kuhleh

[kuhleh]

EXPERIENCES AND LESSONS FROM WORKING IN AND WITH A COMMUNITY

It is unfortunate that the time allocated for me to be in the community is slowly coming to an end.

Like every other block, the block had its own great moments and moments where I wish I could just slow down time so I can get to catch up with everything and maybe get to understand what is going on. There are a lot of experiences that I have taken away from working with the community and some lessons that have become life lessons.

OT appraises the environment that a person lives in and how it can impact on one’s functioning; and yes it has been appraised in the other blocks but from working in and with the community, it now makes complete sense why it does, because obviously it plays an important role in one’s functioning in occupations and OT is occupation based, right?. It is true though, one’s environment can either exacerbate one’s performance in occupation and it can make it better again.

OTs can be the only shinning or sparkling light or the only beam of light in the person’s life when all that people around them see is a person that is existing and not merely living which slowly takes away all the light in their lives. I can imagine the pain of losing your independence and having to rely on someone for everything and above that, have that person doing all these things not not out of love but because they feel they have to and as they do them they say words or anger full of anger, hatred and all, wouldn’t I just think death is way better than being a burden in someone’s life?

Apart from the environment, the block has shown me that OTs are capable of changing people’s lives and give them something to wake up and look forward to in the mornings. I have seen my colleagues helping out with a client with finding a job and that on its own has brought some structure into her life and with the roles she hadn’t previously been able to fulfill, the intervention has been done such that it helps her rethink and restructure her life so that she can be able to fulfil her roles. Isn’t that just amazing?

Anyway moving on, we sure have multiple roles in clients’ lives and it is unfortunate that due to life, we are sometimes left feeling like we did not do enough for those clients. Death is said to be an existential factor and a journal by Pollard, N. (2006) questions if dying is an occupation? What is your take on that?

For me, finding out that my client was late kind of got to me, I had been working with her for the past weeks and although I could see her deteriorating in front of me, I did not think death could come so soon or fast rather but then again there are some factors that we as OTs or as human cannot control in life. The feelings or emotions I was going through when I found out were overwhelming, a part of me was angry with myself for not getting her out of that house she had been living in sooner and then at that time I questioned my own treatment yet a part of me felt like I did everything I could to help her but it had to happen and she had fought so hard, that time came and she could fight no more.

This experience then got me to look at life just like the Kawa model explains it, life is more like a river  which is obviously not empty but has water, the river walls and base, the drift woods, the rocks, and the spaces between in which water flows and when there’s no longer any spaces left for the water to flow, it stops and that is the end ("The Kawa (river) model of occupational therapy", 2017), like her life depicted by the water, it got shaped by the environment she was in and the kind support and love that she was getting, with these shaping her quality of life, there were still so many other things which were slowing down her water flow and these included her medical condition, decreased functional status, perception of being a burden to her family, not being given her medication, not having anyone to give her the optimal amount of care, lack form of support from family and also just losing meaning and hope in your own life. And these stopped the flow and brought her life to an end.  Although we may also be in denial of what is most likely to happen, for the sake of the client, palliative care has to be done.

This picture may carry different meanings for everyone but to me it shows that as much as life is unpredictable, people seem to always be expecting the good things from it that when the bad comes or happens, we easily get shut down or broken because we never prepare ourselves for such but wouldn’t it be boring if we could predict our lives?

In conclusion, working in the community has taught me so many lesson’s more than these and going back to hospital based rehabilitation, I will now look deeper into family dynamics, I will now want to know more of the environment that the person is going to be living in which is way beyond knowing if there’s running water or electricity at home, but the resources available as well, yes we teach these client to independently do activities which include feeding themselves while seated and weight bearing on the affected hand or even using it for support and showing all these assistive devices to the family to use but we hardly ever stop to ask if there’s even a table at home because we automatically think there’s one.

It has come to my attention and has become an eye opener that I can give a client amazing treatment but if I forget or ignore the context that the client is going to, all the work goes in vain because the client will never ever get to use the taught skills therefore making him/her dependent.

 References:

Pollard, N. (2006). JOS Comment. Journal Of Occupational Science, 13(2-3), 149-152. http://dx.doi.org/10.1080/14427591.2006.9726508

The Kawa (river) model of occupational therapy. (2017). The OT process. Retrieved 26 May 2017, from https://theotprocess.wordpress.com/2013/07/08/the-kawa-river-model-of-occupational-therapy/

https://onsizzle.com/i/life-is-unpredictable-always-be-prepared-for-the-best-and-3096040

#occupational therapy #ot #communitybased #cbr

[kuhleh]

The role of OT in health promotion, primary health care and the use of media

Health has been defined by the World Health Organization as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” ("Constitution of WHO: principles", 2017)). From interpreting the statement, it basically says that to be healthy does not mean that a person has not been affected by a disease or a person is disabled pointing out that a disability doesn’t mean that one is unhealthy. However, from human nature I feel like most of people including myself would have thought that a person living with a certain disease is not healthy which is being supported by health being defined as the state of being free from illness or injury ("health definition - Google Search", 2017). So which health definition seems right by you?

Looking at Occupational therapy in health care, it is clearly defined that we have a role to play in the different levels of care which include promotive level of care, preventive level, remedial level, rehabilitative level and palliative level of care. Among these levels our role may be clinical or educational.

Focusing on the promotive level, our target population then becomes those people who are well with But does this “well” now looks at a person a complete physical, mental and social well-being where a person might still be ill or disabled or it looks at a person who is free from illness or any sort of injury? Our role is however aimed on maintaining their optimal physical and mental health. Occupational therapy promotes health and well-being through developing, improving, sustaining, or restoring skills in activities of daily living (ADL), work or productive activities, and play or leisure so that individuals can actively engage in their valued occupations.

Furthermore, OTs promote health through providing training for skills in areas like caregiving, parenting, and stress and time management and also among many other, socialization. One cannot forget that OTs also after identifying personal and environmental barriers that limit a client from engaging in healthy activities, they then identify solutions to those barriers, that then promotes a person’s health right because occupational therapists believe that “health is strongly influenced by [individuals] having choice and control in everyday occupations” (CAOT, 2002 cited in ("Occupational Therapists | Epical Solutions", 2017)), and this then makes occupation a determinant of health. Meaning being able to actively engage in these occupations, health is bound to be promoted. Occupational therapists understand the complex and dynamic interactions between the person, their environment and activities they need to engage in daily. They also recognize the importance of habits and routines that may help promote the adoption and maintenance of healthy behaviors.

Primary health care “emphasizes prevention and wellness, and recognizes that success in improving people’s health is largely determined by factors in their daily lives. Wilcock (2006) suggests four levels of health promoting OT interventions to improve and/or sustain health and wellbeing using primary health care. These are; preventing health destructive behavior and illness, slowing down or preventing further disease progression in those undergoing health issues, maintaining health and well-being in those with chronic diseases and maintaining quality of life for the terminally ill individuals. The literature has suggested that the majority of clients receiving occupational therapy services in primary care were adults and older adults. What could be the cause of this though?

