OT3 Psych Blog

They say life is full of self-development, full of opportunities for growth and all about learning. I can safely say that this Psych fieldwork block has definitely been that stepping stone to my self-growth.

In of my academic growth, I feel that I have grown in terms of being an occupational therapist. I have developed in terms of my handling skills as well as my ability to treat. This block has also allowed me the opportunity to develop my skill in session write-ups and the appropriate use of treatment principles. I definitely feel that my clinical reasoning has also improved. Studies have shown the importance of clinical reasoning for a health professional, as it is a key determinant of patient care (Brown, 2018).

This block has assisted me to grow more than just academically. It has helped me to recognise my sense of resilience. It has also taught me the importance of not only focusing on my short comings or weaknesses but to also appreciate my strengths as small wins. Being critical of your performance is vital to ensure improvement however, giving yourself recognition and praise for a job well done is also important. We do this with our clients all the time and perhaps we should remember this principle for ourselves too.

Secondly, this block has taught me to be appreciative of all the opportunities that I have been granted in life. I have the opportunity to study at a tertiary institution which will aid toward the development of my career. I have a loving family who I can always count on. Research states that a good support system is associated with greater levels of success. Majority of the clients residing this facility do not have such opportunities, and this encouraged a certain amount of self-reflection into my life. We often think of our problems such as having countless deadlines, a humongous workload or even having to submit these weekly blogs, as major issues we have deal with. We fail to acknowledge that there are numerous people out there with substantially bigger problems that what we have. Yes, we all have troubles, but would it not be beneficial if we at least attempt to recognise and acknowledge the positive aspects too?

In conclusion, this block has definitely been one of the most memorable ones with lots of lessons and opportunities for self-growth both academically and personally. While I am a bit nervous for 4th year,  this block has also helped me to feel more equipped to handle the upcoming stresses and challenges.

References

Amabile, T., & Kramer, S. (2011). The Power of Small Wins. Retrieved 11 October 2019, from https://hbr.org/2011/05/the-power-of-small-wins?cm_sp=Article-_-Links-_-Comment

As 3rd year OT students, we were given the privilege to assist in hosting the research day for the 4th years. We able to attend and listen to the insightful and interesting research studies presented by the 4th year students.

I can safely say that our class as a whole were blown away by the standard and quality of the research conducted by the students. With each group that came up to present, it was evident as to the amount of work, effort and time that was put into ensuring their success. I feel that there were definitely some take-home tips or useful strategies, that we as third year students could utilize in the following year.

Firstly, the concept of “teamwork” was highlighted. As the saying goes: “Unity is strength. When there is teamwork and collaboration, wonderful things can be achieved.”- Mattie Stepanek.

Research within a group can be difficult at times due to group members presenting with opposing viewpoints. This often leads to the development of conflict within the group. Therefore, communication is key within a group to prevent such disputes. Studies say that group projects are more likely to succeed when the members effectively communicate with each (Frank Cervone, 2014).

Group work also means that the workload becomes divided or shared in contrast to it resting solely on one individual. According to Burke (2011), working within a group means that there will also be a wider source of information to work with, as each member contributes his/her knowledge to the project.

Another tip that was offered by the 4th years, was “consistent work”. They all had agreed that consistent effort needed to be put into the task to ensure its success.

Research states that it is important to also recognize the small wins along the way (Amabile & Kramer, 2011). This can serve as a motivator to work harder and to keep persevering.

In conclusion, the 4th years have certainly raised the bar high for us as 3rd year students. Although we feel a bit anxious and nervous for the year ahead, I believe that research day has also inspired us to rise up to the challenge. This OT degree has moulded us into more than just health professionals, it has groomed us into resilient go-getters ready to take on whatever comes our way!

References

Amabile, T., & Kramer, S. (2011). The Power of Small Wins. Retrieved 4 October 2019, from https://hbr.org/2011/05/the-power-of-small-wins?cm_sp=Article-_-Links-_-Comment

Burke, A. (2011). Group Work: How to Use Groups Effectively. The Journal Of Effective Teaching, 11(2), 87-95.

