mercy701

[mercy701]

Go below the surface and stay there.

As the founder of reflection, John Dewey once said,” We do not learn from experience…we learn from reflecting on that experience.”

Dewey emphasised the point that reflection is not a passive recall event but rather an active and deliberate process, where we make a concerted effort to develop self-reflection as a talent by using and practicing it on a regular basis Through the exploration of this blog we will embark on a journey of self-reflection, particularly in the context of the Inanda community experienced by myself in the past four weeks.

Upon my first visit to the community, I already had preconceived conceptions of what was awaiting me, based on opinions of others as well as lived experiences, but all this soon came undone as reality began slowly but forcefully creeping in. Driving into the Inanda community was nothing I hadn’t been exposed to in other informal settlements, from the overcrowding of houses to the layers upon layers of waste surrounding these homes. Although these environmental factors have a great impact on the health and wellbeing of the community, there are more severe issues that are imbedded deep within and spreading like a plague across the community whilst remaining out of sight. These issues include concepts such as Maternal and child health, sexual abuse, and gender-based violence, substance abuse, as well as high crime and unemployment rates.

Within the duration of the week, four out of six clients that I screened had been victims of sexual abuse, with three of them involving minors, this shocking statistic relays the severity of the issue. What has been noticed in the past few weeks, is that rape is spoken about so casually and frequently as if it is normalized, but this mindset needs to be exterminated. We, not only as occupational therapists, but as current members of the community, need to stress the severity of the issue as well as the human rights being impacted by it. As a result of corruption in the system, the success rate of sexual abuse cases is decreasing due to people abusing their power or privileges at the cost of the vulnerable. Another contributing factor is that many members of the community are not educated or informed about how to seek help or that’s its available to them. Even if members are educated, its limited especially with regards to the process, how to go about it, if you are faced with difficulties, such as insufficient evidence, disappearance of cases, and or being wrongfully accused.

The current process being utilised in Inanda is a prolonged and tedious process, as the social worker at the clinic only deals with the disability aspect of social work, thus sexual abuse cases have to be referred to the department of social development. With this process being long, What I learnt ais that its tedious and prolonged, due to disconnection as well as the redirection to various departments. As a result this poses a threat to the safety of your client by exposing them to risk of potential future abuse until the process is undergoing, which questions the underlying ethics of the process. This guided me to thinking of alternate forms of social assistance, not forgetting to provide my occupational therapy services in the duration. I feel this experience taught me the reality of the system in communities other than my own and challenge my way of thinking and approach of situations while still upholding the safety, dignity and well-being of my client. This is an issue directly interfering with basic human rights of safety and dignity and should not become a compromise between safety/health and sustainability of life. It needs to be emphasised that this right should be viewed as a basic need of survival and part of our roles and responsibilities as human beings.

In our role as OT’s we can fulfil our purpose by putting the following measures into place; discussions with social worker and CCGs in order to come up with an efficient referral system aimed at the respect and protection of these victims and preservation of their fundamental human rights, integrating sexual abuse into our daily health promotion to educate more people of the community and reach as many impacted soles as possible to emphasise the severity and relevance of sexual abuse to their context as well as their pertaining rights. Since many of these victims are forced to stay in these relationships due to dependency whether financial or emotional, thus we should focus on empowerment of these victims through skills development or finding suitable places of work to promote independence.

Another important issue prevalent in this community is the importance of maternal and child healthcare. Due to the high teenage pregnancy rate evident in our daily screening at the clinic and commuting to Inanda, many mothers that come in are there for immunisations and blood testing, but once they are made aware of any points of concern in terms of development of her child or her own physical and psychosocial health, they voice their concerns. At the clinic the clients are educated on the fundamental aspects of maternal health and childcare but lacking in terms of childhood development. This is where our role as OT’s comes in, educating mothers on the developmental milestones of the child, how to identify these markers of concern and how to encourage development in your own way with your child, as well as become aware of any concerns to your own physical and psychosocial health.

The Inanda community is ravaged by unemployment, due to lack of quality education, resources, health care and other essential services, this unemployment then influences the crime rate as well as the high rate of substance abuse. These unlawful and harmful acts are then carried down to future generations through modelling and learnt behaviour, further crippling this society. Therefore we need to create a large focus on youth development, as its very unrealistic to try to change the mindset of the adult community as they are more reluctant to change due to the aftermath of apartheid system. It’s easier to try to understand the perspectives, values and goals of the community from their mouths before going ahead and providing them with the assistance you believe they would want or benefit from, although it should be a collaboration of the therapist and community members, we need to give them the lead. As we need to keep in mind, we as outsiders are coming into their homes to offer them assistance and thus it should be considerate of their viewpoints and terms.

The number one skill this block has taught me thus far that is pertinent to an Occupational therapist is adaptability. Working in the community teaches you that you have no means of predicting future circumstances simply by following the theoretical process, you need to identify and understand the needs of the community. In order to do this you have to be able to adapt to your situation, something to put this into some perspective; in the interim of this week I ran a group at the local Crèche, and I planned a physical group outside for the first time. As the group began the kids were reluctant to engage so we prompted them through demonstration and verbal encouragement. As the group progressed the structure became more informal, but it promoted social participation and play which were our main aims making it meaningful. This also allowed us to focus on the individual needs within the group and promote the required needs through means of the activity, also known as the occupation as a means approach, thus guiding me towards how to implement my theory to this particular context. I was also challenged by the language barrier, but I listened, understood and repeated what the teacher was saying to the children and while facilitating them through the activity. After the group we engaged in clean-up, promoting healthy living through youth development and commuted to the classroom. The change in the children was amazing, they were all at some stage of self-regulation thus making it easier for the teacher to work with as a larger group and helped us in meeting our aims for the group.

In conclusion, through the exploration of these concepts, we can link them to topics referred to in previous blogs, such as the importance of maternal and child health to our society and lives, social and economic issues such as substance abuse, sexual abuse as well as crime and unemployment. These issues can all be further explored through linking it to the sustainable developmental goals previously referred to in my blogs. This self-reflection provides my positionality on all these issues and how I perceive my role as a future Occupational Therapist.

  References

Admin, D. (2022). Metoo - Tears Foundation. Tears Foundation. Retrieved 8 April 2022, from https://www.tears.co.za/metoo/.

John Dewey (1859–1952) - Experience and Reflective Thinking, Learning, School and Life, Democracy and Education. Education.stateuniversity.com. (2022). Retrieved 8 April 2022, from https://education.stateuniversity.com/pages/1914/Dewey-John-1859-1952.html.

Musawenkosi H L Mabaso, Z. (2022). Overview of Maternal, Neonatal and Child Deaths in South Africa: Challenges, Opportunities, Progress and Future Prospects. PubMed Central (PMC). Retrieved 8 April 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948143/.

