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If you change your approach, vision, thoughts and attitudes ....you ultimately change yourself...only then can you attempt changing others!!

Be The Outlier...that’s what makes the difference not the Followers!

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My Journey Towards Becoming “the different”OT...

This been my last blog for this block..or perhaps forever I began to begin unpacking the person I really am through reading of my previous blogs. To my light has it brought to my striking attention that initially I dreaded the writing of blogs and thought of this as a ‘waste of my time’ or just another component to mark us for..yet after having the experience of blogging I not only improved on my writing skills yet such reflections have gotten me to discover my thoughts and what OT I would actually like to become...

It is often heard off in our profession as many state openly “ I want to be a peads OT or a physical therapist” whereas I being one of them at some point now ask myself what do I want to be..I wonder if it is just me who has no goal or lacks passion or is it others who are so enthusiastic..Being on this community block and writing this very same blogs where I get to speak my mind made me realize that I want to be an OT to humans...an OT who treats kids, physical, or mentally ill patients. Even the categorization of the patients tends to now prick at my nerve...why I question why discriminate what group of people one would like to treat or work with?. After the 6weeks which I’ve spent embedding myself into the community I discovered not only myself yet gained deeper insight into my profession as a whole. The diversity of a community setting is an aspect that is indescribable as being an OT within the community breaks the barriers of all social constructs including skin colour or type,accent language, finances, race, age or gender. In turn it teaches one the diversity of our profession leading to me thinking why would I ever say what OT I would want to be when by doing so we assume our own negative positionality.

The lessons learnt within this block are not temporary yet are life long lessons which I will not only apply as an OT but will apply to my lifestyle, thoughts, values, and my entire being as these lessons ultimately changed the person I once thought I knew best.. myself! With tutorials, a scientist of a supervisor, community members, and a team which always questions your reasoning behind decisions, I have unpacked an evolved me. Unintentionally prior to community engagement I had assumed that I prepared adequately for community integration and participation however currently I question how much of learning and preparation will ever be enough. Through this opportunity of being within a community setting and almost experiencing community struggles or community successes as my own I realized the stereotypes, preconceptions, fixed beliefs and my weak points of my upbringing as I discovered that the OT I was previously can never be compared to the OT I have become as my view of life as a whole has changed to such an extent that I doubt I even know myself however its a feeling that I enjoy as it allows me to continue my adventure in discovering what OT and person I am yet to become.

As I leave the community soon I feel a heavy pressure on my shoulders for all the people seeking help, I only wish that I could spend my lifetime towards improving their lives. I have on this block gained the exposure of being an OT like I’ve never experienced before as I discovered the drastic change from ward based and community based interventions. I discovered how unrealistic and almost unethical suggestions that I have put forward to patients previously as it is only in community which I discovered a persons true context not just of the individual yet the influence of a greater society on the person and their compliance. In community it is evident of the struggles people face, it strikes one as family plays a major role in a persons life and their acceptance or rejection of intervention. It is often where therapists question integration of OT theory and practice yet in community it is of a varied situation as I had began to question OT theory as holistic intervention in my belief goes against all theory to doing whats best for your client. 

It is often so easy to look at the surface and describe everything to appear normal however once digging deeper only then is it noticeable on the problems that one actually faces. This was the block that trained my assumption mind into an occupational science mind to question everything that is happening and to reflect on such not only in a community setting yet in my life as a whole as then only will the true essence of what is happening actually appear. I leave the community setting wishing I could stay longer as this as taught me life lessons which I had never thought I would question. I wonder have I become the scientists minion?.....yet if so what’s wrong with that I ask... as I will forever be grateful for the OT I become...- Directed at CC

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Is this really health promotion.. because I believe it’s beyond any word actually…What Are Your Thoughts..??

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The Room For Enhancement of OT Practice Within Community Settings...

Multiple articles explaining the role of Occupational Therapists in communities and throughout the field , include aspects such as; Advocacy, building community capacity and one of the given cited roles is Health promotion and prevention (Mitchell & Unsworth, 2004). ‘Health promotion is a prevention strategy that allows people to manage and improve their overall health status’ (AOTA, 2015). I as a practicing community based Occupational Therapist find myself in a predicament of the roles I assume within the community as in my believe and understanding, Health promotion goes beyond a mediocre educational approach and information sharing.

Health promotion acts as a framework to multiple spheres this includes; rehabilitation, maintenance, preventative and promotive roles. This however does not do justice to this widespread definition as health promotion varies from the largest to smallest acts this includes the mere communication or providing advise to a local person on the street about living better to providing OT intervention to a client on a weekly to even hosting large talks and discussions about living better. In my opinion Health promotion is OT and Vice Versa as isn’t OT all about ‘living life to the fullest’?. Through this definition the scope of Health promotion would enhance greatly from the few basic roles discussed above, as Health promotion is basically everything which an Occupational Therapist may do as the end focus of Occupational Therapy and Health Promotion focuses on the provision of meaningful occupations to promote healthier habits and client centered successful engagement in daily life which in turn acts towards the end goal of facilitating health and well-being across a persons lifespan (AOTA, 2015)

Being a final year Occupational Therapy student I am however faced with the dilemma of the effectiveness of health promotion. On various occasions, research and experience from previous community interactions, it is a common question posed if Health promotion is of any benefit at all (Scaffa,2001). In the circumstance of the community, it is often questioned as improvements are rarely seen, as it is difficult for one to take heed to a health promotional talk when some do not have the means to follow through with such instructions. It is the thought of a minor educational speech for example on the prevention of diabetes having to influence the prevalence of such within the community, yet also having the knowledge that many cannot follow a diet because they don’t have a choice of what foods they wish to eat due to their living situations. The sound of such initially sounded ridiculous and bluntly absurd, although as I enhanced my knowledge of community practice I began to realize that health promotion is not to target a population group having a specific diagnosis, or people with similarities or people who aren’t as they would classify it in hospital based OT practice as a “potential client”. To my expanded knowledge, it is uncertain of who would benefit from such health promotion practices however, it is also of uncertain of the problems which may prevent a person from living fully… It may not be depression or a disability which OT’s intervene in yet it might be teen pregnancy, relationship and family conflict or multiple other reasons as to why a person cannot live fully. This means that there is room for health promotion beyond disabilities and targeted OT population groups, as the goal of health promotion is not achieved in such circumstances whereby one is not living life to their full potential.

