themindofaconflictedrebelot

[themindofaconflictedrebelot]

Occupational therapy into the community: lets talk primary healthcare and the media.

So many people don’t fully understand the role of occupational therapy within primary healthcare thus resulting in people not knowing about the services that occupational therapy offers and this, in turn, leads to complications within the community that could have been avoided.

The role of occupational therapy is to work within and with communities and families to promote occupational performance and prevent complications, deformities and illnesses. Through the use of the client-centred approach and treating clients holistically, occupational therapy has a unique role in addressing health behaviours that to enable the clients to work together with the occupational therapist to promote function and find ways to treat dysfunction (Dahl-Popolizio et al, 2018). Occupational therapy works with problems that affect our client’s health using activities and occupation-based strategies that work within the client’s context and environment and keeping in mind their performance patterns and spirituality using a holistic approach which ensures that occupational therapy has a vital role in reaching the goals of the community as a whole through primary healthcare settings (Dahl-Popolizio et al, 2018). One of the most important roles of OT is addressing an increased majority of personal health needs of our clients that can be associated with a decreased occupational performance in their areas of occupation; namely, their activities of daily living, instrumental activities of daily living, rest and sleep, education, work, play and leisure, and social participation (Metzler et al, 2012). To promote function in these areas we may have programmes such as functional mobility that improve engagement within the community and community integration, for example, enabling clients with physical impairments that lead to them being unable to walk to improve their ability to mobilise within their community with the use of a wheelchair. We also can provide lifestyle and environmental adaptations to promote function such as with one of my client’s we had to adapt his home environment to allow for wheelchair accessibility in the process of working towards enabling him to be more independent in mobilising with a wheelchair within his home environment and hopefully within his community. Medication incompliance is another reason that individuals have a decreased function in their areas of occupation, and occupational therapy plays a vital role in medication management to prevent loss of function and other complications (Metzler et al, 2012).

Google, (2020): The figure above represents the different aspects of occupational therapy in the primary health care sector. 

  Within communities, there is a wide range of chronic conditions that affect function, and occupational therapy works towards using programmes and approaches that work towards improving and maintaining function in areas of occupation by influencing the multiple factors that affect occupational performance. We also help with preventing complications that will negatively affect independent functioning in persons with chronic conditions namely; SCI, CVA, and cerebral palsy (Metzler et al, 2012). Occupational therapy provides programs that highlight the importance of occupational participation in mental health and these programs can improve the functioning in clients with mental health illnesses (Trentham et al, 2007), and enable them to cope with these illnesses and fully participate in their areas of occupation.

Occupational therapists work towards promoting health and advocate for their communities and their clients so that they receive the necessary interventions that they require to function to their optimum levels (Wood et al, 2013). We have a role to find out the needs of our communities and our client’s and seek the necessary for them that they need if we are unable to help them in efforts to promote their occupational performance and also empower these communities to fight for their rights within the health care sector. We make use of collaborative and interactive approaches in us providing health care services, to enable a wellness orientated approach, with the use of the strengths-based approach as we make use of the strengths of the community to enable them to improve their occupational performance (Wood et al, 2013).

Google, (2020): This figure symbolizes the use of media in occupational therapy health promotion and prevention and OT’s as health advocates.

For the community to be able to access these services people need to know how to get a hold of us, they need to know that we offer these services and in this comes in the media. In the primary health care setting the media plays a big role in health promotion as it provides an increased opportunity for the promotion of health in the society, allowing public health professionals to influence a wider audience and more health issues (Gupta et al, 2013).

Neiger and colleagues (2012) stated that there are five comprehensive aims for the use of social media in public health within health promotion and health prevention. To interact with clients about the occupational problems and difficulties that have in their communities, what are the barriers and conditions that impend their occupational performance. To establish and promote occupational therapy programs using online platforms. To distribute important information that may help prevent disability and an unfit balance between the person, occupation and environment and enable people to know that the correct channels and health professionals that they need to reach out. To increase the spreading of critical information in larger and more diverse viewers and listeners to address common issues that we have in our communities and educate clients about ways to enable them to live healthier lives. And to enable public engagement in the provision of primary health care services working towards reaching their needs as communities and forge partnerships with clients to enable better service provision.

Take the radio station in the community that I’m working in, for instance, this radio station has been used by the students from previous blocks in the community to access the community at large and educate them about the occupational therapy services provided at the park by the students and how to go about seeking occupational therapy services. This allowed them to reach a wider audience and for the community to know that there are services offered to help them with the problems that they have that impend function and cause a disruption in their occupational performance. This is of vital importance because a lot of people in our communities do not know that there are such services offered to them and they don’t know how to go about getting assistance. Most of them stay at home and do not engage in the correct programmes to enable function and thus the occurrence of complications such as contractures, pressure sores and other illnesses that further impend function.

Neiger and colleagues (2012) state that the media is not a factor in behaviour alteration or enhanced health statuses in healthcare but Gupta and colleagues (2013) state that the media is a  communication advantage for public healthcare that has the likelihood to encourage and alter many health-related behaviours. I agree with the latter because media plays a crucial role in health promotion and giving people the necessary information that can enable them to change risk behaviours once they know the effects of engaging in such behaviours. Part of health promotion and prevention is giving people within communities the necessary information to prevent disorders, illnesses and impaired occupational performance. Using the media is a way of reaching a wider audience to inform people and in this way influencing their behaviours.

It is sad how we are in 2020, in the 21st century and still, our role as an occupational therapist is hardly understood in the community and primary healthcare. It’s a pity that we even have to have to explain to other health practitioners what our role is in primary healthcare. So, this is me educating and advocating for occupational therapy as a profession. This is us; this is OT in the primary healthcare sector, this is us in the communities and this is how we use media to help us help our communities through health promotion and prevention. So, my question to you is, do you still not see the importance of occupational therapy in the primary health care setting?

References

 Dahl-Popolizio, S., Doyle, S., & Wade, S. (2018). The role of primary health care in achieving global healthcare goals: Highlighting the potential contribution of occupational therapy. World Federation of Occupational Therapists Bulletin, 74(1), 8-16.

Google (2020). Retrieved 2 October 2020, from https://www.google.com/search?q=primary+healthcare+and+occupational+therapy&sxsrf=ALeKk030V1INNO1X7H-3hM6bE5XmDyVTAQ:1601662095066&source=lnms&tbm=isch&sa=X&ved=2ahUKEwig1eehwJbsAhVIQUEAHUgrAdwQ_AUoA3oECBYQBQ&biw=1242&bih=597

Gupta, A., Tyagi, M., & Sharma, D. (2013). Use of social media marketing in healthcare. Journal of Health Management, 15(2), 293-302.

Metzler, C. A., Hartmann, K. D., & Lowenthal, L. A. (2012). Defining primary care: Envisioning the roles of occupational therapy. American Journal of Occupational Therapy, 66(3), 266-270.

Neiger, B. L., Thackeray, R., Van Wagenen, S. A., Hanson, C. L., West, J. H., Barnes, M. D., & Fagen, M. C. (2012). Use of social media in health promotion: purposes, key performance indicators, and evaluation metrics. Health promotion practice, 13(2), 159-164.

Trentham, B., Cockburn, L., & Shin, J. (2007). Health promotion and community development: An application of occupational therapy in primary health care. Canadian Journal of Community Mental Health, 26(2), 53-70.

Wood, R., Fortune, T., & McKinstry, C. (2013). Perspectives of occupational therapists working in primary health promotion. Australian occupational therapy journal, 60(3), 161-170.

[themindofaconflictedrebelot]

Is the sustainable development goals for my community the same as for your community: come take a drive with me on a goal setting journey?

When using appropriate and context-appropriate sustainable development goals, they show us the importance of considering the needs of the clients within a community and the community but also looking at the needs of future generations and environmentally sustainable best ethical practice and intervention implementation within different communities (Jenkin et al, 2016). For the community I saw the need to implement these five sustainable development goals; namely, good health and well-being by promoting healthy lives and promote well-being for all ages (SDG3), gender equality is a human right and is vital for a peaceful, prosperous world (SDG5), peace & justice (SDG16), decent work and economic growth (SDG8), and Education (SDG4) as a way to help to improve their livelihoods and work towards a healthy community. Even though the broadness of sustainability makes it difficult to understand as a comprehensible whole, and focusing on some aspects, while realising their interdependence with others, maybe fruitful for occupational therapy (Wagman et al, 2020).

Google (2020).

Good health and well-being impacts all the others SDG’s and from my primary focus would be at implementing this goal within my community as health is the basis for engagement in life’s most treasured areas of occupation. Using the famous definition of health by WHO (2015), health is a complete physical, mental and social well-being, and it is not merely the absence of disease or infirmity. Most people due to their condition be it mental, physical or psychosocial related difficulties are unable to live their lives and engage in their most valued and age-appropriate areas of occupation. Working in this community has shown me that there are so many people that may seem “healthy” from afar but once you get to know them you get to understand that they are not well in different ways apart from the physical aspect. For example, one of the clients that we saw at the clinic and during the health promotion talks and as we were trying to get to know and see if she or someone close to her needed occupational therapy assessment and intervention, she then opened up to us after we told her that we work with mental and social issues too and not just physical difficulties, she then explained how she feels so scared of being a mother and how her child’s father left her and she is even contemplating terminating the pregnancy, she went on to tell us how the whole pregnancy has negatively impacted her life. And we wouldn’t have found about all these problems if we just assumed that she was fine because she physically looked fine. So as an occupational therapist we look at a person holistically and this way we can promote good health and well-being. And this is an approach that is wildly required in this community because there is are a lot of community members that look healthy from afar but you need to dig deeper and find out their difficulties so you can bring about a complete state of health within the community and with all persons no matter their age.