“I am whoonga

I take kids from their parents, and parents from their kids

I will make you my slave, and stand with you till your grave

I take everything

I am whoonga”

The above words were those of a young man who is currently recovering at a drug rehabilitation center. This young man came into our class and I am certain that we all thought that this was just going to be a standard ‘Say no to drugs” lecture. Instead we got a real in-depth perspective on the personal impact the drugs had on his life, his family and him as an individual.

The client was from a good home, one in which he was brought up well and instilled with values. Often society is under the presumption that drug users are from financially unstable homes. This is not the case. Drug addicts can be anyone irrespective of their jobs, ages or ethnic groups ("Anyone Can Become Addicted to Drugs", 2019).

The client stated that he began using the drug after being influenced by his friends. Research reveals other common causes of drug use include wanting to relax, to improve one’s mood, or to simply become intoxicated (Boys, 2001). The client further revealed that his mother was a teacher and was often very busy to pay much attention to him. This could have also led to his drug use. The following image reveals additional reasons for drug use.

Being addicted to whoonga, resulted in him committing various crimes such as shoplifting as well as murder to satisfy his habit. It also caused him to live on the streets for a while, where he was forced to fend for himself. It was at this point, that the client realized that the things or actions he was willing to do for his addiction, was more than he could handle. It was his turning point. This led to him admitting himself into the rehab facility and seeking the help he required. As mentioned before, he is currently in the rehab program and determined to come through this shining.

He went on to say that he felt it was ironic that he was presently in rehab for drug addiction. This is because in school he was a peer mentor who educated others against such things. In listening to this and everything he spoke about; I cannot seem to look past the uncertainty and unpredictability of life. We honestly do not know where life will take us. I therefore feel that it is so important for us to be grateful and appreciative for all that we currently have.

Life is undoubtedly tough at times. I feel that we need to develop good and healthy support structures to provide us with that much needed stability to deal with whatever is thrown our way. Studies have shown that apart from having a good group of friends and a strong familial support, religious coping has also proved to assist with overcoming stressful situations (Tix & Frazier, 2019).

In conclusion, I strongly feel that while life may be unpredictable, the decisions we make can still help to determine at least the possible direction in which we are going.

References

Anyone Can Become Addicted to Drugs. (2019). Retrieved  September 27, 2019, from https://teens.drugabuse.gov/videos/anyone-can-become-addicted-drugs

Boys, A. (2001). Understanding reasons for drug use amongst young people: a functional perspective. Health Education Research, 16(4), 457-469. doi: 10.1093/her/16.4.457

If there is anything that can relate to OT fieldwork, it would be the above quote by Albert Einstein. Without fieldwork experience, our lectures would just be lectures. The provision of theoretical knowledge to individuals, without the opportunity to practice what is being taught. Research has revealed that the retention and understanding of knowledge is better or improved through experience (Richardson, Davey, Done & Adamss, 2006). Fieldwork has afforded us this prospect of active learning which I feel is extremely important with respect to our career. OT is a health profession that requires us to be hands on with our clients. We are not sitting behind a desk, but need to be practically involved with them.

Being on psych block has allowed me to grasp a better understanding of various diagnoses, through the interaction with clients presenting with them. Through the assessment of clients, one is able to observe the impact of the client’s diagnosis on their daily functioning. For example, on fieldwork, one of my clients, was an autistic male.  Research has indicated autistic individuals to experience difficulty with social interaction/communication (Orsmond, Shattuck, Cooper, Sterzing & Anderson, 2013). This was observed during prac by him struggling with the demonstration of social skills resulting in him being socially withdrawn.  

Third year psych block also means that we are allowed to treat. I am still in the process of learning how to do this perfectly, but with time and additional practice I am sure I can achieve this. I have learnt through feedback from my supervisor that my treatment principles need to become more specific. The principles are in essence the basis of treatment. They determine what, how and why you want to achieve a specific goal with your client, as explained by my supervisor.

