Learnings in this block

“Vulnerability is the birthplace of innovation, creativity and change” (Brown, 2011).
I feel as though I have had to be vulnerable and have expressed many emotions throughout this block with the friends I’ve shared it with. I have had to expose my areas of weakness, lack of understanding and develop in vital areas, to create a more admirable therapist. This block was emotionally and physically draining, however my prac group were very supportive of each other and I am extremely grateful for them.

“There are no secrets to success. It is the result of preparation, hard work and learning from failure” (Powell, C). This block has taught me so much as a person and a developing therapist. As a person it has taught me to take every day as it comes and keep going, because the end is near. As a student OT, I have realized the great impact research, clinical reasoning and client context has on the treatment you provide and sessions you plan.

According to (Greenwood, Beth) these are the qualities which make a good OT. I will elaborate on how I have grown in these areas.

Communication and Listening

“Interpersonal skills and ability to communicate with your patients are vitally important. First, you must listen to your patients, who can explain how they feel or what their symptoms are”. I feel I have developed in my interpersonal skills, when communicating with my patients. I have learnt how to handle many new situations, when dealing with acute psychotic patient’s, such as using a therapeutic face when they dive into their world of delusions. I learnt how to express my concerns with empathy and how to ask my patients questions about their concerns, which are vital to gain context to formulate a problem list. I also learnt through midterms how important it is to receive collateral information, as Mr L’s sessions would have had a complete turnaround, had I gathered this information sooner. The client, blinded by the word ‘discharge’, barely answered any of my tests, or interview questions honestly.

Organization and Problem-Solving

“Much of OT work involves solving problems, according to OT Career Path. An OT needs organizational skills to manage her own daily activities and schedule as well”. As a student OT, I have come to terms with the fact that organization is the key to successful sessions. Even having a note written for reminders during the session, a notebook, pen and forms readily available allows created a more productive day. Organization in terms of researching and planning treatment also falls into this section. I have improved greatly in this area and will continue to grow through its value. Time management is also vital. I have definitely learnt to treat faster and use my time more wisely. Through this I have grown in my confidence and handling of patients during treatment sessions.

Compassionate Care

“Compassion, empathy and patience are necessary skills for an OT and are often driven by a desire to help others. A patient who is suffering from an illness may be grieving for her lost skills or the life activities she once enjoyed”. I do my best to develop therapeutic relationships with my clients so that they feel we have developed a safe, trustworthy relationship. I have learnt to show compassion for their struggles and develop aims alongside them. 

I learnt something valuable through my finals client, and I was mad with myself for doubting her strengths until the last second. Mrs J is a shizoaffective client and she explained in my first session with her that she had published a book. She mentioned the title and that it was on amazon. After having dealt with an extremely delusional client for midterms, I completed disregarded this achievement not believing it was true. After observing her writing strength through a poetry session, I decided to research the book she had mentioned. My client had a five star book published on Amazon. Not only would she possibly have felt saddened by me not ever mentioning that I had looked up the book, but it would have improved her mood and self-esteem too. This was an important learning experience.

My plan for my psychiatric block in fourth year is to not be as shy; to try more complicated activities, such as baking, cooking and extravagant art work. Psychiatry treatment, through occupational therapy, is abstract. I have always been frustrated by this, but I have realized this provides an opportunity for me to explore my strengths in psych and I should make the most of it! After fourth year, we will need to determine our OT path and I am undermining my strength in psych. I should therefore grab it by the hands and explore it on a deeper level, because I have finally discovered its great importance and worth. Dealing with Bipolar Disorder, Schizophrenia Spectrum Disorder, Personality Disorders and Schizoaffective Disorders in third year will be an experience I will never forget. I am extremely grateful for this opportunity.

It is the first time I have effectively worked in an MDT, despite the difficulties a student faces with this important skill. When I called the client’s social worker for collateral and I was the first to inform her of  the client’s discharge, I began to experience the true feeling of being health professional.

In conclusion, this psychiatric block showed me the impact OT’s can have on psychiatric patient’s lives. The patient’s don’t realize how much they give to us as students, whilst we try our best to improve their quality of life and enrich their circumstances. This acute hospital taught me valuable life skills, taught me how to deal with discharge (haha) and forced me to understand patient’s context on a much deeper level, in order to do what is best for them. 