Google (2020).

The next SDG that needs to be implemented is gender equality is a human right. I’ve seen so many women in my community abused; physically, emotionally, and sexually. The rate of gender inequality is evident in their family dynamics and the number of women who are at the mercy of violent males, it is evident when assessing engagement in areas of occupation such as IADL’s with the females being the ones who engage in home management and the care of others. With predominantly community members from the isiZulu cultural culture, with males placed at a place of supremacy when compared to women. It’s sad how gender inequality is embodied by culture and religion, this way of thinking has been conditioned in us over generations and generations and when you look at it that is the case in most cultures and communities. The stepping stone is to empower women, empower them with prevocational skills to enable them to find means of employment, educate them on gender equality without judging, going against or contradicting their beliefs. By this way, we can try slowly try to change how they raise their children and the beliefs they raise them with and hopefully, the next generation will be freed from the chains of gender equality.  Thus we need to open their eyes to their possibilities and potentials so that they stop believing that they are inferior to women because in the notorious RGB’s words, “Women belong in all places where decisions are being made, it shouldn’t be that women are the exception”.

Google (2020).

I’ve seen much injustice in the healthcare sector in my community that I have implemented the peace and justice SDG because as an occupational therapist I need to be able to point out all the injustices in the community and advocate for my client’s. Puzzling how we need to advocate for the ethical treatment of our client’s within the health setting, taking for example when I had to advocate and arrange a meeting with the local social worker that in the community that I’m currently working in, I had to try to convince her to look into my client’s case and then after that she continued to give reasons as to why she couldn’t see the client and all of these reasons were non-void, due to this I had to then refer to another social worker in another clinic around the area who was then able to work with her. So, even if you advocate and you hit a brick wall you need to find other means of getting your client equal health care services that they need. It’s difficult to understand how healthcare workers are the people that are supposed to be advocating peace and justice but they are the same people performing injustices but sometimes all you can do is your part and in doing so make sure that you give your client the best possible interventions. With the amount of food security economic instability within the community that I am working at I saw the need to implement the decent work and economic growth SDG as it aims for sustainable economic growth and decent employment for all. As occupational therapists we play a vital role in work as this is one of the areas of occupation, and most persons within the community that I work are unemployed and the majority of these people are persons with a disability, not even one my client’s that I have seen thus far are employed scary right, and this is evident in the food insecurity in the community. This leads to most children from family’s attacked by food insecurity going to school with empty stomachs and this negatively affects their ability to learn and retain information in class and this, in turn, leads to increased failure rates. This is one of the main areas that affect children’s performance in their education area of occupation, with this harming their ability to find employment and the cycle keeps on repeating itself. To curb this cycle, we need to start with equipping these community members with the correct prevocational skills that will enable them to find means of employment. Taking into consideration my 16-year-old child who is diagnosed with mild intellectual impairment, she is currently not schooling and is not engaging in any development activities thus she will not be able to get decent work in future. To stop this, I have arranged referred have spoken to her social worker, who is going to help enrol her in a special school at the beginning of the year next in since she was able to find a school this year because it is too far into the year and schools are not excepting new learners and also due to COVID-19. But as her occupational therapist I have to start now with improving the psychosocial factors that are impaired to enable her to improve her function by engaging in leisure activities that will give her skills that she will be able to use to find a job, for example, she may be able to work as a packer at a supermarket or work in a sheltered workshop. There is a great need to implement the SDG that relates to education to enable the community members to have access to inclusive, equitable quality education (Bebbington and Unerman, 2018). The number of children that are of school-going age and are not in school is alarming and the number of children who are stuck in a mainstream school but they are not able to meet the demands of a mainstream school is also scary in the community that I’m currently working in. The role of occupational therapy in the case of children who are in a mainstream school but are not coping with its demands is to work with schools to identify these children and work towards getting the into the necessary special schools and skills workshops to provide them with the necessary tools that they need to engage in life. When working with children that are of school-going age but not going to school, we need to assess the reasons behind them not going to school and work with the social worker to find them the correct school placements. In not forgetting about informal schooling we have a big role in providing community members with skills that will enable them to cope with their daily lives and improve the independence and function in their areas of occupation. In occupational therapy, activities need to be occupation-focused and promote health. Community mobility enables clients with access to activity arenas for participation and thereby influences health and in community-based treatment, we need to work towards improving client’s community to allow them to access places to engage in meaningful occupations. Intervention may include geriatric interventions to support and promote health in the elderly as per SDG 3. We also need to look at working towards to improving the care of ‘the sickest older adults’, who are at risk of becoming marginalised when the ordinary care system fails to sufficiently acknowledge or address their needs, we need to offer interventions that decrease deteriorations in health and wellbeing or that prevent deformities (Wagman et al, 2020). But in promoting environmentally sustainable occupational performance and lifestyles’ (Jenkin et al, 2016), we need to work with other stakeholders in the community when designing interventions for the people within our community to provide comprehensive treatment. Takes my take on SDG’s, community-based intervention and occupational therapy, what is yours?

Google (2020).

References

 Bebbington, J., & Unerman, J. (2018). Achieving the United Nations sustainable development goals. Accounting, Auditing & Accountability Journal.

Google (2020). What are sustainable development goals. Accessed from: 

https://www.google.com/search?q=what+is+sustainable+development+goals&sxsrf=ALeKk00-5GCFztGKKt_Dd1sbBkC7-h9Oww:1601058730318&source=lnms&tbm=isch&sa=X&ved=2ahUKEwj_8YnH-ITsAhUqThUIHaGlBjIQ_AUoAXoECBUQAw&biw=1242&bih=597#imgrc=ZUszBwpNscHswM

Google (2020). Feminist quotes. Accessed from: https://www.google.com/imgres?imgurl=https%3A%2F%2Fi.pinimg.com%2F564x%2F83%2F62%2F4d%2F83624d245be2d335dd80384789fd1961.jpg&imgrefurl=https%3A%2F%2Fwww.pinterest.com%2Fpin%2F271201208796614969%2F&tbnid=sVazvpJF5Hx10M&vet=12ahUKEwi86sD8-YTsAhXE3eAKHTtUCooQMygCegUIARC0AQ..i&docid=A8R4kX0ylhORdM&w=564&h=423&itg=1&q=The%20notorious%20RbG%20quotes%20and%20sustainability&ved=2ahUKEwi86sD8-YTsAhXE3eAKHTtUCooQMygCegUIARC0AQ

Jenkin, K., Sellar, B., Stanley, M., & Thomas, K. (2016). How sustainable development is understood in World Federation of Occupational Therapy policy. British Journal of Occupational Therapy, 79(8), 505-513.

Wagman, P., Johansson, A., Jansson, I., Lygnegård, F., Edström, E., Björklund Carlstedt, A., ... & Fristedt, S. (2020). Making sustainability in occupational therapy visible by relating to the Agenda 2030 goals–A case description of a Swedish university. World Federation of Occupational Therapists Bulletin, 1-8.

World Health Organization. (2015). Health in 2015: from MDGs, millennium development goals to SDGs, sustainable development goals.

[themindofaconflictedrebelot]

I am a being alone but affected by all things dead and living, What’s your positionality?

I am an African woman and no I am not black; I’m brown, not that black is not beautiful, trust me is but you have to be problems with basic colour concepts if you look at me and think that I’m black. I am a woman, most of the time this works at my disadvantage, I am a person that has lived most of her life being judged by the way she looks and the colour of her skin before they even got to understand her, judged by the way she pronounced words with her unique accent that some may say is not ‘English’ enough. I have had to fight to be treated like my brother’s equal in a patriarchal home, fight to be recognised in racist schools, fight for marks just because some people think that this brown girl cannot have an operating or a somewhat well “conditioned’’ brain that can reason, I have had to use fight using my mental capacity because that was the only resource that I had to work. Like most I had to dream and look outside the box that my socio-economic status tried to trap me in, I had to climb higher ladders than some to reach where I am and sometimes had an upper hand compared to other’s but one thing is for certain little to nothing was ever handed to me on a silver platter. I used my culture and religion as a way to escape used my academics to try to save myself from the cycle of poverty and this cycle that so many brown people find themselves stuck in. I have experienced good and bad, I have experienced how it feels like to have a mother that is there but at the same that is not there, I have experienced wanting and sometimes needing but not receiving. I have experienced how it feels to cry without anyone to care for you, I have experienced feeling so hopeless that you become numb to your circumstances. I have lived way too much for a 21-year-old. And I am still living, I have been a mother to children that I’ve never given birth to, supported a family both financially and emotionally to a point whereby I have no one to cry to because I am the strong one the nurture and I feel that I am responsible for everyone around me. I feel everyone’s pain thoughts that I feel like I no longer feel how I feel, I’m numb towards life, this is how I cope. I want to feel so bad that I feel through others, this is how my positionality towards life has been formed and this is my stance when I approach life and every person I interact with.

(Google, 2020) The figure above illustrates a dynamic system which is a persons positionality and the multiple factors that affect this system.