 Media has become a tool for OTs in improving or enhancing professional networking and education, organizational promotion, patient care, patient education, and public health programs. These medias include social networking platforms, blogs, microblogs, wikis, media-sharing sites, and virtual reality However, they also

As everything has a good and bad side of it, even though the role of OT may be to use media as a way to share information with a large number of people and making the information easily accessible, the internet cannot always be reliable as it may also present possible risks to clients and OTs regarding the distribution of poor-quality information as some sites allow whoever visits them to edit the information, damage to professional image, breaches of the client’s privacy – do these client’s even give consent?, violation of personal–professional boundaries, and licensing or legal issues.

There are various roles that OT practitioners have to play during their interventions, but do all these roles get fulfilled or some are seen as more important than others leading to some being neglected?

References

Constitution of WHO principles. (2017). World Health Organisation. Retrieved 19 May 2017, from http://www.who.int.about/mission/en/

Health definition – Google Search. (2017). Google.cp.za. Retrieved 19 May 2017, from https://www.google.co.za/search?

Occupational Therapists | Epical Solutions. (2017). Epicalsolutions.com. Retrieved 19 May 2017, from https://www.epicalsolutions.com/occupational-therapists/

Wilcock, A. (2006). An occupational perspective of health (2nd ed.). Thorofare, NJ: Slack Incorporated.

[kuhleh]

A POLITICAL PRACTICE OF OT and LIFE IN THE COMMUNITY

It is said that occupational therapy is based on the belief that a universal and fundamental relationship exists between people’s dignified and meaningful participation in their occupations of daily lives as well as their health experience, well-being and quality of life. Furthermore, researchers have shown that the decision on whether the occupation is dignified and meaningful is not only informed by culture but it is probably also politically negotiated leading to the conclusion that being able to access meaningful occupation, as a right is not only treatment but also it is a political endeavor.

So, does this mean one’s quality of life can be improved by engaging a person in what he/she may find as meaningful? But what if a person can no longer participate in those occupations due to a disability, does this then negatively influence the person’s well-being?

Of course we may all have different answers to these questions but picture this, you are a well-qualified nurse who’s also the bread winner in the home, you find yourself in a car accident that leaves you with complete paralysis of your four limb. Wouldn’t this really get to you and may even lead to depression? Your whole life has been changed by this one accident leaving you dependent and taking away the ability to engage in those occupations you find as meaningful, surely chances are, your quality of life will decrease as you will no longer find meaning in it and the stress and depression affect your well-being thus decreasing your health as a whole. So I guess you now know what my responses are for the above questions.

But then again, how do we then know it is about time to break it to the person that due to the diagnosis or impairment, her residual abilities restrict her from participating in the activities that have been meaningful to her her whole life therefore new activities have to be introduced to her life? How do we then classify that as? Occupational injustice? Occupational apartheid? Or what? I ask this because participation is disrupted and this is based on a disability.

As a student, I have got to work with diverse and multivariate grounds and within these one faces many challenges, which have multiple causes and in turn have an effect on multiple things as well. One cannot run away from the fact that there is a big gap in the community regarding job creation, which then has an impact on the health of an individual, family, neighbourhood and then the community as a whole.  This is because without these jobs the community members especially the youth has become more susceptible to unemployment, which leads to a continuous cycle of poverty and the youth trying to suppress the stress levels or their unemployment situation with the use of drugs, which then leads to crime, in turn influencing the society as a whole badly.

The youth is however uneducated which of all the reasons may be the leading cause of the high unemployment rates as they do not have any sort of qualifications and let us face the truth, of course some people make it in life without any proper education nor any sort of qualification but in most cases one has to be qualified to get a proper dignified job that one can make a living out of.

How do we then get to fix this structure?

So then to fix the structure, one has to educate the youth in order to eradicate poverty as this will increase chances of the youth being employed thus likely to lead to reduced drug usage in turn improving quality of life  and health of the community residents.

Reference

Pollard, N., Kronenberg, F., & Sakellariou, D. (2014). A Political Practice of Occupational Therapy (1st ed.). London: Elsevier Health Sciences UK. 

[kuhleh]

Me as a vendor...

Occupational science is a discipline, which explores the relationship of daily occupations, health and well-being using systematic approaches. Its field is interdisciplinary in the social and behavioural sciences, which focuses on the study of humans as occupational beings. Occupation in this regard being an activity that a person engages in daily and finds it as being meaningful and purposeful as well. Occupational science then gives us an inclusive framework for Occupational Therapy Practice and Occupational Therapy in the wider health setting (Yerxa, 1990).

As individuals, we all have the capacity to choose the kind of activities that we want to engage in and/or be part of for various reasons. These include being passionate about them, sometimes just because we are comfortable while doing them and we do not want to move out of that comfort zone or simple because we want to make end meets. We then give these occupations identity, we become competent in them in the specific environment or setting in which these occupations take place; all this allows us to perform in those occupations (Bar, & Jarus, 2015). A single occupation may have different meanings for different people and different people may attach different meanings to different occupations as well.

Assisting in one of the projects in the community gave me a chance to be part of the vendors’ community for those +/-30 minutes. Wondering what a vendor is? It is somebody who sells something (Cambridge Dictionary | Free English Dictionary, 2017)...still cant paint a picture of what that is?, no problem, refer to Figure 1. The whole job consists of unpacking, folding and/or hanging and actually selling including counting change if any and overseeing that people pay enough. When I got there, they told me it was going to be better if I sat down or if I stood in the shade and just helped with unpacking the clothes and folding them. I, however assured them that I would really love to help with the actual selling process, reason being, the other parts of it are not really anything new for me. Honestly, when they told me to sit I thought it was because they think I will not manage, like I will get tired easily or something but at the back of my mind I thought I will be able to do it since I spend most my time on my feet. To my surprise in the blazing sun and having to stand in more like one position is not the same as being in a sheltered environment, moving around and getting time to sit down as well.

FIGURE 1 : Clip art of a vendor selling clothes

In addition, never will I have thought I would be able to actually convince someone to buy something and actually succeed in that. I feel like since people like to compare clothes and question why one is priced higher than other item that looks almost the same, you will have to be able to state something that a person will actually see and agree with you in therefore making the ability of thinking right there and then very important. This also goes to the ability to be able to watch on who is taking what and who has paid for what so to try limit some items being lost as well. Although I had never thought about it, social skills are important in such an occupation as you have to try to convince someone to buy something yet not being pushy and all and you should be able to discuss the pricing of items and make a decision that suits both you and the customer which then brings in some sort of flexibility and not just being rigid and all regarding prices.

From a distance, I am sure many people think like me – being a vendor is not tiring since you, in the case of these women, just stand and wait for people to come purchase something. Well, from my experience, like most other occupations, it is tiring…from all the standing my feet were hurting and I had to loosen my sneaker laces just so I can allow my feet to breath because well, it felt like the shoes were getting tighter with every single minute that passed and trust me from that day I had a headache and the following day as well. So imagine spending every in that sun without some sort of shelter, how can that possible affect one’s health?

