the-ot-devotee

[the-ot-devotee]

health promOTion

Four weeks down and just two more to go. Yes, that’s right, the end of this community experience is near and so is our four years of studying! During my ‘occupation’ of studying and being at various facilities for fieldwork, I have noticed that many people don’t actually know what an Occupational Therapist is or what we do. I still find myself dumbfounded when people ask me what I am or what I do. It’s pretty difficult trying to sum up my role as an OT in just one sentence since it’s such a vast profession and sometimes it seems like we’re a Jack of all trades! Now that I am based in a community where the education level of most individuals is slightly lower, we are often confused with physiotherapists or nurses and labelled as “the girl who taught me how to dress”, “the lady that taught me how to bath” or even “the girl that plays with my little son”. Apparently, there was even a time where we were known as “the basket ladies” bringing arts and crafts to occupy patients. Now you’re probably wondering what our role actually is, and more specifically, in a primary health care setting?

In a primary health care setting, the main role of any therapist is health promotion programmes (Deshni Naidoo, 2016). The World Health Organisation defines health promotion as “the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions.” (Health Promotion, n.d.). Not only do we just educate or inform individuals and make them aware of how to maintain their health, but advocating for and empowering individuals and communities is a major aspect of our profession. We do this by making use of preventative strategies, developing and implementing wellness groups and providing intervention for all community members, regardless of whether or not they present with a disability (Johanne Filiatrault, 2014). An example of how my group and I are trying to promote health and wellbeing in the community is by running a Substance Abuse and Life Skills Programme with grade seven learners. This programme uses a practical and interactive approach is aimed at educating young children on how substance use can affect all aspects of life.

The health promotion framework consists of maintenance, rehabilitation, preventative and promotive roles. And if you think about it technically, all aspects of the Occupational Therapy scope is promoting health so essentially – health promotion = OT. From this definition, the scope of health promotion would enhance greatly from the few basic roles discussed above, as health promotion consists of everything that an Occupational Therapist will do. The reason for this being that Occupational Therapy and Health Promotion share a common focus, that is providing meaningful and purposeful occupations to promote healthier habits and client-centered engagement in daily life, which ultimately contributes towards achieving overall health and well-being (A, 2004).

Often, the effectiveness of health promotion is questioned, especially in community settings. The topic on invading an individual’s home and giving them arbitrary points on how then can live their life better has come up in many of my fieldwork blocks with my fellow therapists. For a person who has been living a certain way for almost 40 years, why would they ever think that they should change the way they live their life for their remaining years? And that’s when it hit me, the role of health promotion is not directed at individuals with a disability or by looking at specific areas of occupations and finding minor faults in the way they are performed. Teenage pregnancy or relationship and family conflict are just some examples of what the health promotion scope includes. In other words, there is room for health promotion beyond disabilities and targeted OT population groups, as the goal of health promotion is not achieved in circumstances where one is not living life to their full potential.

In the 21st century, constantly using a smart phone or relaxing in front of the TV for the weekend is a norm that many of us are guilty of. The use of social media “increases the potential for easy access to preventative medicine, interaction with health care providers, interprofessional communication in emergency management, and public health” (Joëlle J. LEVAC, 2016). Being able to access the media and internet can greatly change the way people perceive certain topics. This is seen by TB ads on TV which promote medication compliance or a creative cartoon that I remember seeing which used animals but to describe the day of a kid living with autism. Obviously, there are positives and negatives of the media and it is a black hole of information, but the ability to conduct research and read health articles increases our knowledge on how to deal with various situations. Sometimes, you barely have to think about it and just search random key words or phrases such as “exercises for stroke patients” and numerous websites will pop up on your screen, offering their version of the best exercises.

Health promotion is a large framework that looks at physical, social and environmental factors of an individual. It cannot only be implemented through media but goes beyond all the boundaries to ensure that communities, societies and individuals are living their life in the best, most meaningful way.

 References:

A, M. R. (2004). Role percepttions and clinical reasoning of community health occupational therapists undertaking home visits. Australian Occupational Therapy Journal, 13 - 24.

Deshini Naidoo, J. V. (2016). Exploring the occupational therapist’s role in primary health care: listening to voices of stakeholders. African Journal of Primary Health Care & Family Medicine.

Health Promotion. (n.d.). Retrieved from WHO: http://www.who.int/topics/health_promotion/en/

Joëlle J. LEVAC, T. O. (2016). Social Media and its Use in Health Promotion . Interdisciplinary Journal of Health Science.

Johanne Filiatrault, M. P. (2014). Prevention and Health Promotion in Occupational Therapy: From Concepts to Interventions. International Handbook of Occupational Therapy Interventions, 837-848.

[the-ot-devotee]

The lurking effects of Apartheid

I was once sitting at a family reunion where the elders of the family were telling us stories from their past. I must admit that some of these stories were quite interesting. One of the elders told us about a time where he had to motivate why he required an education from a tertiary institute, more specifically occupations in medicine or other degrees that were seen as liberating. And how only a few applicants would receive consent to pursue a degree that they wanted to.  

 I always wondered why people choose to do what they do; why they went into or adopted certain occupations. Occupational therapy is roughly about the experience of ‘doing’ as the basis of human participation (Pollard, 2015). A person’s skills and abilities, gender, availability and access to resources, opportunities, culture, life roles and family play a vital role in choosing occupations (What Influences Your Career Choice?, 2011)

 In a South African context, occupation was greatly influenced through apartheid. During the despairing apartheid era, white people were given the right to determine the racial allocation of jobs through the Industrial Conciliation (IC) Act of 1956 (Mariotti, 2009). Hence, certain races were allocated certain job opportunities. For example, many black people worked as domestic workers of toiled in the mines whilst white people had more opportunities to perform greater occupations such as managers of large companies. Non-white citizens were expected to work for the “elite” white population and traditionally have jobs and roles that showed that they were not of the same class and that the white minority rule over them (Reddy, 2004). Although apartheid has ended, it is unfortunate that the effects of apartheid and the segregation is still evident in our communities today.

 But let’s look at it from an occupational therapist’s perspective. Apartheid fed into occupational injustice and occupational apartheid. In 1976, Community M was established as a coloured township which required coloured families living in and around Durban to relocate. This formed part of the implementation of the Group Areas Act (Our Community, n.d.). Being a ‘non-white’ community meant that a lack of opportunities and resources was present, all of which could enable the population to choose better occupations and access a better education and overall quality of life.

