An OT is Born

I have always pondered over the importance of employment in psych OT, knowing its value but doubting the strength I would have as an OT to guarantee my patient to be re-employed post-discharge. I understand that a person with a physical disability deserves their place again in their work space and how this can be achieved through environmental accommodations to be made etc. However, trying to convince an employer to take back their patient with a diagnosis, such as schizophrenia or bipolar, seems to be a difficult task in my mind. I therefore wanted to explore this topic further by reading an article. I have come across clients that have been unemployed for many years or are in a sheltered workshop, such as Durban-North challenge. My mind is now exploring options for young, acute clients who may wish to work, as I am now experiencing this with my 22 year old client.

Occupational therapists have skill in the employment service area because occupation is central to the frame of reference of occupational therapy, and this includes work. Therefore, occupational therapists have the expertise to holistically consider the persons physical, behavioural, cognitive, social and emotional capacity in relation to employment. Task analysis is a core skill of occupational therapy and allows barriers and enablers to be identified. Subsequently, occupational therapists are able to determine the necessary interventions to enhance the job-person fit.

Occupational therapists have many assessment tools such as the occupational performance history interview, the occupational self-assessment, the volitional questionnaire, the worker role interview and the work environment impact scale that they are informed of and trained to use to accurately recognize strengths and barriers to employment. Occupational therapists possess the expertise to adapt the job demands and environment together with the person to achieve their maximum capacity for work.

I am now going to list examples of modifications which can be made in mental health accommodation for return to work, according to (Bezdikian, 2017). The OT should develop a detailed return to work plan. Accommodations should be agreed as well as expectations of responsibilities and consequences of not meeting performance standards should be discussed. This plan should also include a crisis plan of how one should respond in the event of client relapse and support or resources. Modifications can be made by use of written instructions for greater clarity and the employee’s ability to recall details, include more frequent breaks e.g. Six 5 minute breaks and not two 15 minute breaks and possible exchange of tasks. The client should have weekly meetings with the supervisor to discuss his work ethic, struggles and receive feedback. Co-workers should be educated on the diagnosis too. More examples include: quality work training, breakdown of large tasks into smaller steps, use of technologically advanced equipment, use of checklists or possible counselling.

Meaningful employment has been shown to improve self-esteem, increase personal empowerment and social contact, social identity and status, reduce clinical symptoms, development of personal wellbeing and higher levels of functioning.

OT’s use activity analysis to break down skills so that they can be gradually mastered and help people resume past roles or adopt new ones. It was suggested that occupational therapists should continue to focus their attention on listening to their clients to understand where they are on their recovery journey. Occupational therapists are able to provide a range of different vocational services to people with a mental illness. Treatment in social skills training, stress management and time management skills are also key strategies.

The article gave me the confidence in our role as professionals to strive for patients’ opportunity in the work place and empowered me to advocate for our psych clients. It frightened me to think of how I could powerfully impact someone’s life someday by promoting their return to work and I struggled to understand my capability when it came to Work in the psych field. I have also realized the need to do further research in the area of vocational employment and the formal assessments we use as OT’s to be more competent in this area. Occupation in the form of work provides much meaning and value to peoples’ lives and therefore, whether it be in a supported or open labour market, it is vital for us to address it and creatively discover treatment options to make recommendations for the clients’ return to work. 

References:

1.       Machingura, T. and Lloyd, C. (2017), "Mental health occupational therapy and supported employment", Irish Journal of Occupational Therapy, Vol. 45 No. 1, pp. 52-57. Retrieved from https://doi.org/10.1108/IJOT-02-2017-0004 on the 7/08/2019

2.       Bezdikian, D. (2017). Workplace Strategies for Mental Health. Accommodation Strategies. Retrieved from www.workplacestrategiesformentalhealth.com on the 8/08/2019

3.       Mental Health Treatment. Then and Now. (2019). Retrieved from https://courses.lumenlearning.com/wmopen-psychology/chapter/introduction-to-mental-health/  on the 10/08/2019