Coming from a background that I come from and the experiences that I have gone through I analyse every situation and try by all means to gain a deeper understanding of the different people that I interact within the community because I have learnt through myself that physical appearance can be deceiving and the only way you can truly understand a person and a community is by understanding all it’s the dynamics and the things that influence those people. Thus, my positionality has guided me into looking into other people’s experiences through life and to find out how these have affected them and their functioning in everyday life, it has shown me the importance of assessing and understanding my client’s and their family members positionality when preparing for treatment and I have learnt throughout my life experiences that a person is a dynamic system that is forever changing and every experience leads to repercussion or a change in behaviour and understanding of life.

(Google, 2020) The figure above illustrates the different factors that affect my positionality and stance in life.

Jafar (2018) defines positionality as the recognition and declaration of one’s own position and stance within a specific context and Hopkins and colleagues (2017), defined positionality as a unique perspective on issues that arise from a person’s enculturation, their previous experience, personal beliefs and values, and daily work. There are both correct when the definitions are put together as they somewhat give a full understanding of positionality when both definitions are used in conjunction rather than apart because when they are used apart they fail to give a holistic explanation of the concept of positionality.

Hopkins and colleagues (2017), state that positionality is influenced by our nature, perceptions, relationships and the people we communicate with, but these are the factors that influence my positionality it is also influenced by the experiences of the people around me, gender, race, my experiences, my socioeconomic status, my background and how other people treat me. Thus, when I look at people in my community, I look at the different factors that affect each person individually so that I can fully understand their problems.

A general mistake that I normally make is when approaching African people, I normally speak to them in isiZulu and not every African person speaks isiZulu, so I have learnt to ask first before each encounter what language each client speaks. This was due to me feeling as if the only way us, “Black” people can show each other that we are one of the same kind forgetting that even though African with the community appreciate it when you approach them with their home language but I can’t always assume that every African speaks isiZulu because there are so many African Languages and they could speak either of them. When I understood how this positionality affected my assessment, that’s when I changed and whenever I begin assessing a client I first ask which languages they understand and they speak so that my assessment process is not negatively affected due to the client not understanding what is asked of them and instructions.

Dealing with a variety of people within my community and the community which I am currently placed at I have developed a way of thinking that helps me to not “judge a book by its cover”, knowing how I am a person and how I can easily fool people into thinking that my life is perfectly fine and I only allow them to see the position of my life that they want to see when assessing conditions I want to look more within the person rather than just their condition and assess different persons differently rather than having a specific sequence for evaluation and assessment for specific conditions because one thing I’ve learnt from these close to four years of doing this degree is that each person is different and everyone has a unique way that their treatment and assessment should be approached. When assessing clients it is important to try to understand your client’s and gain insight on which concepts and phenomena affect their overall function and everyday lives, by assessing more than just their condition by looking into their experiences and how these may have affected the person that they are today and their functioning (Hopkins et al, 2017). For example, a lady within the community that I am currently working at is diagnosed with intellectual disability and at first, that seemed like the main issue and focus of treatment but through sitting her down and engaging in a conversation with her to gain a deeper understanding of how she grew up and how she was treated growing up due to her condition. She then mentioned how she was called names and how people assumed that she was “stupid” and how this then made her believe that she could not do anything and then this led to her having a decreased self-esteem. The most frightening and scary thing is that the emotional abuse and name-calling did not only come from people outside of her family, but her mother was also the main person who called her by names, emotionally abused her and stole her disability grant from her and used it for her things and most of the time took the money and used it to buy alcohol and then came back home to abuse her more when she was drunk and even abuse her physically. This has resulted in her thinking that she is what they say she is resulting in her feeling helpless and negatively affecting her judgement, this has even resulted in her harbouring feelings of anger and even when her children do the slightest mistake she ends up hitting them to a point that she even thinks that she may hit them until they become hospitalised. Her boyfriend reported that this is the main issue that she has, and her low self-esteem leads to her thinking that she is not able to handle her own money even though she knows basic maths. From all this, you can see how different perspectives influence her function in her areas of occupation namely, her IADL’s (caring for others and money management).

From this, you can see that my positionality and my experiences in life have made me dig deeper than the client’s condition. After all, I have conditioned myself to think that treatment is not only about the conditions because I believe we are all persons walking around with undiagnosed mental illnesses, as we are scarred by our experienced, some build us and some may destroy us. So when assessing and treating I go in with an open mind as you never know how a person is functioning in life until you ask and understand them and lives. When creating programmes for the people of the community, we need to not only consider our positionality but the positionality of the community members of the community that we are working in as this influences the structuring of the intervention and the focus of intervention as there are people that require the intervention. This is why we must use a phenomenological approach when creating programmes and providing interventions as this allows to better understand client’s conditions and gain a holistic understanding of their needs by exploring their experiences and how these affect their positionality (Hopkins et al, 2017). A phenomenological stance allows you to understand the community member’s fully and understand their goals for treatment so that you as a therapist can work towards reaching them. For example, the client previously mentioned with an intellectual disability her main aim for treatment is for her to be able to work so that she can be independent and prove her mother wrong by showing her that she is not stupid and that she has made something of herself, and to deal with her anger for her to be able o give her children the love and care that she never received when she was growing up. So, these are important when creating a program for her, by me having a phenomenological stance towards assessment and treatment I was able to better understand her needs by gaining a deeper understanding into her positionality and how this affects her treatment. But this also led to me feeling her pain and I’ve spent the last few hours thinking about how she must feel in this exact moment?

As much as my positionality has not yet influenced the assessment and treatment of my client’s negatively, I need to make sure that it not emotionally texting for me and I do not take my client’s problems with me at home and I end up being negatively affected by this as much as my positionality allows me to understand my client’s better and put myself in their shoes as I want them to receive the best possible treatment I can give them. So, we need to acknowledge that our positionality impacts our treatment approach towards our client’s, because if we are not mindful of the role of that our own and our client’s positionality and cultural ways of knowing influences treatment and our engagement in communities, the results of such can be dangerous to the communities and the individuals within them (Milner, 2007). So, now what you have to ask yourself is how is your positionality affecting your life, your relationships and your engagement in daily life? And is your racial and cultural awareness, consciousness, and positionality affecting how you treat others?

(Google, 2020) The figure above shows how you need to first unpack and understand your positionality before understanding how it will affect others.

References

Google (2020). Retrieved 18 September 2020, from https://www.google.com/search?q=positionality&sxsrf=ALeKk01uq0oAyCDABZ-_G--35NhIgz6y-A:1600451870273&source=lnms&tbm=isch&sa=X&ved=2ahUKEwjypNTpo_PrAhWAXRUIHd1DAg4Q_AUoAXoECA4QAw&biw=1242&bih=597

Hopkins, R. M., Regehr, G., & Pratt, D. D. (2017). A framework for negotiating positionality in phenomenological research. Medical teacher, 39(1), 20-25.

Jafar, A. J. N. (2018). What is positionality and should it be expressed in quantitative studies? (vol 35, pg 323, 2018). Emergency Medicine Journal, 35(9), 578-578.

Milner IV, H. R. (2007). Race, culture, and researcher positionality: Working through dangers seen, unseen, and unforeseen. Educational researcher, 36(7), 388-400.

[themindofaconflictedrebelot]

The fact that we have to ask why maternal and child health is important to society, does more than just disgust me it’s appalling.

The fact that we have to ask why maternal and child health is important to society, does more than just disgust me it’s appalling. Hold up let’s rewind a bit and let me try to carefully analyse this situation. With all that’s happening, I have a feeling that after making such a statement I have to validate it; it’s a pressing issue, isn’t it? Now sit back and let me educate you. Get comfortable as I take you on a ride, a ride that I’ve been on for a very long time. To think that we have to still discuss why maternal and child health is important to society is scary, this is the primary determinant of the health of the next generation, this is of the utmost importance in predicting future public health challenges for families, communities, and the health care system (Maternal, Infant, and Child Health | Healthy People 2020, 2020). How we dare forget the fact that improved maternal and child health benefits the whole community? Frustrating issues like these go unnoticed and disregarded in our communities. Like in the community I’m currently working in, little to no notice is paid to maternal health, the way health professionals, yes I said it, Health professionals pay no mind to mothers the same people who are the main source of life for the children that they are so focused to treat.

(Google Image Result for https://www.millscoia.us/images/departments/phn/maternal_logo.jpg, 2020)

As a future occupational therapist, such issues alarm me, the fact that we as health professionals are so stuck on the medical model that we forget to look at our client’s holistically. I am also guilty of such, this other day I was on medical model mode. Quick screening; baby crawling, check; baby walking, check. I was consumed with human function and in child health, I forgot, to look at the child in a holistic manner that I had to pull myself aside and remind myself that, “no man Lucy, you are an occupational therapist, what are you doing? First, why are you only looking at the child and whether they present with any physical problems or difficulties, Get your head in the game, rewind, please? Think holistic, think about the factors that impact this child, think about how the mother is doing, think about social and environmental factors, think holistic, why are you getting so caught up in trying to find conditions to treat, be the occupational therapist that you are”. So, I had to go back and look at my client’s mother, I’m an occupational therapist and I work with improving engagement in areas of occupations and being a mother is an occupation. This role has a significant contribution to the overall development of a child (Acharya, 2014). Interventions focusing on strengthening mother-child interactions through engagement in context-appropriate play activities are of the utmost importance, nutrition interventions and targeting improving child growth and development must go hand in hand with this (Rahman et al, 2008).

