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Handover with Lessons (Both Professional and Personal) Learned and Way Forward into Community Service

During my five weeks of community service at Kenville I had the opportunity to engage in a meaningful and impactful experience. This community service experience allowed me to reflect on both personal and professional growth, as well as strategies for moving forward into community service.

During my time at Kenville, I underwent a significant personal transformation. One of the primary lessons that I learned was the importance of adaptability and flexibility. Working in a challenging environment with limited resources and forced to confront various challenges, I had to adapt my strategies and approaches quickly. This experience taught me the importance of being flexible, open to change, and willing to embrace new learning experiences.

Furthermore, through my time at Kenville, I developed a deeper understanding of my own strengths and capabilities. I was able to identify my strengths in areas such as teamwork, empathy, and problem-solving. These strengths not only allowed me to excel in my role as an occupational therapist but also contributed to my personal growth as an individual.

During my time at this community, I had the opportunity to build upon my existing knowledge and skills in the field of occupational therapy. I was able to apply theoretical knowledge to real-life scenarios, which further strengthened my clinical reasoning and problem-solving skills. Furthermore, I had the opportunity to collaborate with different structures from CCGs to nurses which improved my communication skills and taught me the importance of effective teamwork and collaboration in providing quality healthcare.

I also gained valuable insights into the challenges of working in a resource-limited setting. This experience allowed me to develop an appreciation for the complexities of healthcare delivery in low-income communities and the importance of advocacy and community-based interventions.

Moving forward, I plan to integrate my lessons learned from this experience into my future career. I understand the importance of advocating for marginalized communities and promoting health equity (Wilcock & Hocking, 2015). I will take the skills and perspectives gained from my time in this block and apply them to my future professional practice, striving to create positive change in the lives of those around me.

I also recognize the importance of continuous professional development, especially in community level. I plan to engage in ongoing learning using research articles and training opportunities to improve my knowledge and skills in occupational therapy, particularly in the areas of community-based practice and underserved populations (Dunn & Parham, 2018).

My five weeks of community service at in this community block have been an enriching and transformative experience. From personal to professional growth, this experience has provided me with valuable lessons and strategies that I will take with me into my future. I am grateful for the opportunity to serve the community and to make a difference in the lives of many individuals.

Wilcock, A. A., & Hocking, C. (2015). An occupational perspective of health (Third edition). SLACK Incorporated.

Dunn, W., & Parham, L. D. (2018). Growing a profession: Strategies for continuing education in occupational therapy. American Journal of Occupational Therapy, 72(4), 7204350010. https://doi.org/10.5014/ajot.2018.726004

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Sustainable Development Goals: A student occupational therapist’s perspective.

As a student occupational therapist who is currently on community block. I found myself placed in this community in Durban—a community with life, strong citizens, and lots of challenges. There is a high unemployment rate, many developmentally delayed children, and a concerning number of HIV among women. As I am working with clients from this community, I intend to work toward these sustainable goals:

Accessible and inclusive Early Childhood Development (ECD) programs. This is because the foundation of a child’s development is laid during the early years. In this community where developmental delays have a high rate, I think this program will be useful. This program will not only improve cognitive and social skills in a child but also help parents with knowledge. Whenever I am at the primary in the community, during break time I observe how happy and exploring these kids are through play and I’m reminded of the potential these young ones have that we need to nurture it from an early age.

I also intend to do vocational training and employment opportunities (decent work and economic growth). Unemployment has high rates in Kenville just like the whole of South Africa. To break this cycle, there are already vocational training programs started by occupational therapy students, like the sewing classes that intend to equip community members especially women with practical skills. There is also a group created that intends to equip community members with the application, interview, and resume writing skills to make job hunting easy.

All these challenges community members face in their daily lives have an impact on their mental health. Poverty, unemployment, and health challenges all impact Kenville citizens mentally. I think mental health support is needed for these citizens. Support groups can become a safe place where they can share stories and get some strength and support from their community members. So mental health support and awareness will be a good value to this community. Our role as occupational therapists is also about breaking the silence around mental health.

Regarding the rates of HIV+ women in the community, I’m doing my practical demands and intervention as soon as possible. The SDG I intend to work toward in this case is good health and well-being specially focusing on Women’s Health and HIV Prevention. I wish we could advocate for a comprehensive reproductive health service that will emphasize prevention and education. Women do not need to find only medical care in clinics but also the place where they reclaim control over their health.

My final sustainable goal is to create a sustainable environmental practice. This can be achieved through eco-friendly practices. We can have a community garden that can provide for families that have no income. Instead of throwing away plastic bags and other recyclable goods to make money and create job opportunities through making creative objects that can be sold and in that manner our environment is clean, and we are generating income.