Reflection, learning and education – infed.org:. Infed.org. (2022). Retrieved 8 April 2022, from https://infed.org/mobi/reflection-learning-and-education/.

[mercy701]

“Without action, its just a slogan”

("SDGs: Is "Leave No One Behind" Just a Slogan?", 2022)

The above picture refers to the slogan of the united cities and local governments (UCLA), this is pertinent to our aim of achieving the above mentioned sustainable developmental goals as it should be our underlying focus throughout this process of sustainable development. In the picture, we see a solid figure, with a faded figure behind it, this is especially relatable to our context of both the Inanda community and South Africa, as it’s a silent plea to remember one another in the name of humanism when we embark of this journey of tackling our communities’ greatest challenges in relation to global sustainable development. In the following blog we will explore the five most pertinent sustainable developmental goals to the community of Inanda and how we as Occupational Therapists play a role in achievement of these goals.

 The first sustainable developmental goal that applies to the context of the Inanda Community is Clean Water and Sanitation, the goal is “to achieve universal and equitable access to safe and affordable drinking water and sanitation for all”. Within the context of Inanda, there is a large amount of human and natural waste being dumped in an unsafe manner, in close proximity to many homes. This lack of a waste elimination system filters down to pollution of water systems, thus negatively impacting health of all surrounding community members as well as destruction of ecosystems. However as OT’s, our role in achieving this goal lies in the education of community members of the impact of this pollution in the community, in order to raise awareness of the severity of the situation and its threat to the health of both them and their future generations. We are also responsible for working among community members to identify solutions to tackle this issue, such as implementation of recycling programmes, not just saving materials like paper and plastic, but making use out of them through sustainable projects and activities.

Within our daily commute through the Inanda streets, we come across the vast amount of pregnant young girls, I say “young: not teenage as many of them are under the age of 12. applying to the SDG to achieve good health and wellbeing, this is a very shockingly scary reality which needs to be combated at its earliest, this also poses a threat to the already high HIV rate pertinent to the community. This is witnessed in the clinic with children being tested every day for HIV, as well as other birth complications. Another rampant illness in this community is TB, and with the compliance of PPE being very low due to poor insight, it’s a possible epidemic. Due to the low unemployment rate and poor economic growth in this context, there is a high substance abuse rate, including children from the age of nine onwards, this negatively impacts the lives of those around them as they become dependent on these forms of substance at an early age and develop poor coping strategies, as well as harm the lives of those around them. We can fulfil our role as OT’s by educating and supporting these young mothers through family planning and goal setting, as well as emphasising the importance of maintaining both their physical and mental health during and after pregnancy. In terms of HIV and other non-communicable diseases, the clinic does offer support groups, but as OT’s we can assist with treatment of complications of these diseases and illnesses. And lastly in terms of Substance abuse we can look at relapse prevention programmes but first and foremost values clarification and goal setting, as well as treatment of any underlying mental health impairments.

In terms of education, there are quite a few primary and high schools in the area but a shortage of creches, resulting in many children under the age of seven being left at home with little to no intellectual stimulation. Although there is access to schools, they are over capacitated, with a ratio of 45 students to one teacher, making it difficult to control all the children and cater to their individual needs. Another impeding factor is that many of the teachers are not trained in early childhood development, restricting the level of education being received, as teachers aren’t equipped with the skills to identify and ensure that the appropriate developmental milestones are being reached at the correct age by the children in the community. In our role as OTs to achieve the sustainable developmental goal of quality education, we are responsible for the advocacy for recruitment for more teachers in creches or the development of more creches. We can also play a role in training of teachers in features of early childhood development, by educating them about the developmental milestones and the importance and impact of these milestones in terms of school placement and skill development. Another way we can advocate for quality education is through the reintegration of the red flags project, which is a current Inanda project aimed at identifying and flagging possible students which require OT services, as well as imparting of knowledge pertaining to certain conditions in order to adjust and condition the school environment to meet the needs of the children to promote success in education.

In the context of Inanda community, due to the lack of industrial businesses and most community members being reliant on social grants, people are forced to travel outside the community to work due to lack of job opportunities or left unemployed. Although many of the community members are skilled, they aren’t made aware of how to utilize these skills for the benefit of the community, this shortage of skills development and poor-quality education limits the economic growth of this community. In order to achieve this goal of decent work and economic growth, we can recognize and advocate for these skilled community members by guiding them through the self-development process, but with their own hard work in order to promote entrepreneurship and sustainability of the community. Through this advocacy and improved education, the amount of job opportunities will increase, maybe even within the community through the upliftment of skilled community members or small businesses.

The last sustainable developmental goal pertaining to the community of Inanda is partnerships for the goals, this is relevant as it’s a major barrier to the development of the community. In the past NGO’s such as Green Corridors, were involved in the development of the Inanda community, specifically the Inanda Wilderness Park, but this partnership was strained by the vandalism and theft of resources and projects supplied to the park, by various community members. The cause of this is vandalism and theft can be attributed to the purpose of the partnership not being expressed appropriately, or in a way that is respectful to the views and ideas of the community. How we as OTs, come into practice here, is through acting as a sort of mediator or pilot study for future developments of this partnership. By advocating for usage of the previously developed and vandalised area, through its utilisation for individual and group clients, we can raise awareness of the benefits of the partnership through action, as well as mend the relationship between the Inanda community and green corridors, which may even result in new and promising partnerships in the future.

References

Localizing the Sustainable Development Goals - Leaving No One Behind. UCLG - United Cities and Local Governments. (2022). Retrieved 1 April 2022, from https://www.uclg.org/en/media/events/localizing-sustainable-development-goals-leaving-no-one-behind.

SDGs: Is "Leave No One Behind" Just a Slogan?. Doctors Without Borders - USA. (2022). Retrieved 1 April 2022, from https://www.doctorswithoutborders.org/latest/sdgs-leave-no-one-behind-just-slogan.

Sustainable Development Goals | United Nations Development Programme. UNDP. (2022). Retrieved 1 April 2022, from https://www.undp.org/sustainable-development-goals?utm_source=EN&utm_medium=GSR&utm_content=US_UNDP_PaidSearch_Brand_English&utm_campaign=CENTRA.

[mercy701]

Our positionality shapes the perspectives we hold.

(CUNY Graduate Center, 2020)

In the picture above, we see a number of things, from a person’s body in multiple positions, to animals and powerful imagery such as water being poured into an abyss. This painting is part of a series of artworks named “The    Developing Socially-Conscious Pedagogy Educator Series”, it was created by a group of students from the CUNY Graduate Center based in New York. The message behind this work seeks to engage, disrupt and resist social issues such as racism, xenophobia, homophobia and many more systems by inviting peoples’ participation in the imagination of and commitment to socially-conscious practices, which speaks to our topic.