(Google, 2020)

Many mothers present with maternal depression and postnatal depression, especially with unplanned pregnancies and the mother’s not having a job and ways to provide for their children. These untreated mental conditions are associated with adverse public health and social consequences for both mother and child (Hanlon, 2013). Occupational therapy interventions such as problem-solving, behavioural and cognitive techniques such as coping skills, educational on medication compliance can help mothers with such conditions to better handle and fulfil their role as mothers and better facilitate their children’s growth. As an occupational therapist, it is my job to provide the child’s mother with the necessary support to assume the role of being a mother and successfully perform it especially in the community I’m working in with a lot of teenage mothers who are uncertain with how to fulfil their new now, within a community fill of food insecurity, with parents stressing about how they can make ends meet and the serious issue of malnutrition. This is where occupational therapy comes in with intervening and providing the mothers with emotional support such as coping skills and ways to the problem to effectively cope with their problems and fulfil their roles as parents. With mother’s with mental issues, occupational therapy can help mothers to develop competencies for the role of a mother (Acharya, 2014).

(Google, 2020).

Health promotion involving promoting mental and social development by responding to a child’s needs for care, and through development stimulation such as talking, playing and providing a stimulating environment’ are a key goal in when working in the community (Rahman et al, 2008). You first need to understand the child and how they feeling both physically and mentally to get a holistic overview of them, thus you need to talk to them, the people around them and get a sense of how they behave within a society by having them engage in play activities that are of their interest to allow for a sense of communal understanding. As a form of health promotion and prevention, we as occupational therapists can educate mother’s on preventive strategies such as breastfeeding and early infant feeding counselling, hygiene promotion, immunization, health education and health-seeking behaviours (Rahman et al, 2008), because of most the mothers in my community are young mothers and they are not sure of how to handle their newly found role of being mother’s and this will help to guide them and prevent paediatric conditions such as malnutrition and maternal distress, and promote early interventions and identifying of conditions such as developmental delays etc. When working in a community all stakeholders and community healthcare workers need to work together to facilitate maternal and child interventions. Interventions should be developed working hand in hand with the community and the community health workers, in order to engage with mothers, empower them with the necessary skills to fulfil their role, provide them with support, practical help and advice on child development in a psychologically therapeutic manner, taking into consideration the context and culture within the community (Rahman et al, 2008). So, it took that small reminder, me pulling me aside to remind myself that I’m not working with objects but with people and people are influenced by multiple factors including their social, emotional and physical contexts, and not just their conditions. People operate in a community and in order to fully understand them you need to understand how they live and their challenges within their community. So, when looking at maternal and child health we need to stop assuming that the mother is healthy, we need to assess both child and mother. So, the fact that we are still asking why maternal and child health is important to society is quite unpleasant. So as occupational therapists it is also our job to advocate for mothers and children, to educate other health professionals such as nurses and community health workers on healthy birth outcomes and the importance of early identification and equip them with skills to identify children and mothers who need intervention for effective referrals to occupational therapy for the treatment of developmental delays and disabilities and other health conditions among children to prevent death or disability and enable children to reach their full potential ((Maternal, Infant, and Child Health | Healthy People 2020, 2020). So, as I conclude don’t tell me that you still do not know why maternal and child health is important to society. Mother’s and children are the very foundation of our society, the next generation, the only way that the human race will continue to live on and here we still are questioning their health importance you have to be joking, you have to be and if not you have to re-assess your mindset because something is wrong with your thinking.

(Title: Maternal and Child Health — MEASURE Evaluation, 2020)

Reference

Acharya, V. (2014). Preparing for motherhood: a role for occupational therapy. World Federation of Occupational Therapists Bulletin, 70(1), 16-17.

Google.com. 2020. [online] Available at: <https://www.google.com/imgres?imgurl=https%3A%2F%2Fwww.mcsprogram.org%2Fwp-content%2Fuploads%2F2015%2F09%2F15175823919_39cbd50650_k.jpg&imgrefurl=https%3A%2F%2Fwww.mcsprogram.org%2Ffour-ways-addressing-gender-makes-maternal-and-child-health-programs-more effective%2F&tbnid=lMmUdlYRJmVxyM&vet=12ahUKEwix0ou5yeHrAhVK0OAKHanHC-MQMygpegUIARCUAg..i&docid=cLbFwGrtQhKciM&w=1024&h=683&q=maternal%20and%20child%20health&ved=2ahUKEwix0ou5yeHrAhVK0OAKHanHC-MQMygpegUIARCUAg> [Accessed 11 September 2020].

Google.com. 2020. [online] Available at: <https://www.google.com/imgres?imgurl=https%3A%2F%2Fi.pinimg.com%2F236x%2Ffc%2F53%2F68%2Ffc536802ca6606652b7c8a54fac1c9d0--benefits-of-breastfeeding-breastfeeding-week.jpg&imgrefurl=https%3A%2F%2Fwww.pinterest.com%2Ftuftscgph%2Fmaternal-and-child-health%2F&tbnid=InTSgm7CP-Cg1M&vet=12ahUKEwix0ou5yeHrAhVK0OAKHanHC-MQMyhFegQIARBt..i&docid=9kRapcn0SJssjM&w=236&h=217&q=maternal%20and%20child%20health&ved=2ahUKEwix0ou5yeHrAhVK0OAKHanHC-MQMyhFegQIARBt> [Accessed 11 September 2020].

Google.com. 2020. Google Image Result For Https://Www.Millscoia.Us/Images/Departments/Phn/Maternal_Logo.Jpg. [online] Available at: <https://www.google.com/imgres?imgurl=https%3A%2F%2Fwww.millscoia.us%2Fimages%2Fdepartments%2Fphn%2Fmaternal_logo.jpg&imgrefurl=https%3A%2F%2Fwww.millscoia.us%2Findex.php%2Fmaternal&tbnid=PX9c2jzwL_pzrM&vet=10CFMQMyj1AWoXChMI0KuQnM7h6wIVAAAAAB0AAAAAEAM..i&docid=cstplDXUmlq10M&w=678&h=188&q=maternal%20and%20child%20health&ved=0CFMQMyj1AWoXChMI0KuQnM7h6wIVAAAAAB0AAAAAEAM> [Accessed 11 September 2020].

Google.com. 2020. Title: Maternal And Child Health — MEASURE Evaluation. [online] Available at: <https://www.google.com/imgres?imgurl=https%3A%2F%2Fwww.measureevaluation.org%2Four-work%2Fmaternal-and-child-health%2Fcarousel%2Fmaternal-and-child-health%2Fimage&imgrefurl=https%3A%2F%2Fwww.measureevaluation.org%2Four-work%2Fmaternal-and-child-health&tbnid=9YjYFnjbTVYZEM&vet=12ahUKEwix0ou5yeHrAhVK0OAKHanHC-MQMygCegUIARDBAQ..i&docid=zOIqco7YdREcWM&w=1170&h=473&q=maternal%20and%20child%20health&ved=2ahUKEwix0ou5yeHrAhVK0OAKHanHC-MQMygCegUIARDBAQ> [Accessed 11 September 2020].

Hanlon, C. (2013). Maternal depression in low-and middle-income countries. International health, 5(1), 4-5.

Healthypeople.gov. 2020. Maternal, Infant, And Child Health | Healthy People 2020. [online] Available at: <https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health#:~:text=children%2C%20and%20families.-,Overview,and%20the%20health%20care%20system.> [Accessed 9 September 2020].

Rahman, A., Patel, V., Maselko, J., & Kirkwood, B. (2008). The neglected ‘m’in MCH programmes–why mental health of mothers is important for child nutrition. Tropical Medicine & International Health, 13(4), 579-583.

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Research presentations on research day

What a day, what a day, you could literally see the fear and anxiety in the eyes of the fourth years. From the morning, the event organizer making sure that everything is in order and every one of the third years knows their role. Everyone looking ever so formal. As the keynote speaker spoke to us, I could see the love for research in her eyes. Research is an activity of systematic enquiry that seeks answers to a problem (SOAS, 2019). She so badly wanted to convince us to take on research as one of our future endeavours. But she did enlighten me on the topic at hand, she gave the field of research a face, and using her lens you could the broad aspect of research and the change you could bring out as a research, the people you could affect, the lives you could, and the knowledge you could broaden. With all this, she also highlighted what research could do for you, your career and the doors it could open for you. She spoke about the use of imagination in research, this struck heart because everything starts with imagination and if you lack imagination you will never want to do more, bring about change and innovation. Because all the biggest inventions started as someone's imagination, the greatest research ever is written was all imagination. No one ever brought about change by replicating stuff, thus, this is crucial component research, well in order to bring about new innovative research. She also mentioned how what happens in our unique context could be something mesmerizing in the northern hemisphere, thus it is important to do research that is for our context because we tend to rely on research from the western culture neglecting the fact that we are from different contexts and different backgrounds and what works in those countries will not necessarily work in our context and for our people due to vast amount of differences. She spoke a lot of sense, especially with the diversity in South Africa in terms of culture, race and languages.