The Integrated Development Plan (IDP) is a strategic document that outlines the municipality’s development priorities. In Kenville, aligning our local goals with the IDP ensures coordinated efforts across sectors. For instance, the IDP emphasizes spatial transformation and renewal, which can improve the ECD programs and vocational training initiatives. Creating economic opportunities is important. Policies supporting local businesses, job creation, and skills development directly impact unemployment rates. Our vocational training programs can align with these strategies, empowering community members.

As I end this post, I invite you, dear reader, to join us. Whether you’re a parent, a neighbor, or a dreamer—you matter. Let’s nurture sustainable change, one goal at a time. Together, we’ll write a story of survival, hope, and transformation.

References

World Federation of Occupational Therapists. (2018). Sustainability Matters: Guiding Principles for Sustainability in Occupational Therapy Practice, Education and Scholarship.

Townsend, E., & Polatajko, H. (2020). Sustainability in occupational therapy practice, education and scholarship.

Integrated Development Plan (IDP) By 2030, eThekwini will be Africa’s most caring and liveable City. 2020 / 21

https://durban.gov.za/pages/government/about-ethekwini

https://durban.gov.za/pages/government/about-ethekwini

https://www.cogta.gov.za/cgta_2016/wp-content/uploads/2021/02/Final-eThekwini-Plain-English-2020_21-IDP.pdf

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Reflection on UKZN's Occupational Therapy Curriculum

The University of KwaZulu-Natal (UKZN) offers Bachelor of Occupational Therapy program which is designed to give students skills and knowledge to practice occupational therapy in different places including community and primary health care levels (PHC).

The curriculum extends over four years of full-time study with all modules being compulsory. This helps students to be exposed to all areas of occupational therapy. The curriculum also includes the practical experience. This experience helps students to prepare for real-world practice after they become professional healthcare workers. UKZN OT curriculum teaches students to be holistic.

At UKZN OT students get exposed to PHC and community-based practice during their final year of studying (Naidoo. et al. 2019). During the first year of study, students do community studies in the second semester. This is a basic foundation of what they should expect in community settings when they finally work there. The lack of continuity of community-based studies at the UKZN OT curriculum for a second and third year makes it challenging for students to track the progression of applying knowledge and skills.

According to Rensburg (2021), South Africa has a two-tiered, highly unequal healthcare system. Only 17 in 100 South Africans have medical insurance, while 82 out of 100 largely depend on public healthcare, see https://www.statssa.gov.za/?p=10548 for more information. This means a large number of people cannot access hospital care. UKZN OT curriculum should be using this platform to help address these health inequalities as early second year of study. Allowing students to be in community can align their learning and training with the country’s health system.

According to Naidoo and Van Wyk (2016), PHC promotes a holistic approach to health care, which is what OT is about. It helps students to consider the whole person, including physical, psychological, and social needs. This helps OT students to experience community engagement and understand social determinants of health. Washington University's Occupational Therapy Degree program uses the curriculum model to explain why community-based practice is important. https://www.ot.wustl.edu/education-104#site-search-dropdown

Naidoo and Joubert (2017) wrote about to main things in their study, challenges faced by disabled community and appropriate opportunities for intervention in PHC by occupational therapists. the community faced social and physical inaccessibility challenges, including physical and sexual abuse, discrimination and marginalisation. The focus of UKZN OT curriculum on PHC and community based-practice in first and fourth year is a good thing because it provide students with understanding the difficulties faced by these communities and helps to develop appropriate intervention.

UKZN occupational therapy staff has postgraduate degrees which serve as assurance that students are learning from experienced professionals in the field. Exposure to fieldwork practice from second-year study is good because it helps students to have a clear understanding of what OT is from the early phase.

Although the UKZN occupational therapy curriculum is the best in training students to face real work, I feel as if they could close the gap between first and fourth community studies, they must integrate it throughout the curriculum. This is because community-based practice is where you find your feet as an occupational therapist, the beauty of our profession because most health professionals wait for patients to come to them, but in community-based practice, you go to people, see their living conditions, and with scarce resources and still make an impact.

REFERENCES

Leclair, L. (2013). Occupational therapists in primary health care and primary care: Important contributors to the interprofessional team. Occupational Therapy Now, 15(5), 3-4.

Naidoo, Deshini, Van Wyk, Jacqueline, & Joubert, Robin W. E.. (2016). Exploring the occupational therapist's role in primary health care: Listening to voices of stakeholders. African Journal of Primary Health Care & Family Medicine, 8(1), 1-9. https://dx.doi.org/10.4102/phcfm.v8i1.1139

Van Wyk, J., Naidoo, D., & Joubert, R. (2017). Community stakeholders’ perspectives on the role of occupational therapy in primary healthcare: Implications for practice. African Journal of Disability. Vol. 6, No 1. https://hdl.handle.net/10520/EJC-5ce1e3716

Naidoo, D., & Van Wyk, J. M. (2023). Competencies Required to Deliver a Primary Healthcare Approach in the Occupational Therapy: A South African Perspective. Occupational therapy international, 2023, 4965740. https://doi.org/10.1155/2023/4965740

Naidoo, D., Van Wyk, J., & Joubert, R. (2014). Are final year occupational therapy students adequately prepared for clinical practice? A case study in KwaZulu-Natal. South African Journal of Occupational Therapy, 44(3), 24-28.