Okay, so two women sell these clothes and at the end of each day, they then fairly; being guided by decisions that were discussed and agreed on, divide the money accordingly. As I have previously stated that we attach different meanings to different occupations, one of them decided to use ALL of the money she had made that day to get clothes for herself from the left sale yet the other took that money home. At first, I obviously judged the other woman for using all the money on clothes and not taking anything home and felt the other one did a reasonable thing. Although it came to my realisation that their reasons behind them engaging in the occupation is surely not the same, nevertheless I still felt the woman who spent all her money on clothes didn’t really make a wise decision. However, that was and is still my opinion and well, we are all entitled to our opinions right?

At the end, it all goes down to what we find as meaningful to use.

By the end of the day, it made sense to me as to why they told me to SIT in the SHADE because well…okay, I think you know the answer to that by now.

 References

Bar, M., & Jarus, T. (2015). The Effect of Engagement in Everyday Occupations, Role Overload and Social Support on Health and Life Satisfaction among Mothers. International Journal Of Environmental Research And Public Health, 12(6), 6045-6065. http://dx.doi.org/10.3390/ijerph120606045

Cambridge Dictionary | Free English Dictionary, T. (2017). Cambridge Dictionary | Free English Dictionary, Translations and Thesaurus. Dictionary.cambridge.org. Retrieved 5 May 2017, from http://dictionary.cambridge.org/

vendors meaning - Google Search. (2017). Google.co.za. Retrieved 5 May 2017, from https://www.google.co.za/search?q=vendors+meaning&source=lnms&tbm=isch&sa=X&ved=0ahUKEwj0tOD7kdnTAhULLsAKHf0DDpwQ_AUICigB&biw=1440&bih=794#tbm=isch&q=vendors+clipart+selling+clothes&imgrc=LK9hUrHnd0aKXM:

Yerxa, E. (1990). An Introduction to Occupational Science, A Foundation for Occupational Therapy in the 21st Century. 

Occupational Therapy In Health Care, 6(4), 1-17. http://dx.doi.org/10.1080/j003v06n04_04

[kuhleh]

The transition from hospital-based practice to community based practice; and how these two practices differ

Many scientists have defined community practice. Some have looked at it from a general perspective and some as community practice in occupational therapy. One of the definitions is that it is “the application of practice skills to alter the behavioural patterns of community groups, organisations and institutions or people’s relationships and interactions with these entities” (Hardcastle, Powers and Wenocur, 2004). In OT, community practice explores the role of occupation in the shaping of the society and in daily life activities in the community setting (Fagan, 2010).

Community practice opens the door for the profession of OT to grow and apply occupations in a natural setting. With community practice, the OTs gets a chance to conduct home visit that allows for identification of barriers to occupational engagement. The benefits of community based occupational therapy practice includes that; it provides treatment that has a potency that is unattainable elsewhere due to that it presents life as it is as it and provides a clear picture of the dynamics that affects a person’s ability to practise health occupation.

Community based practice differs from hospital-based practice in various ways. I say this because, even after my second week in the community, I am still trying to create some structure for myself to follow , find a better way to manage my time effectively and well, learn and adapt to that I am my own “manager” now, there’s no one for me to report to everyday about what I did with clients and how they responded during treatment and all. Of course, I have a weekly timetable, but still this has to be flexible due to various reasons. These include that clients are sometimes not ready on time even if treatment time was discussed the previous day and in cases where the driver is late to pick me up or just took one of the other students to other places and since some places are distant from each other, this then means I have to wait. This then leads to some visits starting at later than the allocated times thus affecting the allocated times leading to the need of adjustments to be made while understanding that no one can be blamed for it.

According to literature, there are differences between hospital-based practice and community based practice, and temporal adaptation is one of these differences (Meyers, 2010). Kielhofner (1997) then defines temporal adaptation as the process of adjusting to temporal changes in living skills. This then looks at that hospital based OT has a structure to follow and work begins at certain time for her yet for a community based OT there is very little routine to most days and may need to go to different places each day to do her work. Which is true, because as previously stated, the structure I have been trying to create for myself is impossible to follow, because at least in hospital you know what time clients have a bath, take their medication and all so to plan your sessions accordingly. Yet in the community, it is impossible to do so.

I have found myself in a situation where at 11 o’clock my client had not taken a bath or had breakfast for that day because her daughter was not around and the other family members stated they are waiting for her to come back so she can perform her ADLs for her since she is her responsibility. This then goes back to flexibility and life being presented as it is in the community settings because in hospitals, family members all come to visit their relative and as a therapist as soon as they state that they all live in the same household and are mostly at home, automatically you assume they will all assist in taking care of the client and the burden will not be for one person.  But this experience has been an eye opener for me on actually getting to understand the family more and not just taking the picture they paint. Because this means that issuing a home programme means, it will only be carried out on the days that her daughter is there and when she is not, the programme will not carried out. Therefore, ways of ensuring that it is linked to ADLs are important so to reduce strain on the caregiver on having to set aside time to carry it out.

The second difference to be discussed is that in one of the settings there are usually many OTs, some with years of experience to serve as role models while OTs in the other setting will often work independently (Meyers, 2010). So, which one between these is community based? If you said the latter, you right. In community, I am just my manager and yes, as I stated, I am still trying to get used to this as it means I have to problem solve on my own with regards to problems that may arise during practice or with the other students who themselves still have limited experience in the field. In the community I do not have anyone who will not only solve the problem for me but will cue me to critically analyse it and encourage me problem solving it.

The third difference to be discussed is the supplies and equipment seeing that in hospitals there is quick and easy access to equipment and supplies needed for treatment while in the community the therapist has to use what is found in the home or one has to bring it. This may be a good thing as a therapist gets to see the client’s full potential. To my realisation, in hospital settings we magically assume that every household has a table, but in one of my home visits, there was no table. So, even if the client was independent in feeding while in hospital as there was a table supporting her plate or bowl, as soon as she got home she then became dependent as even myself would prefer feeding the person than holding the bowl while she feeds herself.

This then takes me back to the model of human occupation, which emphasizes the importance of understanding the environment both physical and social in which one has to perform the occupation. This is due to the assumption that the environment influences occupational behaviour as it can provide opportunities for performance and/or press for certain behaviours (Letts, Rigby, & Stewart, 2003). This then presents as an occupational barrier for the client as when I asked to see if she can feed herself, the client could do the activity, even though the pace is not fast, considering her impairments, it is acceptable but due to the environment, the client has become dependent.

http://www.munchkinandflan.com/?p=444

From my point of view, this picture then depicts that a person can have the drive, capacity and skills to perform an activity yet the environment affects the participation thus affecting one’s competence in that occupation and the loss of occupational identity as the client is dependent thus requiring adaptations to that occupation for the client to regain the lost identity.

I wish I can discuss all the differences but I have to love and leave you all. Just an update though on my progress, in these weeks I have however realised that I should see the client’s that live within a walking distance from one another first before going to places that are far and requires that the drives takes me there so in some way my time has been managed better. With the upcoming weeks, I am still looking forward to making the best out of it in understanding the community more and providing the best treatment to all clients.

Let’s face it: community based practice does differ from hospital based practice in more ways than discussed here, if you’re interested in knowing more you can read the book “Community practice in occupational therapy (1st ed.)”, the full details are provided in the reference list and you can even access it online if you want.