As the research presentations started, before I forget my role in the day was the timekeeper for the first session. Who knew to keep time was so hard, with that being said, the problem was not keeping the time, I felt so bad when I had to stop one research group before they finished presenting. I had to look at this from different dimensions firstly ethics, making sure that all the groups were given the equal amount of opportunity in this case time. But I still felt bad. Moving away from my overthinking, over caring and emotional self, I learnt a lot from the presentations, most of the research questions were based on topics I wouldn't have considered and thought of research in occupational therapy. They were very informative in terms of giving me a different way or perspective to view things. We sometimes forget to look at events holistically and scrape the surface by doing this we miss the components that influence life itself. To think as an OT student, "holistically" should be my second name but still... but that's why we read and do a literature review to get insight into other people’s ideas to build the basis of our thoughts and ideas to form a foundation for us to imagine. But still research still looks really scary but that's life it looks scary before you dive into the deep waters and gain an understanding of how to swim, but it's up to you to choose whether you learn to swim or you drown due to a lack of initiative and volition to better self and train self-skills that are needed for you to be able to swim. Life operates by taking it one step at a time but with that you need to strategically plan every move in order to be able to reach the desired outcome. As there is a great importance of planning in life so is there in research reasons behind the research proposals, coming up with all the topics, problem questions, aims, objectives, and methodology etc needs careful scrutiny and planning. Apart from research, I learnt a lot from the interactive session we had after the presentations, from learning from each other and teaching each other and looking after each other as a collective, because you never know what's going in the life of others even when you think you have it worse off but someone else could be going through things you can't even begin to imagine, so be kind, be kind, be kind, and be kind. With this being said, this also applies to our clients, sometimes you can find your client not in the mood to do anything and if you don't carefully analyze the situation you'll just say "no my client is lazy" but what you don't know is that they have their own battles that they are fighting and you as the therapist as suppose to be helping them get through them and not judge them. Because some of our clients are fighting mental battles that we can't even begin to imagine so our job is not to judge them and think that they just want attention and they don't want to do work but to find the underlying problem because by doing this you'll be able to find the root of the issue affecting their abolition which in turn affects their function leading to them losing their independence to function in their areas of occupation.

With all this being said, keywords, imagine, innovate and always remember to be kind at all times, we all have battles that we are fighting. We are all going through something be it academics or personal, just because I joke a lot and I'm always happy it doesn't mean that I don't also go through stuff, so think before you talk, listen to yourself in your mind, respect the persons you work with or come across in my case, my colleagues, my supervisors, my clients and everyone else. Because we all people at the end of the day we have feelings we hurt, and we find joy. Like we aim to help our clients find their joy let's not take it away from others. One of the fourth years spoke other communication, and I felt that because if you don't communicate you end up building this inside and when you explode a lot of people get hurt in the process. So be kind. That's if for my catharsis this week.

#TheCrazyHeartfeltYoungOTMessenger.

 REFERENCES

 SOAS (2019). Retrieved 5 October 2019, from https://www.soas.ac.uk/cedep-demos/000_P506_RM_3736-Demo/module/pdfs/p506_unit_01.pdf

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Exam prep- gaining insight on psychological diagnoses

You know-how information loses its interpretation when it goes through a lot of channels of communication because everyone gives it their own perspective and understanding thus it ends up losing true meaning. You know the saying that says it's better to hear something straight from the horse’s mouth, well I felt that when we had exam prep and speakers with the conditions spoke to us.

I found that when I listened to the speakers that didn't have the conditions that they spoke about, it felt like I was in a lecture and I didn't gain any new information since it was stuff that I was already taught, I've had lectures on substance abuse which is the harmful or hazardous usage of psychoactive substances, such as alcohol and illicit drugs (WHO,2019); I've had lectures on autism which is a ‚spectrum disorder (a child’s symptoms can present in a wide variety of combinations, from mild to severe) (Speaks, 2011) and I've had lectures on down syndrome, which is a set of physical, mental, and functional anomalies that are a product from trisomy 21, the existence in the genome of three rather then the normal two chromosomes 21 (Epstein, 1989); this led to me not feeling as if it was of any importance or relevance to me at this stage of my life. But when the persons with conditions spoke to us, I felt enlightened, I felt as if I was able to get a glance into their lives and for a second try to understand what it is to be in their shoes. Remember what I mentioned about hearing something straight from the horse’s mouth, listening to the persons diagnosed with the conditions made me gain further understanding about what they go through and how they were treated by the health system and their experiences with the different health professionals. It opened doors to understand how they want to be treated and how they feel about their conditions and how it has impacted them in their lives and not merely the definition of their diagnoses but how it feels to live with the condition on a daily basis, how other people treat you and how they look at you.

And getting a chance to engage with them in such a platform, ask them questions and get their perspectives and learn their life stories was beyond amazing. To get to know which treatment strategies helped them and what they found beneficial from their occupational therapists was also really interesting and enlightening. It also showed that our profession is not just a mere profession, every single time we get a client, we are given a chance to change a life, make a difference and leave our footprints. For most of us listening to them made us learn to love the degree if we didn't love it anymore, for those who loved it already it made them love it much more. You see with this degree your client's give you the strength and courage to wake up in the morning. They give reason to love the degree because all that you do is for them, to improve their function, to improve their independence, to make their lives more enjoyable and to make their lives worth living and they reminded us this. Knowing that you are able to change lives is the greatest feeling in the world, for me, the greatest gift I could ever receive is the happiness of those around me and the happiness of persons brought about by my profession gives me immeasurable happiness.

 References

 Epstein, C. J. (1989). Down syndrome. In Abnormal States of Brain and Mind (pp. 43-44). Birkhäuser, Boston, MA.

Substance abuse. (2019). Retrieved 28 September 2019, from https://www.who.int/topics/substance_abuse/en/

Speaks, A. (2011). What is autism. Retrieved on November, 17, 2011.

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That crazy young OT is at it again: Let’s talk catharsis and what I learnt about myself so far during this block

Yaloom describes a catharsis to ability for a group member to release feelings about past or here-and-now experiences, this release leads to member feeling better (Kivilighan et al, 2004). So, this block is filled with cathartic moments so far. I am a person that takes respect very seriously and when someone belittles me, I take that to heart so during these past few weeks I’ve learnt to keep my emotions in check and sometimes let things be if I can’t change them. It has been a roller-coaster ride with mainly high’s (Thanks to my supervisor making prac bearable), and I’ve learnt to have more confidence in myself and my craft, yes, I am going to get somethings wrong but that’s life, what I do afterwards is what that matters.

I’ve learnt that I am scared of evaluations after a practical exam, I literally freak out, I end up having word finding difficulties, all the anxiety (Felman et al (2019) describes anxiety an emotion characterized by feelings of tension, worry and physical changes) I seriously don’t know where it comes from because naturally I’m not that shy and everyone knows I’m an extrovert but evaluations just give me chills I get so anxious that I end up not saying what I want to say, this is something that I really need to work on, I’ll try meditating now before every evaluation.

 I’ve learnt that l can be hard headed somethings ant I need to calm and remember why I’m doing all of this to begin with.

I am growing as a therapist even though sometimes I may not feel like I am, but it is happening. I put a lot of pressure on myself to get things even I do get some where with improving my client’s function I end up not acknowledging that because things didn’t as well as I intended forgetting that the little that I do for my client matters.

Most of all I learnt that I take making mistakes to heart and I sometimes don’t regard them as a learning experience this then leads to me feeling really sad if I make. Ron Carpenter Jr (2013) said that, “A teachable spirit and a humbleness to admit your ignorance or your mistake will save you a lot of pain. However, if you're a person who knows it all, then you've got a lot of heavy-hearted experiences coming your way” so I’ve let to take my mistakes as a lesson so that I can learn from them thus saving myself from heavy-hearted experiences.

  References

Felman, A. and Dillon Browne, P. (2019). Anxiety: Overview, symptoms, causes, and treatments. [online] Medical News Today. Available at: https://www.medicalnewstoday.com/articles/323454.php [Accessed 14 Sep. 2019].

Kivlighan, D. M., & Holmes, S. E. (2004). The importance of therapeutic factors. Handbook of group counseling and psychotherapy, 23-36.

Ron Carpenter. (2013). The necessity of an enemy. Colorado Springs, Colo.: WaterBrook Press.

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Casual Day- Time to shine with all your abilities and disabilities

From the planning, to everyone being on the same page. Group dynamics. But we all tried to make everything a success and it was, we even managed to get sponsors for the food. Our clients had a great time I also said so. Before I get carried away let me educate you a little bit about Casual day, it was launched in 1995, it is an awareness and fundraising project that benefits persons with disabilities. Every year on the first Friday of September, South Africans are encouraged to go to work dressed differently and to wear the Casual Day sticker to show their support for disabled people (Safmh.org.za. 2019).

This whole experience has personally taught me that I may not always agree with everyone and that since I sometimes have decreased frustration, I need to let things just play out sometimes. Since I’m out spoken if I disagree with something, I will let you know. I feel like its better to ask questions and let everyone know your stance rather than keeping quiet, and it’s better to fix issues rather than acting as if everything, thus creating more bad blood. But then again, it’s life and you can’t get along with everyone so all we can do is respect and tolerate each other. Bill Bradley said that, “Respect your fellow human being, treat them fairly, disagree with them honestly, enjoy their friendship, explore your thoughts about one another candidly, work together for a common goal and help one another achieve it. No destructive lies. No ridiculous fears. No debilitating anger”.

Professional I learnt more about working in a team, and that there are many resources in the community you just have to look for them and everyone on team is a valuable piece of the puzzle.