Positionality according to research can be defined as the political and social context which creates your identity as well as its influence on your perception of the world around you (Pollock, 2021). An important aspect of positionality is privilege, which can be described as a special right or advantage exclusive to dominant groups while at the expense of target groups (Pollock, 2021). These dominant groups may often believe that they have earned these privileges, however these are privileges are granted to people in dominant groups whether they need it or not.

Positionality can be divided into various social identities, each with their own life impact and influencing emotions and experiences. The first identity is race/ ethnicity ,and I fall  under the Asian race. Being this race and with our grandparents having gone through Apartheid, our views of other racial groups are to an extent influenced. However these were not instilled in me, or impactful in my life, as I feel I did not experience the same things my grandparents did therefore, I have no right to these views and biases. Due to the struggles of Apartheid and a sense of belonging, the Asian community is a tight knit one, thus we fall victim to nepotism “there’s always a contact”. Although this is a good thing for members of this group, it puts others at a disadvantage and restricts us from helping one another as a diverse community in the context of our society. Its important to understand that race is a form of power, its been utilized that way in the past, with the oppression of target groups by dominant racial groups, this is seen when we hear stories from our grandparents about how they were restricted to certain areas or facilities due to their race in accordance with the Apartheid system. Currently I feel we are still to an extent this power is still abused, and unfair to certain racial groups, as our access to education and work is restricted, although we are given equal opportunities as other racial groups, we are limited by amount. (i.e. how are so many members of the Asian race wo meet the requirements not granted access to institutions and forced to study abroad or change their qualification). However i believe that if made aware of the implications of this power, we can use it to uplift one another and remove the negative connotation attached to it .

The second identity is gender, is defined as a socially constructed system which ascribes qualities of masculinity and femininity to people, although we may identify as a specific gender that corresponds with our sex assigned at birth (cisgender), not everyone does (Pollock, 2021). As therapists and people of this society, we need to be more knowledgeable of the various gender identities, regardless of our beliefs  pertaining to it. This impacts not only how we view and treat our clients, but those around us on a daily basis. I identify as a cisgender female, but throughout my childhood I felt more inclined to the male gender, as I preferred boys clothing, cars and tools, playing sports like rugby, with most of my friends being boys, but my family keep trying to make me conform to the supposed norms of the female gender by making me wear dresses, buying me dolls and restricting me from playing outside with the boys. Although we need to move away from this mindset that our gender is defined by the types of toys, activities and behaviours we exhibit, gender is fluid and not defined by these concepts. It is true that our gender is influenced by the input we receive from our environment, but we should not force these gender “defining norms” on others and respect their own expressions. When working with our clients and the people around us we need to accord them with respect, because only then will they feel comfortable enough to share and contribute to treatment or life in general. A person will only accord you the amount of respect they feel you deserve, which is influenced by your treatment of them and others.

The next identity is Socio-economic status, which is a construct defined by our social capital (trust, norms, reciprocity and knowledge seen in our social relationships, and is influenced by our exposure to experiences), and our cultural capital ( buildup of skills, behaviours and knowledge that promote our social mobility. These factors also increase our access and opportunity. I would define myself as working to middle class in terms of my family's’ wealth, coming from a single parent home with siblings, we were able to afford all basic amenities and luxuries occasionally, but my family is going through financial strain with the cost of tertiary education for both my siblings and myself. In terms of education, I went to a model c school, thus I acquired a good level of education and was given the opportunity to acquire tertiary education. This has impacted my outlook on all other social classes, as I feel I have experienced both lower (days where we had no electricity because we could not pay the bill) and higher class (enjoying delicacies such as sushi and going to fancy restaurants) to a certain extent and can perceive the impact of both when dealing with others. This however should not be a defining factor, as our country has the highest gini coefficent in the world, we need to be aware of these classes in order to understand the impact it has on others and to provide assistance where available. In terms of ability status , I am able, this has led to myself taking what I am capable of for granted, I am aware of those with disabilities, and understand the implications of it, which is honed by my knowledge acquired in this profession, but I find that on a personal level I do not acknowledge that individuals with disabilities are people before their diagnosis/disability. Although our country has moved towards empowerment of people with disabilities, we forget that we are a culturally rich community, and many of us are still ruled by our traditional ideations of people with disability, which leads to ableism, where people with impairments are viewed as insufficient, flawed and inferior to the able bodied.

 Religious beliefs are an important aspect of our positionality, but we need to change how we utilise this knowledge, I come from a multicultural home, with many religious beliefs such as Christianity, Hinduism and many other influences, but one thing they all have in common is the perspective of those that are not belonging to these various cultures as being wrong and not condoned. I have myself experienced being subjected to these views from within my family, as I have chosen a path of spirituality and come to accept all religions as one, which did not sit well and resulted in being ostracized. As growing therapists and individuals of this society we need to move past these views and open our minds to new perspectives with a fundamental basis of respect and willingness to learn in order to promote a safe environment for individuals to express and identify themselves.

https://drive.google.com/file/d/1uujd5XyB39C0NAOkDhmTN85H91AM0gAt/view?usp=sharing

References

Misawa, M. (2010). Queer Race Pedagogy for Educators in Higher Education: Dealing with Power Dynamics and Positionality of LGBTQ Students of Color. International Journal of Critical Pedagogy, 3 (1), 26-35. Retrieved from http://libjournal.uncg.edu/ijcp/article/view/68.

Pollock, M., 2021. What is positionality? - Engineer Inclusion. [online] Engineer Inclusion. Available at: <https://engineerinclusion.com/what-is-positionality/> [Accessed 25 March 2022].

The Center for the Humanities. 2022. Educator Positionality Mind-Mapping. [online] Available at: <https://www.centerforthehumanities.org/programming/educator-positionality-mind-mapping> [Accessed 25 March 2022].

[mercy701]

Why is Maternal and child health care important to society?

(Taylan D, 2021)

I have chosen this picture as I view it as a true depiction of our role in maternal health, that they are precious in our hands, and we as a society are responsible for their health outcomes.

Why is this important?

Maternal and child health is a vital public health goal in South Africa, their well-being influences the health of future generations and can aid in the prediction of future public health concerns for families, communities, and the health-care system. The South African Demographic Health Survey estimated that for every 1000 children that are born, about five women die during pregnancy or within two weeks after childbirth (SADHS, 2016). Its important to note that South Africa has made progress in the last two decades in terms of improving mother health and reducing maternal mortality, the majority of maternal deaths are preventable (SADHS, 2016).

Pregnancy can help identify and prevent existent health risks in women, as well as future health issues for mothers and their children. These dangers to one's health may include: hypertension, heart disease, diabetes, depression, STDs, inadequate nutrition and weight, and many others ("Maternal, Infant, and Child Health | Healthy People 2020", 2022)

Increased access to quality preconception (before pregnancy), prenatal (during pregnancy), and inter-conception (between pregnancies) care can lower the risk of mother and infant mortality and pregnancy-related problems. 1 Furthermore, favorable birth outcomes, as well as early detection and treatment of developmental delays, impairments, and other health issues in newborns, can help to prevent death or disability, allowing children to attain their full potential ("Maternal, Infant, and Child Health | Healthy People 2020", 2022).