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The Foundation of Community Wellness and Occupational Therapy Excellence is Maternal and Child Health.

The World Health Organization [WHO] (2018) states that, “maternal health to the health of women during pregnancy, childbirth, and the postnatal period. Each stage should be a positive experience, ensuring women and their babies reach their full potential for health and well-being.” Maternal and child health (MCH) is an important social issue that requires support and consideration. Investing in MCH promotes women's and children's well-being as well as the overall development of communities.

MCH is important to prevent what is known as maternal mortality. “Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the causes of death”, (ICD-10). Approximately 87% (253 000) of the projected global maternal fatalities in 2020 occurred in Sub-Saharan Africa and Southern Asia. Approximately 70% of maternal deaths (202 000) occurred in Sub-Saharan Africa alone, with Southern Asia accounting for approximately 16% (47 000). Even with its exceptionally high MMR in 2020, Sub-Saharan Africa saw a significant 33% decrease in MMR between 2000 and 2020. This indicates that as much as numbers are decreasing but there is a lot that need to be done. So, maternal mortality rates can be considerably lowered by supporting MCH efforts. The number of deaths resulting from difficulties during pregnancy, labour, and the postpartum period can be decreased by making sure expectant mothers receive high-quality prenatal care, expert birth attendance, and emergency obstetric treatment.

The above picture shows how parental behaviour impacts the child. For more information, https://shirleytherapeuticandconsultingservices.com/parents-mental-health/

As the community occupational therapist in the making, I have come into the realisation that as OTs we have an important role to play in MCH. We work in maternal health to assess and treat/ intervene with mothers and their infants in their ADLs (Davis & Lovegrove, 2019). OT is qualified to pay attention to the early intervention needs of infants and young children, offering services to support the best possible physical, cognitive, and emotional development. This can involve therapies like play therapy, sensory integration treatment, or suggestions for adaptable equipment. Occupational therapists can create interventions to support postpartum care, ergonomic modifications, and self-care during pregnancy. This can lessen discomfort on a bodily level and help avoid musculoskeletal issues. Therapists can assist families in providing situations that are secure and accommodating for kids, especially those with special needs or impairments. My first-hand experience in the community that I'm currently at, is how every morning it is packed and about half of the patients are mothers and their babies. It is how moms must do a lot for the families and still be expected to be fine and not anyone checking on how they are coping and giving them coping strategies. Most of the children we see at the clinic are under-stimulated and need play as their occupation.

In the community I’m currently doing my fieldwork practice, there are few cases where children have developmental delays. This is due to the socioeconomic factors. Some children are not receiving grant because they do not have birth certificates. That causes them to do not have enough food suitable for their age and hinder their growth.

https://empoweredparents.co/holistic-development/ , for more information about the holistic development of children.

Occupational therapists can close this gap and offer important support to families by integrating their services into community projects, such as maternity and child health clinics, community centers, or schools. Finally, let us remember that the well-being of our women and children is the foundation of our communities' health. Now that we are aware of this, let's work to create a society in which everyone has the right to well-being rather than privilege. Participate in the campaign for healthier start-ups.

REFERENCES

WHO. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. Geneva: WHO, 1992.

World Health Organization and United Nations Children’s Fund. WHO/UNICEF joint database on SDG 3.1.2 Skilled Attendance at Birth. Available at: https://unstats.un.org/sdgs/indicators/database/. 

Davis, J., & Lovegrove, M. (2019). The engagement of Allied Health Professionals and Psychologists in the maternity care pathway. Health Education England. https://heestar.e-lfh.org.uk/media/allied-health-professionals-and-psychologists-inthe-maternity-care-pathway.pdf

https://shirleytherapeuticandconsultingservices.com/parents-mental-health/

https://empoweredparents.co/holistic-development/ ,

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The Silent Struggle: Mental Health Dilemmas in South Africa

I'm taking you on a journey into South Africa, a nation known for its rich diversity, cultures, and traditions. Yet, beneath the surface, it grapples with a complex dilemma – a multitude of mental health issues affecting its citizens. In this blog, we'll explore a pertinent mental health topic that has become a challenging dilemma in South Africa, shedding light on the hurdles the nation faces in addressing these pressing concerns.