References:                                                                                

1. Greenwood, Beth. "Qualities of a Good Occupational Therapist." Work - Chron.com, http://work.chron.com/qualities-good-occupational-therapist-26306.html. Accessed 24 April 2019.

2.  Gibbs, M. 5 Powerful Quote’s from Brene Brown’s Ted Talk. http://empowerlounge.com/5-powerful-quotes-from-brene-browns-tedtalk-about-shame/

3.  Powell, C. Failure Quotes: Brainy Quotes. https://www.brainyquote.com/topics/failure

Research Day

On the 25^th of September, the OT department had their research day. This is the day in which the fourth years take to the stage and present 1.5 years’ worth of blood, sweat and tears, in just 10 minutes! The third-year students were responsible, along with Mr P, to ensure the day ran successfully and we got the opportunity to listen to the 5 fourth year research presentations.

It was really interesting to learn more about the different topics, which were each so unique and interesting.  The groups were so well co-ordinated, from the attire worn, to the quality of the PowerPoint presentations. It left me in awe of the hard work they had put into this, but also left me speechless for what the year ahead is going to look like. Am I equipped to produce such efficient work? I thought that this day was very important for us to gain insight into what is expected of us in fourth year and how the Research Day of presentations will berun.
The research presentations quality were exceptional and really set the bar for the UKZN, OT research standard. Some of the topics which interested me were “The Impact that Strike Action has on OT Students”, “Substance Abuse in OT” and “The Impact that Oculocutaneous Albinism has on Individual’s Occupational Participation”. Their presentations were all so well-rehearsed, it was immaculate.

At the end of the day the students gave us advice for Research and working in teams. Some advice was humorous and some was extremely useful. They told us to use our strengths and to be honest about our weaknesses.

Research has definitely hit my group with a bang. I have never exactly been the leader in my previous groups, as other personalities, who stress more than I do, have taken over in the past. However, when I realized my group was extremely passive and nothing was being said, and therefore, nothing was being done, Iknew I needed to take on this role. Wow... it has not been easy. To be honest, I am extremely jealous of the fourth years who are about to be finished with the Research module.  

Some people don’t do their work. Full stop. Other people do their work, but unfortunately struggle to perform sufficiently in certain sections, as a result of writing in their second language. It is my first time witnessing the struggles that my fellow friends face, trying to study in their second language.

This has lead to me having to redo people’s parts, or rather informing my supervisor that I will redo them, after this hectic week. Unfortunately, this puts a huge burden on the rest of the group to perform at the necessary standard.

As Gina informed us last week Monday to have our proposal in by Friday, we had to divide the work into 6 and each person chose their roles. This method did not work out, as students had chosen sections they were not competent at and within a very hectic week, students did not put in great effort.

In our meeting with Gina, we discussed our difficulties in communication. With advice from fourth years in the same room too, we have developed new strategies.

1)      The group will not split up the parts but will rather meet weekly, for two hours, with defined objectives to complete.

2)      Each person is required to respond with a yes or no to suggestions made on the group to show alignment and take responsibility.

3)      Within our group of 6, we will pair up, and each have objectives to complete within those two hours.

According to University of Waterloo. (2019), To function successfully in a small group, students need to be able to communicate clearly on intellectual and emotional levels. Effective communicators:

• can explain their own ideas


• express their feelings in an open but non-threatening way


• listen carefully to others


• ask questions to clarify others’ ideas and emotions


• can sense how others feel based on their nonverbal communication


• will initiate conversations about group climate or process if they sense tensions brewing


• reflect on the activities and interactions of their group and encourage other group members to do so as well.

According to University of Waterloo, 2019, the following is necessary when forming a new group: Individual responsibility and accountability, constructive feedback, problem solving, management and organization and knowledge of roles.

“Intra-professional team building in occupational therapy is critically important to the vitality and expansion of the profession. Teamwork must be a cognizant process; knowledge and multiple skills are required in order for therapists and assistants to work together successfully” (Blechert, Christianson & Kar, 1987). Our profession requires necessary team work skills and experience, which is why a task like this, provides us with important learning opportunities.

I am excited by my groups research topic and Research Day made me realize how the effort will all be worth it in the end. Here’s to learning to work in a team with many different personalities, growing my leadership skills and working together to produce an impactful report and presentation in 2020.