What determines this?

The environment in which individuals live, learn, work, and play has an impact on a wide range of health risks and consequences. Environmental and social factors such as maternal health behaviors and health status are influenced by environmental and social factors such as access to health care and early intervention services, educational, employment, and economic opportunities, social support, and the availability of resources to meet daily needs  ("Maternal, Infant, and Child Health | Healthy People 2020", 2022).

Implications for OT

In a study conducted by Le Roux et al, measuring the impact of community health workers on maternal and child health outcomes in rural South Africa, it has been concluded that home visits by paraprofessional community health workers (CHWs) have been found  to improve maternal and child health outcomes.

Access to high-quality health care is more difficult for rural residents than for urban residents. Rural health facilities are not only less accessible due to distance and topography, but they are also frequently under-resourced, poorly kept, and lacking in important medication. Furthermore, a shortage of qualified and skilled healthcare providers, such as doctors, occupational therapist, and nurses, may exist in rural areas, resulting in suboptimal health outcomes.( Le Roux et al, 2020)

CHWs are well-liked and respected members of the community who can act as a link between people's homes and government-run primary health care facilities. Community health workers' effectiveness in reducing the burden of treatment in understaffed and under-resourced settings. ( Le Roux et al, 2020)

Thus we can conclude that there is a greater need for occupational therapists in the field of maternal and child health particularly in a rural setting, in terms of advocacy of the profession, as many clients requires the services of Occupational Therapists but are unaware of the profession. Another contributing factor is the issue of limited health care staff and the burden of care, as OT’s we are versatile, thus able to fill in the gaps of knowledge by threading through layers of information or adapted skills to provide client with diverse and purposeful treatment.  ( Le Roux et al, 2020)

Why is this relevant to Inanda Wilderness Park?

I find the information and articles I have come across for the duration of this blog is beneficial to my practical placement, for the following reasons:

- Teenage pregnancies are a major issue, from girls as young as twelve. Therefore girls  require education regarding maternal health as well as family planning.

-HIV/AIDS is another serious issue within the community, parent and child in most cases. A lot of education is being done regarding this at the moment and prevention has been put into place, but this statistic is still increasing in the high school children.

-Drug abuse is pertinent  in both the primary and high schools. This has an adverse impact on these children developing complications at a later stage, as well as when considering family planning.

Therefore in conclusion Maternal and child health is a highly important part of our society, as it represents our future, and how we value them. Its vital to most communties, but more so in rural contexts due to lack of education, resources, intervention. It also provides us with an indicator for possible complications of a foetus during pregannacy and how we can deal with it appropriately, reducing maternal mortality through early intervention.

References:

Maternal, Infant, and Child Health | Healthy People 2020. Healthypeople.gov. (2022). Retrieved 18 March 2022, from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health.

le Roux, K.W., Almirol, E., Rezvan, P.H. et al. Community health workers impact on maternal and child health outcomes in rural South Africa – a non-randomized two-group comparison study. BMC Public Health 20, 1404 (2020). https://doi.org/10.1186/s12889-020-09468-w

Africa, S. (2022). Maternal health care in SA shows signs of improvement | Statistics South Africa. Statssa.gov.za. Retrieved 18 March 2022, from http://www.statssa.gov.za/?p=13102&gclid=Cj0KCQjw29CRBhCUARIsAOboZbJ7oezXuN5SvySt3Fp79mWsXE8PLqb6I9NLE0cmLnuplPAQFKX57VIaAu1cEALw_wcB.

[mercy701]

Advice to my future OT self

Looking towards the future, I see the version of myself I’m aiming to be. The future of OT, a successful, independent and mature young woman. A vision of hope and peace for others, as well a beacon of strength and courage in times of darkness.

My journey to my future self is divided into two steps, developing or honing important skills needed to be a good OT, as skills needed for myself personally.  They reach the same destination, and may sometimes overlap, but that’s the beauty of Occupational Therapy, it’s a toolkit for a better quality of life regardless of your situation.

 (Inspirational And Motivational Quotes : 30 Inspiring Quotes for Strength, 2021)

Some important skills I have come across, and feel is a requirement for becoming a good OT include:

Being aware of transference and projection and how to deal with it. Projection can be divided into three parts

                  1. Neurotic projection- most common type, where people attribute                            feelings, motives, attitudes that they find difficult to deal with to                              someone else.

                  2.Complementary projection- occurs when individuals assume                                 others feel the same way the do.

                 3. Complimentary projection- occurs when individuals assume others                       are able to do the same things as themselves.  ("Transference,                             Countertransference and Projection • Counselling Tutor", 2021)

Another important aspect is viewing the client as a person, rather than a client. This helps use build rapport better and is done by, listening attentively and acknowledging your client’s words and feelings, keeping any promises made to the client, as honesty builds trust in the relationship.

Making sure the client understands what your purpose in their life is, to prevent attachment, depression, as well as for them to gain an understanding of why they require OT, as a general reinforcement of insight. ("Essential Skills and Attributes for Occupational Therapy", 2017)

One of the skills, I learnt in this block is the importance of collateral. Sometimes when you receive a client file, its not elaborate or lacking of important information, your only means then of acquiring that information, is through speaking to the client’s family, carers, head of the facility as well as other health professionals.

The last but most important skill, is for the focus of all therapy sessions to emphasise the improvement of the client’s quality of life.

I have also identified some important skills for my future self personally:

The first thing is to separate your clinical work from your personal work, don’t ever let them mix because that could lead to projection as well as negative energy for yourself.

An important point to remember is that skills taught to the client, such as social skills or behaviour modification are useful, as they can be applied to everyday life, but in the same breath be careful not to offend/over step your boundaries with others.

Remember not to overanalyze everything, as I have a tendency to do so, but at the same time don’t take things at surface level. The aim is to to look deeper but don’t look for things that aren’t there.

And lastly stay positive and hopeful regardless of your personal situation, as you need to remember that you have an impact on the lives of others, thus always remain a light in the darkest of times.

References:

Inspirational And Motivational Quotes : 30 Inspiring Quotes for Strength, C. (2021). Inspirational And Motivational Quotes : 30 Inspiring Quotes for Strength, Courage and Goal Achieving #amazingquotes #i…. OMG Quotes | Your daily dose of Motivation & Positivity, Quotes, Sayings & short stories. Retrieved 6 November 2021, from https://omgquotes.com/uncategorized/inspirational-and-motivational-quotes-30-inspiring-quotes-for-strength-courage-and-goal-achieving-amazingquotes-i-2/.

Transference, Countertransference and Projection • Counselling Tutor. Counselling Tutor. (2021). Retrieved 6 November 2021, from https://counsellingtutor.com/transference-countertransference-and-projection/.