Alright enough about casual day let talk about prac prac, so it’s my first time having a client with schizophrenia, which is a disorder of markedly distorted thinking, perception and affect. Main symptoms include thought disorder, delusions, hallucinations, and negative symptoms. Cognitive deficits develop over time. Subtypes have been delineated by course and major features (Parnas, 2011). I was sad when he locked himself inside his room and he didn’t want to attend the casual day event, but I did get a chance to speak to him for a few seconds before he walked out on me but that’s a start right. And I’ve been reading up on one of his interests which is astrophysics, which is the application of the theories and techniques of modern physics to astronomy (Science.nasa.gov. 2019). And I’m finding ways to approach him and build a therapeutic relationship. It has been a hectic week but then again that’s the purpose of life for the thrill, right.

You may encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter the defeats, so you can know who you are, what you can rise from, how you can still come out of it, Maya Angelou (A-Z Quotes. 2019).

   References

 A-Z Quotes. (2019). Bill Bradley Quote. [online] Available at: https://www.azquotes.com/quote/530057?ref=tolerance-and-respect [Accessed 7 Sep. 2019].

A-Z Quotes. (2019). Maya Angelou Quote. [online] Available at: https://www.azquotes.com/quote/367242?ref=strength-and-perseverance [Accessed 7 Sep. 2019].

Parnas, J. (2011). A disappearing heritage: the clinical core of schizophrenia. Schizophrenia bulletin, 37(6), 1121-1130.

Safmh.org.za. (2019). Casual Day - SA Federation For Mental Health. [online] Available at: https://www.safmh.org.za/index.php/get-involved/casual-day [Accessed 7 Sep. 2019].

Science.nasa.gov. (2019). NASA Astrophysics | Science Mission Directorate. [online] Available at: https://science.nasa.gov/astrophysics [Accessed 7 Sep. 2019].

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Movie Week: Your favourite young OT relaxes

What a week, with all the politics, but we are going to get this degree. So, after a hectic week, I just needed to take a breather and relax and I did this the only way I know how, movie!!! So, I took a few hours to watch one of my all-time favours, The Notebook. Firstly, let me give you a brief description of the movie. This movie is about a couple that fights against all odds to be together and when they in their late adulthood, the women gets Alzheimer's disease which is a condition characterized by the deposition of amyloid in the extracellular compartment of the brain in the form of congophilic amyloid angiopathy ) and amyloid plaques (APs), leading to the wasting away of brain cells causing a continuous decline in thinking, behavioural and social skills that disrupts a person's ability to function independently (Small et al, 1999). In her case she forgot her family and her husband reads her their life story out of notebook in order to help her remember. In this movie dementia gives the person watching it emotional insight about how the condition affects the people around the person with the diagnosis and how people with dementia struggle on a daily basis. Like how the lead lady (woman with dementia) feels when her children visit her and she can’t remember them, in some scenes she is overwhelmed and afraid because she feels lost and doesn’t know what is happening.

You get to in some way be in her shoes and those of her family at the same time, this film also shows how important a good support system is, because even though she forgets her husband, he does not give up on her and keeps on visiting her. By reading her the notebook he helps her keep their memories alive.

The husband does this throughout the movie in some incidences she is remembers the husband and they rejoice in the moment. Since her condition is in the later stages, memory loss was far more severe. She couldn’t remember her family members, she forgot her relationships, and sometimes would feel lost because she didn’t know where she was. Her husband didn’t overwhelm her, and he didn’t force their relationship he used memories to help her remember him. “Thin, I think, that fabric between realities. Maybe minds aren't lost. Maybe they just slip through and find a different place to wander”, these are words by C.J. Tudor. So, in this movie the lead lady’s memories were placed deep within her unconscious not lost but they wandered, but with the support and love from her husband and the notebook she was able to retrieve these wandering memories.

This movie also provides the person watching it with intellectual insight into the condition. It inspires the families of person’s with dementia not to give up on their loved ones and that there’s hope even though the condition is progressive.

This movie has made me want to build more beautiful memories, be it with my friends, my classmates, my family or my client’s.

Movies aside, now let’s talk about my academics. It’s been a hectic few weeks and it’s going to be a hectic week ahead. And this week was the first week of prac for finals. A hectic start in deep, from group dynamics to the struggle of getting client’s but all is well. I just have to take everything one step at a time and continue building these long-lasting memories and give my clients the best treatment I can.

Remember, “What you remember saves you.”  (W. S. Merwin, 2008).

    References

Creative, T. (2019). The Notebook. [online] Nicholas Sparks. Available at: https://nicholassparks.com/stories/the-notebook/ [Accessed 31 Aug. 2019].

Goodreads.com. (2019). Remembrance Quotes (255 quotes). [online] Available at: https://www.goodreads.com/quotes/tag/remembrance [Accessed 31 Aug. 2019].

Small, D. H., & McLean, C. A. (1999). Alzheimer's disease and the amyloid β protein: what is the role of amyloid?. Journal of neurochemistry, 73(2), 443-449.

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The reflections of a young student OT: Assessment and intervention.

“Go back?" he thought. "No good at all! Go sideways? Impossible! Go forward? Only thing to do! On we go!" So up he got, and trotted along with his little sword held in front of him and one hand feeling the wall, and his heart all of a patter and a pitter.” (J.R.R. Tolkien, 1937). So yet again, it’s another week of prac and “Still I rise” (Maya Angelou, 1976), with smart aims and client responses at hand, with heavy mornings and sleep telling me to not wake up still I rise. From the endless assessments and treatment sessions, where should I start? Let’s just start at the beginning. From the previous week of full on assessments both standardised and un-standardised, to figure out the client’s level of functioning and the client’s needs, to this week and starting intervention. And since both my clients have intellectual disability I chose the behavioural applied frame of reference, which emphasizes the use of behavioural modification to shape behaviours, which purports to increase the tendency of adaptive behaviours or to decrease the probability of maladaptive learned behaviours (Behavioral Frame of Reference, 2019).

The approaches I chose are behavioural modification, prompting and fading. For example with my client with social skills problems I will use the behavioural modification approach to teach him effective ways of communication in order to improve his social skills, interpersonal relationships and extinguish undesirable behaviours such as his incorrect use of words and aggressive behaviour towards other client’s.

Another approach is prompting, for example, the use of verbal prompts such as verbal instructions during the teaching of a skill and sessions and visual prompts such as pointing, signalling, using demonstration by showing the client how they should do something during the session.

This week I learnt my supervisor taught me that from the client’s role you are able to build a foundation for your client’s treatment because you are able to find out what they need to do to fulfill their roles and if they are not fulfilling their roles, what is stopping them from doing so. From this as a therapist you are able to treat the underlying factors that impact their function in these areas negatively, thus improving their participation in activities, their function and independence. For example for one of my client’s he has a social skills problem and this leads to him not being able to communicate effectively with his colleagues due to his poor choice of words and his slightly aggressive nature, so this will impend his function at work because in the workshop/challenge he needs to communicate with the other workers so that they can reach a good finished product. If he can’t use his verbal skills correctly then this may cause conflict with his colleague’s thus impacting his role as a worker negatively, leading him to not being able to fulfill his role as a worker.

I also learnt that as a student therapist I tend to depend on my activity to make the session a success and to reach my aims of assessment and treatment. And that I should implement more principles and more things that I could do a the therapist (student therapist) to reach my aims and not depend fully on the activity because activities could go wrong but I need to be well equipped to for these situations and to give my client’s the best intervention I can.

Roy T. Bennett once said, “You need to have faith in yourself. Be brave and take risks. You don't have to have it all figured out to move forward.” And hey, I’m only a student and I’m giving it my all and that’s what that matters. I’ll keep on pushing forward and doing the best I can for my client’s because after all it’s all about them.

  References

Moving Forward Quotes (367 quotes). (2019). Retrieved 16 August 2019, from https://www.goodreads.com/quotes/tag/moving-forward.

Behavioral Frame of Reference | OT Theory. (2019). Retrieved 17 August 2019, from https://ottheory.com/index.php/therapy-model/behavioral-frame-reference.

[themindofaconflictedrebelot]

The Birth of a supreme therapist: A tag along on my journey as a student OT

Wow it’s been a hectic week among other things, but the show must go on. It’s time to put on my “therapeutic face” get it “game face” and ‘therapeutic face”, lets hope you did. It’s the end of yet another week of psycho social practical’s and I’m really enjoying it. I’m not saying it’s perfect don’t get me wrong or anything, I do stumble and fall, but I pull myself up and move on cause that’s life, a roller-coaster ride and I’m doing my best to enjoy the ride.

Starting psycho-social treatment, now that’s another thing, it gives me Goosebumps just thinking about it. But we all know the key right? learning from others, reading, practicing and more reading. So, one of the articles that caught my eye was an article about intellectual disability titled ‘Occupational Therapy and Intellectual and Developmental Disability Throughout the Life Cycle’ which gave me further insight on the different types of interventions for intellectual disability and advised my choice of treatment for my client’s with intellectual disability. It taught me that intervention in intellectual disability often requires repeated drills and practice to achieve internalization and learning, and performance in a variety of contexts to enable generalization (Yalon et al,2010). Thus, I need to be patient with my client’s.

My journey as a student OT has been influenced by many things such as learning from others and reading but also my moral compass and ethics.

It’s not an easy road but all that matters is that I’m getting there, I’m learning, I’m changing lives for the better and I’m doing something that brings me joy and undying happiness. With that being said I may dislike my degree sometimes due to the workload, but I truly love what I do for my client’s and that’s what always reminds me why I’m doing all of this in the first place.