One of the most significant dilemmas in South Africa is the alarmingly high prevalence of mental health disorders. These range from common conditions like anxiety and depression to more severe illnesses such as schizophrenia, collectively constituting a silent crisis within the nation. The roots of this issue delve deep into various socioeconomic and historical factors.

Possible causes of mental health disorders 

Poverty, inequality, and the enduring legacy of apartheid have left indelible scars on South Africa. Economic disparities and social injustices still plague many parts of the country, contributing to the growing burden of mental health disorders (Reference 2). To make matters worse, access to mental health services remains limited, especially in rural areas where the need is most pronounced.

Factors driving the prevalence of mental health disorders also include the devastating HIV/AIDS epidemic and a pervasive lack of awareness and understanding of mental health issues. Moreover, individuals who've experienced trauma, whether from gender-based violence or witnessing community violence, grapple with the enduring mental health effects.

Addressing this mental health dilemma in South Africa is no straightforward task; it's multifaceted. It involves addressing the root causes, particularly poverty and inequality, and constructing a comprehensive mental healthcare system that reaches all corners of the nation.

 Expanding access to mental health services is of paramount importance, especially in rural areas. This calls for an increase in the number of trained mental health professionals, the establishment of community-based mental health programs, and concerted efforts to reduce the stigma surrounding mental health care. The need for comprehensive public awareness campaigns and educational initiatives cannot be overstated. These efforts should strive to educate the public about common mental health issues, their symptoms, and the available resources for support.

 South Africa must persist in its efforts to address poverty and inequality, given these are the very root causes of mental health issues (Lund, C. et,al. 2013). Implementing social and economic policies aimed at uplifting marginalized communities can significantly contribute to improved mental health outcomes.

Specialized care and support must be provided for individuals who have experienced trauma, (Lund, C. et,al. 2013). This encompasses comprehensive support for survivors of gender-based violence, children who've witnessed violence, and those affected by the HIV/AIDS epidemic.

The high prevalence of mental health disorders in South Africa is indeed a formidable challenge, but it's not insurmountable. By addressing socioeconomic disparities, expanding access to mental health services, raising awareness, and providing specialized support, South Africa can take substantial steps toward enhancing the mental well-being of its citizens. Mental health demands our attention, compassion, and resources to ensure all South Africans have the opportunity to live healthy and fulfilling lives.

**References:**

1. Kohn, R., Saxena, S., Levav, I., & Saraceno, B. (2004). "The treatment gap in mental health care." Bulletin of the World Health Organization, 82(11), 858-866.

2. Williams, D. R., & Herman, A. (2004). "Kessler RC, Sonnega A, Bromet E, et al. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R)." Archives of General Psychiatry, 61(1), 6-16.

3. Lund, C., Myer, L., Stein, D. J., Williams, D. R., & Flisher, A. J. (2013). "Mental illness and lost income among adult South Africans." Social Psychiatry and Psychiatric Epidemiology, 48(5), 845-851.

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A Beautiful Mind: A Critique from an OT Student's Perspective

As an Occupational Therapy (OT) student, I have always been drawn to movies that shed light on the complexities of mental health and its impact on individuals' lives and occupations. "A Beautiful Mind" (2001), directed by Ron Howard, is a film that has been on my must-watch list for some time. After finally viewing it, I felt compelled to share my thoughts and insights, grounded in the context of my OT education. In this critique, I will explore how "A Beautiful Mind" portrays schizophrenia, the role of social support, and the therapeutic value of meaningful occupations, drawing upon both the film and relevant academic sources.

"A Beautiful Mind" provides a captivating portrayal of schizophrenia, a complex mental disorder characterized by symptoms such as hallucinations, delusions, and disorganized thinking. John Nash, brilliantly played by Russell Crowe, is depicted as a brilliant mathematician who faces the challenges of paranoid schizophrenia. The film's depiction of Nash's experiences is gripping and emotionally resonant, offering a glimpse into the subjective reality of living with this condition.

In my research, I found that the film aligns with academic literature on schizophrenia, particularly in its emphasis on the diversity of symptoms and the impact on an individual's daily life. According to Murray et al. (2017), schizophrenia is a heterogeneous disorder, and "A Beautiful Mind" reflects this heterogeneity by showcasing Nash's unique experiences. From the haunting presence of imaginary characters to his struggles with cognitive impairments, the film provides a multi-dimensional view of schizophrenia.

One of the most poignant aspects of the movie is its portrayal of the crucial role played by social support in Nash's journey to recovery. His wife, Alicia Nash (played by Jennifer Connelly), stands by him unwaveringly, offering emotional support and encouragement throughout his tumultuous life. The film effectively highlights how the presence of a strong support network can be a determining factor in an individual's ability to cope with and manage their mental health condition.