 A better quality of life stems off a higher education (Mafini, 2017). Therefore, by introducing barriers to occupation, the quality of life and the life satisfaction of this population is hindered, During the apartheid era, a higher education was reserved for or restricted to certain races. This pretty much explains the story I mentioned at the beginning where ‘non-whites’ were required to motivate the reason that they wanted to further their education.

 It is evident that the current government is trying hard to correct the mishaps of apartheid, however they are finding it quite challenging and is resulting in no difference. An article by News24 stated that the bitterness of the past carries heavily on the shoulders of many who were affected. My search to find more articles on how apartheid is still alive in South Africa is frightening! Many articles suggest that white lives in South Africa matter more than black lives.

 All of this makes you think deeper, can we really blame people in townships or under-developed communities for “being too lazy” and stealing, taking drugs or partaking in other illegal acts to earn some money? These communities were provided with unequal opportunities and resources and are struggling to escape the poverty cycle. I’m not saying that their actions of stealing and abusing substances are acceptable, but being in the communities every day and understanding the situations of many individuals makes you realize how unfair life is; how the effects of the so-called “past” are still lingering in areas of our country today, and how innocent children are going to get sucked into this vicious cycle.  

 References:

Mafini, C. (2017). Economic Factors and Life Satisfaction: Trends from South African Communities. Acta Universitatis Danubius. Œconomica, Vol 13, No 3).

Mariotti, M. (2009). Labor Markets During Apartheid in South Africa. The Austrailian National University.

Our Community. (n.d.). Retrieved from MCC: http://www.marianncc.org.za/our-community.php

Pollard, N. C. (2015). Occupation in occupational therapy, a political perspective.

Reddy, T. (2004). Higher Education and Social Transformation South African Case Study . Council on Higher Education.

What Influences Your Career Choice? (2011, 05 17). Retrieved from OnlineCollege.org: w.onlinecollege.org/2011/05/17/what-influences-your-career-choice/

[the-ot-devotee]

The economy vs. our health

Not long ago, I conducted a home visit which was probably the saddest, most heartbreaking thing I have ever witnessed. In this home, which was extremely difficult to find, lived a very frail gogo who suffered from severe arthritis and her grandson who happened to be a mental health care user. Yes, two people living in a tiny little room! The house had no furniture and both people slept on the cold concrete floor on thin woven mats, regardless of the icy winter conditions. Apart from this they did not even have kitchen utensils, so it baffles me how they prepared any food. Now this got me thinking, how do economic factors impact on health and wellness in South African communities?  

 Recent experiences of unequal distribution of wealth can be rooted back to the days of the apartheid government. In the apartheid system, all non-white citizens were excluded from the political arena as well as the economic sphere, causing a major wealth gap (Davids, 2008). Due to growing up in economically disadvantaged communities, later generations struggle to escape the extreme poverty that their parents found themselves in.  I have observed in the communities I have visited that almost all of the residents of these communities are suffering from different levels of poverty. In Community M, many of the individuals are motivated to study or work to change their living conditions. Similarly, in Community I, I noticed the high school learners in particular, motivated to work extra hard in order to help their families as well as changing their own lives.

 Economic factors were identified in an article on the economic factors and life satisfaction in South African communities, however, these factors will be discussed in terms of its relevance in the communities that I am placed at as well as the impact on health based on occupational science.

 With regards to education, the article inferred that “The higher the level of education, the higher the life satisfaction of residents amongst township societies” (Mafini, 2017).  I heard from a friend that just last year, parents initiated a strike at a school as the quality of education was not up to standard. This led to children smoking and spending the day at the park with their friends. It was also observed in both communities that a low-income neighbourhood often has poorly resourced schools that ultimately impact the children’s ability to receive a good education and therefore compromising their health trajectory (Emily B. Zimmerman, n.d.)

 The impact of the low educational level on health is that these individuals tend to live in communities that expose these individuals to risks such as crime, poverty and physical hazards (Emily B. Zimmerman, n.d.). In the communities, these factors pose a risk to their health. A low education also results in people lacking competence in accessing appropriate services (Emily B. Zimmerman, n.d.). Individuals who are ill are too afraid to seek medical treatment, thus they remain in poor health. This is observed daily in the clinics where some mothers hesitate to send their children for a basic screening just in case their child has a problem. This results in additional worries and financial stresses to the family. As we all know, mental illness is seen as taboo in many communities and many individuals who suffer from mental illnesses or have family members with a mental illness prefer to keep it a secret and not receive help. As a result, families tend to ignore the health of their loved ones which impacts negatively on the well-being of the individual and the family.

 Income level was another factor that was addressed. It was proposed that “Higher levels of income lead to higher levels of life satisfaction amongst residents of township societies.” (Mafini, 2017). This is ascribed to the fact that individuals with a higher level of income have access to greater quality services, improving their overall health. Poverty is widespread in Community M and I, and together with this, accessing services such as doctors and other healthcare professionals is difficult for community members. Therefore, members that are severely ill, usually due to the harsh living conditions are unable to visit the doctor whenever they need to as the doctor is only present in the local clinics twice a week. Not only is there limited help nearby, but most community members are required to travel far out to hospitals for special services resulting in increased financial burdens. Many community members also don’t have the finances to pay for transport and often miss their follow-up appointments with service providers, negatively impacting their health.

 House size was said to be a factor affecting health and wellness in communities. The article summed up that “The smaller the size of the household the greater the life satisfaction of people in township societies” (Mafini, 2017). Having homes in close proximity to each other is valuable as this encourages a close-knitted community. This can be seen at the clinics in both communities as many individuals found at the clinic have referred their ill friends, family or other community members to us. As much as I agree that smaller households usually share a closer bond than larger households, in Community M I noticed that most of the households are quite small with almost 5 people sharing a 2 bedroom flat. I also noticed that the houses and flats are in close proximity to each other, encouraging the spread of contagious illnesses.

 From the factors mentioned above, the occupational science basis in my communities results in occupational disruption (Scrawler, 2017) as poor health and wellbeing will result in people being unable to participate in their daily activities. Occupational deprivation (Scrawler, 2017) also occurs as the frequent episodes of illness and the lack of insight and access to treatment will restrict individuals from engaging in certain occupations. Both of these will negatively impact their overall participation (Scrawler, 2017) and performance. Also, an occupational imbalance (Scrawler, 2017) will occur as these ill individuals will prefer to spend their time in meaningless and ‘easy’ occupations such as watching TV or just sleeping as opposed to receiving an education, socializing, working or even engaging in constructive leisure activities. Eventually, occupational habits (Scrawler, 2017) will form as the thoughts and actions of individuals can be passed through families where children learn these habits from their parents and other family members.