Personally, I have learnt that I am an extremely positive person, keen to learn, open to constructive criticism and resilient. I think these are important qualities to have as a student, as it opens the door for learning and helps you to survive in the stressful life of a student. I conclude this blog entry with the inspiring quote below:

References

Orsmond, G. I., Shattuck, P. T., Cooper, B. P., Sterzing, P. R., & Anderson, K. A. (2013). Social participation among young adults with an autism spectrum disorder. Journal of autism and developmental disorders, 43(11), 2710–2719. doi:10.1007/s10803-013-1833-8

Casual day has always been exciting. It was something I would look forward to in primary school. Back then, it was just an excuse to dress up and be fancy. However, this year, as a 3rd year OT student, I was given the opportunity to do something good for others. It was by far the best experience I have had of celebrating casual day.

As a group of students, we had organised a fun day for the residents at the psychiatric facility, in which games were played, snacks were provided and certificates of participation were handed out at the end. The excitement expressed on the faces of these clients were priceless. They were really having fun while dancing and playing the games. They were laughing and smiling through it all. Seeing them enjoy themselves filled me with a sense of happiness myself.

In terms of the snacks, they were provided with sandwiches, focaccia slices, cool drink, cupcakes, biscuits, marshmallows and popcorn. The clients were observed to thoroughly enjoy all these treats. I truly felt a sense of warmness as they all ate till, they were full. They were really appreciative of the food as it was different to their regular or routine meals at the facility. Personally, my parents have always taught me as I was growing up that the greatest blessing is to feed someone, or to give them a plate of food which they will enjoy. Therefore, I was ecstatic at being able to do this for the clients.

Through this experience of casual day, I have learnt to be appreciative of the little joys that life has to offer, to always be thankful for all that I have, such as my family, a home, nutritious meals and so on.

From a professional point of view, I feel that we could have planned better or more in advance to ensure the smooth running of everything. I felt that there were too many loose ends that needed to be tied on the day, such as the paint still needing to be bought for hand-printing on the wall, or not having the Macarena in a format that would be supported by the HiFi. We each should have known our specific roles in every activity of the day to avoid the running around or any confusion. The fault was ours for not utilizing the time prior to the event in order to plan efficiently. While life was extremely busy with various other deadlines, it was evident that we needed to exercise better time management skills.

Group cohesion within our student group also needed to be improved through clear communication regarding each of our viewpoints concerning aspects of the day. A group in which all members work together in achieving a goal, is a group which is more likely to attain success (Ingram, 1996).

In conclusion, although we planned a fun and exciting day for the clients, who thoroughly enjoyed themselves, there are still some professional aspects that we could improve on. I feel that more effective time management skills and better teamwork, could have made event planning much easier and flawless.

References

Letter to Time:

“They say you heal all wounds, but they don’t talk about how you destroy all that’s good in the world, how you turn beauty into ash. Well, you’re nothing more than a petrified wood to me. You are dead tissue that won’t decompose. “

These were the words of Howard. A father who was at the pits of his depression following the loss of his 6-year-old daughter, who past away due to a rare form of cancer.These words indicate to me his feelings of despair and the worthlessness he associates with the time, in which he is expected to continue living in the absence of his daughter. These feelings of worthlessness are commonly felt by depressed clients, thereby increasing the risk of possible self-injury or suicide (Blair-West, Cantor, Mellsop & Eyeson-Annan, 1999). The anger felt by him toward time was further expressed by him stating that his life is now a prison sentence.

Howard writes letters to not only time but to 2 other abstractions, namely Love and Death. The movie centers around him working through his feelings regarding these 3 abstractions. The film visually represents these 3 abstractions in the form of 3 individuals. I feel that this representation was much required in order to effectively illustrate the intrapsychic turmoil going on within his mind. This was in a way therapeutic for him, allowing for a certain amount of catharsis. As mentioned above he expresses feelings of anger towards time, as he is forced to live and continue with life without his daughter. He experiences trouble accepting death as he feels it has separated him from his beloved child. With regards to love he feels that there is nothing left worth loving in the world. His interaction with Love can be seen in the following video, in which she urges him to see that the love he has for his daughter has not been lost after she passed away. It was still there; present in the very pain he is currently feeling.

The above video clearly portrays the feelings of someone who is experiencing grief and depression. It also reveals the need that these clients have in terms of needing someone or something to show them the positiveness in all that they are going through. Or in other words the “collateral beauty”. In Howard’s case, his collateral beauty was the fact that his time on earth was indeed a gift and should not be wasted.