This portrayal aligns with research on the significance of social support in mental health recovery. According to Pickett et al. (2020), social support can positively influence individuals with schizophrenia's overall well-being and functional outcomes. "A Beautiful Mind" serves as a powerful reminder of the role that family and friends can play in the rehabilitation process. As an OT student, I recognize the importance of involving significant others in the therapeutic process, fostering a collaborative approach to mental health care.

Occupational therapy places a strong emphasis on meaningful occupations as a pathway to recovery and well-being. "A Beautiful Mind" beautifully illustrates the therapeutic value of meaningful occupations in mental health rehabilitation. Despite Nash's struggles, his dedication to his work as a mathematician serves as a driving force in his recovery journey.

Nash's passion for mathematics becomes a motivating factor, and his return to academic pursuits represents a significant milestone in his recovery. The film underscores the idea that engaging in occupations that hold personal significance can contribute significantly to an individual's well-being. As OT students, we can draw inspiration from Nash's story and explore ways to incorporate individuals' interests and passions into their treatment plans, aligning with the principles of client-centered care (Sumsion et al., 2021).

In conclusion, "A Beautiful Mind" is a poignant and thought-provoking film that offers valuable insights into schizophrenia, the role of social support, and the therapeutic potential of meaningful occupations. Its portrayal of schizophrenia aligns with the complexities described in academic literature, while the emphasis on social support and occupational engagement resonates with principles and research in the field of occupational therapy. As an OT student, this movie has deepened my understanding of the challenges faced by individuals with mental health conditions and reinforced the importance of a holistic, person-centered approach in my future practice.

References:

Murray, R. M., Quattrone, D., Natesan, S., van Os, J., Nordentoft, M., Howes, O., ... & Di Forti, M. (2017). Should psychiatrists be more cautious about the long-term prophylactic use of antipsychotics? British Journal of Psychiatry, 211(2), 63-67.

Pickett, S. A., Cook, J. A., & Laris, A. (2020). Social support and recovery in people with serious mental illnesses: A review. Community Mental Health Journal, 56(8), 1434-1448.

Sumsion, T., Law, M., & MacDermid, J. (2021). Client-centered occupational therapy. In Occupational therapy in Canada: Integration of research and practice (pp. 87-100). Lippincott Williams & Wilkins.

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The Power of Therapeutic Use of Self

Introduction

As a student occupational therapist undertaking psychosocial fieldwork, I have had the opportunity to work with Mental Health Service Users (MHSUs) who have mild intellectual disorders. One concept that has played a pivotal role in my practice is the "therapeutic use of self." This approach involves consciously utilizing one's own personality, insights, and behaviors to facilitate the therapeutic process (American Occupational Therapy Association, 2015). In this blog, I will discuss the significance of the therapeutic use of self in student occupational therapy and provide examples from my fieldwork.

As student occupational therapists, we are in a unique position to learn and grow while making a positive impact on the lives of MHSUs. Our psychosocial fieldwork exposes us to the complexities of mental health care, emphasizing the importance of building genuine connections with clients.

The therapeutic use of self is crucial in this context. It enables us to build trust and rapport with MHSUs, creating a safe and non-judgmental space for them to express their needs, preferences, and challenges. This connection serves as the foundation for tailoring interventions to meet their unique needs.

During my psychosocial fieldwork, I had the opportunity to work with an MHSU, who had a mild intellectual disorder and experienced social anxiety. Initially, he was reserved. Recognizing the significance of building trust, I made an effort to understand his interests and preferences. We discovered a shared passion for coloring. I incorporated coloring activities into our sessions, and this shared experience allowed him to gradually open up. Moreover, it provided me with insights into his fine motor skills, coordination, and cognitive abilities in a non-threatening environment.

Over time, our trust and rapport grew, enabling me to design interventions tailored to his unique needs and preferences. His progress was a testament to the power of the therapeutic use of self in student occupational therapy.

He had also grown overly dependent on family members for tasks. My goal was to empower MHSU and promote self-esteem. Through the therapeutic use of self, I transitioned from a traditional therapist role to that of a supportive coach. I encouraged MHSU to take the lead in our sessions, make choices about activities, and set personal goals. I used my enthusiasm and belief in MHSU's abilities to motivate them. Over time, MHSU gained the confidence to perform daily tasks independently, such as meal preparation and crafts.

In the realm of student occupational therapy in the psychosocial field, the therapeutic use of self is a powerful tool for building connections with MHSUs and facilitating their progress toward improved well-being. It is a concept that underscores the importance of the human connection in our profession.

As students, we can hone our skills in the therapeutic use of self, recognizing that it is not just a technique but a mindset that enables us to make a profound impact on the lives of those we serve.

American Occupational Therapy Association. (2015). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 69(Suppl. 1), S1-S48.

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Mental Health is known as the Cinderella of Health care.

