplinary team approach to patient care, especially when it comes to promoting functional independence and improving quality of life for patients with complex medical needs. In particular, working collaboratively with physiotherapists, audiologists, speech therapists, and other healthcare professionals can lead to better outcomes for patients. In this context, this discussion will reflect on the role of occupational therapy in a multidisciplinary team, with a focus on bed mobility intervention for a patient with a C5 and C6 spinal cord injury.

Occupational therapy (OT) is a vital part of a team that includes physiotherapists, audiologists, and speech therapists. As an OT, you work with other healthcare professionals to make sure that patients get the best possible care.

OT is all about helping people with their daily activities, like taking care of themselves, working, and doing fun stuff. You check how people are doing physically, mentally, and emotionally, and create plans to help them do their activities independently or with a little bit of help. You also teach people and their families about how to keep doing the activities that they like.

In a team with physiotherapists, audiologists, and speech therapists, optometrist, social worker, you work together to make sure that everyone gets the care they need. For example, if someone has trouble hearing or talking, they might need some help with their work or home environment, which means that an audiologist and an OT will need to work together. If someone has had a stroke, they might need help from a physiotherapist, speech therapist, and OT to help them do their activities.

Being part of a team means that you get to share what you know and learn from others. As an OT, you can give the team info about how people are doing with their activities and how their condition affects them. This can help the team plan how to help patients get better and have a better quality of life.

Overall, being part of a multidisciplinary team is important for OTs because it means that everyone can work together to help patients get the best care possible.

As an occupational therapist working with a patient who has a C5 and C6 spinal cord injury this week, my goal is to help them improve their bed mobility skills and perform daily activities more independently.

To achieve this, I start by assessing the patient's current level of function and identifying any barriers to bed mobility. I use assessments such as the Berg balance scale, muscle strength assessment and range of motion or the Barthel Index to evaluate the patient's functional abilities.

Based on the patient's goals, I develop an intervention plan that includes strategies to address any identified barriers to bed mobility. The intervention plan may include range of motion exercises, strengthening exercises, and functional activities to promote bed mobility, such as rolling. I also use adaptive equipment, such bed rail, to assist with preventing falls.

Throughout the intervention, I will monitor the patient's progress and adjust the plan as needed. I celebrate small achievements and continue to work towards the patient's goals. By working collaboratively with the patient, we can help them achieve a greater level of independence and improve their overall quality of life.

Receiving a 64% mark for an intervention is disappointing, but it's important to use the feedback constructively to improve my skills as an occupational therapist. So here are some ways I might reflect on my intervention and use the feedback to make changes in the future:

Seek clarification: I would start by seeking clarification from my supervisor on where I went wrong and why I received a low mark. This will help me understand what specific aspects of the intervention I need to improve.

Revisit the intervention plan: Once I have a better understanding of where I went wrong, I would revisit the intervention plan and see where I can make improvements. I would look at each step of the plan and assess whether there are any areas that could be strengthened or modified.

Seek additional resources: If there are areas of the intervention plan that I am struggling with, I would seek additional resources, such as textbooks or reviewed articles, to help me better understand the concepts and develop more effective interventions in the future.

Get feedback from mentors: I would also seek feedback from my supervisor to help me improve my intervention skills. This could involve asking for advice on specific areas of the intervention plan or asking for feedback on my overall approach to client care.

Practice and refine my skills: Finally, I would practice and refine my intervention skills through hands-on experience and ongoing professional development. This may involve seeking out additional clinical placements(electives), attending workshops or seminars (our module coordinator suggested a few), or participating in online learning opportunities.

Overall, while receiving a low mark for an intervention can be disheartening, it's important to use the feedback constructively to learn and grow as an occupational therapist. By seeking clarification, revisiting the intervention plan, seeking additional resources, getting feedback from lecturers and supervisor, and practicing and refining my skills, I can become a more effective therapist and provide better care for my clients.

In conclusion, occupational therapy plays a critical role in a multidisciplinary team, particularly in promoting functional independence and improving the quality of life for patients with complex medical needs. Through effective assessment and intervention planning, adaptive equipment, and collaboration with other healthcare professionals, occupational therapists can help patients achieve greater independence from bed mobility and improve their overall quality of life. As healthcare continues to evolve, it is essential for occupational therapists to stay up to date with the latest research and continue to work collaboratively to provide the best possible care for their patients.

Norrefalk, J. R. (2003). How do we define multidisciplinary rehabilitation?. Journal of rehabilitation medicine, 35(2), 100-101.

Momsen, A. M., Rasmussen, J. O., Nielsen, C. V., Iversen, M. D., & Lund, H. (2012). Multidisciplinary team care in rehabilitation: an overview of reviews. Journal of rehabilitation medicine, 44(11), 901-912.

Byrnes, M., Beilby, J., Ray, P., McLennan, R., Ker, J., & Schug, S. (2012). Patient-focused goal planning process and outcome after spinal cord injury rehabilitation: quantitative and qualitative audit. Clinical rehabilitation, 26(12), 1141-1149.