References

Fagan, L. (2010). OCCUPATIONAL THERAPY IN THE COMMUNITY. Australian Occupational Therapy Journal, 24(2), 22-27. http://dx.doi.org/10.1111/j.1440-1630.1977.tb01088.x

Hardcastle, D., Powers, P. and Wenocur, S. (2004). Community Practice: Theories and Skills for Social Workers. 2nd ed. Oxford university press, pp.3-4. 

Kielhofner, G. (2004). Conceptual foundations of occupational therapy (1st ed.). Philadelphia, PA: F.A. Davis Co.

Letts, L., Rigby, P., & Stewart, D. (2003). Using environments to enable occupational performance (1st ed.). Thorofare, N.J.: Slack.

Meyers, S. (2010). Community practice in occupational therapy (1st ed.). Sudbury, Mass: Jones and Bartlett Publishers.

model of human occupation - Google Search. (2017). Google.co.za. Retrieved 28 April 2017, from https://www.google.co.za/search?q=model+of+human+occupation&sa=X&tbm=isch&imgil=Sbn4ePqc456pwM%253A%253B4q1_CMXya3AyJM%253Bhttp%25253A%25252F%25252Fwww.munchkinandflan.com%25252F%25253Fp%2525253D444&source=iu&pf=m&fir=Sbn4ePqc456pwM%253A%252C4q1_CMXya3AyJM%252C_&usg=__QP6WG94oLAYAkR1URxSHtHPxcVk%3D&biw=1920&bih=925&ved=0ahUKEwiF5viz1MfTAhVhCMAKHXrTDfkQyjcIZg&ei=nnkDWYWfDOGQgAb6prfIDw#imgrc=Sbn4ePqc456pwM:

[kuhleh]

Reflecting on experiences, feelings, interactions and professional views during my first week in the community

The community block is one block of which most people consider as being not so hard to fail yet one can easily fail it too if not careful. You might be asking yourself why people would say this, because I, myself asked the same question over and over and OVER again yet I never got to an answer until my first week in the community which is this week. Truth is, I’m still a bit confused about how everything will work because at the moment everything is so overwhelming and there’s just so much to do or let me say try to fit in the little time we have in the community.

I cannot lie, on my first morning of the first day of the community block I felt really prepared, well, maybe let me say I thought I was prepared, of course not to my very best but I was, trust me though that changed before 10 am of that morning. I got so confused, felt lost like I knew nothing, all the notes I had went through didn't help on that day. I needed a structure to follow, like some direction of some sort. Within an hour, I realised panicking and being anxious wasn't going to help me in anyway, I stayed calm and decided to take it as it comes, and well, I made it through the day and lucky enough I have made it through the week as well, and as for next week, I’m looking forward to seeing if there’ll be any changes.

I, however had preconceived ideas of what the community would look like. Coming to think about it now, every community is different in its own ways with regards to values, culture and everything. When I saw a lot of teenagers or better yet the youth in the streets I wasn't really shocked, but what shocked me was the situation in the high school. I've went back there almost every day and the situation is the same - the learners are always outside during school/ lesson hours, loitering around like it’s break time. This wasn’t only my concern, but my group members were concerned too and when we finally decided to ask a bunch of them why they were outside the response was, "the teacher is absent", then the question arises, to what extent is this reason true?...But then again, thinking that it's high school, what more could lead to the learners not being in class EVERYDAY???...

I've been and still asking myself the same question. Is it because they don't value education or they just don't see the future after completing matric? Is it because they fail most of the time leading to them losing motivation in attending? Is it because they find some subjects harder than others and that difficulty is giving them stress resulting into them missing class? Are the teachers doing enough to keep these learners in class? ...

Through all of this, one has to keep in mind that some of the teachers lock the doors during the lessons, but could this also be the cause of learners being outside because they were late and the classroom door was locked? Of course the teachers reason is so to maintain order in class and prevent those who are inside from leaving, but couldn't there be another way of maintaining order in class besides locking doors?...I don't know, maybe it's just me but this situation left me with a lot of questions of which I haven't​ got answers to. From all this, another question rises, could this (poor class attendance) be the cause of high teenage pregnancy rate in the school and dropouts?

From the many questions that I have, I then decided to do a little research as to why learners might skip classes, and from an article by Pulgar, N (2015) at Walnut Grove Secondary School, there are a number of reasons with the top reasons being

But then again, you have to ask yourself are all these applicable to this context? If not, which ones could you exclude and which ones would you add?

Though I could not really get what this meant at first but reflection does require one to think deeply and carefully about a situation thus allowing for learning as it triggers one to questioning her actions, values and beliefs. And “without reflection, we go blindly on our way, creating more unintended consequences, and failing to achieve anything useful,” stated Margaret J. Wheatley.

Now the question comes, what could be our role as Occupational therapy students in such a situation? Because clearly there is an occupational imbalance for these individuals.

 Reference:

http://wgssgnn.com/why-do-students-skip-class/

[kuhleh]

The last kick of a dying horse is all that matters

There is a famous expression in English which says that when the going gets tough, the tough get going meaning when the situation becomes difficult, the strong will work harder to meet the challenge.

It then breaks me down after putting in so much work and so much determination and yet still not be able to meet the challenge at the end. After mid-terms I had goals I set for myself, goals I wanted to achieve and goals which were personal, set by me and had to be met by me. I had goals that only I knew about and only I could understand. They were based on what I knew I could do and how much I wanted to challenge my own capabilities or strengths or whatsoever.

After getting my final marks, I don’t really know how I feel, I don’t know if I’m hurt or just disappointed in myself. For a moment I had my eyes full of tears and the next, I’m just there staring at the blank space. I wanted to write so I could really express my feelings but I bumped into one of my old poems in the folder that I decided to read it. It was about love and heart break back but today I related to it differently. It is not in stanzas because it would have been really long but here it goes:

“I might be down now but I’ll rise. With my broken heart and shuttered soul, I’ll rise. I might be alone through the darkness of this world, alone in the sorrows life brings, in the sadness living creates, and in the troubles my thoughts get me into but I’ll rise.

It might not be today, not tomorrow either and not anytime soon but at the end I’ll rise. It might be the time I least expect it, the time when most have given up on me and the time when I, myself have lost hope but at the end I’ll rise. I don’t care how long it will take, the bruises I’ll get on the way, the pain I will feel, the blood I’ll lose and the tears I will shed, at the end I’ll rise.

The scars I’ll have will remain as proof of what I have been through, what you and everyone else have put me through, what you and everyone else have let me to deal with alone. The scars will be proof of what I've had to deal with, what I chose to deal with and how much I’ve let you and everyone one do as they please with my life.

I’m lying on bed now, crying my eyes out, and drowning in my own tears, listening to my heart breaking, blaming myself for everything that went wrong. Yes, this is me trying to make sense of the whole situation, trying so hard to overcome the pain I feel and accept rejection. Yes, this is me trying to remember I survived without you before and therefore I will continue to survive, now that you are gone.