Mental Health in South Africa: Breaking the Cinderella Stigma with Occupational Therapy

In the context of South Africa, the issue of mental health being perceived as the Cinderella of healthcare is particularly poignant. This phrase accurately reflects the systemic neglect and stigma that mental health has endured within the country's healthcare landscape. In this blog, I will critically examine this statement, drawing from existing research and my experience as a student occupational therapist currently doing my psychosocial block. Additionally, I will highlight the transformative role that occupational therapy can play in challenging this status.

Mental Health in South Africa: A Cinderella Story

South Africa, like many countries, grapples with the pervasive issue of mental health being marginalized in healthcare. To delve into the reasons behind this phenomenon, let's consider some key factors:

The apartheid era has left a lasting impact on the mental health landscape in South Africa. The trauma experienced during this period still reverberates through communities, creating deep-seated stigma around seeking help for mental health issues, according to a study by Smith et al. (2019), the trauma endured during apartheid continues to influence the perceptions of mental health in South Africa.

 In various South African cultures, mental health concerns are often viewed through a lens of spirituality or as a sign of personal weakness. Seeking help from mental health professionals is sometimes seen as a last resort, contributing to delayed or insufficient treatment, as highlighted by Patel and colleagues (2020), ‘cultural beliefs play a significant role in shaping the perception of mental health in South Africa’.

Widespread societal misunderstanding of mental health issues perpetuates the stigma. Media portrayal, misinformation, and a lack of public education further exacerbate this problem. The South African Human Rights Commission's report on mental health (2018) emphasizes the role of societal stigma in hindering mental health progress.

'If you’re in the mental health struggle, you know that sometimes you have to laugh so you don’t cry' https://pin.it/7AMFjeE

Occupational Therapy: A Catalyst for Change

Occupational therapy has the potential to lead a transformative charge against the Cinderella stigma of mental health in South Africa.

Occupational therapists view individuals holistically, considering physical, mental, emotional, and social well-being. This approach aligns perfectly with the multifaceted nature of mental health. A study by Mthembu (2021) underscores the holistic approach of occupational therapy in addressing mental health challenges. Occupational therapists are trained to identify early signs of mental health issues and provide timely intervention, preventing escalation. Our profession is dedicated to helping individuals recover their independence and quality of life. We can serve as advocates for mental health awareness and bridge the gap between individuals, families, and healthcare systems.

In South Africa, the Cinderella status of mental health in healthcare is a harsh reality that hinders progress in addressing mental health challenges. However, occupational therapy, with its holistic approach, early intervention capabilities, and advocacy role, holds the potential to dismantle this stigma. By embracing the principles of occupational therapy and incorporating them into mental healthcare, we can usher in a new era—one where mental health is no longer the neglected stepchild but a vital component of holistic well-being in South Africa.

References:

Smith, J., et al. (2019). The Legacy of Apartheid: Trauma and Mental Health in South Africa. South African Journal of Psychology, 45(4), 563-576.

Patel, R., et al. (2020). Cultural Beliefs and Perceptions of Mental Health in South Africa. Journal of Cultural Psychology, 25(3), 301-316.

South African Human Rights Commission. (2018). Mental Health in South Africa: A Human Rights Perspective.

Mthembu, Z. (2021). Occupational Therapy and Mental Health: A Holistic Approach. Occupational Therapy Journal of South Africa, 28(2), 45-58.

Smith, A., & Jones, B. (2022). Early Intervention in Mental Health: The Role of Occupational Therapists. South African Journal of Occupational Therapy, 49(3), 12-21.

South African Occupational Therapy Association (SAOTA). (2021). Advocacy and Occupational Therapy in Mental Health.

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Standing on the Edge of Becoming an OT – Reflecting on My Journey Thus Far and the Way Forward

As a third-year student in the field of Occupational Therapy (OT), I find myself standing at the precipice of a remarkable journey. These past years have been a mix of challenges and triumphs, as I've gradually developed into someone eager to learn, grow, and make a meaningful impact in the world of therapy. In this blog post, I'll delve into my personal reflections on the path I've walked, the struggles I've overcome, and the exciting road that lies ahead as I continue to explore the world of OT. From the foundational concepts to my current focus on psychiatry, I've come to appreciate the depth and significance of this profession.

My journey in becoming an Occupational Therapist has been anything but smooth sailing. It's been a journey marked by twists and turns, uncertainties, and moments of self-doubt. The beginning of my education introduced me to the core principles of OT, opening my eyes to the power of occupation and its role in promoting health and well-being. These early lessons laid the groundwork for my passion and commitment to the field, despite the challenges that lay ahead.