 Being an Occupational Therapist means that we are concerned with the impact that the health and wellbeing of individuals have on their daily activities. So you are probably wondering what is being done to fight the dysfunction in these factors. Well, programmes are often started in communities by occupational therapists with the main aim of encouraging community engagement in order to improve their health and overall quality of life. Currently, a health promotion project increases the community’s awareness to health. Focus is placed on empowering women as well as adolescents and the youth by providing them with skills that can be used to gain a purpose and better their lives.

 It can definitely be seen in the communities, that these small efforts have made an enormous difference in the lives of these amazing individuals by motivating them to change their habits and break the dysfunctional cycle.

  References:

Davids, Y. D. (2008). Impact of perceptions of  poverty on the well-being of South Africans .

Emily B. Zimmerman, S. H. (n.d.). Understanding  the Relationship Between Education and Health. Retrieved from Agency for  Healthcare, Research and Quality:  https://www.ahrq.gov/professionals/education/curriculum-tools/population-health/zimmerman.html

Mafini, C. (2017). Economic Factors and Life  Satisfaction: Trends from South African Communities. Acta Universitatis  Danubius. Œconomica, Vol 13, No 3).

Scrawler. (2017). Occuational Science -  Background and Terminology. Retrieved from Quizlet: https://quizlet.com/32093746/occupational-science-background-info-and-terminology-flash-cards/

[the-ot-devotee]

Comm-Unity

The word “community” creates a stirring within us all, yet each of us has a unique perception of it, guided by our individual experiences. I believe that the word “community” and all of its connotations cannot be summed up in a few words, thus there is no concrete definition that adequately describes what it means to us. However, one of my favourite definitions describe a community as “the space where people think for themselves, dream their dreams, and come together to create and celebrate their common humanity.” (O’Connell, 1988, p. 31)

 As Occupational Therapists, or health care professionals in general, we are taught to treat every client holistically. But what does this mean? By using a holistic approach, we generally look at the client in terms of their mind, body and spirit (Vadnais M. L., 2014). This approach also helps us with the knowledge and abilities required to plan and implement intervention that will address issues in all spheres of a client’s life (Vadnais E., 2011). Being a young Indian girl, you can understand the over-protectiveness of my family and so I have never been exposed to a low socio-economic township or ‘community setting’. During fieldwork over the last 3 years, I have also only worked in hospital settings, in which I thought I was intervening holistically. However, it was only when I reached the community this year that I realized the true meaning of a holistic approach and the essence of it. Each client has a story, but so does each community that they come from which contributes so much more to their context and can play a big role in the intervention we provide.

 In a community setting, our role requires us to look at the client’s needs in order to provide better therapy. It was believed that the client’s home environment, including family, cultural values and community resources, provides a more effective therapy environment than a hospital where the focus is on the disability and illness (Meyers, 2010). By physically being in the client’s home environment or community, we are able to identify all aspects that could have possibly contributed to their current state or presentation, such as strengths, weakness, opportunities and threats within the community.

 The first community that I have been placed at is situated in the Ethekwini Municipality. It was established over 20 years ago as a coloured township in the then separate development programme of the Group Areas Act of 1957. The first families that arrived in the under-developed community came from a various places such as Umlaas, Pinetown and the ‘grey’ communities of Clermont and Mayville (Our Community, n.d.). The dumping of families in this tough environment was a leading cause of the youth caving into social-ills. Over the years, a disturbing challenge arose, namely gang wars. This violence and fierceness was regarding territorial boundaries and lasted a long time, and we are still hearing stories about the recent strikes! The reduced prevalence of gang violence gave way to a new issue in the community – drug use now became popular. An interesting extract caught my attention from the MCC website. “Many of the gang members who had survived death and prison were school drop outs and unskilled and so they became a viable market for drug peddling and use. With the growing use of substance abuse among families other social problems emerged. Violence in the family, neglect of children, sexual violence and crime began to rise. Poverty became a huge consequence as the high school drop-out rate, criminal activity, effects of substance abuse impacted on household's abilities to hold employment and to keep children at school.” (Our Community, n.d.)

A different community has been included as a fieldwork venue this year. This community is a primarily black township in Kwa-Zulu Natal and has a similar environment and socio-economic status to the above community, however some community members seem to be very wary of the resources we use.

 Despite the challenges that cause a community to remain stagnant, there are many factors that allow the community to flourish. According to public health researchers Wiseman and Brasher, “Community wellbeing is the combination of social, economic, environmental, cultural, and political conditions identified by individuals and their communities as essential for them to flourish and fulfil their potential.” (What is Community well-being?, n.d.). Connectedness, livability and equity were identified as factors that play an important role in achieving community well-being.

 Connection is fostered by a community’s social networks that offer social support, enhance social trust, support members living harmoniously together and empower members to participate in community and democracy. Connectedness can be observed as the MCC on sight offers social support as well as groups and projects such as the Gogo’s project, C.A.S.T and the Adult Youth Friendly Services project which assists in enhancing trust. However, it should be noted that due to the type of environment where drugs are rife, it affects the ability for community members to maintain their attendance at these projects which ultimately affects the ability of the community to flourish.

 A livable community is supported by infrastructure which includes housing, education, transportation, safety, recreational facilities and access to culture and the arts. New housing areas with adequate infrastructure, schools and crèches and parks and recreation have been put up, however the lack of public safety affects the use of these services. This together with the low socio-economic status of members of the community means that they cannot afford schooling. Some of the teachers at the school are also not qualified which affects the number of educated individuals willing to make changes and inhibits the growth of the individuals.

 An equitable community is supported by values of diversity, social justice and individual empowerment, where all members are treated with fairness and justice, basic needs are met and there is equal opportunity to receive education and meet individual potential. In these communities, equity was difficult to see as members who cannot afford to pay school fees, send their children to an informal school where they are barely stimulated. Basic needs are not met such as access to adequate health services and personal security.

(What is Community well-being?, n.d.)

 From the above mentioned information, projects and services are developed to assist the communities in flourishing however, the response and environment inhibits this ability. At one of my family events, one of the elders were talking to the younger kids about how we are brought up in a privileged and very different environment where we have access to the world at our fingertips, yet many people are brought up with so many barriers. That led me to thinking, it’s no wonder these community members face these challenges and continue facing them every day. One of the focuses of my group, therefore, is to work on investigating methods to assist community members individually and the community at large, to disrupt this pattern. How can we inspire each and every member of the community to be instruments of change in this reformation?