Essential Skills and Attributes for Occupational Therapy. Ouac.on.ca. (2017). Retrieved 6 November 2021, from https://www.ouac.on.ca/docs/orpas/essential/ot_essential_skills_and_attributes.pdf.

[mercy701]

Occupational barriers experienced in mental health.

Mental health is defined as our “emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. Mental health is important at every stage of life, from childhood and adolescence through adulthood.” ("What Is Mental Health", 2020)

According to WFOT, Occupations are referred to as “ the everyday activities that we do as individuals, in families, in communities in order to occupy time and bring meaning and purpose to our lives”  ("About Occupational Therapy | WFOT", 2021)

My understanding of a barrier, is an obstacle or means to make something difficult or near impossible to overcome.

Thus an occupational barrier is an obstacle  which prevents or makes it very difficult to perform or complete everyday activities.

So how does mental health impact these occupational barriers?

Finding the internal motivation (volition) to initiate or perform a task.

Our perceptions of both ourselves and the everything around us.

Our ability to maintain attention and concentration during tasks.

Our orientation to reality.

The content and sequence of our thoughts.

Our mood, energy, and the quality of our sleep.

As Occupational therapists, we aid in this area by teaching you how to cope and combat these barriers. Some examples of ways in which we assist are:

Strengthening your personal care routine.

Helping your family/ carers understand the roles and responsibilities with regards to your care.

Helping explore healthy leisure activities.

Supporting the transition from hospital back into the community.

Assisting in recognizing how mental health affects goal achievement.

Establishing goals and ways in which to achieve them.

As an OT student, I experience various strains on my mental health due to stress, anxiety, sleep deprivation, burnout, and much more. These in turn impact on my occupational performance, as I end up procrastinating, handing in my work late, or with poor quality, in order to meet all my deadlines, when I do attend online lectures, my attention span is very low as I am often tired or very unmotivated to interact.

Over time, I have adjusted my coping strategies multiple times according to what works for me. From my experience, here are some changes I have made in my life and recommend you to do so too:

Saying a positive affirmation to myself every morning whilst standing in front of a mirror: “ Feelings come and go like clouds in a windy sky. Conscious breathing is my anchor.” (Thich Nhat Hang, 2021) 

Breaking down tasks into steps and ticking them off on a to-do-list has made me feel more satisfied and motivated to continue participating.

Allowing myself to take a break, reset and reward myself. The bigger the task completed, the bigger the reward.

References

About Occupational Therapy | WFOT. WFOT. (2021). Retrieved 23 October 2021, from https://www.wfot.org/about/about-occupational-therapy.

A quote from Stepping into Freedom. Goodreads.com. (2021). Retrieved 23 October 2021, from https://www.goodreads.com/quotes/119040-feelings-come-and-go-like-clouds-in-a-windy-sky.

What Is Mental Health. Mentalhealth.gov. (2020). Retrieved 23 October 2021, from https://www.mentalhealth.gov/basics/what-is-mental-health.

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COVID 19 : Trick or treat?

“ Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less.” (Curie, 1934)

As opposed to the general consensus, my outlook on the Covid-19 pandemic is optimistic in nature, although I have had my fair amount of trials and tribulations. At the start of this pandemic last year, we were all overcome with shock and fear of what was to come, and to a certain extent we still have this fear at the back of our minds. 

(Sharma, 2021)

Thereafter came the lockdowns and the quarantining, this impacted both our mental and physiological health, as we were confined to our homes, banned from any social gatherings and were forced to endure the fear of not only contracting the virus, but also dealing with the deaths of those around us. Thus we see a need to increase  access to mental health support services geared towards providing measures for developing healthy coping mechanisms during the current crisis.” (Singh et al., 2020).  Dealing with the ongoing loss of our loved ones really showed us the strength of our minds, and how without even knowing, we are all capable of enduring any challenge that may come our way.

Another important factor which this pandemic has taught us is the power of unity. Although we are not allowed to physically be united, due to social distancing, we need to maintain our unity in mind and spirit. The only way through this pandemic is together, if we all work together to learn and teach one another about the virus, abide by the protocol and restrictions, as well as provide support to those that are in need we can overcome this battle.

Personally one the main disadvantages of this pandemic to my life was the fact that I was prevented from doing my “seva” (service to mankind) (Jois, 2021) , as we are currently not allowed to perform any voluntary work due to the severity of the virus and the pandemic regulations thereof. ("Volunteering during the Coronavirus (COVID-19) pandemic", 2021) .On the bright side, this taught me not to look so far to provide service to others, as I am able to help those around me, be it those who are in need of basic necessities or those who are in need of menial tasks, service to mankind cannot be measured by the importance of the support you provide, but rather the act of helping.

And then came the “vaccines”, this is probably one of the most controversial topics in discussion at the moment. I don’t think any of us have done as much research about medication, side effects and general health prior to this pandemic. With only 13.2% of our population vaccinated ("Before you continue", 2021) , and the remainder uneasy about receiving it, we face a drastic issue as we need to be vaccinated in order to return to our previous quality of living. 

Thus, we as a society need to stay educated and updated on the current affairs and status of this pandemic, in order to make quality decisions that will not only benefit ourselves but those we love and care about, and the only way we can achieve this is by maintaining our strength even through the face of difficulties, and most importantly together as one.

References:

Before you continue. (2021). Retrieved 19 September 2021, from https://news.google.com/covid19/map?hl=en-ZA&state=7&mid=%2Fm%2F0hzlz&gl=ZA&ceid=ZA%3Aen

Marie Curie Quotes - BrainyQuote. (1934). Retrieved 19 September 2021, from https://www.brainyquote.com/authors/marie-curie-quotes

Jois, R. (2021). What Is Seva: The Yoga Practice of Selfless Service. Retrieved 19 September 2021, from https://www.sonima.com/yoga/yoga-articles/the-power-of-seva/

Singh, S., Roy, D., Sinha, K., Parveen, S., Sharma, G., & Joshi, G. (2020). Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations. Psychiatry Research, 293, 113429. doi: 10.1016/j.psychres.2020.113429

Volunteering during the Coronavirus (COVID-19) pandemic. (2021). Retrieved 19 September 2021, from https://www.nidirect.gov.uk/articles/volunteering-during-coronavirus-covid-19-pandemic

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Standing on the edge of becoming an OT- reflections on the journey thus far.

mAs I near the completion of this degree, I venture closer towards the start of my Occupational Therapy career. The journey thus far has been riddled with many ups and downs, but the life lessons learnt and rewards have multiplied.