With all this reading we all need someone to help us make sense of it all and this is where our supervisors come in to guide us and help us in our journey. In this week’s feedback session with our supervisor we practically applied our knowledge of treatment and my supervisor helped to clarify any uncertainty. Even though I’m I still don’t fully get it but I’m getting there.

All I have to remember is that “Not all those who wander are lost.” (J.R.R. Tolkien), of cause I won’t know it all I’m a student and even when I’m a qualified OT I still won’t know it all cause nobody does and nobody will ever do, life is about learning and evolving. And it’s up to me to make this journey of mine as epic as ever and change lives in the process.

 References

 Yalon-Chamovitz, S., Selanikyo, E., Artzi, N., Prigal, Y., & Fishman, R. (2010). Occupational therapy and intellectual and developmental disability throughout the life cycle: Position paper. IJOT: The Israeli Journal of Occupational Therapy/כתב עת ישראלי לריפוי בעיסוק, (חוברת 1), E3-E8.

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The insightful dairy of an OT student’s practical work experience part 1: The anxiety and thrill of starting the Psych Block.

First things first let's talk about how I felt before the practical preparation session, I had prior knowledge about treatment in mental health, but I didn’t feel that I was fully equipped to start the Pysch block. This led to me reading a few articles online about the OT treatment role in mental health which then further informed my knowledge on what is expected of me during fieldwork. For example, social skills training, accommodations, compensatory strategies, identification and implementation of healthy habits, rituals, and routines to support wellness, and community re-integration amongst other things can be used as intervention strategies to improve the client’s community participation, daily functioning, and quality of life (Aota.org. 2019). On the morning of the practical preparations, I felt anxious regarding the expectations of this block since I’ve never treated a psych client before. But as the practical preparations started I gained more insight and understanding on what is expected of us in this block. I also started to remember things I had forgotten. Things seemed to be falling into place the only thing I still didn’t have a clear understanding about was the subprogrammes, but I left the practical prep feeling less anxious. I then read up on the possible diagnoses that I could get in the facility that I was going to, to further improve my knowledge base. I read articles about autism, which is a broad range of conditions characterized by challenges with social skills, repetitive behaviour’s, speech and nonverbal communication (Autism Speaks. 2019)  and I watched YouTube videos about people sharing their experiences about living with mental illnesses (Ted talks). I also read more about intellectual disability and schizophrenia (which is when active, has symptoms such as delusions, hallucinations, trouble with thinking and concentration, and lack of motivation. But with treatment, most symptoms of schizophrenia will greatly improve) (Psychiatry.org. 2019). With all this theoretical knowledge Day 1 of Practicals came, I had to put it into practice. It helped that my supervisor helped use to distress in the morning before we started our sessions and saw our clients. But what challenged me the most was doing sessions without knowing the client’s diagnoses and having to figure it out during the session because you don’t know which principles to use, what may upset the client, and what assessments to focus on. Discussing with the supervisor after the sessions helped to put things into place and hearing the other students challenges helped to understand that we are still learning and it will happen that we don’t get everything or do everything perfectly on the first day but what matters is that we learn from our experiences. But the second day was exciting I even managed to get one of my clients who isolates himself to participate in a session and I found out what’s the reason behind his isolation, and at the end of the session, he was glad he tried. It’s times like these when you fall in love with the profession. What I’ve learnt this week is its better working with others than working alone because we will all need each other at some point. We need each other to improve each other’s insight, and to grow. I also learnt that it is also important to be a backbone for our client’s when they need it, to understand their fears and to put yourself in their shoes so that you can understand them better and thus plan a more effective intervention plan. And if you don’t understand ask and read more because no one knows everything after all I’m still a student.   “Those people who develop the ability to continuously acquire new and better forms of knowledge that they can apply to their work and their lives will be the movers and shakers in our society for the indefinite future.” – Brain Tracy, thus to become ambassadors of the profession, improve the lives of our clients, and make changes in mental health we need acquire as much knowledge as possible (from our classmates, group members, supervisors, articles and journals).

References

 Aota.org. (2019). [online] Available at: https://www.aota.org/~/media/Corporate/Files/Practice/MentalHealth/Distinct-Value-Mental-Health.pdf [Accessed 2 Aug. 2019].

Autism Speaks. (2019). What Is Autism? | Autism Speaks. [online] Available at: https://www.autismspeaks.org/what-autism [Accessed 2 Aug. 2019].

Psychiatry.org. (2019). What Is Schizophrenia?. [online] Available at: https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia [Accessed 2 Aug. 2019].

[themindofaconflictedrebelot]

The rocky road that led to the end of this block: Summing it all up if that’s even possible.

It’s another week yet again but not just any week it’s the final week and most probably this is my last entry this week. With all the challenges life has to offer moving forward can be a struggle sometimes but I’ve managed to wake up for all these prac mornings even though sometimes it was harder then usual. Motivation, the degree and every client that is depending on you as their therapist to offer them treatment that’s according to your standard of care. With each week bringing upon a new challenge, new client’s, new diagnoses, and more research to be done.

At first, I was frustrated by the fact that I had to start all over again with a new client every Monday due to all the improvement I had foreseen for the client I had the previous week. To such an extent that when I decided to final demo for the first time I was so happy because of my client’s improvement that I saw her as my demo client. With everything prepared, assistive devices made, smart aims written and structuring of the activity at the back of my mind. Only to arrive at the hospital to be told that she has been referred to another hospital. You can only imagine how I felt, it wasn’t just frustration it was also the fact that I had planned a lot for this client and I still had a lot that I want to do with her. As the weeks went by the repetition of similar events happened. And I found another demo client, I saw her for one session on a Wednesday assessed her and treated her. As I prayed that the following Monday she will still be there so that I can continue conducting treatment. As I woke all prepared for my demo again, I had this feeling that she was discharged as I went into the hospital I went to the senior OT and asked her whether or not my client was discharged and she told me that she’d check for me, I still had this feeling and I couldn’t shake it off so I went straight to the client’s ward only to be welcomed by an empty bed. Then again, I felt hopeless. Me thinking to myself about only if I knew I wouldn’t have spent my whole Friday night preparing for that session. So, I had to choose, I do the demo (practical examination) that day with a completely new client or I use one of my colleagues’ clients or I assess on that Monday and treat the following Monday. The third choice was not an option because deep down I knew that the same thing would happen. And as for the second option, two of my colleagues were doing their demo’s that day and I felt like I had to assess the client on my own so that I could understand them entirely and build rapport with them. So, I went with option number one. I got a completely new client with traumatic brain injury that resulted in him having left hemiplegia. As I thank God again for granting me the ability to be able to build new relationships faster, so I sat down with my client for an hour and got to know his and this is how our rapport was built, rapport building is imperative to gather and assess as much relevant information as possible to identify and address the client's needs in a holistic manner (Tahan et al, 2012). I assessed him and got to know him holistically in a matter of hours. And then I had to come up with a smart aim in less than 2 hours. And on that afternoon, I had to do my demo.

With all that being said this sequence of events has led me to being more on my feet when it comes to treatment and assessing. If you asked to assess a client 6 months ago it would have taken me a full 3 to 4 sessions to be able to get a full clinical picture of the client. But being in an acute setting has taught me to be more efficient in assessing clients and treating because you never know how much time you have with them before their discharged, they could be discharged home or to another hospital. At first, I was really startled when my client that was in a coma after a traumatic brain injury was discharged to another hospital and I didn’t think that it was possible to discharge a client who is still in a coma, well its possible alright.

These experiences ha taught to be able to think on my feet and they have also taught me how to write principles for different clients and different diagnoses. With a new diagnosis every week you are forced to read up more and conduct more research thus giving you a broader understanding of the different roles that occupational therapists play in the lives of these individuals. With some clients making more progress than others, but when they do you feel a joy that’s unlike any other. You see being part of the reason a person that thought that could never sit again gives you more fulfillment than you could ever ask. Having a client thanking you for all that you’ve done to improve their lives, taking a trip down memory lane with each and every new client, getting to understand different persons views on life and being there for your clients when they need you, getting to know how their diagnosis has affected their lives and building relationships with the different clients; you see those are some of the motivating reasons to wake up in the cold mornings and wear that scrub, even though not every client will appreciate what you are doing for them but those that do make you being a student OT something to be proud of.

Let me see if I can remember all the diagnoses, let’s see if we can still remember, we had a client with left hemiplegia, three clients with tetraplegia, one client with acute myeloid leukaemia, stiff man syndrome, two traumatic brain injuries which is the most common cause of death and disability in young people (Ghajar, 2000).two clients with scleroderma, two clients with epilepsy and a client with cerebral palsy; if I remember correctly. With every client having a clinical picture that’s unique to them requiring principles of treatment that are client specific. And this brought about a bigger opportunity to enhance self in the profession and bigger grounds for learning that a set of slides could never teach no matter how long they are. From being completely lost in terms of finding client specific intervention (aims, principles etc.) to what I know now I feel like I’ve grown a lot over this period of four months.

Nothing feels better than seeing your client improve their functioning, the smallest thing as them learning how to button their shirts again to them being able to sit independently. But it pains me that I could not see the end product of my client’s intervention.