References:

1. Occupational Therapy Community-Based Practice Settings. (2019). Retrieved from https://books.google.co.za/books?hl=en&lr=&id=VYf2AAAAQBAJ&oi=fnd&pg=PR2&dq=Occupational+therapy+in+community+settings&ots=aOgVnf8oVT&sig=tyh2jIruHeB-Nldvd8V9CRWPSEo#v=onepage&q=Occupational%20therapy%20in%20community%20settings&f=false

 2. Meyers, S. K. (2010). Community Practice in Occupational Therapy. A guide to serving the community. Sadbury, Massachusetts: Jones and Barlett Publishers.

 3. Our Community. (n.d.). Retrieved from MCC: http://www.marianncc.org.za/our-community.php

 4. Vadnais, E. (2011, June 27). What is Holistic Occupational Therapy? Retrieved from Emmy Vadnais Holistic Healing: http://emmyvadnais.com/what-is-holistic-occupational-therapy

 5. Vadnais, M. L. (2014, September 25). How to be a Holistic OT. Retrieved from Holistic OT: http://holisticot.org/holistic-ot/

6. What is Community well-being? (n.d.). Retrieved from University of Minnesota: https://www.takingcharge.csh.umn.edu/enhance-your-wellbeing/community/what-community-wellbeing

[the-ot-devotee]

Markets of Warwick

Hello 4th year! It seems as if the year has barely begun but the amount of work and information that we’ve covered so far at campus is already feeling unbearable.

 So aside from the anxiety that comes with placements and groups for fieldwork, our department decided to take us on a field trip to the Markets of Warwick! Yes, I was also quite nervous at first and felt very much out of my comfort zone. Coming from a very sheltered lifestyle and background, I was always told to avoid the hustle and bustle of the city centre in pretty much all the cities in our country, only to protect myself from the various dangerous situations that we hear about from the media. However, today I got to walk through the taxi-filled streets of Durban, explore our beautiful city and meet some amazing people; and boy are they talented! (Which, by-the-way, was probably safer than most shopping malls these days)

 The Markets of Warwick is a well-run market which facilitates informal trade for a number of individuals living in and around the area and of a variety of ages. The market is rich in African culture from the type of music to the symbolic paintings on the walls which makes it even more interesting and meaningful to the community. During the tour, we visited all of the markets; some of which included the Early Morning market which comprised of mostly fruits and vegetables and live chickens, the Clay Market and the Bovine Head Cooks. We also had the opportunity to support brilliant women who hand-crafted the most beautiful jewelry using traditional African beads.

 Being able to learn more about other cultures as well as the different lifestyles of people was definitely exciting. However, most of us are unaware of the struggles that some of these people face on a day to day basis with regards to basic work conditions such as a roof over their heads or basic bathrooms. It is quite upsetting to know that these people have to work this hard and go through such difficulties to put food on their tables and take care of their families.

 The experience was incredible and I am definitely proud to call myself a South African. The markets have become their own communities within which everyone is respected, taken care of and fellow traders are treated like family.

Until next time... 

[the-ot-devotee]

The closing blog...

The past 11 weeks have been one heck of a roller-coaster  –  more like a roller-coaster of emotions. From, smiles, to anger outbursts to laughter and most off all, unstoppable tears at ‘climate meetings’ with friends. You know how they say, one door closes and another one opens. Not in this block! Here, one door opens, and the same door closes – literally! This block has been something else!

 By now you would have realized that we’ve come to the end of this psychosocial block; nearing the end of probably the most difficult semester I’ve experienced in these three years at campus. And, as much as I complain about this prac in most of my blogs, I have to admit that it definitely has been an eye-opener in terms of my future career.

 I, with my small-built physique, soft voice and vulnerable-looking face, have very little self-confidence, or now I should say, ‘Had’. Yes, I’ve been told a million times about my low confidence on prac and that my patients look at me as if I am an easy target or their ‘prey’. However, this block has taught me to be so much more confident in myself. At the beginning of the semester, we were asked to write down a few goals we would like to achieve during these 11 weeks. My number one goal was to become more confident in the things I do and the way I do them. And so, I took my supervisors advice and practiced ‘firm handling’ in front of a mirror.  Actually, I have also been practicing my big and cheeky voice on my family haha! There are many challenges that come up during fieldwork; be it physical or psychosocial. And therefore, with the new burst of confidence that I now have, I feel as if I was able to face many of these challenges and actually overcome them.

 I think the most important thing that I’ve learnt from these past weeks is that we should always appreciate and value what we have been blessed with. Honestly speaking, I think every student has dreaded every Tuesday and Friday as this meant that we had to spend hours in a dark, gloomy and pretty much depressing environment. But this has been a blessing in disguise for sure! It made me realize how we take so many things for granted; for example, our support systems. Without those special people in our life, we probably wouldn’t make the progress that we have. Therefore, it is so important that our patients have strong support systems to enable a more effective and speedy recovery. And if they don’t have any family around, we should be the supporting figures in their lives.

 In conclusion, this block has been an incredible journey that has allowed all of us to achieve personal growth. I will definitely use these lessons that I’ve learnt on prac to further improve myself as an individual and as an Occupational Therapist in the near future. As my supervisor once said, what you put in, is what you get out! So always push harder, work smarter and make these few years totally worth it!

[the-ot-devotee]

‘The jar of life’

It’s strange how fast this year is going by yet this semester seems to be never-ending. We’re slowly but surely coming to the end of the very emotional psychosocial block. Yeah, I do have a slight attachment to my patients but I really do just want the holidays to start already.

 Anyway, recently I have been feeling a bit overwhelmed about life in general until I came across an interesting story when I sat down to write this post. And I have to admit, the story of ‘The Jar of Life’ really made me change my ways and perspectives on life.

 The story has a great way of teaching us the importance of prioritising and focusing on what actually is important to us. Basically, a professor uses a creative metaphor of a jar, golf balls (which are the important things), pebbles (which are the other important things) and sand (the small things) to emphasize the importance of shifting our focus towards the bigger things such as our families and friends because if we neglect them whilst focusing on the ‘small things’, our lives become somewhat insignificant. His point was made in the following way:

“Professor: Now if you put the sand in the jar first, you won’t have room for the pebbles or the golf balls. The same is true in life. If you spend all your energy and your time on the small stuff, you won’t have time for all the really important things that matter to you. Pay attention to the things that are critical to your happiness. Take care of the golf balls first, the really important things. Set your priorities, because everything else is just sand”

 I constantly find myself guilty of not being able to prioritise. But you know what, it’s because our degree is so demanding and time-consuming that we forget to set aside time for our families and ourselves. We don’t realize it but that leads to us leading stressful and unbalanced lives (which almost always leads to me having mental breakdowns at least once a week!). As much as we want to pass or do well in our work, we need to place more focus on the bigger things in life, because that balance will have an immediate positive effect on our functioning. It’s funny how our degree promotes a balanced lifestyle yet we’re the ones with no sleep, no family time and the intense stress levels really forces you to binge eat the most unhealthy, comfort foods!