Secondly, death needed to reinforce its inevitability to Howard, to show him that it was not something within his control or that he could have protected his daughter from. Death further went on to say that, “Nothing is ever really dead, if you look at it right”, which I feel is a beautiful and reassuring perspective on death as a whole. With regards to Love, she showed him that his love for his daughter will never die and that love is within everything and everyone.

The intrapsychic turmoil within him had led to him becoming socially withdrawn. The movie clearly depicts the impact his depression has on his occupational functioning. He neglects his job of being an advertising executive and avoids his friends. He experiences difficulty with sleeping. He also does not ensure his bills are paid timeously. The above points all resemble the clinical presentation of an individual suffering from severe depression.

The movie also highlights the difficulty experienced by his friends, who are unable to adequately care or support him due to a lack of awareness and understanding regarding mental health. This indicates the need for mental health awareness to raised.

In conclusion, this movie has indicated that depression is not something that can just be pushed away, it is something that needs to be thoroughly explored and worked through.

 References

Blair-West, G., Cantor, C., Mellsop, G., & Eyeson-Annan, M. (1999). Lifetime suicide risk in major depression: sex and age determinants. Journal Of Affective Disorders, 55(2-3), 171-178. doi: 10.1016/s0165-0327(99)00004-x

Beginning psych block this semester was both overwhelming and interesting. The reason for it being overwhelming, was no doubt the fact that the last time I was on psych block was about a year ago. I don’t know about the general population, but in terms of students, our memory is not known to be very exceptional😂.

Psych block does feel a bit different to me, with regards to physical seeming more concrete and tangible than psych. However, over these past few weeks in which I engaged with many psych clients; I have realized something. I have come to the conclusion that with psych assessment, one has to be extremely observant. The key to efficient assessment in psych is to OBSERVE, OBSERVE, OBSERVE! “Visual observation is a fundamental skill underlying all occupational performance assessments in occupational therapy” (MacKenzie & Westwood, 2012)

Having a client who is not very verbal, also forced me to rely on my observation skills in order to make the necessary deductions. As a student, I feel that I am still refining this skill, and need to make certain that nothing goes unnoticed and that my assessment findings are more comprehensive. However, on this note, it is also advisable to not perceive everything to be an issue or problem for the client as well.

The reason for psych block being interesting to me is the fact that I have noticed an improvement in myself as a developing OT. I can safely say that I do not feel like my “nervous 2nd year OT” self. When I reflect back on 2nd year, I recall always being on edge and completely unsure of myself. My ability to interact comfortably with clients has improved since then and my confidence has definitely grown as an OT. I am proud of myself for growing in this aspect, but I am aware that I need to develop in other areas too.

Treatment is still an aspect that is relatively new and that I am still developing on. Treatment consists of numerous components, such as subprogrammes, treatment AFR’s and approaches. All of these things tend to overwhelm me at times, due to the amount of content, brainpower and time required for task. I definitely do not think that it is impossible to do all these things, but due to us currently being students, it does require a lot more effort and determination.

With regards to actually treating a client on psych prac, I felt that a limited amount of treatment was done. This is due to the length or duration of midterms being extremely short and us attempting to gather our psych assessment skills fast enough.

In conclusion, I certainly feel that I have come a long way since first year OT. From not knowing what assessment entailed, to not having the briefest idea of what a subprogram was and let’s not forget the numerous models and approaches that accompany it; I am now able to perform these tasks. However, the quality of these various aspects may not be exemplary, as I am still in the process of learning as a student. Therefore, even though I feel that I have grown in terms of being an OT, there is still room for additional progress and development.

References

“Occupational therapy (OT) is a holistic and client-centered health profession concerned with promoting health and well-being through occupation. The primary goal of OT is to enable people to participate in the activities of everyday life.” – Stein and Cutler’s study (as cited in Sarsak, 2018).

This definition regarding occupational therapy emphasizes a unique characteristic or aspect of the health profession, namely holistic or client-centred. This simply means that the client’s views and opinions regarding their therapy, must be considered and utilized to further guide his/her intervention. As students, we sometimes tend to be focused on achieving our own goals with regards to the client, and we lose sight of what the client actually feels he/she requires assistance with. I feel that as a developing OT on my psych block, it is important that I develop this skill of including my clients in their treatment planning. I feel that this could increase the clients’ willingness to participate in therapy by working on aspects he/she believes to be important. It also grants the client a much-appreciated sense of autonomy, which is rarely given to them in a psychiatric residential facility.