As we move towards the end of another block and I’m happy with how things went, with a great team, including my always ready to help prac mates, them always having my back and always making me smile and being there when I’m in need of a shoulder to cry on, to the most understanding supervisor that cares about our well-being, to most of the hospital staff, the two OT’s that made me feel welcome into the facility, to the 2 minute sessions we spend on the chatting about ways to improve to help my client’s regain functioning, to them finding time teaching me how to sew, to them telling me that everything will be alright whenever I felt like everything was too much and tears were trying to escape into the outside world.

I’ve felt the concept of ubuntu during the duration of this block from my team to the caring nursing staff that behaved like mothers to me, and to my great clients. Someone once told me that, ‘you can never outgrowth learning, and that learning doesn’t always have to take place in the class room’, learning is a process that’s never ending and with every new person you meet they come with a handful of resources that could help you learn more about life and its dynamic nature. And that every person has a story to tell it’s up to you whether you listen, or you act as ignorant OT, everyone has words of wisdom to share from their past experiences no matter how small. Colson Whitehead said that, “It is failure that guides evolution; perfection provides no incentive for improvement, and nothing is perfect.” With this being said I’m not perfect and I have made mistakes during the prac block, but I’ve also shown a lot of improvement.

 References

 Ghajar, J. (2000). Traumatic brain injury. The Lancet, 356(9233), 923-929.

Tahan, H. A., & Sminkey, P. V. (2012). Motivational interviewing: Building rapport with clients to encourage desirable behavioral and lifestyle changes. Professional case management, 17(4), 164-172.

[themindofaconflictedrebelot]

Growing and aspiring to be the best Occupational therapist as possible.

It’s another week yet again, as we keep on pushing and moving towards greatness as we aspire to become the best occupational therapists we can be. I’ve seen growth in myself in the past few weeks of my physical block. With having difficulties with the construction of client specific principles and being able to do continuance assessment. As time goes by I feel as if I can see the improvement in myself. And I’m also adjusting to having different client’s every week with a completely new diagnosis that I’ve never heard of before.

 This week I have a client diagnosed with a condition called Dermatomyositis, which is an ‘idiopathic inflammatory myopathy (IIM) characterized by an inflammatory infiltrate primarily affecting the skeletal muscle and skin. Most common and peculiar cutaneous lesions include Gottron's papules, Gottron's sign and heliotrope rash. Different DM subsets have been identified until now encompassing classic DM, amyopathic DM, hypomyopathic DM, post-myopathic DM, and DM sine dermatitis’ (Laccarino et al, 2014). My client experiences Gottrans sign and she has a heliotropic rash. She also has co-morbidities such as hypertension, diabetes and delypidaemia; which ‘may include elevated LDL cholesterol, elevated triglycerides, and/or low HDL (protective) cholesterol’ (Gerber et al, 2006).

 I’m growing in terms of looking at my clients as wholistic as possible. I’ve taken all the feedback from my supervisor and put it into practice. I also have learnt that it is very important to seek help if you are struggling in that you gain more knowledge and understanding, and you don’t carry on doing the wrong thing over and over again. I’ve also learnt a lot about working with others and not in isolation.

 C. JoyBell C once said that, ‘The only way that we can live, is if we grow. The only way that we can grow is if we change. The only way that we can change is if we learn. The only way we can learn is if we are exposed. And the only way that we can become exposed is if we throw ourselves out into the open. Do it. Throw yourself’. So by the hospital having multiple diagnoses, I’ve been exposed, that way I learn, thus changing my way of thinking and allow for me to grow as an occupational therapist.

 References

Iaccarino, L., Ghirardello, A., Bettio, S., Zen, M., Gatto, M., Punzi, L., & Doria, A. (2014). The clinical features, diagnosis and classification of dermatomyositis. Journal of autoimmunity, 48, 122-127.

Jim Gerber, MS, DC, DACBN. Petzing, DC; Ravid Raphael, DC, DABCO; Anita Roberts, DC; Cherye Roche DC. (2006). Delypidaemia. Clinical Standards, Protocols, and Education (CSPE) Committee 5, 50-55.

[themindofaconflictedrebelot]

The importance of the multidisciplinary team and teamwork

Another week yet again, with all the studying and practical work this kid is barely surviving. With the client’s coming and going every week, I’m shook. On Monday I was prepared to do my final demonstration exam and when I reached the hospital I found out that my client was discharged, I was so sad and frustrated at the same time. If only the hospital staff had good communication amongst each other, the doctors would have notified the OT department about the client’s discharge earlier on. And the client would have gotten a good discharge from OT and more intervention would have been done. And the clients would have been referred accordingly to the base hospital.

 A multidisciplinary team approach is “discipline oriented, with all professionals working parallel and with clear role definitions, specified tasks and hierarchical lines of authority. The physician is responsible for inpatient treatment and coordinates the treatment plans used by the other professionals in the team” (korner,2010) and the hospitals uses that approach instead of the interdisciplinary approach which is when the different health practitioners, “meet regularly in order to discuss and collaboratively set treatment goals for the patients and jointly carry out the treatment plans. They are ideally on the same hierarchical level and there is a high degree of communication and cooperation among the team member” (korner, 2010). When all the practitioners work together the client benefits optimally, and for example when one of my client’s for midterms was not willing to participate in my treatment sessions, the nurses helped me to get him to co-operate and participate in the treatment sessions since we had a good working relationship.

 Good communication and interaction amongst the different team members helps the different practitioners to in their treatment sessions because this gets the knowledge they need to perform treatment such as what they need to treat and the cause of loss of function.

 For example, as an occupational therapist you need to get the go ahead from the doctor before you can mobilize the client, and if there is no team work and communication between the two, the client will not receive sufficient intervention, and this could to the client having complications.

 Like Helen Keller once, alone we can do little, together we can do so much”. So, its important to work with other health practitioners to have a good end product in terms of the client’s treatment.

 References

 Körner, M. (2010). Interprofessional teamwork in medical rehabilitation: a comparison of multidisciplinary and interdisciplinary team approach. Clinical rehabilitation, 24(8), 745-755

 Firth-Cozens, J. (2001). Multidisciplinary teamwork: the good, bad, and everything in between.

 Hartgerink, J. M., Cramm, J. M., Bakker, T. J. E. M., Van Eijsden, A. M., Mackenbach, J. P., & Nieboer, A. P. (2014). The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients. Journal of Advanced Nursing, 70(4), 791-799.

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Putting the clinical reasoning cycle into practice.

Week 7 and I am happy to say that I enjoyed working with my new client’s this week and I have a client that I can now see improvement in. And slowly but surely, I’m getting used to writing principles that are client specific.

In performing the therapy for all my clients, I need to have reasoning behind the therapeutic activities that I use in the client’s intervention. There are three types of clinical reasoning that I can use, “Procedural reasoning focuses on the process used to maximize clients’ functioning. Interactive reasoning emphasizes occupational therapists’ understanding of clients’ feelings about themselves and about the intervention they receive. Conditional reasoning involves the understanding of clients’ disabilities in specific life contexts” (Lie etal, 2000). During the cause of treating the different client’s I believe that I’ve used all the types of clinical reasoning when the situation needed it. For example I’ve used procedural clinical reasoning when I wanted to improve the client’s performance skills and their perform in activities of daily living, I’ve used Interactive reasoning when I spoke to the client about what they want to improve in their function and what are their interests and what their occupations and roles are at home, I’ve used conditional reasoning when I researched the client’s condition and assessed their level of functional to understand how their diagnosis limits them from participating in their occupational roles and occupations.

 But my take on the topic is that clinical reasoning improves as the therapist time spent on doing practical work increases and them learning more and reading more in terms of articles, books and journals.

 Henry Wadsworth Longfellow  once said, “The love of learning, the sequestered nooks, And all the sweet serenity of books”, the more you learn and read the more you understand and you can put theory into motion and practice and critically evaluate your therapy and think about new and better ways to do intervention.

  References

  Liu, K. P., Chan, C. C., & Hui‐Chan, C. W. (2000). Clinical reasoning and the occupational therapy curriculum. Occupational Therapy International, 7(3), 173-183.

Mattingly, C. (1991). What is clinical reasoning?. The American Journal of Occupational Therapy, 45(11), 979-986.

[themindofaconflictedrebelot]

The thrill of midterms

Week 6 and we still at, it has an adventure full of up’s and downs. From adapting to a complete change of scenery from the previous hospital I went to. And having your client’s being discharged every other week and have numerous new conditions you’ve never heard of. And having to find principles relevant to your client. And having to treat using play. But with all this my supervisor was always there to assist. Feedback is one of the most powerful influences on learning and achievement, but this impact can be either positive or negative. ( Hattie, 2007). Its better receiving constructive criticism and also what you did right so that it doesn’t discourage you and it gives you hope that you can improve.

  All in all, midterms has been somewhat like a roller coaster find with you never getting a chance to get off and catch a breather. With all this remembering we still have to attend lectures. But what I learnt is that crying and complaining doesn’t help at, because eventually you have to pull yourself up and continue, because the aim is getting this degree.

With the feedback from my presentation and demo that I got from supervisor I now know what to fix and what to focus on for finals. And I feel that I will do better in future like the saying goes, “Practice makes perfect”.

But no one’s perfect but we keep on doing the best that we can. As Elbert Habbard once said, “ There is only one way to avoid criticism: do nothing, say nothing, be nothing”.

 References

 Hattie, J., & Timperley, H. (2007). The power of feedback. Review of educational research, 77(1), 81-112.