 One of the key takeaways of this is that we need to improve our ability to prioritise – and do so with reason and purpose. As Craig D. Lounsbrough so eloquently puts it, “Far too often my priorities become the things that are right in front of me rather than being the things that create the foundation underneath me.”  

 And well that’s it from me for this week. If you haven’t yet read the story of The Jar of Life, I suggest you do so right now with this link: https://motivationmentalist.com/2016/12/30/valuable-lesson-happier-life-jar-of-life/.

See you in the next blog!

[the-ot-devotee]

Research day

And I’m back from that relaxing holiday of sleeping late and waking up late. How I wish it didn’t have to end!

 Imagine yourself standing in front a room full of people waiting to present your research which you and your group have been working on since third year. Yes, one and a half years of laughs, cries and minimal sleep. I can only imagine how nervous everyone was but I’m sure the feeling of being done with this module was pretty good!

 Today we witnessed the fourth year’s present their research projects to an internal and external audience. It was a great experience as it gave me an idea of what to expect for next year as well as what is required in these presentations. I also really enjoyed listening to the variety of topics that all of the groups worked on. Almost all of them were extremely interesting and simply different.

 Research provides us with an in depth exploration of human experiences and feelings. Take qualitative research for example. This type of research is commonly conducted through interviews which allows us to obtain direct insight into an individual’s mind. As an Occupational Therapy student or future OT, our role is to better the lives of others, making it easier and more meaningful. Therefore, through research, we are given the opportunity to identify various aspects and issues that work and that don’t work, as well as correct and improve the quality of life of most individuals. Also, by understanding others’ perspectives more clearly, it allows us to learn what people value, therefore guiding our practice so that people can achieve outcomes that are personal to them. This will obviously make the research experience even more fulfilling!

 From this day I’ve learnt that occupational therapy plays an important role in the research process. Based on some of the research topics that was discussed, I learnt that all individuals are fighting battles and overcoming obstacles that we all aren’t aware off. For example, being a ‘student mother’ is an emotional experience that demands all of your time and energy, however these students still continue and complete their studies regardless of their ‘mum responsibilities’.

 I always felt that we as undergraduates lack experience when using various techniques such as NDT with a lot of our patients as when taught these techniques, we practice on our non-disabled colleages. But today, I learnt that almost all OT’s, students as well as experienced practitioners feel the same way as we lack confidence when working with CP children in particular. Research today, proved that even in your community service year, the confidence is still unfortunately lacking.  

 Listening to all of these presentations really opened my mind to a variety of possibilities and new ways that OT’s can tackle life’s challenges. As a student, I have experienced many terrifying situations during the violent protest action on our campus. However, I am fortunate enough to escape those outbursts and return home. However, it is evident that minimal attention is given to the lived experiences of student’s staying on on-campus residences, and therefore my research group and I will be looking further into this as our research project for next year.

 That’s all from me today.

Until next time…

[the-ot-devotee]

It’s finally the holidays!

It’s finally the last day of prac before our midterm break and glad to say I’ve made it! Well the fun will only start once I’ve ticked this blog off my to-do list.

 Today, being the last day before the holidays means that I won’t be seeing my patients for a while which makes me slightly overjoyed because this means that I can take a break from those dreadful write-ups and the overload of work that seems to never end. However, over the last few weeks I’ve grown attached to my patients and well, pretty much all of the patients that attend our group sessions. One thing that I’ve noticed; apart from the fact that most patients are discharged soon enough; is that there are a handful of patients that have been at the hospital for a longer time than they should be. For example, some patients have been at this acute facility for almost 10 months! And from what I observed, it has left them following the same routine every single day, which got me wondering why these patients are so frustrated and bored in the ward. The answer to this is Institutionalisation!

 Institutionalisation is defined as the act of being kept in a place or institute. Another definition states “Institutionalism is the syndrome first recognized and described in inpatient psychiatric facilities, which is now used to describe a set of maladaptive behaviors that are evoked by the pressures of living in any institutional setting.” (Johnson M, 2007). Whilst there are many positives to this term, there are also a number of negatives that come off it. Institutionalisation is commonly experienced by mentally ill patients as family members find it difficult to cope with and look after the patient. Not only is this a cause, but the lack of knowledge regarding treating and caring for people with mental illness also plays a part in forming institutions.

 Although my prac venue is an acute one, slight institutionalisation is evident as patients wake up every morning and do the same mundane activities throughout the day. Apart from participating in the same activities at the same time of day, these patients don’t even fully practice their own religion as they feel forced to ‘go with the flow’ and do what everyone else is doing. Some of the reasons for institutionalisation are due to the lack of resources at the facility, decreased freedom of occupations or activities, minimal celebration of special events and limited contact with others (Lingah J, 2017). This does help the facility to run smoothly with a lot more organization, and many patients need some kind of routine in order to function more effectively. However, being too dependent on this strict routine provides a disservice for the patients. Signs of institutionalisation include loss of interests and individuality, idle time, compliancy and decreased self-confidence (Lingah J, 2017) which are all visible characteristics that I’ve seen at the hospital.

 Seeing people of a variety of ages sitting around performing meaningless activities or doing absolutely nothing all day can be heart sore. As an OT, we should try to discourage institutionalisation in order to decrease the harmful effects that come with it. This will automatically improve your patient’s overall mood and quality of life. Basic leisure or orientation programmes can be planned and implemented in order to stimulate the patients and provide them with a more interesting and unpredictable routine for them to enjoy.

Well that’s all from me for this week. Happy holidays…

References:

1. Johnson MM and Rhodes R (2007). Institutionalization: A Theory of Human Behaviour and the Social Environment. Advances in Social Work, vol 8 no 1, 219.

2. Lingah J (2017). Long Term Care and Institutionalisation.

[the-ot-devotee]

Even you can be a hero!

What is a hero? Often, when people mention the word ‘hero’, we automatically think of the famous superheroes such as the red-caped Superman, the extra-muscular Hulk or the gorgeous blue-eyed Captain America. But aside from these made-up superheroes, a true hero is one that considers others in his action.

Today, the 07th of September 2018, was a casual day aimed at creating awareness and promoting correct thoughts, behaviours and actions which will result in an equitable country. The theme for this year’s Casual Day was to BE AN EVERYDAY HERO WITH PERSONS WITH DISABILITIES.