The vastness of Health promotion are yet to be discovered and developed  in multiple articles  and in the perspectives of many as many articles which I’ve researched continue to speak of home modifications, skills training and basic rehabilitation and intervention with the emphasis placed on disability (AOTA, 2015). Many of these therefore miss the component of health promotion which not only requires working with individuals with disabilities yet expands to the community as an entirety.

The role of media intrinsically links to a form of health promotion as with the world becoming a technologically advanced era, it is of a great resource by using the internet, websites and social media to promote health and well-being. Had it not been for research and media it would not be possible to even site such articles within this blog. The use of media makes a great impact on the enhancement of ones knowledge, although media as with all social networks have both positive and negatives associated with its use. It is seen greatly on online sites, links and you tube videos whereby as a final year student ethical considerations for a patient is of doubt. As with media, news spreads rapidly, however the positivism of such is lost in the fact that patient respect, confidentiality and ethics are of question. On the other hand media serves as a great platform to generate insight into our profession, to improve knowledge and aim to make us aware of recent and newly developed techniques and intervention strategies yet due to the lack of filter on media the trustworthiness and reliability of such is of the contradictory. This brings to my thought on the recent tutorial I’ve researched, indicating the positive aspects of ‘fidget spinners’ although to my agreement much of the articles and information posted within the media including social networks, online sites and newspaper articles, are much of a subjective belief which stimulates much doubt and debates among practitioners, imagine then..the extent of media influence on the thoughts of our patients who do not have the knowledge of the profession as practitioners do and their change in belief to aspects which may not be supported adequately.

In conclusion the additions to health promotion, and intervention in primary health care include the use of media as health promotion consists of a vast definition. Although the use of media as a form of health promotion can either be used effectively or abused greatly by many practitioners and patients as doubt is created based on their trustworthiness. Despite the negatives of media, as a modern technological advancement it is of utmost opportunity to make use of social media as a strategy to promote health however this should be used in a correct and trusted manner to allow for correct promotion of well-being. Yet my argument continues to stand as yet again I believe that health promotion is not contained to social media yet still goes beyond all boundaries which prevents providing an opportunity for people to engage in a life with has value, worth and meaning, allowing one to live in their best possible state.

Reference List

Mitchell, R.,& Unsworth, C.A. (2004). Role perceptions and clinical reasoning of community health occupational therapists undertaking home visits. Australian Occupational Therapy Journal, 51, 13-24

Scaffa, M. (2001). Occupational Therapy in community-based practice settings: Philadelphia: F.A. Davis.

Centers for Disease Control and Prevention. (2014). Chronic disease prevention and health promotion. Retrieved from http://www.cdc.gov/chronicdisease/overview/

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If you cannot influence ones negative and stigmatized  thoughts and beliefs then change is simply not evident- Humaira Khan

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Occupational Apartheid/Occupational Justice: Just “Fancy Terms” in the community life

Being a Fourth year Occupational Therapy student, in all honesty, when reading this blog topic I wondered what a political viewpoint of OT was inclusive of,  and how is this related to the community. I decided that nearing the end of my community block it is vital to research what OT political practice beliefs, views and thoughts were concerning. Upon racing through the 30-50 page articles I had come across the word Occupational Justice and Occupational Apartheid. I screamed with horror OH!!!! identifying one familiar word. I had remembered these terms discussed in first year and never spoken of again. I had never come across these words in the governance of community practices in the articles I’ve research so why then does this hold much importance in a political viewpoint to OT practice I continuously asked..

A main focus of Occupational Therapy includes the act of ‘doing’ or engaging in occupation including Activities of daily living as a means to improve, maintain or restore a persons functional capacity. The engagement in an occupation is however related to and influenced by space, facilities and resources which either permit or hinder specified occupational engagement (Pollard, 2013). This however is related to the political governance and laws which restrict possible meaningful occupational engagement and development. Many articles therefore argue that the role of Occupational Therapy does not only channel into rehabilitation aimed at restoring and adapting function yet should develop a new dimension focusing on social and political circumstances especially within a community context(Pollard & Sakellariou,2014). Often this lack of occupational engagement due to restrictions, brings about Occupational Injustice and leads to words such as Occupational Apartheid being unpracticed. 

The belief of Occupational Apartheid focuses on communities being deprived of occupational engagement due to social, economic, political or social status reasons (Kronenberg, Pollard & Sakellariou,2009). “The development of such restricted practices stems from the process of mis-recognition, or the stereotyping of personal identities into a grand narrative” (Fraser, 2000)

Within the community it is evident that such restricted practices are present. A thought which pondered upon me was, if occupational apartheid and occupational justice were to be maintained within the community why then is there no golf course or nursery in the community as this is usually built in more ‘affluent urbanized areas’. It is this very same stigmatized thought which restricts and limits peoples engagement in meaningful occupation. It is such thought which leads to the development of such unproductive, disrespected members of the community. Perhaps this golf course can lead to the “old men” who sit around, engaging in an occupation which may be meaningful to them, which may allow for their sense of enjoyment and their engagement in productive leisure tasks. It is possible that a nursery may lead to members of the community engaging in gardening as an occupation to allow for their products to be sold within the nursery thereby generating an income... Yet, I wondered why would this not be built in such a community....

This arrived at my thought of not just the stigmatized views of people yet the evidence of racism within the government and organisations which places limitations to occupational engagement. It is the view that “coloured” members do not engage in golf or gardening isn’t an interest of “Africans or Indians or any race for that matter ”. It is such a dimension of racism that restricts members of the community from developing and engaging in occupations which they may develop meaning in. Limitations placed on occupations are also related to socio-economic status and class (Pollard et al, 2014 ), specific occupations are regarded as those which are engaged by the richer and others by the poorer however this is of the incorrect believe as by doing so government may hinder potential prosperity, talent and growth of an individual which in turn leads to restrictions placed on a community as a whole.