References:

University of Waterloo. (2019). Teamwork Skills: Being an Effective Group Member. Retrieved on the 6^th of October 2019, from https://uwaterloo.ca/centre-for-teaching-excellence/teaching-resources/teaching-tips/tips-students/being-part-team/teamwork-skills-being-effective-group-member

Blechert, T.F., Christiansen, M.F., & Kari, N. (1987). Intra-professional Team Building. American Journal of Occupational Therapy, 41(9), 576-582.

FunnyAnd. (2019). Every Group Project at School. Retrieved on the 6 of October 2019, from http://funnyand.com/every-group-project-of-school-file/

An Inspirational Day

On Thursday, the 26^th of September, the OT third year class fell in love with OT again. As Debbie put it, OT students become more drained by their degree as the years progress. A day, such as this, sparked a sense of motivation in each individual again, after months of exhaustion. Most students fall out of love with the degree, because of its intensity and the way it takes over ones life.

The first person to speak was a lady who is the founder of the foundation, Action in Autism. Her speech was extremely comprehensive and interesting. I enjoyed the examples she gave of her child who has Autism. She established the foundation after realizing the poor support for Autism in our province and country. The Action in Autism, (2019) website describes autism as follows: Children with autism show marked impairment in social interaction, verbal and non-verbal communication, and limited and restricted interests and behaviour. It is a neurodevelopment disorder and occurs in the first three years of life. There is ongoing uncertainty about the cause, treatment, intervention and prognosis within the condition. International statistics indicate that 1 in 68 children have autism. The cost of caring and providing for a child with autism is huge – the child in most cases requires 24-hour care. Many parents are unable to take their children into public spaces. Since the young age of 2, I have spent a lot of time with a family friend who has autism. My family friend is 22 and I have had multiple unique experiences with autistic behaviour, as a result. Many people don’t understand this diagnosis, which is why these client’s struggle to integrate into their communities effectively.

An autistic man, age 19, came to speak to us about his experience with autism. As a young boy, his anxiety was a major problem. He explained that it was his occupational therapist that got him where he is today. What I found to be extremely interesting was his emphasis on the fact that an autistic child’s sensory problems should be the main priority and the psychological problems are secondary. The speaker continued, describing his discomfort with psychiatrists compared to his OT and this is because they did not understand this concept. He provided us with a tip wih regards to how his OT managed to use brushing and compression to remove his hand-gesturing, flapping tendencies when he was in an anxiety-provoking situation. The client struggled through schools, with some only suited to physical disabilities, others with poor teachers, trying home school and then the difficulties he faced with teachers showing him ‘special attention’, when going to a regular school from Grade 9 to 11. The speaker has since gotten a diploma in IT and is planning on moving to the UK next year to live independently and get a job there. As you can imagine, each one of our OT hearts were bursting with pride, understanding how far he has come through therapy.

We then had a discussion from a head social worker at NPC about how the centre is run, followed by a client from the rehabilitation unit. This is what this client had to say, “I started in the name of fun and it led to me killing someone. Don’t do drugs and choose friends wisely. I grew up in a good, supportive home. I ended up stealing from that home”. To hear the raw truth of how the drug completely took over his life captured all of us. He would steal, destroy, lie, abuse ad even kill someone to support this poor habit. This put the diagnosis into perspective for me. He described how his OT student, this semester, has helped him delve into the inside, as he has always focused on the outside. Through this he realized his relapses on many occasions was not only out of boredom, but to seek attention from his mother. He stated that his OT student has helped him more than his professional social worker. This had the whole class in laughter and very proud of our friend. Getting to ask these clients raw questions about their diagnoses, which we had not yet been exposed to, really helped grow my experience as a student. According to Opp, A. (2019), Occupational therapy practitioners study the habits and behaviours of clients that occur each day, throughout the week. They display to clients how their behaviours and thoughts revolve around drugs or alcohol and how they lose their identity, as they lose the roles most meaningful to them. Practitioners then construct or rebuild those occupational roles by determining what activities bring clients the most joy and sense of well-being—without drugs or alcohol. I researched this to understand our role in this sector and thought this paragraph appropriately reiterated our purpose when dealing with substance abuse.

Down Syndrome is a diagnosis I have not been exposed much to in my life time and it was therefore interesting to listen to a mom share her wisdom on this diagnosis. I have a great heart for children with this diagnosis and am excited to work with them in the future.

In conclusion, a session like today was extremely educational. To hear patients’ explain their positive experience with OT and how it helped them, definitely re-inspired our class and reminded us of the purpose and impact we can make. I believe sessions like this should take place once a term.