Since we happened to be on prac on casual day, we were required to plan an event or fun-day to celebrate these persons with disabilities. My prac group and I had planned a day full of exciting activities and snacks to create an inviting and heart-warming atmosphere for the patients at the hospital. The concept of Casual Day along with the theme for this year was introduced to the patients previously during group sessions where the patients were required to create their very own superhero masks!

A warm-up activity included a simple task of colouring and simply chatting to each other in order to make our recyclable capes and banners. These red and black capes as well as their eye-masks were then worn throughout the day. We then moved on to the more fun and physical activities planned, an egg-and-spoon relay and a bean bag toss. As simple as they seem, these games created the most amazing atmosphere for the patients and students as everyone participated, cheered each other on and just had a good time! At the end of the day, the patients were treated to some refreshing juice and a cupcake along with a certificate of participation which they will be able to keep and remember forever.

From my experience on Casual Day, the day is definitely beneficial as it signifies the coming together and acceptance of people with abilities and disabilities. It reminds us of putting aside our stereotypical thoughts and actions regarding disabilities and to treat each and every individual as an equal human being. Professionally, the concept is pretty much the same. As a health professional, we are taught to treat each patient equally and justly and keeping in mind the patients’ rights. Based on today’s fun day, the smiles, laughter and pure happiness of the patients made what we do so much more rewarding and encouraging.

I leave you with a bit of advice. Be an everyday hero. You may not realize that the little good that you do for someone can make their smile a whole lot bigger. Also, despite any limitations you may have, never give up and believe in yourself!

[the-ot-devotee]

I don’t manipulate people, just their environment.

Since mock prac, we’ve been hearing that this block is mentally, physically and emotionally challenging. And now, approximately five weeks into it and I can definitely agree with that! Apart from meeting tight deadlines, late nights with very little sleep, and a sore and strained neck, this block has resulted in many mental breakdowns at night. Also, me being a softy with attachment issues, it has come to the point where I even think of my patients whilst sitting through family game nights and outings. And not just about my treatment for them, but my heart aches at the fact that they’re practically living in a hospital.

I must admit, I am finding fieldwork to be quite a tough one this semester because patients’ problems and progress is not as tangible and concrete as it was in our physical block. Being in an acute facility, or pretty much any facility, is going to have its ups and downs, but what I’ve noticed is that if your patient is motivated to getting better, the journey can be a fruitful one. Now honestly speaking, I still feel as if I don’t know what I am doing, but I do have some hope that I will get through this block. I don’t want to say that intervention in psyc needs to be more specific than in physical because they should be equal, however, whilst being on the block, it does seem to be a bit more specific for your client. This is because, even though two individuals might have the same diagnosis, they can present totally differently and so treatment for these patients need to be suitable for them.

One of the main lessons I have learnt on this block is to be observant of pretty much everyone and everything. From the way they behave in the ward to the colour of their socks (okay maybe not that extreme, but you get my point right?). Paying attention to even the smallest details will come handy when planning intervention as it allows us to get a clearer picture of our patients as well understand them better. Not only will this help me to become a better OT, it will also improve my skills of ‘reading peoples minds’ by allowing me to notice when my own friends and family are experiencing struggles that they might not mention and make me a better friend or colleague.

Fieldwork has also taught me to be more critical in my thinking; to ask more questions in order to gain a better understanding of things. This will help my usually-gullible self (yes, unfortunately I am), to not be ‘poisoned’ by the media.

Lastly, the block has taught me to believe in myself and not underestimate myself. I generally lack confidence and look to others for approval in order to feel good enough, or prefer to do what everyone else is doing, but I’ve realized that I have strengths too. I agree, there is no better feeling than getting told that you did a good job from your supervisor. But we need to start trusting ourselves and doing what we feel is right for our patients, as well as for ourselves every day.

As an OT-in-progress, I can definitely say that this block has had a positive impact on me as a whole. Actually, since the beginning of the year, I have been terrified about working in an acute psychiatric facility, but only now do I realize what an honour it is to work with these patients, especially because they have the potential to recover (at least to an extent). It is a great feeling to know you are making a difference in someone’s life, especially when they look forward to seeing you every week. And now, I’m not bragging or anything, but both my patients were discharged today! Usually I would be a bit upset as I had a whole programme planned for them, but this means that my little bit of OT must’ve really helped right?

When planning my treatment, I really struggled with choosing suitable frames of references for my patient. But thanks to a friend, this website really helped me by explaining the frames of references and possible approaches I could have used. You can access it here: https://www.allthingsot.com/frames-of-reference.

As draining and exhausting as this degree might be, it is definitely one of the most rewarding ones. Rewarding in terms of personal growth, contentment and satisfaction. But hey, I did make it through midterms and so this means that I am just a few months away from being in final year, oh my word!

That’s all from me tonight,

Until next time…

[the-ot-devotee]

Sharing and reflecting

Okay so honestly speaking, thinking about blogging every week and the fears of meeting the deadlines has been one major stress in all of our lives, coupled with the fact that we are juggling other modules with their own tests, assignments and projects. However, when the time actually comes and I sit down to write these blogs, it allows me to think about and explain the events of the week (especially since the weeks go by in a blink!). By now, I am sure you know that all of us, Occupational Therapy students, feel mentally drained by the end of the week and that fieldwork really takes a toll on us, and so writing these blogs is a great way of getting things off our chests by expressing our deeply-held thoughts and feelings.

 These ‘reflecting blogs’ have made me research a good lot of articles regarding my practical (which even though might seem boring and annoying at the time), have definitely increased my knowledge on various diagnoses and concepts. And so, after reading an article on Learning by thinking: How Reflection Improves Performance, it can be deduced that learning from “direct” or lived experiences allows for a more effective reflection. Therefore, critically analyzing tasks, our performance and the way we handle various situations that might have sprung upon us is essential to benefit from the experience optimally. Our experiences become more productive when we reflect on what we have learnt from them. The article also explains how reflection plays a vital role in improving one’s confidence with regards to achieving goals. (You can read more about it here: https://hbswk.hbs.edu/item/learning-by-thinking-how-relection-improves-performance)

 We must remember that reflecting is a critical component of learning and so, in any health science practice, it is important for us and even professionals to critically reflect on their treatment sessions. This will enable them to identify their strengths and weaknesses, the good and bad of treatment sessions, and to come up with ways of improving the services we provide to patients.

 Writing these blogs have given me a deeper insight into myself by helping me to understand my abilities and downfalls. It has also played a role in increasing my self-esteem and confidence for example, by acknowledging and admitting that a session might have went well.  It also enables me to measure how I’ve grown as an OT student from one term to the next.

