Occupational Therapy

OCCUPATIONAL THERAPY

Definition

Occupational therapy is the application of goal oriented, purposeful activity in the assessment and treatment of individuals with psychological, physical or developmental disabilities. (Susan b fine, 1972 )

Goal

Main goal is to enable patient to achieve healthy balance of occupation through the development of skills that will allow to function at a level satisfactory to himself and others.

Settings

Psychiatric hospitals, nursing homes, rehabilitation centers, special schools, community mental health centers, day care centers, halfway homes, and de-addiction centers

Points to be kept in mind

·         Consider patients interest

·         The activity should utilize the patient's strengths and abilities

·         Select short duration activities

·         Selected activity should provide some new experience for the patient

Process of intervention

·         Initial evaluation of the patient; what patient can do and cannot do

·         Development of immediate and long term goals by patient and therapist

·         Development of therapy plan with planned intervention

·         Implement the plan and monitor the progress

·         Call for review meeting

·         When immediate goals are achieved, set further goals

Types of activities:

·         Diversional activities like organized games

·         Therapeutic activities; for example carpentry

Suggested Occupational Activities

·         Anxiety disorder: simple concrete tasks with no more than 3 or 4 steps that can be learnt quickly

Eg: kitchen tasks, washing, sweeping, mopping

·         Depressive disorder: simple concrete tasks which are achievable; it is important for the patient to achieve the success. Provide positive reinforcement after each achievement.

Eg: crafts, weeding gardens a Manic disorder: non-competitive activities that allow the use of energy and expression of feelings. Activities should be limited and changed frequently Eg: sweeping

·         Schizophrenia (paranoid): non-competitive, solitary meaningful tasks that require some degree of concentration so that less time is available to focus on delusions

Eg: puzzles

·         Schizophrenia (catatonic): simple concrete tasks in which patient is actively involved.

Patient needs continuous supervision

Eg. Molding clay

·         Antisocial personality: activities that enhance self-esteem and are expressive and creative, but not too complicated. Patient needs supervision to make sure each task is complicated

Eg: leather work, painting

·         Dementia: group activities to increase feeling of belonging and self worth. Activities needs to be structured, requiring little time for completion and not much concentration. Explain and demonstrate each task, then have patient repeat the demonstration

Eg: cover making, packing goods

·         Substance abuse: group activities in which patient uses his talents

Eg: involving patient in planning social activities, encouraging interaction with others

·         Childhood and adolescent disorders:

Children: playing, story telling, painting, poetry, music

Adolescents: creative activities such as leather work, drawing, painting

Advantages

·         Helps to develop social skills and provide an outlet for self expression

·         Strengthens ego defenses

·         Develops a more realistic view of the self in relation to others

Nurses role

·         Observer

·         Teacher

·         Parent

·         Supporter

·         Guide and Friend

·         Warden