In Occupational Therapy it is enforced upon one to provide occupation based ‘client-centred’ interventions yet I reflected on how this would be possible in a restricted and limited environment. How is it possible to provide and engage a client in an occupation which they may have an interest, meaning and value towards yet it they are unable to afford, lacks knowledge on how to engage in such or leads to unsustainable intervention due to limited facilities. 

This led me to me questioning what the role of Occupational Therapy would be within a community where such unfair political practices are occurring. Advocacy my mind immediately yelled as this is the first word that calls out when asked the role of OT within a community. Thinking realistically I arrived at the belief that even the role of advocacy will not combat the lack of occupational justice being provided within undermined communities. As how is it possible to advocate when members, government, communities and organisations continue to exist with preconceptions limiting their provision of space, services, facilitates and funding to such underestimated communities, thereby influencing communities motivation, knowledge and overall engagement in occupations which may hold value once engaged.

This draws to my final thought that as an Occupational Therapist we need to collaborate in working towards changing preconceptions of higher authority figures before attempting to change the view of occupations within the community members. It is therefore the role of OT which needs to include the scope and focus of economical, social and political perspectives when providing and analyzing occupations within the community.

Reference List

Fraser, N. (2000). Rethinking recognition. New Left Review, London, v. 3, p. 107-120

Kronenberg, F., Pollard, N & Sakellariou, D. (2009). A political practice of Occupational Therapy  ChurchHill Livingstone Elsevier. Sydeny Toronto.Retrieved from https://books.google.co.za/books?hl=en&lr=&id=sTgZvvi-MjgC&oi=fnd&pg=PT3&dq=political+practice+in+occupational+therapy&ots=ticBFDw_ai&sig=ogJLv8YPxXSeLUzhOp9l89h1kZM#v=onepage&q=political%20practice%20in%20occupational%20therapy&f=false on 12th May 2017

Pollard, N. (2013). Occupation in Occupational Therapy, a political perspective. Critical Appraisal. DOI: 10.13140/2.1.2509.3927. Retrieved from file:///C:/Users/Humaira%20Khan/Downloads/Critical%20Appraisal%20final%20no%20appendices.pdf on 12th May 2017

Pollard, N & Sakellariou, D. (2014). The Occupational Therapist as a Political Being. Sheffield Hallam University. 22(3), 643-652. Research gate http://shura.shu.ac.uk/8798/1/pollard_occupational_therapist.pdf on 12th May 2017 

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What Is a REAL Occupation? Is The Question To Be Answered...

Having a blog topic regarding an occupation and the engagement in an unfamiliar occupation, initially seemed of no difficulty or not as threatening as it may sound. My preconceived mindset thought it’s as simple as seeing people laying and making bricks and doing such just to simply identify how their occupational engagement differs from others. Why did I think this being an OT in final year!??  According to a variety of publications and research, “Occupation” is defined as employment or work which people engage in to earn their livelihood(Grand Valley State University, 2014 ), this goes to the extent whereby even Google recognizes occupation as a form of work. I however as a final year occupational therapy student... by this phase eventually gained the knowledge to be aware that in OT an ‘“Occupation” refers to any of the many activities people do on a daily basis that have meaning to them and "occupy" their time’(Molineux, 2003)...furthering into what we often take for granted is inclusive of play, leisure, self care, home management and the typical others..

In the above description, I began to wonder if my knowledge of an occupation was sufficient enough to decide on an unfamiliar one that I would engage in. This thought had developed from the small yet largely variable word ANY. This led to me questioning if an occupation was more than the domains of OT practice, beyond our areas of occupation and could this mean that an engagement in such occupation which almost “doesn’t fit in the category” means that it is atypical,... negative or what we usually term unproductive? Being apart of a larger community it is evident to see a variety of occupations that people engaged in on daily basis however I had discovered that although members may seem to be “Unproductive”, or “negative” as we describe it, surely this is still an occupation their performing..

I wondered if the substance abusers getting their drugs, going to sell them and obtaining their cash would then be classified as an occupation or for instance the crime in the community having been at an increase due to those who ‘hang’ around waiting for their chance to snatch a phone or anything which they can then sell to support their families or alternatively  pay for their kids education.. would such still then be considered as a negative occupation. I wondered for an entire hour or two and at the dire end arrived at my conclusion that one may not identify an occupation as being negative until they are aware and determine the reasoning for such ‘atypical’ or ‘abstract’ occupational engagement. 

As I walked past the influx of large groups around the corners, in pathways and staircases or in parked vehicles which had nothing but the stereo-player that worked, my mind repeated the known definition of occupation...any activity, something that they engage in which occupy their time..this led to me walking up towards a group of 4-6 males with no prepared expressions or words that I would even use when I approach them. At this point even the thought of my phone in my hand my fully resourced bag over my shoulder stroked not even a single muscle fibre with fear. It was decided that I would engage in an occupation which almost seems as though it cannot even be regarded as an occupation as I would engage in an occupation of what middle age men did the entire day...which is...nothing!! My initially impressed screamed out to me this isn’t even an occupation why couldn’t I just make life simple and visit the vendors and sell items, yet I was actually curious to understand what is meaningful about such occupational engagement to these men.

As I hung around with them, I initially tried to find the meaning in the engagement in such an anomalous occupation, until my realization that I would not find it meaningful because I’m not performing such everyday...it isn’t my routine or how my life was..For a day I spent ‘hanging’ around with them, I had developed enough rapport and mainly courage to pose questions to them. I uncontrollably asked so why do you’ll choose to engage in such an occupation which involves you having to do nothing or simply listening to music in a car for majority of your day...everyday??. I asked expecting the most obvious answers of ‘we are bored’, ‘there’s nothing to do here’ or ‘I’m simply lazy’, ‘I’m old’, ‘I’m unemployed what do I do?’.Yet, I had received none of the above, instead I had gotten the response stating, “This takes me away from all the violence, the fighting/shouting and screaming, the conflict of my son being on drugs, my daughter being pregnant at 15, my wife possibly having an affair and me being an alcoholic, being away from home and performing what I’m doing is what provides me with peace..”-Anonymous.