This is me reminding myself of my worth, reminding myself of how strong I am, reminding myself of how many people really care and love me, reminding myself that you were given a choice and you chose not to choose me. This is me accepting what I can’t change. I might be down now but I’ll rise again. When the cloud in my eyes clears, when the dark become light, and when the sun rises, I will rise with.”-Kuhle

Rising in this sense isn’t about picking up the broken pieces of my heart anymore but it’s about me graduating after surviving so much that has been thrown my way, the sleepless nights and the early morning, having to deal with criticism with every corner or direction I chose to take, and the lover/heart breaker is my degree, that I personally decided on pursuing after it kind of chose me, all that it has put me through, the setbacks, the disappointments and everything.

However, I have gained a lot from this fieldwork block, the better understanding of the theory being taught in class, experiencing how little things really could make a difference in a person’s life and what we sometimes take for granted can really be all the person needs to make meaning out of their lives. I have also got to understand myself even more, it’s so easy for people to say you need to break out of your shell, communicate more and everything but sometimes they seem to forget that English isn’t everyone’s home language and not everyone if fluent in it therefore on its own becoming a barrier when in discussions with people who use English every day since you still have to think of the point you want to say then translate it into English, trust me that’s no child’s play. And trust me I’m not blaming my background for all this like most people would do/say, though it had a role too but I’m currently working on making myself better.

Anyway, this is my last blog for the year and I’m honestly so glad I’m done with fieldwork, if all goes well, I will be back as a fourth year student…time to prepare for exams now, my former high school principal (may her soul rest in peace) used to say, “It’s the last kick of a dying horse that matters.” This has always be my motivation and inspiration that even if my DP isn’t that great, studying hard for exams will always make a difference, maybe not a lot but there will be a difference

May your holidays be the greatest…x.o.x.o

[kuhleh]

The Jar of Life

The famous large mayonnaise jar and the golf balls have been used by many to explain the importance of prioritizing things in our lives. I used to think it was true that we can have time for everything we want to do if we manage our time correctly or let me say if we set our priorities straight but that has seemed to change over the past two years in varsity. My priorities haven’t really changed but their order has definitely changed because truth is amount the things we consider as being important in our lives, we also range them according to being importance, like there are really important things and less important things among our most important things if that even makes sense. Anyway, rewind, I was talking about the change in my priorities right, okay so I’ll just take 4 my golf balls which are family, friends, religion and education among these, religion has become the least important among the most important things yet education or let me say my career has seem to become the most important thing. Of course I haven’t rejected my family and friends but my school work has taken up almost all of my time.

I could say life and time are the best teachers in the world since life basically teaches us to make good use of time as we can never have it back once it has passed and on the other side of the page time teaches us the value of life. We are not going to live forever, that’s one thing we can never run away from, we all come to this world to be tourists, to enjoy life, to do good deeds and to leave after wards. In the journey it’ll happen that some leave earlier than the others and some will choose to settle down in the places we choose to visit, it’s okay to be sad and it’s okay to cry and it’s also okay to change priorities as well as with these events it is definite that our priorities will change. Change isn’t always good but it is the essence of life, we all got to be willing to surrender what we are for what we could become or better yet what we want to become.

Like in the jar, life sometimes becomes so overwhelming to a point that you actually get to see that if something else was to happen you could literally break down. Things happen after we have come to that conclusion but we still stand tall and act all fine and good, that’s because there’ll always be a space somewhere, somewhere in between everything is the little hope that makes you keep pushing and never giving up, somewhere between all the things cramped together is the little voice telling you keep your eyes on the prize and nothing else and somewhere between packed and squashed together we find the little friend willing to listen to all our sorrows, wipe away our tears, kiss our wounds and make them heal.

Relating this to my life now, the semester has been a really hard one to get through, studying, assignments, fieldwork, the loads of group work and above that my mom being so sick and requiring intensive care. I couldn’t really get a grip of everything or get anything done on time. In my life she is a golf ball and without her I could see how much empty space I’ll have in my life and I could see the wound that was never going to heal yet somehow it motivated me not to give in to the situation, I wanted her to be proud of me in whatever situation we ended up in, I remember one day I went to the hospital to see her and all I could see was the strong woman fighting for her life,  it hit me how blessed I am to have been able to wake up and do all the things I did and how important it is to value those in our lives, their presence and all, for we never know when they’ll stop being tourists and return back home.

Surprisingly enough all that I had in my jar somehow helped me through this difficult time, the support, love and everything. I think the reason it’s called a jar of life it’s because it helps one through life, it has all the things one really requires to survive in this world we live in. 

[kuhleh]

Research day

On the 26th of September, the final years (OT 4th years) had their research day in which they had to present their research work that they started doing in 3rd year as groups. We as this year’s third years had to attend the event. At first I thought it wasn’t going to be interesting to sit and listen to the presentation in such a way I made sure I had both my phones charged so I can keep myself busy as the presentations took place. To my surprise I actually enjoyed sitting there and listen to the different presentations looking at the different styles used and the creativity that was shown through all the groups.

I can’t think of any word better to describe the day besides saying that it was an awesome day. Seeing how much group work can come to produce something so beautiful when people effectively work together. Since they had a certain time to present their presentations, the students had their parts well prepared and that made the presentations to flow and they picked up their pace of speaking whenever any member might have presented in a slower pace. One thing I liked was how one of the groups actually had one of the members saying how the responses from their research participants as in that way it was a lot faster thus saving time and easier to hear and understand what was being said.

Even though we started on working our research this year seeing the students presenting and seeing their happy faces and them being proud of themselves as they finished presenting made me look forward to the same moment next year. To them the end is getting clear and I’m genuinely happy for them and honestly I wish them all the best there can be out there.

[kuhleh]

What I’ve learnt about myself thus far...

There's always something to learn about yourself in every new situations you are placed in, it won't always be something good of course but that isn't a bad thing. 

So, I started my practical block with so much confusion and anxiety as I didn't know what exactly I was meant to do. Nothing really made sense at that time and even now somethings still don't make sense but I'm definitely doing the best I can. To be honest, I'm glad I've gone through my mid-terms without literally breaking down because truth is, there were times when I was so overwhelmed by everything that was going on, the write ups, the endless critiques and many other things.

But through it all, I've learnt a thing or two, not only about myself but life in general too. You know this block has challenged me more than any other blocks, in all the feedback I've been getting from the beginning has been more negative than positive, I tried to overcome it on my own but I couldn't, I had no other option but to move out of my comfort zone, move out of my little cycle of friends and ask for help from someone else. It took a lot in me to actually go talk to that person but it was worth it, for the first time during my mid-term demos my supervisor was impressed with my write-up and there was more of positive feedback than the negative one.

I'm such an anxious person, like my anxiety would just kick in and I'd break down, I remember one of my psycho-social supervisors in second year told me I had to find ways to deal with my anxiety whenever it kicked in because I can't always break down and I did, even though it didn't work so well, but the levels were lowered, I'd just sit there count to ten then proceed with whatever I was doing, but now I just take a deep breath and proceed. 

I’ve become a better person in terms of handling myself and expressing my opinions during discussions on practicals. I still need to work more on my principles because as we say,”through repetition a skill can be mastered” so as I got them right now, I want to make sure I don’t go back to the way I used to do them, like I don’t want to disappoint my supervisor or myself for that matter

[kuhleh]

Invited speakers left me thinking...