[OT Potential, 2021]

Start of my journey

My journey began prior to studying, whilst I was in matric I volunteered at a hospital in Durban and shadowed the OT working there. My honest first opinion was that it seemed quite simple and similar to physiotherapy, only after my third day did I see the real impact Occupational Therapy has on clients, in terms of treatment and recovery, before you think of treating of a client, you need to study and understand them on every single level to plan a treatment that is unique to them. I was also exposed to a number of different conditions, which I had no prior knowledge about, and it was really intriguing to know that as an occupational therapist I would frequently be expanding my knowledge in terms of health conditions, treatment options, equipment, as well as understanding the purpose of other health professionals. 

[AOTA, 2021]

Then began the foundations of my OT knowledge, my first year was everything you would expect, your first year of university to be and more. It was exciting meeting new peers and lecturers with similar passions to yourself, learning about the true purpose we serve as OT’s and expanding our knowledge on health science as a whole. In the same breath it was also challenging and overwhelming as the workload was something unexpected, transitioning from school to university level and we had to learn to think creatively and in a new light and direction all together. I personally found it beneficial that we were exposed to fieldwork from our first year as it gave us a better understanding of what is expected of us when working with clients as well how to interact appropriately with them.

Then came my second year and swept me straight off my feet, from anxiety-provoking to feeling content and immersed in gratification. In my personal opinion, second year was the most difficult for me, as we were exposed to much more theory and tests and assessments compared to first year. As difficult as this year was for me I gained a great amount of experience from it, I was exposed to many challenges and there were times I felt this career wasn’t for me, but with the guidance and encouragement from my supervisors and peers, I held on firm and here I am today as a third year OT student.

Lastly, the first semester of third year was the most beneficial for me in my last three years, although the transition to online learning was a bit of a disadvantage for me, as I am a tactile learner but I have learnt to adapt and now understand some of the benefits thereof, such as being able to organize my time better, meeting deadlines, and referring back to lectures for recap. While at fieldwork I feel that I grew into my role as a student occupational therapist, with guidance from my supervisor I was able to learn to adapt my way of thinking to accommodate others, sharpen my assessment skills as well as  identify the areas I required improvement in and improve accordingly. 

It has been a long and eventful journey and although my journey as a student occupational therapists come to an end, the real  OT journey begins.

[Marie the OT, 2021]

References:

Lyon, S. (2017, July 24). OT Potential. Retrieved September 4, 2021, from OTpotential.com: https://otpotential.com/blog/occupational-therapy-quotes

 Allison. (2018, December 24). Allison the OT. Retrieved September 4, 2021, from Allisontheotstudent: https://allisontheotstudent.home.blog/2018/12/24/the-journey-beg

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Week 5: Reflecting on cultural humility.

Cultural humility is defined as “a lifelong commitment to self-evaluation and critique, to redressing power imbalances and to developing mutually beneficial and non paternalistic partnerships with commitments on behalf of individuals and defined populations.” (Tervalon M and Murray Garcia, 1998). From this definition, we can understand cultural humiity can be divided into three aspects:

The first aspect is the lifelong commitment to self- evaluation and critique (Tervalon M and Murray Garcia, 1998). This explains that we never reach an end point in the journey of learning, thus we must be humble and bold enough to critique ourselves, as well as have the desire to continue learning.

The second aspect is a desire to fix power imbalances (Tervalon M, Murray Garcia, 1998), which is the understanding that every person has something different to offer, thus helping us see the value in each individual. For example, during clinical interviews, the client has all the knowledge regarding their life, symptoms and strengths, while the health practitioner has all the knowledge that the client does not. One has the more power in scientific knowledge, while the other has power in personal history and preferences. Thus both parties must work together and learn from one another to obtain the best treatment outcomes.

The last aspect is the willingness to develop partnerships with people and groups who advocate for others (Tervalon M, Murray Garcia, 1998). This emphasizes the fact that cultural humility is greater than the individual and must be understood systematically. Thus, although individuals can create a good change on their own, through the use of groups and communities we can obtain a greater impact . It is also difficult to self evaluate / fix power imbalances  on your own, thus its more beneficial to have a larger organization.

Cultivating of cultural humility is an important aspect in improving attitudes towards understanding of other cultures, which is essential for occupational therapists, as we work with a highly multicultural and diverse client populations. With regards to my client, although it is important to address an adult female, as ma’am or their surname, my client preferred being called by her name. This however helped me build rapport with her and sustain a level of comfort between the client and myself (therapist). I was not very comfortable with this at first due tot he cultural background I come from, but I was required to perceive the situation from the clients cultural context. I think I could learn to apply this practice to my intervention planning, specifically when addressing / communicating with clients, understanding their cultural context before imposing mine/ assuming according to cultural norms. This will not only help me build rapport with the client, but also allow me to have a more diverse outlook on the clients life, this is helpful and aids in planning on appropriate forms of treatment for the client, as well as to administer it in a respectful, client focused manner to produce the best outcomes.

Multiracial and multiethnic individuals make up the cultural richness  of our diverse nation, as therapists we are responsible for recognising and valuing the cultural diversity of our individual clients. Therefore, we must consider cultural humility when formulating our therapist-client relationship, while acknowledging that we will always be in the process of learning and growth.

REFERENCES:

  Greene-Moton E, Minkler M. Cultural Competence or Cultural Humility? Moving Beyond the Debate. Health Promotion Practice. 2020;21(1):142-145. doi:10.1177/1524839919884912

Waters, A., & Asbill, L. (2013, August). Reflections on cultural humility. CYF News. http://www.apa.org/pi/families/resources/newsletter/2013/08/cultural-humility

Beach MC, Saha S, Cooper LA: The Role and Relationship of Cultural Competence and Patient-Centeredness in Health Care Quality. New York, Commonwealth Fund, 2006. https://www.commonwealthfund.org/publications/fund-reports/2006/oct/role-and-relationship-cultural-competence-and-patient. Accessed Nov 18, 2019Google Scholar

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Week 4: The use of evidence based practice to guide intervention.

Evidence based practice has been defined as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual clients.” (Sackett, Rosenberg, Gray, Haynes & Richardson, 1996).

My understanding of this is that it is a process that incorporates both clinical reasoning with the best available evidence from accurate research, while still considering the values and preferences of clients.

Figure 1. A framework for evidence-based occupational therapy practice:

( The process of evidence-based practice in occupational therapy: Informing clinical decisions,2000)

This framework is an accurate representation of evidence based practice: it shows that clinical decisions are required to be made at all stages of the occupational therapy treatment process. In order to make these decision, clinical questions need to be formulated, which need to take into account the specified client/group of clients requiring treatment, as well as their treatment context. Thereafter, valid research needs to be identified, which offers clinical usefulness, which then gets applied to the client, and clinical reasoning comes in to to determine the correlation between the evidence  and the clients context (person, occupation, environment). This leads to relevant, accurate outcomes, making the process more efficient.