Therein did I discover the meaning in such occupation...yet my ‘no filter’ voice screamed why then don’t you engage in leisure?? such as playing a soccer match or a card game, or go for a jog, learn a new skill or garden, why chose to do nothing.. don’t you’ll have interests, meaning or values or just in bold HOBBIES I woundingly questioned. ‘Yes’ said the man who was content with sitting and gazing into the sky everyday and all day. He replied saying we do have interests, we do have goals, we have aspirations we enjoy engagement in tasks like what we do all the time..this right here!, which gives us joy and pleasure isn’t that the meaning of leisure he threw back towards me”. Definitely I responded...pausing for a good amount of time, gazing around thinking if that is an incorrect form of leisure as leisure in my knowledge is the range of items listed on an NPI Interest checklist, thereby thinking what is actually leisure?

Historically and currently occupational therapy regarded leisure as an area of occupation consisting of quantifiable and discretionary time, and included an activity used to achieve clients' targeted outcomes (Suto,1998). From this definition I gauged the agreement with my rigid mindset that such definition is an indication that the members engagement in an occupation which includes sitting on the staircase or in a car listening to music or just gazing around oblivious of most of their surroundings was actually NOT a negative occupation and it still allowed them to achieve their outcomes of relaxation and enjoyment and assisted them in developing their own forms of coping strategies to the problems they face.

From an occupational science perspective I still appeared confused as to how a lack of engagement in activities of daily living or instrumental activities or community survival tasks continue to be functional and of benefit. Researchers described occupational science as attributing humans as occupational beings as humans are described as having an innate need to engage in and orchestrate daily occupations within the duration of their lifespan(Clark., Frank., Jackson. & Yerxa,1990). This alone led to my thought that why then do these community members don’t present as these occupational beings... 

Rudman and Dennhardt (2008), discuss occupation as a basic need of all people, regardless of culture and indicate that although culture has an influence on occupation, there has been little critical reflection on the cultural underpinnings of central occupational concepts. Hocking(2012), draws the attention to the fact that most influential occupational therapy theories have been developed in urban areas of the English-speaking nations of the Western world which reflects only minority viewpoints. Occupational therapy and its relation to occupational science interventions could therefore benefit greatly from the understanding of the diversity of occupational engagement which would guide OT practice.

This brings me to my conclusion that after spending such time engaging in an ‘occupation’ which seemly presented as nothing, may continue to appear as unproductive if one does not wish to understand that occupations go beyond areas of occupation as we typically believed however, occupation is diverse thereby to understand such one has to understand the meaning for such engagement. Then only will such occupation be viewed in a different light.

Resource List

Yerxa E.J., Clark, F., Frank, G. & Jackson, J. (1990). An introduction to occupational science, a foundation for occupational therapy in the 21st century. Occupational Therapy Health Care. 6:1–17. Retrieved from; Taylor & Francis Online, [Google Scholar]http://www.tandfonline.com/doi/full/10.3109/11038128.2015.1083054?src=recsys

Rudman D,L. & Dennhardt, S. (2008). Shaping knowledge regarding occupation: Examining the cultural underpinnings of the evolving concept of occupational identity.;55:153–162. Retrieved from http://www.tandfonline.com/doi/full/10.3109/11038128.2015.1083054?src=recsys

Hocking, C. (2012). Occupations through the looking glass: Reflecting occupational science ontological assumptions. In: Whiteford G,E. Occupational Science. Society, Inclusion, Participation. Wiley-Blackwell. pg 54–66

Grand Valley State University, (2014). Occupational science and therapy .Michigan. Retrieved from https://www.gvsu.edu/ot/a-definition-35.htm

Suto, M. (1998). Canadian Journal Of Occupational Therapy. Leisure in Occupational Therapy. 65(5).Columbia. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/000841749806500504

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WHAT MAKES A COMMUNITY PRESENT THE WAY IT DOES...

Being a part of the community for two entire weeks I still feel like I haven't grasped the concept of how the community actually functions. In fancy terms I’m still attempting to grasp my footing into community before I can even try to provide meaningful intervention. In the two weeks I have however seemed to identify a varying degree of potential problems which the community may face however one in particular seems to strike me the most yet have no particular effect on the community members which led to my occupational science thinking asking myself why does it bother me so much yet when asking community members they seem to have no concern relating to the issue of DUMPING and LITTERING throughout the community.

As I looked like a tourist with my hands full of items which I was carrying for my home visit I still made the space to hold the renowned Zulu burger in my hand, to my regret the usual terror dogs were around leading to me simply “making a run for it”, I had dropped my Zulu burger which I anxiously awaited to take a bite of...After I took a few deep breathes and looked around me to ensure that ‘scruffy’ was no longer behind me, I felt my guilty conscious engulf me as dropping my burger on the road may have led to me being a part of littering. Going back to pick up the now ‘rubbish’. I viewed a large pile of litter just dumped around with a smell almost unbearable and impossible to control my gag..I could not possibly pick up all of the litter but I surely picked up my small cling wrapped, crumpled burger to throw into a bin as if that will make some difference to the community appearance.

Proceeding to my home visit, I looked around for a bin and to my horror there was no bins in sight! I performed my home visit, throwing my rubbish into the bin of my clients home and felt the desire to ask my client ‘where are all the bins?’, she responded asking’ what for?’.. My mind searched for a critical reason and all I could conclude to was the most obvious… “To throw my dirt of course’’ I replied, she giggled and responded by saying ‘OH! just throw it were all the litter is, I’m sure someone is responsible for picking it up’.