References:

Action in Autism. (2019). What is Autism? Retrieved from https://actioninautism.org.za/what-is-autism on the 27^th of September 2019.

Opp, A. (2019). American: Occupational Therapy Association. Recovery with Purpose: Occupational Therapy and Drug and Alcohol Abuse. Retrieved from https://www.aota.org/about-occupational-therapy/professionals/mh/articles/recoverywithpurpose.aspxn on 27th of September 2019.

MB. (2019) 21 Motivational Quotes to Motivate You to be Successful in 2019. Retrieved from https://www.mulliganbrother.com/single-post/2019/01/30/21-Motivational-Quotes-to-Motivate-You-to-Be-Successful-in-2019 on the 28^th of September 2019.

What I have learnt on fieldwork block and about myself so far.

This fieldwork block has been a real eye-opener into the world of mental illness. Before this block my only experience of psychiatric illnesses were with intellectual disability and dementia. It was therefore extremely necessary for me to experience a wider range of mental illness before fourth year. I am extremely grateful for my opportunity and have tried to make the most of my experience at this acute hospital.

I have learnt the importance of finalizing the problem list as soon as possible, from the most important to the least important. In an acute hospital, patients are discharged readily and it is vital that the relapse prevention subprogramme is completed, to prevent future relapses, if it is necessary. I have therefore learnt that assessment findings are the priority, rather than a swift start to treatment. Information from the file or collateral information (Especially when dealing with manipulative schizophrenic patients) could completely change your treatment mindset.

I have also learnt how a person’s mental health can change over time. When the demands placed on a person exceed their resources and coping abilities, their mental health can be impacted. This is especially true for patient’s who lose their support system. For example, my patient’s father was a doctor. When he looked after my schizoaffective patient by ensuring she took medication, checking on her and stabilizing her moods, she maintained a job for 30 years. As soon as he passed on, she relapsed multiple times. Later, when her husband died she now only had the responsibility of cooking for herself and therefore became anorexic. Her depression after this death caused such a poor self-esteem and she relapsed multiple times again after that incident. Critical life events impact majorly on a person suffering from a psychiatric illness and this is a major reason why support systems are so important.

I have had to adjust to the abstract nature of intervention in psychiatry, compared to physical. I've developed myself with the psychiatry intervention needs, with experience. However, I am still learning to adapt each activity to completely suit the client’s needs. I felt as though I have managed to create subprogrammes which genuinely suit my clients rather than only specifically suiting their diagnosis, in comparison to midterms.

I have learnt more about how to be empathetic and develop a therapeutic relationship with a psychiatric patient. I have also had emotional moments where I’ve seen progression in patients through group therapy or casual day. These moments have opened my eyes to not only viewing these clients as patients, but as people. People with a life prior to their diagnosis and people with real emotions and feelings. I love how as OT’s we can embrace individual’s differences and allow them to use these differences to enjoy their lives to the fullest.

This to me is why I am so incredibly passionate about this degree. I told my career counsellor in Grade 11 that I wanted to pursue a career that allows me to help people. Had I not said those words to her, I could be on a completely different path right now. I had no idea what OT was and trusted her as she responded to me, “why don’t we look into occupational therapy”. My passion for this degree continues to grow day by day, as a I learn more in each block.

References:

NDC. (2018). Learn about Mental Health. Retrieved on the 23^rd of September 2019 from https://www.cdc.gov/mentalhealth/learn/index.htm

Soeker, M.S. (2014). Occupational therapy students’ perceptions of the challenges they experience in adapting to a psychiatric fieldwork placement.  Education Research Journal Vol. 4(6): 65-73

Islam, MJ. (2014). Experiences of occupational therapy students in the first fieldwork education: a qualitative study. Retrieved on the 23^rd of September 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4301239/

The image was retrieved from Pinterest: https://www.pinterest.nz/explore/social-work/

Casual Day: JOY, PASSION, LIFE

On the 6th of September 2019, South Africans celebrated the 25th year of Casual Day, using the theme ‘Time to Shine’.

Written in the article by NCPD National Office. 2019 was the following: “We are inviting YOU to go with your glow on Casual Day 2019… from the sparkle in your eyes to the bright neon of your outfits. To encourage everyone to shine their light and take up their rights! No longer are persons with disabilities to be relegated to the shadows, this year we call on YOU to ... stand out… to be visible… to live loud and be seen!”