Sometimes in life we go through situations where we think they are the worst and there’s no way anyone can experience anything worse than that. However, it surprises me how these situations we consider to be “the worst” change over time and as we keep coming across the different obstacles or better yet as life keeps challenging us.

Somethings seem too tragic in such a way you’d think they only exist in fictional stories or movies and in that way you never think that you’ll ever get to meet someone facing those situations ever in your life. Well, I have got a chance not to only meet a few of those strong people that have been able to survive the most challenging things in life but I even got to watch them as they talked about their situations, how their lives were changed and have been shaped by all those life challenges, got to see them containing themselves as the memories haunt them, as the situations play as a movie on their minds and dealing with the wounds that open every time they share that experience.

The sadness was heard from the voice yet strength could be noted as well and I sat there thinking, well I might actually think my life is hard and I wish I had so much better but in those moments of actually listening to the speakers I realized that all I have to do is to be thankful for my life is not perfect but it could have been worse and truth is I don’t think I would be so strong so to be able to survive everything and be able to talk about it without literally breaking down.

It’s surprising how much we as the youth or let me say the young adults of today have actually relied more on social media and with that in mind, social media influences our behavior and the decisions we tend to take about our lives. We never really get to realize that some people’s lives are impacted by the kinds of things we recklessly say. Truth is, to me an eating disorder was more like a phase that people especially teenagers or maybe people in the early adulthood get to go through just because they are concerned about their weight and may be due to their low self-esteem which is caused by the comparison done between self and the other people in the same age group or a group of friends or even siblings. It amazes me to actually get to know that such a disorders can be caused by something so serious like depression, anxiety and abuse.

What I took from all of this is that complaining about life doesn’t really help, life is not and will never be fair, the little you have should be cherished and giving up on life just because of circumstances you are facing at that time is never the solution, and giving up on life just because everything seems to be falling apart and nothing seem to be working out shouldn’t be even an option and above all pushing away those who are actually there for you during those dark times should be something to stay away from, because they may not really understand what you’re going through but the fact that they are there should matter more than anything else. We are all responsible for our lives and our well-being, when you feel you’re failing to cope on your own it is better to talk about it and find professional help where possible before irreversible damages are made.

[kuhleh]

Casual day

The 2nd of September finally came, I mean we’ve been told about it since the beginning of this block. At first the truth is I didn’t really understand what it was all about but with the discussions I had with my group members during the meetings and all, I got the clear picture of what it was and those are the perks of having the GREAT team members, right?

You might be asking yourself why we had meetings if you hadn’t yet figured it out, but like since we had casual day coming up we had to plan for the different activities that we would get the people from our workshop to engage in. The residents seemed to know a lot about casual day than I actually expected and as for the games they wanted to participate in, they gave a positive response when asked and seemingly a lot of them were interested in one sport in particular which was cricket leading to us to deciding that we would use it as one game at the end that everyone had to be part of whether as a spectator or by playing the actual game and it was during this time that they got to sing the song they had been practicing for like 2 days since we could only give it to them on that Tuesday.

The clients were involved from the very beginning of our planning till the end as the day was more about them and less about us, so they had to enjoy themselves and have fun. From the activities that they wanted to engage in and the ones we had in mind, we all came up with a decision to make them engage in some of theirs and have something new from our side as well, with that in mind we had skittles, ring toss, 3 tins, cupcake decorations, the photo booth and the big cricket game.

The clients were involved in groups to make the materials required for the different activities, where one group made the rings for the ring toss game out of newspaper, the other group painted the bottles which were going to be used for skittles, one other group decorated the tins that were going to be used while the last group of clients were making tokens which I forgot to mention above, so these were used so that everyone had a chance to engage in a certain activity which was represented by different colors so a person had to produce his/her token before engaging in that activity, however they were given an option to exchange the tokens with friends if they don’t want to engage in that activity or due to concerns like those that were not allowed to take pictures, they had to exchange their tokens for the photo booth with someone else or just take two of one of the tokens.

Well, I had a lot of fun and a great day myself and the clients also enjoyed the activities to a point where they would ask to repeat specific activities when there was no one on that station. It was great to see the manager and the other staff members joining and wanting to engage in certain activities as well. What I actually noted is that some clients didn’t want to engage in certain activities but as soon as they saw people enjoying that certain activity, they then wanted to engage as well, so they just needed that little motivation to actually engage in that activity. Some however were a bit confused and the staff members helped us with those that had to be moved from one station to the next, and some games had to be adapted like the distance from the target points. When all this was done, the clients all got certificates for participation with a packet of chips.

It amazes me how little things can actually mean so much to people. You don’t have to spend a lot of money or come up with fancy games in order to get people participating and enjoying activities, what matters is finding the right activities for the clients, looking at their different levels of participation as well as their strengths, with that the likelihood of the event being fun are increased because you might have really great activities which the clients might not find them as fun or enjoyable because they cannot successfully engage in them.

[kuhleh]

Reflecting on blogging, sharing, thinking and reflection

Someone anonymously said, “Learning without reflection is a waste. Reflection without learning is dangerous”, coming to think about it now, reflection is one way to learn from the experiences that one has faced because truth is, if we never reflect from our experiences we wouldn’t learn because from experiences alone we don’t really learn a thing.

Honestly, I feel like since I’ve started blogging I have learnt a lot about myself and got to understand some of the diagnosis more. This is because even though it seems as hard work at times when I have to read articles in order to reflect or even watch a movie, I‘ve gained a lot of information from all this and as in movie various mediums are used to present the diagnosis which are visual, verbal and auditory, this then paints a clear picture thus giving a better understanding and it more practical. This also gives better understanding as to how it affects the person and those around her.

Fact is, in real life, clients will not present the same way as we are taught in theory so even though they will present with some of the features, sometimes I will have to read more in order to understand somethings and through blogging I’ve learnt there are more sources rather than just googling everything. There are really cool bloggers with great information and stuff and movies which can be watched during free time, which are pretty interesting yet I can always take something out of them which I can use in my journey of becoming an occupational therapist.  

Reflection has given me the ability to assess my thinking, actions and behavior and evaluate their effectiveness and areas that need improvement. It has helped me look back at my personal experiences during practicals and see if there is improvement with every week I’ve spent there or there’s no change everything is still the same as the first week. This then builds my personal insight and makes me realize whether I’m at the right track, I need to work harder or I just need help in order to be able to survive this block.

I am reserved person by nature and I don’t really like sharing my personal experiences but like there was a point where I had to write about my experience in one of the weeks, and trust me that was not easy because I’m not used to showing or just talking about my experiences to people. I honestly believe that sharing is a good thing since I can learn from one person and that person can learn a thing or two from me as well but I feel like it’s not that easy sometimes and I strongly believe I’m not the only one who feels like this but then again life is not about receiving at all times but it’s simple a combination of being thankful for what you receive and sharing it with others which is why I believe as much as sometimes I don’t feel comfortable about writing about my weaknesses and failures, someone out there who is more like me will bump to it and silently think that if someone like him/her could actually do it, then they can do it too.