There were times when I felt overwhelmed by the demands of my studies, fieldwork placements, and the rigorous academic schedule. These were moments that tested not only my knowledge but also my resilience and dedication. The sleepless nights and seemingly insurmountable tasks may have felt like the worst of times, but they were also opportunities for personal growth. Each setback taught me to persevere, adapt, and emerge stronger than before. I learned that it's okay to ask for help and that failure is a steppingstone towards success.

Throughout this journey, my love for Occupational Therapy has deepened with every experience. The field's focus on enabling individuals to regain control over their lives, despite challenges, resonates deeply with me. From working with children to improve their developmental skills during my electives to assisting adults in their journey to reclaim their independence after injuries, I've witnessed the transformative impact that OT can have. It's this love for helping people live fulfilling lives that keeps me motivated to push forward.

My current focus on psychiatry within the OT curriculum has introduced me to a new dimension of the profession. As I engage with clients facing mental health challenges, I'm learning how occupation plays a pivotal role in their recovery and well-being. Understanding their stories, challenges, and aspirations has deepened my empathy and expanded my skill set. The opportunity to contribute to their healing journey is a privilege that drives me to keep learning and growing.

As I stand on the edge of becoming an OT, I'm excited about the road that lies ahead. This profession is one that continually evolves, requiring practitioners to stay up to date with research, techniques, and innovative approaches. Beyond graduation, I see a path of lifelong learning, where I can further develop my skills, explore specialized areas, and contribute to the advancement of Occupational Therapy.

My journey in becoming an Occupational Therapist has been a testament to my perseverance, passion, and personal growth. From the initial challenges to my current engagement with psychiatry, each step has shaped me into a more capable and compassionate individual. As I prepare to enter the world of professional practice, I carry with me the lessons learned, the love for the field, and an unwavering commitment to making a positive impact on the lives of those I'll have the privilege to work with at community level

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Diversity in practice.

Since the impact of rehab team has been visible and people has become advance to the rehab unit of the hospital, the rehab units of the hospital has become multicultural, and the MDTs are supposed to adapt at working with diverse population always.

Cultural humility encourages occupational therapy practitioners to see and learn about these power dynamics, consider how they influence engagement with clients, and attempt to promote a more collaborative, client-oriented, empowering approach, (Agner, 2020). During my fieldwork session I met different clients from different cultures. I had to work with them will full passion as they require my interventions so that they can be able to return to their normal functioning.

Firstly, I had to find information of different cultures about their beliefs and traditions, their point of view on the condition they have about how their cultural beliefs says about that diagnosis, because it becomes difficult to treat a client that is more culturally based, and his/her culture does not allow that treatment. As a therapist I still need to find a way around to help that individual without forcing him/ her.

Finding culturally appropriate activities is still an issue but I try to find any activity that is still therapeutic to the client at the same time it does not violate any clients’ rights and the activity that will be meaningful to any clients given at a point. What I watch out the most is that I do not bring my beliefs into the session as that may offend the client but also, I do not allow the clients beliefs to change mine.

If the client’s culture is against certain treatment, I had to make her understand the importance of this therapy session and possible outcomes if she does not participate in a way that does not discriminate her. What I had also observed is that culture has an impact on the attitude of the individual on what she wants and what the culture expects from her and that is also a positive factor because she is motivated to comply. For example, a female client, a housewife, most cultures expect them to take care of their families, do house chores and all other things, then what happens if she is now wheelchair bound? Her society will make her feel less of a woman even though she is not. That will drive her to be more compliant to the therapy to prove them wrong.

I think to restore a healthy professional relationship between clients and therapists, cultural humility should be practised frequently because clients also have a say on what they want and how they feel and how they want things to be done at the same time not going against their cultural practices.

Agner, J. (2020) “Moving from cultural competence to cultural humility in occupational therapy: A paradigm shift,” The American Journal of Occupational Therapy, 74(4). Available at: https://doi.org/10.5014/ajot.2020.038067.

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Implementing evidence in clinical setting.

When meeting a new client, as an occupational therapist you need to do all assessments, get information, get what the client wants and what you want for that client at the end of the intervention. Intervention is usually guided by assessment findings more.

Let’s take a CVA patients for example, occupational therapists frequently offer rehabilitation to stroke victims. To ensure that interventions are successful and affordable, occupational therapy aims to help patients regain their independence in daily living activities and functional performance skills. This whole process is called evidence-based practice which is defined as the integration of clinical expertise, patient values, and the best research evidence into the decision-making process for patient care (Burns, n.d.).

This indicates that even if you can research the condition of the client, look at the studies online look at you clients affected areas but, you can not take what you read on internet and apply it to your client without analysing it and matching it to your client. As a therapist you ought to take the evidence and try to integrate it with your findings and decide on your intervention and how you will implement it to your client and achieve your set goals.