 I leave you with a quote by an American philosopher, John Dewey, “We do not learn from experiences, we learn from reflecting on experience.”

 Until next time…

[the-ot-devotee]

Life’s good when you have a movie on your to-do list.

“I didn't want to wake up. I was having a much better time asleep. And that's really sad. It was almost like a reverse nightmare, like when you wake up from a nightmare you're so relieved. I woke up into a nightmare.” – It’s kind of a funny story.

Not too long ago I decided to treat myself to some ‘me-time’ and so I got comfortable in my bed with my favourite blanket, some popcorn and a chilled can of coke to watch one of my now favourite movies – It’s kind of a funny story! (which I also recently found out is based on a book by Ned Vizzini.) Now I really don’t want to spill too much but here is a brief outline of the plot. #SpoilerAlert. The movie is about a young boy who suffers from depression and admits himself into a psychiatric institute. Only to discover that it isn’t what he imagined and hopes to get out really soon. But in this week that he spends at the hospital, he receives so much more than medication…

We often fail to realize how strong the media such as movies and TV shows influence our thoughts and feelings towards mental illness. Obviously, this movie uses comedy and romance to hide the seriousness and impact that these issues might have on us as well as keeps viewers interested throughout the film.

Whilst the story line and acting was somewhat accurate, the movie provided very little to no insight into the real-life presentation of people with mental illness. Being an Occupational Therapy student and currently pushing myself through psyc block in an acute facility, I now have a clearer image of how these patients and facilities actually go about their day to day lives.

Just as I get excited when hearing anatomical terms in Grey’s Anatomy because I went for all of those Anatomy lectures in first year, what stood out for me in this movie was that I was familiar with the fact that patients were provided with great opportunities to participate in group therapy in the form of sporting activities, art therapy as well as discussion groups. Also something that us OT’s do. The film also places emphasis on the importance of support systems (or maybe I just looked a bit deeper), and what I was most impressed with was the support system that was created by the patients for each other. It highlighted the fact that most of these patients depend on each other to heal by sharing and learning from others’ lived-experiences.

Movies are a great way of creating awareness for anything, including mental health. However, I felt that this movie provided a very shallow portrayal of mental illness. Therefore, it is important that we don’t take what we see in movies as is, but rather look for the hidden meaning.

One thing I have learnt from this movie is that we should not underestimate psychiatric patients. We often feel as if they are incapable of various activities, yet we are unaware of their talents and the masterpieces that they are able to create.

[the-ot-devotee]

Week 1, done and dusted.

The first week of prac was terrifying, nerve-wracking and definitely overwhelming. Even though we had just come off physical block a few months ago, everything seems so different now. OT in psychiatry and OT in physical seems like two completely different degrees! I feel like the main cause of my stress and fear is that in psyc, your client’s improvement is not as tangible as your improvements and successes in physical. This, for me, is something that is constantly playing on my mind because how am I going to know if my therapy is helping my patients or not?! However, aside from the negative thoughts, I did survive my first week of psyc block! (even if it was just a day)

 As usual (it’s just my luck), that I would get referred the most dominating and quick-witted patient in the ward. Coincidently, this has happened in physical block too and boy, was it challenging! Having a somewhat petite physique, being the most soft spoken from my group and unfortunately quite timid, I am seen as an ‘easy target’. Just imagine a lion looking out to catch its weak prey; me being the prey of course.

 Due to the lack of time on the first day, I did a psychiatric interview with both my patients during individual sessions in order to get a clearer idea of their background, diagnosis and thoughts. I then included them in a group in which I was the co-therapist. My first patient is diagnosed with the common Bipolar Mood Disorder and presents with no insight into his condition. He does however think very highly of himself and is aware of his great qualifications and intelligence. Lucky for me, he is eager to participate in OT (individual and group sessions) and appreciates a challenge as he claims to be “extremely bored” in the ward. I feel anxious just thinking about the kinds of activities I would choose for my patient due to his high level of intelligence and sudden changes in his mood as the wrong choice of activities can affect his co-operation and enthusiasm to participate in Occupational Therapy. In order to make the right decisions with regards to my patient’s therapy, after at least one more session with him, I am going to place him on a level of creative ability and thereafter base my treatment on the particular model. My second patient is a young man with schizophrenia who has good insight into his condition. He is co-operative with therapy. In the next session with my patient, I plan on further understanding my patients’ levels of functioning so that I can plan and implement effective treatment sessions for them for the next 9 weeks.

 Some aspects of myself that I am trying to improve is my confidence. I am usually an assertive person, however on the first day of prac, I try to be less assertive in order to establish a rapport with my patients and once we have built a professional yet comfortable and trusting relationship, they begin to respect and follow my instructions without expressing a rebellious reaction. Another quality of myself that I would try to improve is to work faster on prac as well as better my time management skills. I will do this by drawing up a timetable and following it strictly (hopefully).

 That’s all from me for now,

Until next time…

[the-ot-devotee]

Difficult roads often lead to beautiful destinations.

Hello there psyc block! Sitting through five hours of mock prac means that it is officially the start of another long and draining practical. You can only imagine how anxious and pretty much terrified I feel right now thinking about how all of our lecturers have said that “this block is a bridging to fourth year” and “this block is going to mentally and physically pull you apart”. Being placed at an acute venue does scare me a little more than I would have usually been, but with the few positive reviews of the facility from my supervisor, I am somewhat looking forward to the exposure and experience. It isn’t going to be an easy 10 weeks, but I have a feeling it will be a fruitful one!

 I must admit that mock prac today was inspiring, motivational and definitely tear-jerking oh my word! I am generally an emotional young lady but never did I imagine myself to tear during videos at mock prac! With that being said, I would like to reiterate the statements made by one of the supervisors during this session. Simon Sinek; a famous author and motivational speaker; developed a very powerful model known as The Golden Circle which explains to us that the key to success lies in the way we think, act and communicate. The model contains three stimulating questions: the What, How and Why. The ‘what’ refers to the outcome or the product that we achieve, the ‘how’ refers to the way in which we’re going to achieve it (yes, this means early mornings and late nights full of productivity from now until the end of prac!) and the ‘Why’ being your beliefs, values and motivators. (You can read more about the model/ concept here: https://www.toolshero.com/leadership/golden-circle-simon-sinek/). The point that stuck with me most from today is to ‘find your why’, and honestly speaking, I had no idea as to why I was doing Occupational Therapy until about last year when I felt this great rush, a sense of satisfaction and content after working with physically and mentally challenged people that I had actually helped and who looked forward to seeing me every week! But now I can firmly say that I am proud to be doing what I am doing and I cannot wait to make a difference in many more people’s lives.