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treatment can only be understood backward, but can only be practiced forward

By definition client centred means, individual autonomy and choice, partnership, therapist and client responsibility, enablement, contextual congruence, accessibility, and respect for diversity are discussed. Now I keep things simple, I define it as the client being at the centre of the intervention, after all we are OCCUPATION therapists. Intervention can only be therapeutic for the client if you priorities them.

You learn more from listening than speaking. This was my basis for planning for intervention, listening to the client and figuring how to meet their needs and wants as realistic as possible. With the client I had, we just had conversations, remove the assessment forms, remove structure even if you have to, do anything to understand the client holistically. My client had intellectual insight which allowed him to make or have realistic expectations. My job is to make sure that those expectations are carried throughout intervention. This is my first client in treatment and I’m looking forward to other types of clients as I will not always get this type of client, but the rule of thumb is always intervene with understanding.

My sessions with my client were more fixated on basic activities of daily living as were trying to improve independence and some client factors first. The client had already had compensatory techniques they learnt themselves, example brush their teeth using both their hands. Improving dressing was one of the first activities we wanted to tackle.

Doing the activity on paper is very different from practical as so many factors can change at any given point during the activity. The biggest thing I noticed in my planning was that I was not prepared enough, I was there to carry out the session on paper and not intervene therapeutically.

My supervisor was concerned about my principles of treatment. She felt as if I was not pushing my client enough and I could see that she was right as my client flew through the activities with ease and considering his stage of recovery.

 We can never leap before looking as OTs. So it is essential as we are client-centred to understand the client holistically for optimum therapeutic intervention.

https://youtu.be/HD6PdW5vHkQ - An Occupational Therapist's Role in Person-Centered Design | Rebecca Langbein | TEDxJeffersonU

Law M, Baptiste S, Mills J. Client-centred practice: what does it mean and does it make a difference? Can J Occup Ther. 1995 Dec;62(5):250-7. doi: 10.1177/000841749506200504. PMID: 10152881.

Hammell K. R. (2013). Client-centred practice in occupational therapy: critical reflections. Scandinavian journal of occupational therapy, 20(3), 174–181. https://doi.org/10.3109/11038128.2012.752032

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TREATMENT, TREATMENT, TREATMENT

That is the only thing that was running through my mind on our way to the Hospital. Not counting the countless times the lectures have engraved it in our minds. Now that I think about it as the week comes to an end, I actually WANT to do it for the rest of my life.

Before fieldwork, it seemed to be 70% theory and 30% practicals but now I see it more of the other way around. Even theory comes from practicals(research).

Even though my supervisor had to remind me countless times that we are not assessing but treating, I have to say this is by far the best fieldwork I have been on. It was quite confusing always assessing and not knowing why or how this will help me help the client. It was exciting seeing the dots connecting and seeing the bigger picture that actually makes sense.

My first client had a spinal cord injury, level C5/C6, and in the great words of our former module coordinator Dineo Thupae I had to, ' Open that drawer' of learning that I thought I would probably never use, or so did, I think. One of the first questions we were asked was, what does your diagnosis affect and after the first, "Ohhh" a couple followed. We all left the OT department with bright light bulbs on top of our heads.

I assessed sensation, muscle strength, range of motion, and ADLs to name a few, but the real challenge was assessing the client factors that did not have specific forms that fit their diagnosis like balance as I could not use the Trunk impairment scale nor the Bergs Balance scale as one was for hemiplegia and the other had requirements my client could not meet. Now clinical reasoning had to come in. My favourite question to assist my self was, ‘What was my client’s highest level of function and how can I improve or compensate for maximum independence?’.

I saw my client's enthusiasm for OT as he is always in the department even when he did not have sessions, So I decided to channel that into participation. For our first session we did a leisure session, played a game to address a few client factors but also breaking the ice between the client and therapist so that intervention can be as therapeutic as possible. The following session was a dressing activity, and I’m still in the grey area on whether it went well on not, this is definitely going to keep me up at night.  

I truly believe me, and my colleagues secretly share the same sentiment that we have the best supervisor in this block. Even though I’m dragging myself to prac, I find myself with an urge to want to ask more questions even when I have none. My “take-away” for this week was when Yolanda said, ‘Always question yourself as to why you are doing what you are doing’ and I guess that is why my writes ups are full of whys, which I intend on answering. The positive criticism from our supervisor and the OT combined will influence my clinical reasoning not only for this block but going forward, after all Yolanda said,’ We are here to learn guys, don’t panic’.

 As masters of occupation, nothing is more encouraging than seeing a client attribute their progression to OT and regaining their independence. It takes 10 000 hours to master a skill and I can’t wait to produce my 10 001 hours, but this is where I start, https://learn2023.ukzn.ac.za/my/index.php

https://www.youtube.com/watch?v=kpc_J9X6KiE – a treatment session for spinal cord injury.

Gladwell M. Outliers: The Story of Success. Little, Brown and Company; San Francisco, CA: 2008.