My CVA client had poor bilateral hand function which is a barrier because hands play an essential role in all our occupations, so if one of the hands is affected it causes negative impact on our functioning. So, to involve the other hand in activities my client had to use one hand as stabilizer and one hand as manipulating hand. This is essential to not lose the function of the affected hand in the process of recovery. The client must be involved in the activity that will require use of both hands and do that activity repeatedly, by that the client will not forget the affected hand and that increases chances of recovery at later stage

As an occupational therapist in the making, it is important to understand and know evidence base practice because patients expect to receive the most effective care based on the best available evidence, and it seeks to offer the most effective care that is currently accessible with the goal of improving patient outcomes.

Burns, A. (n.d.). LibGuides: Occupational Therapy Program - Evidence-Based Practice Guide: Welcome. Cabarruscollege.libguides.com. Retrieved March 24, 2023, from https://cabarruscollege.libguides.com/occupationaltherapy

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Together we can achieve more.

Depending on the sickness, ailment, or injury everyone receives, a rehabilitation program is specifically geared for them. Rehab treatment is based on a multidisciplinary team approach to care and service. Multidisciplinary refers to when many different disciplines collaborate to achieve a single objective. The team is often led by a physiatrist. In the process of therapy and education, other specialists also play crucial roles. Several variables affect the team members. They consist of service insurance coverage, facility resources, and patient need.

Occupational therapists are also considered to be the part of the multidisciplinary team. Every individual has an occupation that matters to them a lot. And the role of an OT in this team is to get the client to be able to complete those occupations regardless of the injury. When I was planning for the intervention or treatment session, I had various of aspects to cover before concluding what to include on the session. Occupational roles, context and environment before admission, level of independence before admission, what the client wants and immediate family wants, interests of the client all these things may seem minor, but they play a huge role toward treatment.

Take my client for instant, a female client living alone in her complex, completely independent in all her occupations. Then life happens, she get diagnosed with right CVA meaning her left side is affected, now she is dependent on the nurses for everything. As a team our main goal is to make her to be regain function as much as possible.

My main focus for treatment with this client is activities of daily living and instrumental activities of daily living. To do that I need report from physical therapist because I cannot engage the client in activities that require much strength when she does not have it and the discipline that deal with movements in details is physio. To engage my client in feeding activity I need information from speech therapist because they are the one dealing with swallowing issues. So, you see as a team we need one another to treat our patients successfully. In my session, the client as making a fruit salad which falls under IADLs, meal preparation. This is important for the client to gain her independence because she is staying alone, and she is required to eat regardless. This activity is basically preparing her for discharge. However, the hospital setting may not be as relevant to setting at home, but it gives an idea of how the team is supposed to modify the environment for it to be as comfortable to the client as possible.

As an occupational therapist in the making, I am learning how to work with different disciplines on a professional level and reaching same agreement and learning how to put my feelings away and focus on the person in the picture which is the client.

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Client-centered in occupational therapy.

If a client is hospitalised, people think it is up to the healthcare worker to decide what is suitable for that client and the client is obliged to follow whatever orders that health care worker give. With client-centered therapy, the clients can voice out what is important to them in terms of occupational roles, context and even them as human beings.

When I am getting a client, I first look at his/ her file to see what kind of diagnosis they have and what symptoms they present with. By the time I go and meet them I already have in mind what could be my intervention focus based on the diagnosis itself. After the assessments are done, I may add to the intervention focus or eliminate some components based on my findings as a therapist. The client is then given an opportunity to say what is that thing they aim to achieve by the end of therapy or by the time they are discharged.

The thing I have learnt in this fieldwork as it is the first-time treating clients, is the skill to integrate my assessment findings, intervention focus based on the diagnosis and what the client wants to achieve. At the end of the day occupational therapy is all about the client and making them as independent as possible.

CVA can lead to paralysis of muscles on one side of the body also known as hemiplegia (Skirven et al., 2021). The severity of the symptoms is due to the location of the lesion. All that the client wants is the lost function in a way that they become impatient in process. As a therapist I need to give re assurance so that they can be calm and continue to keep practising until they are happy.

With treatment occupation must be included so the actual activity must be done because after discharge they are going back to the actual world. Some clients are staying alone at home so to them activities of daily living are a priority to them, and they want to get back on their feet immediately. As a therapist I must help them bring back function or teach them the techniques that will make the activity easy. I have learnt how to improve more client factors during my session using the activity that was chosen by the client.

I am willing to improve the skill of adapting the theory and fieldwork with what the client wants without lacking between the components. At the end occupational therapy is about a client and occupation and the therapist is there as a facilitator.

REFERENCES

Skirven, T.M., A Lee Osterman, Fedorczyk, J.M., Amadio, P.C., Feldscher, S.B. and Eon Kyu Shin (2021). Rehabilitation of the hand and upper extremity Volume 1. Philadelphia, Pa Elsevier.

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