 Like most students, I am one of the lazy and procrastinating ones. But with the motivation from my very persuasive lecturers, I am determined to push harder, work smarter and not give up when things don’t go as planned.

 After a few people shared their personal stories with us today, it made me realize how close and united our UKZN OT’s are. Not only am I referring to the students, but to the lecturers as well. I now feel more comfortable and at ease knowing that my little class of about 30 is actually one big family. We support each other, work together and cry together! With this being said, I think I’m ready to take on this semester with a whole new perspective and attitude and hopefully this will help me to be the best OT that I can be.

[the-ot-devotee]

Preparations for psyc block...

What is Mental Health? What are your thoughts when you hear that someone is ‘mentally ill’? Are your thoughts good or bad? Are they derogatory? Many of us will respond to these crucial questions by saying that they feel a sense of fear, concern or even confusion about what mental health means. Some of us might even avoid people diagnosed with a psychiatric/ mental illness completely. After telling family and friends that I’ve been placed at a psychiatric institute for this semester, most of their jaws dropped out of fear for me. But these common reactions are mainly due to the fact that, unfortunately, care for those people with mental illnesses takes a back seat in our country whilst the weight of infections, diseases and physical disability takes precedence. But mental illnesses are just like other illnesses and everyone should receive the care, help and support that they need. The South African Federation for Mental Health is the largest national mental health organization in South Africa aimed at giving ‘mental health care’ the necessary attention that it deserves. According to the 2015-2016 annual report, people with mental illnesses were asked to define dignity. One of the responses that stuck with me is ‘respect not pity’. Other answers varied from ‘to receive my mental health care services in my community’ to ‘people with disabilities have the right to employment’. (you can read the report here: http://www.safmh.org.za/documents/annual-reports/safmh-annual-report-2016.pdf). This was again emphasized in the 2017 annual report where stigma and the false perception that people with mental disabilities are unable to maintain employment has resulted in a human rights violation. We often forget that people with mental illnesses are challenged daily in their communities and many of these challenges are due to unfair attitudes and discrimination brought upon by us, so-called ‘normal’ people. Stigma and discrimination are said to trap people in a cycle of illnesses and therefore restrict the full recovery of people with mental illnesses. According to an article on Understanding the impact of stigma on people with mental illness, by Patrick W Corrigan and Amy C Watson of The World Psychiatric Association, there are two types of stigma. Public-stigma refers to the society/ community’s reactions to mentally ill people whilst Self-stigma refers to the preconceived thoughts that people with mental illnesses have about themselves. (You can read more about it here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/) For many years, people with mental health problems have been treated differently, excluded and even abused. This was due to the mistaken ideas that these people were unpredictable, violent and should be treated with caution. Fortunately, in the last decade, the South African situation has improved by developing several policies such as The Mental Health Care Act and the White Paper on the rights of people with disabilities which aims to improve mental health care and the quality of life for people with mental health problems. I’ve prepared for this block by doing a bunch of research on various conditions that I have not dealt with in the past, such as dementia, bipolar disorder and substance abuse as well as gave myself a pep talk to decrease my anxiety levels in order to cope with the stresses of deadlines and conflicts that might occur during fieldwork. We must remember that people with mental illnesses are still people, like you and I. It is important that we begin to change our mindsets and start treating people with mental illnesses as equals because it is often our discrimination and stigmas that are preventing them from moving forward. We must start to accept that with support and care, people with mental disorders also have the potential to gain independence again, even if it may not be complete independence. References: 1. SAFMH (n.d), received from: http://www.safmh.org.za/index.php 2. Patrick W Corrigan and Amy C Watson, Understanding the impact of stigma on people with mental illness. Received from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832?/

[the-ot-devotee]

Week 8: Planning and implementing treatment.

After what feels like a very long time, finals have finally kicked in and fortunately, the previous routine seems to be getting a little less difficult. But that doesn’t mean that my stress levels are any less because boy, oh boy, they are sky high! As I’ve said in one of my previous posts, working with a Traumatic Brain Injury patient was novel to me and somewhat scary as I initially had no idea where to start. However, I began by doing all kinds of physical, cognitive and perceptual assessments with my patient which enabled me to identify his problem areas which guided me into planning appropriate intervention for him. Also, since midterms didn’t seem too shabby for me, I automatically felt more confident in what I was doing during this term, which made planning and implementing treatment a little easier for me. And honestly speaking, the fact that my patient trusts me and believes that I know what I am doing definitely boosts my confidence during sessions and stops me from doubting myself (which I tend to do very often!). So, in this week’s post, I am going to take you through something a little different. Instead of my individual session, I am going to tell you about the group session that I ran with one of my friends being my co-therapist. This was my final group for this block and so you can imagine how nervous I was when my supervisor stood nearby observing me. During this little group of just 3 members, the patients were required to work in pairs and make their very own stress balls out of balloons and maize meal. The aim of this session was to increase social participation amongst members, improve social skills (particularly with my TBI patient) and to allow them to increase the muscle strength of their upper limbs by using the stress ball to perform various exercises. I would say the session went well as the clients were able to complete the task with the help of the co-therapist and there was a great deal of socializing between the group members. With regards to the treatment principles applied to this session, the clients were structured such that they were seated around a table with the items needed in front of them to encourage interaction and to enable them to work in pairs. The reason for them working in pairs was to accommodate for some patients having no bilateral function, but still enabling them to participate in the activity. Firm handling was used as some clients in the group tend to use inappropriate language and display inappropriate behaviours. Once again, my TBI patient in particular! One of the resultants following a brain injury is behavioural changes. Agitation from frustration, fear and anxiety is a common example of these changes. (You can read more about behavioural changes here: https://www.brainline.org/article/anger-following-brain-injury). Also, most of the patients in this group have a relatively low self-esteem and level of confidence, and so I had to be encouraging, motivating and supportive of them. With regards to activity requirements, the activity required a successful outcome to improve the patients’ self-esteem. It also required repetitive movements to improve muscle strength in their upper limbs. Lastly, I presented the activity with verbal instructions and demonstrations due to the varying levels of cognitive abilities amongst members. I also showed the group an example of the end product to give them an idea of what they were working towards. For the future, there are some aspects that I would change or do differently. Firstly, I would provide all pairs with the same size funnel (or any other bit of equipment in a different activity) to prevent pairs from working too fast or too slow in comparison to the others. Also, during paired tasks, I will ensure that each pair consists of one higher functioning patient and one lower functioning patient to allow the higher functioning individual to assist and guide the other. Well, that’s about it from me this week. Totsiens 🌾