[kuhleh]

Portrayal of mental illness in film

Well, so this week I’m not going to share my experience on my practical site but I’ll just go over a movie I’ve watched which portrayed a mental illness which in this case is depression.

“The hours” is a movie of three women namely, Clarissa who prepares an award party for her AIDS-stricken long-time husband, Richard; Laura, a pregnant housewife with a young boy and an unhappy marriage; and Virginia who is struggling with depression and mental illness while trying to write her novel, one common this is them looking for meaning of their lives. They are all at the depressive phase of bipolar, struggling to sleep or eat, losing interest on things they’ve loved their whole lives and in one of the scenes one of them states that she feels like her life has been stolen from her. These women are often sad or crying and irritated and they all possess the feeling of worthlessness making it hard for them to function. Their interpersonal relationships are affected looking at their children, husbands and those around them.

The movie gives a clear picture of all these three women, and how their loved ones are willing to support and be there for them yet they still want to make everyone believe that they are all okay and there’s nothing wrong. In one of the scenes, Virginia who her husband is caring and loving and has even hired servants to help her out with her chores so she could rest but the fact that there are servants at her house intimidates her and she also feels like her husband is constantly watching her, she decides to run away to take a train however, while still waiting for the train, her worried husband comes looking for her and states he is scared that one day she is going to talk her own life at that very moment she admits that she’s scared too and writing isn’t helping anymore . This then shows that she had the knowledge of how her condition was affecting her and those around her which is why she was looking for ways to deal with it.

It’s sad though to see how this can affect children, leaving them feeling rejected and in fear of being shouting at, beaten up or even called names. In this movie it showed how children struggle to understand this because one moment mommy is fine and playful and the next she wants to be left alone and sobbing on her bed. I feel like the child may feel it’s their fault that mom is crying and all because they don’t understand what’s going on leading them to avoiding being with in the same room with that person. Well, children can see when there’s something wrong and it really saddened me when Richie the little boy cried and ran after his mother as she dropped him off in one of her friend’s houses, as if he knew his mom (Laura) was planning on committing suicide that very same day, in his eyes and voice I could see and hear respectively the fear of never seeing his mom again.

Honestly, I feel like sometimes those around the individuals suffering from mental disorders suffer a lot too especially when its someone really close and important to them. I mean these people lose interest on things that used to matter to them like the one forgetting her husband’s birthday, they are mostly sad and you have to watch them drown in their tears breaking down more each and every day, you want to help them but they don’t want to be helped, you can do anything for them and give them everything but they’ll always be something that’ll sort of make all the effort go into waste, you have to keep listening to them blaming themselves for everything and stating how worthless they are and above all you stay in fear of them taking their own lives.

This is however seen as Clarissa experiences prolonged sadness and crying episodes as she felt like she has failed her husband who was a great writer but is now depressed and seem to be pushing everyone away. She decides to plan a party since he had received a literary award but little did she know that on that day he was going to commit suicide right in front of her after telling her that she’s the most beautiful thing he has ever seen.

I just like how in one of the scenes Virginia says something like that someone has to die in order for the rest of us should value life more and towards the end after Clarissa had lost his husband and started to get help, she stated that she remembers one morning getting up at dawn, there was such a sense of possibility. And she thought to herself: So, this is the beginning of happiness. It was the moment. Right then.

I feel like depression was portrayed pretty well in this movie and maybe for better understanding of how differently people with depression may present, I’d totally recommend this movie even though it’s an old movie but it’s great.

[kuhleh]

The experience of week 1

It’s said experience whether good or bad is a priceless item and experience on its own is a source of knowledge. Which necessarily means whether the experience is good or bad, there’ll always something I can take out of it.

Week one was more like the assessment week and getting to know the client well so to be able to identify the problem areas and be able to plan appropriate intervention for the client. Had some good and bad experiences of course but firstly I’ll just share my good experiences. Monday was the first day of practical and I got to meet one of my clients, well, he’s a client one can work with, we did our assessments and stuff and I was even able to watch him in the group we had to run. Then we got a chance to give feedback about the different sessions we’ve had. I feel like as much as this is a learning experience, I shouldn’t be criticized for everything I had done or I actually doing, I’m sure there’s something somewhere that I am doing right, maybe pointing that out as well wouldn’t leave me so demotivated and feeling like all my hard work has just gone to waste.

However, it’s good to know that something that seem simple and easy for us could actually be something some people really enjoy and from it you can get a lot if analyzed carefully afterwards. This comes from a group session that we had on Friday, I mean it was a simple color in activity but the way it was structured and the handling principles that were used, I actually learnt a lot from that group, looking at how we have to sit the clients, grading the assistance to given among different clients and being part of the group.

If you remember well from my previous blogs somewhere I mentioned that as this block begins I’m not sure what it has for me in it and I am not really sure as to what I am really going to be doing and all but I am going there with everything I have, giving all I can and doing all I can do then taking it from there. That’s the exact spirit I had that Monday morning. I was knocked down that day, my best shot wasn’t a best shot after all, sadly. In me I had hope that Friday will be better but as knocked off as I already was from Monday, I felt like there was something literally pushing me down even more. Truth is, I knew I would get criticized on pracs, I knew things won’t run smoothly and I knew my comfort zone will be challenged a lot but I never knew on my very first week of the psychosocial block I will get to face all of these.

Right now I am overwhelmed by everything and I honestly feel I am stuck at the beginning of the bridge, as I said on my first blog that this is more like a mountain and the higher I keep going the harder its becoming to keep moving, right now I am stuck in just one position feeling like even my assessments are not okay or not good enough. My strengths have become my weaknesses and as for my weaknesses, I rather not go there. I am a shy, and quiet person who becomes anxious in certain situations and I do not like being put in the spot light, of course I cannot blame my background or whatsoever for not knowing activities or being able to come up with activities off by heart at times but truth is, it has an impact, that’s one thing I or anyone else can never run away from, I never got exposure to most of the games or activities we mostly use in groups and by not contributing during group discussions doesn’t mean I don’t want to, I just don’t know what to say or the appropriate games to suggest, I will contribute where I can and when I can’t I expect my group members to help me out. My group members are okay, and by okay I mean they are people one can be able to work with effectively but I feel like during the two meetings we’ve had, some people’s opinions matter or seem to weigh more than other’s opinions leading to some of us being seen as followers, but the question is, what’s the use of voicing out my opinion if it’ll be ignored at all times?

Well, next week is a chance for me to show I have taken the feedback I have been getting by fixing where I went wrong, and whatever comes then will just will be other mistakes to fix.

[kuhleh]

Mock prac musing

So, after doing practical preparations on my own, which I of course discussed on my last blog, a class preparation with my colleagues and supervisors was done. Well, honestly as much as that was aimed on helping us have a better understanding of what was expected as we started our practical block which it did of course but then again on the other side it left me sort of more anxious that I already was. Ever felt like almost everyone around you has control over everything and you’re just one minor stuck there not knowing what to do? well that’s exactly how I felt after that mock practical but somehow I told myself everything is going to be okay, I don’t need to have everything figured out as yet, I’ll just start working from where I am and use what I have and do what I can do and the rest will fall into place with time.