As part of my community practice and provision of successful occupational therapy intervention, I presented confused as to what my role in the community with be in this regard. Do I just engage in the advocacy role of providing bins?? , as an OT role in advocacy is to make use of services to promote health and wellbeing within the community (Dhillon, Law, Stewart, Tremblay & Wilkins, 2010). Speaking to the municipality regarding the provision of bins within the community would then allow for my OT role complete, yet I wonder if that will even assist the community in promoting a healthier environment as being within the community I had noticed the lack of empathy and demotivation of the community member in their involvement towards betterment of the community. Using the occupational science perspective (Whiteford & Hocking) I still could not come to a conclusion regarding why members of the community often reject those who attempt to provide change within THEIR community for a healthier environment for THEM! As a positive and healthy environment is known to improve community cohesion and engagement (Popay, 2006), thereby adding meaning to their involvement and role within the community as an entity. The perspectives and attitudes of the community members is something which I personally believe cannot be learnt without being one of them and being imbedded within the community to understand why they reflect such behaviours. In relation to the provision of bins I had noticed that the inherited practices of the community members are that which prevents them from taking initiative to perform tasks independently which will advocate and allow for their better living. ‘Inherited practices’ relates to the exact quote of my client stating that surely someone is responsible for picking up the litter, though community members fail to realize that not only is it their litter and therefore they should ensure correct hygiene principles but it is their community and they should be responsible for their own actions. I then arrived at my thought which guided me to provide not just any intervention but the key word of ‘MEANINGFUL’ intervention to community members. As according to Wallerstein (2006) a person may only value an item or object when they play a role in achievement of such. The provision of bins will therefore not provide any intervention but in turn promote only the negative development of further inherited practices.

As I critical reflected on what I as an OT can assist with rather than give to the community, I had arrived at my conclusion that my role would not be confined to promotion of bins rather to educate the community on what impact the litter can have on community members health. How this will affect their offspring’s who play and walk around the heaps of litter in every street corner and every drain. Although this is aimed at improving the community through the realisation of them requiring change and needing bins, the thought of how this is not of a concern to community members was a bigger concern to me. This linked to my knowledge that often community members reject health care practitioners, NGO’s and even their own internal community members who seek to influence a positive impact on the community as community members lack the education regarding community based practices and the role of the multidisciplinary team within the community.

Ultimately to conclude, it is vital that change or the motivation to engage in change develops from within an individual. As an OT in community practice it is a lesson to be learnt that one should not become the circle of inherited practices as it is a common trait of community members to easily become dependent on health care practitioners…just because that is how the system always works…Therefore as an OT practicing within the community for the past two weeks I have learnt that, “Successful intervention does not include providing change yet promoting for change” Humaira Khan.

Resource List

Aromataris, E., Brown, A., Davy, C., Gibson, O., Kite, E.,Lisy, K., Lockwood, C., Riitano, D. & McBride, K. (2015). Enablers and barriers to the implementation of primary health care interventions for Indigenous people with chronic diseases: a systematic review. DOI: 10.1186/s13012-015-0261-x

Dhillon, S. K., Law, M. C., Stewart, D. A., Tremblay, M. & Wilkins, S. (2010). Advocacy in Occupational Therapy: Exploring Clinicians' Reasons and Experiences of Advocacy.  Canadian Journal of Occupational Therapy 77(4). 

Popay, J. (2006). Community Engagement, community development and health improvement. A Background Paper prepared for NICE.

Popay, J., Povall, S. L. & Whitehead, M. (2007). Community engagement in initiatives addressing the wider social determinants of health: A rapid review of evidence on impact.  Retrieved on 26th of April 2017 from Research Gate: https://www.researchgate.net/publication/242611483 

Wallerstein, N. (2006). What is the evidence on effectiveness of empowerment to improve health? WHO Europe, Health Evidence Network

Whiteford, E. G. & Hocking, C. (2012). Occupational Science: Society, Inclusion, Participation. New York: Wiley-Blackwell.

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OT beyond the preconceived thoughts of being mediocre

Initially when someone asked me what a community is, I would respond with the same dictionary or Google like description on every occasion,  stating that ���community is a group of individuals who share the same values, beliefs, culture and other commonalities’. Before entering the community I preconceived my definition of community as being quite accurate as my typical, one track thoughts screamed this is what we discussed during community orientation week or this is what my notes say...however did that just provide me with a negative perception of community or did this actually assist me in understanding what a community is...?

‘A community is a readily available, mutually supportive network of relationships of which one could depend’ (Sarason, 1974). Entering into the community, I realised that here I was already entering with a stigmatized, untrained and preconceived mindset of what community actually was as the community distinctly did not present according to the above definition. Living in our own communities we may claim to have no similarities to our neighbours or no commonalities in general other than sharing the same living space. This linked to my current view of how absurd was I to brand and actually stereotype by assuming that everyone in the community would share the same values, attitudes or belief system! Within this first week I have already seen how different each person in the community is as what may be meaningful to one member of the community may be seen as “a waste of time” to another.  This therefore led to my thoughts of needing to provide intervention across multiple domains such as creating and sustaining multiple projects which not only seek to provide care and empowerment to a group of people yet to serve to enhance a positive influence and view of the community as an entirety.

Contemplation consumed my thoughts like the ocean consumes, tosses and flickers a tiny stone around, as week 1 had passed with me contemplating my presence and role in the community. Yes, I’ve read those books about what is the role of an OT in community practice. I’ve heard about ‘building community capacity’, the role of advocacy and health promotion, the enhancement of interpersonal relationships and the rest of those “fancy” roles yet I sat in the community library wondering if I could find some set and stone book that could possibly inform me on what a single individual like I can do to make a difference in this entire community!?! What difference my presence could make to all those wonga addicts who have no jobs or women who are abused in their homes or children/adults with disabilities who are locked away in their houses or the teenage girls who repeatedly are pregnant and no one knows why they can’t just make a correct choice and all those other individual problems within the community such as lack of housing, the demand for proper sanitation facilities, general municipal upkeep  or the basic human need for water and electricity to some houses. Do I then just engage them in what OT’s do best...OCCUPATION, as Wilcock (2006) suggests that ‘occupation provides a mechanism for social interaction and societal development and growth, which forms the foundation of community’. Yet, I still wonder.. what I will do to impact and influence all those community members lives in order to better their lives. I wondered if I should just start talking to people to NGO’s, the CCG’s, the municipality or go door to door signing partitions for what these people claim to be their biggest prioritized need or what should I do to make some positive impact on the community not just for 6weeks yet inform an impact that affects and allows for long lasting positive transitions of the communities views.