During my intervention this week, I made use of evidence based practice, my client presented with increased oedema in her left lower limb. Therefore I incorporated mobilisation and oedema massage into both my treatment sessions as a fundamental basis of treatment, in order to reduce her swelling. “ Manual edema mobilization (MEM) is a relatively new treatment regimen derived from established European and Australian lymphedema reduction regimens. It includes the use of exercises, light skin-tractioning massage techniques following the lymphatic pathways, and the use of low-compression garments. The typical patient who may benefit from the use of MEM has a presumed healthy lymphatic system, is an active participant, and performs some of the techniques independently between therapy sessions. This case report describes the use of MEM on a patient with multiple trauma, which resulted in a significant reduction--78%--of the persistent edema in the affected upper limb. A theoretic rationale is offered for each MEM technique.” ( Howard, S. B., & Krishnagiri, S. (2001)). This has been researched, proven through studies and personal accounts from clinicians over time. Therefore, it is evidence based. 

We, as students , the apply these techniques and theories to our practice in various ways depending on the clients level of function. An important aspect to note is that this evidence can help with not only education of client about their diagnosis, complications and prevention, but also plays a vital role in treatment planning. For example, this week I planned a treatment session, based on my clients clinical presentation of the previous day. During the treatment session, my clients presentation had changed with sufficient improvement. Although this did not unhinge my session, it required me to adapt my session accordingly .Thus, due to my lack of thorough research, I was unable to identify the reasons behind my clients physical impairments and how her condition was changing, therefore unable to critically understand the diagnosis, hindering the treatment. This is not the basis of treatment, but plays a significant role in it, if I had thoroughly researched my clients conditions and presenting symptoms, I would have been able to predict possible outcomes, planned for them and provided the best possible treatment.

Evidence based practice has its fair amount of limitations as well. These include: novel management techniques/implementation of new technology. In these scenarios, scientific evidence is not available / reliable enough, hindering the decision making process and producing an unfavourable outcome .The other limiting factor is the rapid, changing management environment, thus scientific evidence that was formulated in the previous times has limited relevance to todays context. “ In these cases we have no other option than to deal with the available evidence and treat our clients as prototypes by systematically assessing the outcome of the decisions, with constant experimentation to determine what can be applied and which cannot.” (Pfeffer & Sutton, 2010).

In conclusion, I now understand the importance of evidence based practice and will aim to implement it into my critical thinking, in order to guide my intervention planning. As seen above, we understand how the use of evidence based practice is highly efficient in planning treatment. All that is required of you as a therapist, is to extract the relevant information from the research, consider the clients context and apply your clinical expertise to provide accurate and meaningful treatment.

References:

Howard, S. B., & Krishnagiri, S. (2001). The use of manual edema mobilization for the reduction of persistent edema in the upper limb. Journal of hand therapy : official journal of the American Society of Hand Therapists, 14(4), 291–301. https://doi.org/10.1016/s0894-1130(01)80008-9

Sackett, D.L. & Rosenberg, W.M.C. & Gray, J.A. & Haynes, bhaynes@mcmaster.ca & Richardson, W.S.. (1996). Evidence based medicine: What it is and what it isn’t. BMJ (Clinical research ed.). 312. 71-2. 10.1136/bmj.313.7050.170c. 

Pfeffer, Jeffrey & Sutton, Robert. (2006). Evidence-based management. Harvard business review. 84. 62-74, 133. 

CAOT, ACOTUP, ACOTRO, & PAC (1999). Joint position paper on evidence-based occupational therapy. Canadian Journal of Occupational Therapy, 66, 267–269.

 Egan, M., Dubouloz, C.J., von Zweck, C., & Vallerand, J. (1998). The client-centred evidence-based practice of occupational therapy. Canadian Journal of Occupational Therapy, 65, 136–143.

 Glanville, J., & Lefebvre, C. (2000). Identifying systematic reviews: Key resources. Evidence-Based Medicine, 5, 68–69.

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Week 3: Collaborative practice- Multidisciplinary team.

“The multidisciplinary team is the mechanism in organising and coordinating health and care services to meet the needs of individuals with complex care needs. They bring together the expertise and skills of different professionals to assess, plan and manage care jointly.” (care, practice & teams, 2021)

The MDT consists of health professionals from  varying disciplines, such as psychiatrists, occupational therapists, physiotherapists, nurses, speech therapist, social workers and many more. ("What is a Multidisciplinary Team?", 2021) This enables practitioners to communicate better about each others roles and responsibilities and encourage trust among one another. This practice has a holistic view of the client and is  person-centered. Some advantages regarding this practice involve preventing unnecessary errors and avoidance of related harm to individuals and their families, more efficient use of resources, greater productivity and preventative care approaches, and lastly it improves morale and reduces stress.

Previously, I did not apply this approach, but I would like to integrate this type of practice into my intervention planning, as it would make assessment findings and aims of treatment more diverse and detailed, creating a clearer image of clients condition, and what type of treatment to plan. In order to achieve this goal strong organisation would be required, specifically a coordinator is needed, regular meetings should be scheduled and there should be effective sharing of records and findings. Implementation of this practice would give client access to an entire team of experts, improve service coordination, expedite referral process, create new methods of service implementation as well as to allow client to create goals for themselves. (Gaille, 2021)

During the course of this week, I received collateral information regarding clients surgery and conclusions about client from the speech therapist. This was an amazing opportunity, as it provided some insight into clients condition and his current presentation with regards to complications of his surgery as well as his cognitive impairment. This allowed me to view the client from another health professionals point of view, and correlate the integration of assessment findings obtained from the both of us. Thus providing extensive care to client while working towards the same aim.

With regards to feedback this week, regarding the demo and the case presentation, I think both could have been greatly improved. Firstly, with the demo, I focused more on the application of the functional activity, instead of grading it  accordingly to clients level of competence/ participation levels. The supervisor noted that i should pay more attention to structuring and presentation principles, but most importantly is precautions, in order to ensure clients safety and uphold ethical behaviour. Lastly with regards to my case presentation, i did feel it was lacking, as I did not spend enough time summarizing assessment findings and choosing/ applying the correct model, which impacted my holistic view of the client in terms of treatment and what areas to focus on. In conclusion my planning was rationalized but needed to be executed in the same manner during treatment sessions.

References:

care, I., practice, R., & teams, M. (2021). Multidisciplinary teams - Activities to achieve integrated care. Retrieved 3 June 2021, from https://www.scie.org.uk/integrated-care/research-practice/activities/multidisciplinary-teams

What is a Multidisciplinary Team?. (2021). Retrieved 3 June 2021, from https://www.irishpsychiatry.ie/external-affairs-policy/public-information/what-is-a-multidisciplinary-team/

Gaille, B. (2021). 11 Multidisciplinary Team Advantages and Disadvantages. Retrieved 3 June 2021, from https://brandongaille.com/11-multidisciplinary-team-advantages-and-disadvantages/

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Week 2 : What does client centered mean to me?