Just to give you a glimpse of what mock practical entailed, well at first we look at one’s strengths and discussed it with our respective group members and supervisors, moved on to making objectives for ourselves as we start our block, to looking at what motivates us to stay at the course though it rough patches and endless falls for some of us and lastly we shared resources with each other in terms of buying practical stuff, getting information and ideas about activities to use. This however gave me something I can build on as I start this block and with the objectives I’ve set for myself that will work as some sort of motivation for me to push myself even when things get really tough because as Thomas A. Adison says, “Our greatest weakness lies upon giving up and the most certain way to succeed is to always try one more time”, so if I don’t push myself no one will.

Truth is, I never knew about Occupational Therapy and I never even applied for it either and one thing I know is I don’t remember seeing it as one of my options as I kept track of my application statuses but as I got my matric final results I also got an offer from my beloved institution to come pursue my career as an OT. I was confused and sad because I had no idea as to what I was getting myself into as dad told me I had to accept the offer since when I got here I was told I had the wrong code on my CAO form and what not. So in my first year, my motivation was to work hard, get good grades that year and then transfer to the department I wanted which is also in the Faculty of health, but then as the year went I kind of started to like OT, even though I was still not sure of what it was which lead to me taking a week of my June break to go to hospital so I can see what OT really was, and from that day I got interested in knowing what other things can OTs do besides what I had seen in the hospital so, what keeps me pushing so hard right now, is so I can graduate at the end, go out and make a difference in people’s lives and well make my dad proud, failure is just not an option for me.

It’s mostly said that sometimes alone a person is like a rain drop yet if people stand together they can be an ocean, and my ocean has been made by my two friends for the past 2 years but from the last block what I learnt is that sometimes you have to move out of your comfort zone to get what you need. I got to a point where I asked for help from people I had never thought I would, at the beginning it was hard but it got easier. Now my ocean has drops from my colleagues, they’ve shared a lot with me, education wise, their sources of information as well as everything else you can think of and it’s getting deeper and wider. With it growing I can drown easily and the waves will be stronger, but smooth seas don’t make the best sailors, right?, so I’ll just take all the setbacks as a way for me to grow and become stronger because the truth is even expects started off somewhere where they had no idea of what they were doing.

My block starts on Monday and a part of me is excited yet the other still feels like I still don’t know what I’m doing and that’s okay, it’s a learning experience and every criticism will help me grow and understand more. Wish me luck!

*y�;">

[kuhleh]

My preparation for the psychosocial block

A bridge for assessments has been crossed and a walk towards treatment has already started. It’s more like a steep heal, as much as I have started my walk on it, it is getting harder to keep moving forward, at some instances I feel like I am stuck in one position and even if I want to start moving I just don’t know which way to take. Everything is just so overwhelming and the demands seem really unrealistic for me to meet. I know they say the view is always great from the top but the top just seems to be getting further and the way keeps getting steeper. But then again, I’ve started this journey and I have to finish it, with the little that I have in my bag to help me survive, I’ll have to improvise because I believe if others could make it then why wouldn’t I. With this being the first blog in my psychosocial block, I’ll just go through the two books I have read while preparing and how I’ll apply these things in my practice.

The two books I read include one written by Finlay, L. (1988) Occupational Therapy Practice in Psychiatry. Great Britain. Chapman & Hall and the last one written by William, N. & Goldstein, M.D. (2001) A Primer for Beginning Psychotherapy, 2nd Edition. United States.

Linda Finlay (1988), starts from looking at the role of occupational therapy in psychiatry, assessments then treatment planning which is the chapter (chapter 4) currently focusing on since one just started the walk towards treatment. The writer sees treatment planning as a process which involves organizing information in such a way that the client’s problems are identified and treatment principles, goals and activities are specified, the aims then arise from the problems identified.

Logically, this then means in order for me to be able to plan appropriate treatments, thorough assessments have to be done so I can be able to highlight problems and the areas that need a lot of focus which I can refer to as my priority areas. These areas will then help me establish the aims and goals which are realistic, measurable targets for both the therapist and client. Linking to the previous block, I learnt that when setting goals and aims, they need to be specific and include how these will be met and the criteria as to how the achievement will be measured, so this is one format I’ll still follow so to be able to see if I’m still on the right track to attaining my overall aim. All this will then help design the treatment programme specific to that particular client.

Acknowledgement of the client’s strengths, interests and motivation is also emphesized so that the therapist can stress on the strengths and be able to use the client’s strength in one area to address the problem areas, which then means as much as the therapist has to find the problem areas that the client is facing, the strengths need to be identified too and the client has to be made aware of these. By incorporating the client’s strengths and interests, this somehow can aid with the client’s motivation to engage in the treatment sessions planned. Through the engagement in activities, the aims and goals that are set for the client are more likely to be achieved. Activity is central to our profession and with that being said, these activities are supposed to be appropriate and meaningful, right? Now that’s the part I personally find challenging, however I’m working on improving my ability or skills to be able to come up and adapt the activities that the clients find interest in so that at the end the main aims of the sessions are met and the client feels they’ve done something meaningful or purposeful for the day.

One other thing being noted from this chapter is that the environment which looks at the human and physical surroundings sometimes need some adaptations in order to meet the aims and these slight modifications can lead to dramatic effects on people’s performance and attitudes, this can include things like using floor cushions rather than chairs to create a relaxed atmosphere

William N. and Goldstein, M.D (2001) discuss the larger issues regarding psychotherapy in chapter 4 where they basically look at how the therapeutic environment should be like, how the therapist should be like in terms of neutrality and flexibility, what countertransference is and its role and they then look at the mechanisms of change in psychotherapy.

Basically, what they say and what I think I will take with me as the block starts is that the environment that sessions take place in should be a stable, consistent and non-threatening environment as stated above how the environment plays a role in sessions. The stability of the therapeutic environment is important with all clients and the therapist has to be neutral thus providing a setting where clients can be able to express their feelings. One thing that stood out for me is that as a therapist I have to be flexible at all times in terms of both the intervention and the approach. I also need to be ready for unpredictable, new challenges and be able to adapt or make changes to the activity, and what I think can also work is to have more than one activity for each client almost all the time. We then have countertransference, this basically occurs both consciously and unconsciously where the therapists show some emotional feelings towards the client, and according to Gabbard and Wilkison (1994), these should be kept to a minimum, so as I enter the practical blog I know that even though it sometimes occurs unconsciously, I shouldn’t become too actively engaged in the client’s lives.

In summary, treatment planning doesn’t only involve looking at the problems in terms of functioning but also looking at the strengths that you can build on. For the choice of activities to use in treatment, they should be able to fulfill the aims and be appropriate for the client looking at the age, gender, impairments, etc. The therapist has to be able to adapt and modify her role as treatment progresses by grading the expectations and be flexible at all times during the intervention as unpredictable events may arise during the sessions. It is also important to watch out for countertransference as this can lead to the therapist doing everything for the client even that that the client can be able to perform, yes this sometimes occurs unconsciously but it should be kept to a minimum. A slight modification can have a huge effect on the client’s performance and attitude in treatment sessions, so the environment has to be considered too during interventions.