A thought then struck me that no matter how much one may attempt to impinge on change there will always be a problem which remains and that may always influence and become problems to others and it may continue to occur because what if members of the community are just fixated on such views of how their community has always been and believe that this is THEIR community, this is what community is exactly about. There may not be functioning effectively or collaboratively, not have the same goals or vision of their community or not have the same experiences which govern their thoughts yet this does not take from the fact that they still remain a community...and that is exactly what a community is about, not my initial thought of it.

The term inherited practices screamed out to me upon the first week of interacting with the community (and not even the full community..) as it is exactly as described above whereby the community members will always have problems as they themselves lack the innate drives to make a change for themselves and their community yet depend on others to do this for them... Why so??..because that’s how the system always worked... So the next question almost impossible to avoid from popping in my mind was do I as a single OT then attempt to change the system!?.. .in just 6weeks!

I arrived at my conclusion of my thought that no amount of time or intervention provided to the community will allow for those UNrealistic words like UBUNTU and togetherness to occur as the desire to affect change in ones community or life ultimately develops from within an individual however I as an OT is present in the community to assist the development of such desire and thought of making a change. ‘Occupational therapy community interventions move beyond the individual treatment of a client to working on systems that affect the ability of an individual to achieve community goals’ (Brownson, 1998, p.61).  Although change comes from within, change is also influenced by the majority, where as in the case of many communities, the majority considers the community as being negative and having may issues and problems making this a rife and unstable community with a lack of togetherness, however perhaps UBUNTU is not so unrealistic as all it takes is a small doubt of how one is currently thinking,  as according to Albert Einstein, ‘we cannot solve our problems with the same thinking we used when we created them’.

[thehumikposts-ot]

“The most valuable lessons aren’t learnt....their EXPERIENCED”

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So close....yet never close enough...

“Live as if you were to die tomorrow. Learn as if you were to live forever”- Mahatma Gandhi

Yes it’s that blog. That one which I told my friends I can’t wait till we are required to write...That one.. (pointing to the title, CLOSING BLOG with an immense smirk of anticipation)....well this is it!!! It’s finally the end and i’m not shy to be that outlier saying I am entirely glad.. as this has been one long and tedious journey for me. I began this prac block with fear, anxiousness yet still containing excitement however at the beginning I had pictured this long (very long), winding and unsteady road containing bumps, knocks and tons of pot holes which often required help to be pulled out...a road where the end was not even within once sight but surely was within my vision.....

This block had been disrupted greatly by the tons of activists we have at university which hindered my momentum and fuel to keep on driving as this made me lazy leading to me taking breaks and choosing to take the longer alternative routes (If you know what I mean...procrastination). This slacking nature experienced led to a question at large... Was I even making a difference...Did I?...For the time with my client did I give him something to make his life more meaningful??.. This was the greatest doubt and mind boggling thought I had throughout finals. This however served as a motivating factor to pull myself up together, picking up the broken pieces of my car and head on down this road.

Within this journey there was however many rewards of actually going down this route..I’ve picked up many pedestrians (clients) who have taught me not just my handling skills and skills of being a better therapist yet, they had made me understand the meaning of life..the value and how much one should actually appreciate what life offers which will not only help me in my journey to becoming an aspiring OT but has made a difference to my life as a person.Along this road I’ve also tried to drop of such pedestrians but was unable to. Within this prac block the I’ve experienced (still do) the feeling of attachment which makes it now difficult to have to leave my prac venue as I know that there was so much more meaning I could of added to a persons life yet could not due to time constraints.

Nearing the end to this very last blog ...I present with re-mincing thoughts of the past...yet the hope still glimmers due to the thought of having just completed my last prac block for the end of 3rd year which I will never again get to experience. In conclusion.. as my title states that as much as I’ve learnt from the block I believe that learning is never enough as I’m yet to learn and develop as an aspiring OT (Fourth year...might I add)---Hopefully. I will however carry this thoughts, feelings and lessons learnt and apply this to next year hoping to improve as an OT for the sake of the clients and challenges I’m yet to encounter....

PS: This is an original humik blog....(Attempting to lose my title as “The Plagiarizer”)

[thehumikposts-ot]

The Jar of Life

As the above picture describes...not only an individual, a group of people, a race, an entire population, a city, a country, or a province is trapped in a jar as the entire world and earth is enclosed by a jar.

According to a professor, he described the jar of life containing all those important and meaningful aspects of life close towards him within the jar. Whereas all the small things in life which influence the important aspects are outside the jar. He also used golf balls representing the most important things of life, pebbles which were the other smaller things which still made an impact on ones life, and sand which were the remaining things which may or may not make a difference in a persons life. His philosophy was used in order to describe peoples priorities in life.

To me, the jar of life is a restriction and limitation to allowing a person to live fully. It is almost an entrapment telling people that they should only live within this enclosed space and not go beyond. In my opinion within the jar contains all the people who are living just as I do which makes almost everyone as we are all in some way restricted from living freely. Whilst external to this very jar lies politics, society, norms, social status, stigma and stereotypes, rules, standards, expectations, religion and culture, discrimination, deadlines, routine and more....as the list never will end as for each person this may differ. Lying outside the jar are all those things which govern a person and transform the person into learning to live within such a jar.. , even if it is not their choice. The jar is what makes people doubt their freedom, not making their voices been heard and not letting people know how they feel, as people are so accustomed to living within a confined space that they are afraid to go beyond. Many people live this routine life, going in the circling the circumference of the jar daily as they are afraid to free...,due to us being living within a jar our entire lives. We are all in some way limited and restricted from living the way we wish as we are governed by laws and rules which prevent the “freedom” which we are claimed to be given.