This theme did exactly that as we arrived in the wards with our brightly painted faces, large ‘Casual Day’ banner and neon colours. For the clients of King Dinizulu Hospital who experience the extreme boredom which co-insides with institutionalization, the event that we planned shined as brightly as it was destined to. The competitive games, explosive dance moves, vibrant music, tasty treats and painting of hands to unify participation in the event brought endless smiles, laughs and fun into the gloomy wards, on a rather miserable, rainy day. One client spoke to me, as we were about to leave, saying that she expected it to be boring but had a huge smile and stated that it was so much fun.

NCPD National Office. 2019 stated that “The theme of TIME TO SHINE sets out to achieve many things, to highlight and showcase the brilliance that’s created when South Africans unite behind a truly great cause… to encourage people to shine their light and take up their rights”.

The theme brought great unity amongst the client’s and they certainly felt encouraged and happy after this day. I danced continuously for at least 30 minutes with a specific client who has shown to be in a lot of anger, pain and sorrow in the past week, resulting in poor behaviour. I wanted to cry when I saw the JOY she experienced in singing all the ‘Golden oldies’ and strutting her moves.

I also told the clients to listen to the inspirational song, by Andy Grammar, ‘Don’t Give up on Me’ and some of the more elderly ladies specifically resonated with this song and the words which say, “I’m not giving up. I’m not giving up, giving up, no not yet”, these lyrics bring life and rejuvenate those who are feeling hopeless. I noticed the therapeutic benefit of doing this, as well as, bringing in many songs from the past that the clients would know e.g. Dancing Queen by Abba. To add a social element, I told those who were dancing to pair up by holding hands and to dance with that friend and this gave the clients who are experiencing psychomotor retardation symptoms a chance to be more active.

The ladies ward played a few games and then decorated cupcakes and ate them before having a dance party. The men’s ward played games such as bowling, tug of war and bean bag toss and their delicious oranges and chips also gave the day more flavour. Both wards also participated in the casper slide. The men and women both thoroughly enjoyed the day as much as the students did.

According to Mindwise innovations 2019, “Swedish researchers studied more than 100 teenage girls who were struggling with issues like depression and anxiety. Half of the girls attended weekly dance classes, while the other half didn’t. The results showed the girls who took the dance classes improved their mental health and reported a boost in their mood. These positive effects lasted up to eight months after the dance classes ended. 

Teens aren’t the only ones who can dance their way to mental health. Senior adults (and adults of all ages) can reap the benefits too. A small group of senior adults, ages 65-91, was recently studied in North Dakota. After taking 12 weeks of Zumba (a dance fitness class), the seniors reported improved moods and cognitive skills. Not to mention increased strength and agility. Aside from the benefits of movement and music, dancing also allows us to become more connected and social. Making new friendships or reconnecting in an old relationship can be a wonderful side effect of dance. These social interactions can go a long way in improving mood and mental health”.

I chose to research an article on this as I witnessed the benefits of dance in mental health for the first time on Friday. I have been dancing since the age of three and I still do an advanced hip-hop and contemporary class twice a week. Seeing my passion link in with my career made me so excited to use it for the better in the near future. The article I read put it into perspective for me what dance therapy can do for a person’s mood and self-esteem.

In conclusion, I was able to witness the professional benefits that came with Casual Day. The nurses and security guards witnessed a side of patients that they didn’t know existed when they danced and sang at the top of their lungs. The day created a happy atmosphere which benefitted the clients in an exponential way and I know that they will continue to discuss this day for weeks, in their respective wards.

References:

1.       NCPD National Office. (2019). Casual Day: Time to shine with persons with Disabilities. Retrieved from http://www.casualday.co.za/contact-us/ on the 7^th of September 2019.

2.       Youtube. (2019). Casual Day SA. Retrieved from https://www.youtube.com/watch?v=jlep1--HAuw on the 7^th of September 2019.

3.       Grammar, A. (2018). Andy Gramar lyrics. Retrieved from https://www.azlyrics.com/lyrics/andygrammer/dontgiveuponme.html on the 7^th of September 2019.

4.       Mindwise Innovations. (2019). Dancing and mental Health. Retrieved from https://www.mindwise.org/blog/mental-health/dancing-and-mental-health/ on the 7^th of September 2019.