Sarsak (2018), further indicated the importance of a multidisciplinary approach with regards to the psychiatric care of individuals. It has been proven that such an approach would yield more effective management of psychotic symptoms as well as improve occupational functioning. It is therefore important for OT students to develop the skill and confidence to professionally interact with fellow members of the MDT. As Helen Keller said: “Alone we can do so little, together we can do so much.” I believe we all hold pieces of the puzzle and when brought together, it forms a bigger picture to work with, ensuring a greater success.

Sarsak (2018), further highlighted the role of OT’s within the psychiatric setting, by exploring various evidence-based OT interventions. Some of these included reminiscence techniques, group therapy, stress management, relaxation, interest checklist and psychoeducation. All of these have been proven to aid OT intervention and should be considered and practiced during our fieldwork as students. This would not only assist with the client’s intervention but also enable us to develop as OT’s and gain valuable experience with using these treatment modalities.

The above-mentioned points from Sarsak (2018), are all skills that I aim to develop as I grow towards becoming a professional OT. One of the aspects I truly appreciate in OT is the fact that we look at a client and see a person, not the diagnosis, but a real-life person, just like you and I, and that is something I find to be truly special. I would like to end my blog with the inspiring image below which contains the words of Canadian OT, Rachel Thibeault.  I found that her words below, truly explained my feelings toward OT.

References

Abraham Lincoln once said “Give me six hours to chop a tree and I will spend the first four sharpening the axe.” This quote emphasizes the importance of planning and preparation to ensure success or achievement of an end goal. Similarly, prac prep serves as the initial stages of sharpening our so called “axe” or in more literal terms our OT related skills.

The prac prep organised prior to this psych block was one that was much needed. This is due to the fact that my previous psych fieldwork was about 18 months ago. The prac prep day covered various aspects namely, diagnostic and psychodynamic formulation, how to write up SMART aims correctly, intervention planning and so on. I found it extremely refreshing and informative. Competence, knowledge and confidence are factors that go hand in hand for students embarking on any fieldwork journey (Holland, Middleton & Uys, 2013). The knowledge gained from prac prep has enabled me to feel a little more confident in both myself and my abilities as a developing OT.

Apart from the academic aspect of prac prep, it also served as a means of getting acquainted  with my fellow colleagues and supervisor. I strongly feel that having a support system on prac is extremely beneficial. At times, fieldwork can be demanding and may not always be a bed of roses. It is during these times of distress that one can debrief with other members of the group, who are likely to understand and support you better, as they have probably experienced your dilemma before. Students could find emotional relief from sharing as well as devise coping skills together (Cook, 2018).

Regardless of the numerous advantages of prac prep, I am aware that it does not mean that the “axe” ( or our OT skills) can be fully perfected during prac prep alone. Constant work, reading several knowledge sources and reflecting on previous years notes are all critical in contributing toward my OT growth.

As this first week of prac comes to an end, it is now time to reflect on my experiences over this period. I have to admit it has not been overwhelmingly stressful up to this point (not yet at least!). This week was focused on meeting with my clients, building up a rapport with them and beginning with assessment. With one of my clients,  an introductory interview was not suitable due to his decreased social communication. I therefore attempted to make a collage with him on the topic of himself, in order to get to know him better, and to prompt verbal and non-verbal communication through discussion about the collage. Although verbal communication was still very limited, I did get to know him a little better. In the upcoming week, I would like to manage my time well in order to ensure the completion of assessment of both my clients.

In conclusion, the venue in which I have been placed, is extremely homely and offers a warm atmosphere. The clients are also such sweet and friendly souls. I am looking forward to to my time at this place, interacting with these lovely individuals and creating wonderful memories.

References

Cook, J. (2018). Student-led mental health groups are important — with supervision. Retrieved 2 August 2019, from https://thehill.com/opinion/healthcare/395414-student-led-mental-health-groups-are-important-but-with-supervision