However, in relation to the theory it is entirely hard for me to prioritize as the factors lying internal and external to my jar of life are never consistent. As time passes different elements enter and some unfortunately exit my jar of life. Currently my jar is filled with the stress of being a student whilst lying external to this is the lectures, rules, expectations and deadlines which influence and bring about such stress. Within also contains my family, friends and religion as without the pebbles of needing to clean my room, study and going out with my friends, my life would still remain as full. Life however is something that has no boundaries in respect to what or how much the jar can fill yet it does have boundaries to the extent in which ones life can be lived.

Being an OT student, to me it is of high significance to always consider what your clients jar of life may be in order to provide true and holistic intervention AS AN OT!. However, whilst needing to consider this for others OT students are also faced with having to consider it for themselves without losing focus of their own jars leading to them breaking. At the moment the typical description of my jar would be that of one which is completely cracked and shattered however it is still held firmly together. This indicates the need for me to break free from such a routine lifestyle of books and studying daily however the jar still remains firm as it is almost impossible to break free from the jar as one will then have to consider if their even living because, isn’t this just what life is??(Seeks a response)...

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Linking All this Theory Into Practice...

When asked to read articles whilst you’ve got the entire world on your shoulders..no exaggeration as I am after all an OT student. Lets be honest, we feel as if whats the purpose of reading such articles, what gain and benefit is it to me and the one that we all can’t deny is that lecturers just don’t have anything else to make us do..That’s exactly my feeling right now as I have to write this blog whilst I have a load of other work to complete before the end of this weekend. I actually enjoy blogging as it takes my mind away from all the work load that we have and gives me a space to just spill out and vent and currently I feel like this has just become another work task. 

That was before reading these 2 articles of course!!!..

The first article I read was regarding client centeredness (Sepusha,K):What is person centered care and why is it important?. 

This article explained that client/person centered care meant considering the client however, that would mean that every health practitioner is client centered so what then makes us OT’s different. I’ve learnt that for an OT client centered does not mean considering the client in respect to what is needed in terms of intervention relating to his diagnosis however, it is way beyond that. Client centeredness means to consider the persons goals, their values, religion, culture, meaningful activities, their interests and mainly THEIR LIFE. It is about considering what matters to them and not just the therapist, irrespective of what therapist may consider has important, it is what the clients goals for intervention are which improves aspects such as their motivation, willingness, mood and allow for actual intervention to be provided. It basically states that one cannot engage the client in tasks that are not within his interests and thereafter further assess the client as been non-compliant, having decreased attention and motivation as this would mean that all of the above assessment findings are false due to a simple yet broad term such as “CLIENT CENTEREDNESS”.The article further makes mention to client centeredness does not necessarily having a direct aim, specific structure or principle as there is no one definition or set barriers which determine if a person is considering the client holistically or not. 

So getting back to the concept of client centeredness, if the therapist considered the clients values, desires, lifestyle, social circumstances,involving family members and considering the person (Holistically)-Famously used OT term..what then is the importance or significance of such??. Being client centered will allow for a proper assessment to be conducted thus ensuring that the hours spent searching pinterest for creative OT activities does not actually go to waste as it makes some difference geared towards the positive. It assists in providing greater insight and knowledge into the client to ensure a firm understanding of the clients underlining internal feelings adding to their diagnosis and presentation and lastly its to allow the clients to have a say, to let them make decisions regarding the care of THEMSELVES, isn’t that following the ethics of Autonomy. Therefore, to end with article one, it is brought to my attention that not been client centered is not a “by the way approach” but rather it determines whether one is actually performing their roles of their aspiring profession. In summary: “Client Centeredness is about doing things ‘with people’, rather than ‘to’ them.”-Humaira

Moving on to my second article titled; The effects of INSTITUTIONALIZATION (Rich, F).

This article focused on the impact of institutionalization particularly in people with mental disabilities residing in asylums. Imagine your daily lives filled with people telling you what to do, “Go eat now”, “Take a break now”, “Sleep now”, “Don’t read now”, “Pray only on Sundays”, “You can only bath once per day, no longer than 15 minutes”. As harsh as it may sound, these are just some of the descriptions of what institutionalization actually is, as my above article mentioned the importance of client centeredness, institutionalization completely disregards the aspect of intervention surrounding the individual. This creates the client in an un-stimulating and involuntary habituation which results in occupational imbalance along with occupational deprivation which in turn in OT limits the clients active engagement in occupations which were once meaningful to them. Due to this imbalance many clients live at a state of disharmony(Mention to the fact of integrating the PEO-P model used in OT), which commonly results in clients developing further co-morbidities mainly that of a depressed mood, negative attitude, aggression, depression, lack of motivation and decreased esteem, hence further impacting the clients ability to function as he is expected to. The article makes mention to the large stereotypes and stigma attached to people with mental disabilities relating to them belonging to an asylum, which a once functioning independent individual becomes forcefully converted into the dependent incapable individual who usually says “I pay them, they must do things for me”, whilst that very same person remains inactive for more than majority of their day allowing their minds to ponder on why they have been abandoned leading to often delusional explanations as means of compensation.

According to Barton (1960), the term ‘Institutional Neurosis’ was defined as institutionalization resulting in apathy, lack of initiative, submissive to authorities, lack of interests and most importantly the loss of individuality which he stated resulted in the clients deterioration rather than their reason for placement been that of improvement. In conclusion this article has taught me the role of OT in respect to preventing institutionalization by using a mere painting or joyful activity (Which an knowledgeable eye sees as pointless), as means to allow an individual to remain themselves. “The less routine, the more life”- Amos Bronson Alcott

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Research Day

Been given the opportunity to be present at the research day was an honor especially since we got together as a class to actually host the event, however the waking up really early to have to catch the bus at 7am in the morning...I’m not quite sure how excited I felt about that part!...Arriving at the venue I would definitely have to say that I was completely shocked regarding the size of the venue (It was way more smaller) than I had imagined. My imagination expressed a huge setting with tons of clinicians, facility managers, parents, students across discipline and adjudicators (Probably more than 3) sitting along a large panel of critics, however this was none of the above. The room was fairly small a few parents, students and supervisors, making my mind scream these are all familiar people though right? There’s no need or nothing which could possible make one anxious or nervous...