Client-centered therapy also known as person-centered therapy was developed my humanist psychologist Carl Rogers during the 1940s. It is defined as “ an orderly process of client self-discovery and actualization occurs in response to the therapist's consistent empathic understanding of, acceptance of, and respect for the client's frame.”( “client-centered-therapy,2021″)

As an OT student my understanding of the client centered approach is that it is fundamental to our intervention planning with regards to working as a student occupational therapist, and should be integrated into our daily work ethic when dealing with each and every client. This approach serves as a reminder to view each client as a person rather than a diagnosis, thus you are required to integrate the desires, interests, priorities, motivations as well as family/ significant others of the client when planning intervention sessions. Another important factor contributing to client centered therapy is that by inquiring about clients life, you as a therapist are able to build rapport with them. This is important, as the client is able to see that you actually care about helping them and not just see them as a job to get through. The client will also have more trust in you as a therapist and feel more comfortable and open during therapy, allowing for more effective and rewarding treatment sessions. “If therapy goals are set by the client, through a process of client-centered assessment, active participation is enhanced.” ( “Client-centered assessment, Nancy Pollock, 2021″)

This approach has proven to be extremely useful in assessment and intervention planning, as once you have learned about the clients life in detail, you as a therapist are able to plan sessions that are adapted specifically to your client. The client then feels more motivated to perform a task that they are interested in, making the session successful and being able to meet the aims of your session accordingly.

During my sessions this week, at the end of the first day, my client got transferred, and I was assigned another client on my second day, whom was too difficult for a student, which led me to my current client. This continuous changing of clients, does increase my stress levels as I am required to start over each time I am assigned a new one, but I am understanding as this facility deals with acute care, so no client here is inevitably here for a long time and this just builds up my experience as an OT student and being able to do assessments quickly and accurately whilst planning interventions. 

The feedback from my supervisor, was mainly regarding my writeups and how to accurately interpret and plan intervention sessions while learning how to grade the activity while the client is performing it, in order to get the best results and improving clients abilities. This was very helpful as it gave me an indication of how to plan my sessions for the week to come as well as how to structure it accordingly. We also went through the case study and its various sections, this was a great opportunity, as it settled a lot of my uncertainty and gave me clarification of what is expected of us at this level and how to write it up both professionally and appropriately.

With regards to treatment planning, I was first required to understand my clients diagnosis and possible prognosis. My client is diagnosed with severe traumatic brain injury, which is a “Non-degenerative, non-congenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.” (”Traumatic Brain Injury (TBI), 2021″). My clients shows muscle weakness on the right side of his body, spasticity, poor orientation to person and place, and requires maximal assistance with most ADLs. 

In order to integrate client centered therapy into my treatment, I will need to look at basic roles my client may have had, with regards to his age and gender, as well as what activities he may have participated in/ will need to participate in, in the future. Since my client had no background information, my supervisor advised me to focus more on his diagnosis, the impact on his function, as well as gaining independence in all his ADLs.

In conclusion, you may be able to research every theoretical/ standardized way of assessing and treating a client with a specific diagnosis, but every client is different, they are their own person with different responses, abilities and interests. Thus your intervention planning should be structured with regards to them as an individual.

References:

Toyin Dawado, S. (2021). Traumatic Brain Injury (TBI) - Definition, Epidemiology, Pathophysiology: Overview, Epidemiology, Primary Injury. Retrieved 28 May 2021, from https://emedicine.medscape.com/article/326510-overview

Department of National Health and Welfare and Canadian Association of Occupational Therapists. (1987). Toward outcome measures in occupational Therapy)! (H39-114/1987£). Ottawa, ON: Department of National Health and Welfare.

 Pollock, N., Baptiste, S., Law, M., McColl, M. A., Opzoomer, A., &. Polatajko, H. (1990). Occupational performance measures: A [-eview based on the guidelines for the client-centered practice of occupational therapy. Canadian Journal of Occupational Therapy', 57. 77-En

Cherry, K. (2021). 3 Key Qualities to Look for in a Client-Centered Therapist. Retrieved 28 May 2021, from https://www.verywellmind.com/client-centered-therapy-2795999

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Week 1:The application of theory into fieldwork practice.

The transition from online learning back into fieldwork, is quite a gradual one, as currently we are in an adjustment phase. I, myself am returning into fieldwork after a year. Although, I had a great amount of theory and time to understand it at my disposal, the correct administration and adaptation of assessments comes from interactive learning in the field.

The first day is normally said to be the hardest with regards to practical’s, but in my opinion its not the actual work that makes it hard, but rather the fear of the unknown. From meeting a new patient, to deciding which assessments to do and treatment to plan. It's always a fear meeting a patient for the first time, whether they will be friendly  or difficult, and that plays an important role in your relationship with the patient, which in turn impacts how they respond to therapy. 

In terms of assessment and intervention, I did not complete any formal assessments, but rather observed and built rapport with the patient. Observation is an important aspect of assessment, as it gives a functional aspect to your assessment findings, it helps you identify which areas of the patients life will be impacted, as well as which client factors are limited. This is important as client factors form the basis of treatment planning, thus they need to be accurately measured and understood how they form part of patients functionality.

Although I am currently not confident in administering all my assessments, I will seek assistance from my supervisor as well as my colleagues. In order to plan appropriate treatment sessions, my assessment findings will need to be accurate and integrated into functional performance.

The feedback given by the supervisor, focused on administration on the assessments in a specific order, to obtain more integrated findings, seeing how one impacts on another. It is essential to do research into patients diagnosis to obtain a broader understanding of it, how it impacts his function, as well as which client factors are impacted, thus we can identify which assessments to focus intensely on. Another important aspect is review of the session, this will give you an idea of how to improve your principles of treatment, as well as focus on what client has difficulty in, and grade the following session accordingly.

REFERENCES:

Macher, J. P., & Crocq, M. A. (2004). Treatment goals: response and nonresponse. Dialogues in clinical neuroscience, 6(1), 83–91. https://doi.org/10.31887/DCNS.2004.6.1/jpmacher

Trombly, C. (2021). Anticipating the Future: Assessment of Occupational Function. Retrieved 19 May 2021, from http://Trombley, C. (1993). The issue is: Anticipating the future: Assessment of occupational function. American Journal of Occupational Therapy, 47, 253-257

https://www.youtube.com/redirect?event=video_description&redir_token=QUFFLUhqbEVDbXI3dENOZkJLV3Y0UWEwRkNSMWJWb3BTQXxBQ3Jtc0tubDlSSmNpbGNIOHVfUHVLdVEzU0JhOHpjRDBHa0xCREtPaTFRMHVVZmNERUhqNDFRclYwU1MzTy1jb0tsanh0NkZaYzRKMFBSdjc0enlBbHJlZ0JURUEzcjRDTEhmWnd3UlN1UGVkYUpISFdaV25pRQ&q=https%3A%2F%2Fwww.wpspublish.com%2Fwebinars