Little did I really know..(my preconceived assumptions were completely wrong..-something quite usual). As I approached the front I felt the anxiety build up, its that moment when its quite hot yet you are the only one shivering, your teeth chattering your hands trembling...and might I had the feeling that you need to use the bathroom at that very moment was exactly how I felt to be purely a clicker for the 4th years presentation. Just merely clicking to the next slide yet feeling so much anxiety made me realize that this is very threatening indeed and anxiety was one of the things I really had to work on before its my time next year..

Not forgetting to mention the questioning which some even listening to them made me doubt if English is actually my home language as I could barely understand their meanings which scares me even further for next year. Getting to the actual presentations I was quite inspired by many researchers starting with their uniform dress codes relating to their research. Many of the presentations differed greatly from each other which allowed me to discover what presentation styles actually work and not for our future. Many of the presentations also related to me yet my main concern was regarding the presentation expressing the barriers to physical recreation, as this will be the research topic we follow up on. Listening to the barriers experienced and their suggestions/recommendations for the future follow up of this research provided me with a great insight into where to pick off from the immense and outstanding research do by the 4th years.

Much of what was learnt was by observing and listening to the various criticism given and the questions posed. Looking at the different presentation content, styles of presentation and appearance. This day was in particular inspiring for me as I was not only able to experience and learn through the little points I scrambled to remember and note down for next year but it was particularly motivating when looking at the faces of the fourths after all had been done with them been labelled as now qualified OT’s nearly finished with their training process. As I sat along with a group of friends reflecting on the day whilst hearing the pop of Campyne by the fourths in celebratory of their almost completion. I described myself as been at the bottom of a huge mountain with the fourths above and added of course my supervisor in the middle saying cmon I’ll help you along to be as high or higher than the fourths are now, but me and my little research group at the bottom contemplating if we should keep climbing or if well ever be able to reach the top...

This however led to my final thought of conclusion as a wise lady once said: “To make a decision about what to eat, is considered a research..”- Mrs J McIntyre. This has led to my thought that research just isn’t about doing it to obtain your degree but in actual fact its about adding to a larger body of knowledge which will in turn lead to further discoveries and in an all make some difference...maybe not to the world but it definitely will to some individual people within this world. Which in lay terms expresses myself as saying “BRING IT ON RESEARCH 2017″

[thehumikposts-ot]

“Judging a person does not define who they are....yet it defines who you are”

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Invited Speakers Left Me Thinking...A little Too Much

”Lets be honest as most students often do not want to drive all the way to varsity to hear some peoples lived experiences when the youth could be making their own in that time right?. That was just some of my thoughts as I entered the room.. late as usually as it cant be that important the famous bell loudly rang that its not examinable so why waste my time.

Arriving into the room after disrupting an entire row of people who had to move their chairs to let me sit on the side I wanted to so I can “incidentally” slip into my instagram, I sat down taking a very first glance at the speaker in the front and saw tears...not just rolling yet racing down her cheeks. Been the same cold hearted student I decided to listen to her not because I may have cared yet the wifi in the room was poor so I listened as she spoke.

Her speaking and me listening could of been one of the most important decisions I had decided to make as should I have not listened it would truly have been my loss. The speaker belonged to a group called the Compassionate Friends, which was a support group aimed to help people overcome a loss. She began by losing her son at 19 years old due to a car accident. As sorrowful as it seemed I kept thinking there’s many Mothers who lose their children or lose valuable things daily. She further explained how 2 years later she had lost her daughter at the tender age of 16 years in a stampede which led to a 360 turn in my thoughts of how is she even living life, before she later threw out the loss of her husband just 6 months after she had retired with the hope like many to tour the world and perhaps just LIVE...

Upon her retirement she was faced with been told that she was seen to have a brain tumor..so much for touring. She now remains after an operation with a current stent running from her head down into her neck. She lives with her eldest son, oh which I forgot to actually mention was in hospital during her recovery for a drug overdose leading to multiple organ failures...

And this very same women is still standing and was still able to address just a few students who might forget her story seconds after they exited the venue, yet fortunately I was not one of them. Listening to the womens story made me realize the true essence of living. Much of how we present, what we engage in and how we feel is linked to what we wish from life. It had taught be to be appreciative for all I have as complaints do not help one to realize that others are faced with worse. Looking at this women, one would never think that she’d be LIVING the same yet different life. This has motivated me in terms of my profession as often we forget the reason for living as students we live for what we wish to obtain out of life and out of the future. It has helped to constantly remind myself the struggle people go through to just merely LIVE which makes you think twice before giving up on someone....correction makes you never give up on giving a person a meaning to live.

Although this was the highlight of my day I also enjoyed the Critical Psychology speaker as he made me think so deep to my existence in this world. He reflected on how a persons identity is governed predominantly by their existing power structures such as society, environment , social media and many others.This made me question peoples response and reaction to aspects of living, such as why people reject things or why do they even react to things. This had spoke to me in reminding me to always “DE-Contextualize” an individual to gain insight into a person whilst never forgetting to consider the contextual factors which influences their identity.

Lastly we were spoken to by a lady....an extremely scrawny, bony and to be specific a 35kg, 55year old lady!!!! Listening to her speak triggered my guilty conscious with every word as my mind, narrow as a funnel could ever stigmatize her for something beyond her reach. The speaker was one of many who was diagnosed with anorexia at the age of 14 years old and suffered from this condition for 40 years. 

“Anorexia, is an eating disorder characterized by a low weight, fear of gaining weight, a strong desire to be thin, and food restriction. Many people with anorexia see themselves as overweight even though they are in fact underweight”

The women shared her lived experiences, which I couldn’t understand why people would actually self induce a horrible feeling such as vomiting only to look beautiful to herself only if anyone..She discussed how its linked to obsessive thoughts, self esteem, major depression and disruption in her life in terms of relationships, divorce and lastly isolation feeding into death. She described her feelings and dedication to things beyond her control which in essence reflected how strong she actually is. This left me to think that ;... “We live in a world, where judgement is more important than getting to know the person”, and this day made me realize that I’m going to question critically this statement and decide to be the activist saying that I do not wish to live in such a world.