Case Study: The Occupational Therapist
Enter/ Initiate: Ben is a 46 year old man who has a long history of schizophrenia. The Occupational Therapist (OT), who is part of the Community Mental Health Team, has been referred to Ben by a consultant psychiatrist. Bens mother, Jan, has previously sought help from the community mental health team and is concerned about her sons mental and physical wellbeing. The OT will review Bens referral and documentation to establish whether or not the referral is appropriate and to determine if Ben will benefit from the service. The OT will also gather useful information on Bens past medical history, social situation and employment history (Bryant et al., 2014). This process of infromation gathering is important and will provide the foundation.
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The OT will obtain Bens contact details from the referral and make a phone call to Ben, during which the OT will establish whether Ben is interested in availing of the service. If Ben agrees, The OT will arrange a date and location where they will meet. The OT will meet Ben in his flat, where Ben will sign a written consent form to state that he is happy to complete the process. The OT will explain his/her role and how they can help Ben to achieve his goals. An initial interview will be conducted with Ben, which will determine his occupational strengths and challenges, along with interests and goals. By carrying carrying out an initial assessment with Ben, the OT is making sure that he will be engaged and involved in all decisions that will be made in relation to his needs and hopes for the course of intervention. When the OT is educating the client on types of interventions that may suit Ben, he/she would understand that Ben may be under a considerable amount of stress. Therfore, it is important to make sure to take time in discussing his options, giving Ben a chance absorb and fully understand the information given before any decisions are made (Blue book).
Set the stage:
At this point, the OT will continue to build rapport with Ben, as this is a crucial step that enables the client to express their beliefs, values and expectaions with the therapist, while also establishing a collaborative therapeutic relationship (Bryant et al., 2014, pp 351).
During this stage, the OT will also interview Ben using an individualised outcome measure such as the COPM (law et al, 1994). By administering the COPM to Ben, The OT will gain a clearer undertsanding of Bens occupational performance problems along with the areas that he would like to address during the course of his work with the OT (Duncan). After completing the COPM, Ben identifies a number of occupational issues in his life, such as social withdrawal, isolation from his family and professional support, his difficulty eating healthily and also his increased smoking to date. Ben then identifies areas that he would like to work on or address throughout intervention. At this point, after recognising isolation as Bens main occupational problem, The OT would recommend a variety of different support groups that are run by the community mental health team that would facilitate socialisation and communication among those suffering from mental health difficulties in the …show more content…
community. It is also important at this point to negotiate ground rules and expectations of the client and therapist, including their roles and responisibilies throughout intervention. One of the OT’s responsibities will be to provide the client with the information they need to make a decision. They will also be responsible for obtaining consent to proceed with each session. Obtaining consent will also encourage communication between the client and therapist as the client will feel confortable sharing information with the OT (Townsend and Polatajko, 2007).
Assess/ Evaluate:
In order to establish the personal, environmental and occupational factors that are contributing to Bens occupational problems, an assessment must be carried out by the OT. Assessment at this stage is vital, as it will identify Bens occupational status, dreams and his potential for change. Assessments such as The Meyers lifestyle questionnaire (Mayers 2005) and the COPM (Law et al, 1994) (Bryant et al., 2014) could be used by the OT, as they enable the client to identify their own occupational performance problems. Furthermore, this will enable the OT to collaborate with Ben in establishing an intervention plan which will be specific to his needs while being client centred (McColl and Pollock). The Meyers lifestyle questionnaire was developed for those with enduring mental health issues and would be used to identify and prioritise any issues that is affecting Bens quality of life to date (Mayers, 2003). This questionnaire could also measure Bens potential for change, as it will allow him to set goals which will address the main occupational challenges he faces. The OT would carry out this questionnaire with Ben before an intervention plan is achieved. In order to achieve client participation, it is vital that Ben is recognised as an active participant in all discussions and decision making about his needs and aspirations throughout the course of therapy (Townsend and Polatajko, 2007). The OT would use simple language rather than medical terms, as medical terminology can be confusing to clients, giving them the impression that the professional is in a position of power over the client, hindering client centred practice and client participation (Sumsion, 1999). Spirituality would be assessed by the OT by listening closely and taking note of the clients expressed needs, cultures and values (Sumsion, 1999).
Objectives and Plan:
Bens priority occupational issues could include isolation from his friends, recent weight gain along with spending an increased amount of time in bed, which indicates that he may have abandoned his love for painting, previously mentioned in the video.
By setting goals in collaboration with Ben, he will be able to change vague ideas of what he wishes to achieve to into more concrete ways into managing his problems and achieving change (McCullough, 2014). Both long and short term goals could be set with Ben.
Short term goals:
• In 1 week, Ben will choose and attend a task based group in his community
• In 3 weeks, Ben will have prepared and cooked a healthy meal without assitance using recipie cards provided by the OT.
• By week 5 Ben will have learned and practiced the various CBT techniques with help from the OT.
Long Term Goals:
• In 3 months, Ben will cook a healthy meal five days a week.
• In 6 months, Ben will be able to manage his unhelpful thoughts using CBT techniques without prompting from the
OT.
Goals will be set with Ben in the second session of therapy, after his occupational issues have been identified and prioritised using the COPM. The OT will help Ben to come up with a list of short term goals which will enable Ben to achieve his long term goals that are mentioned above. The OT and Ben will discuss a realistic timeframe in which these goals should be achieved, which will enable the OT to establish the duration and number of sessions that will be required to achive Bens needs. Client participation will be addressed in this stage as Ben will be actively involved and in control of what short term goals will enable him lead a more meaninful life. By feeling that he is an active participant in the plan to improve his quality of life, Ben will be motivated to enage in all aspects of the intervention and to attend each session throughout the agreed timeframe. Power sharing will be adressed in the stage as drawing up goals will be joint effort, as the OT will provide guidance and reasoning for each goal, while Ben justifies how a goal will help him.
The OT will obtain Bens contact details from the referral and make a phone call to Ben, during which the OT will establish whether Ben is interested in availing of the service. If Ben agrees, The OT will arrange a date and location where they will meet. The OT will meet Ben in his flat, where Ben will sign a written consent form to state that he is happy to complete the process. The OT will explain his/her role and how they can help Ben to achieve his goals. An initial interview will be conducted with Ben, which will determine his occupational strengths and challenges, along with interests and goals. By carrying carrying out an initial assessment with Ben, the OT is making sure that he will be engaged and involved in all decisions that will be made in relation to his needs and hopes for the course of intervention. When the OT is educating the client on types of interventions that may suit Ben, he/she would understand that Ben may be under a considerable amount of stress. Therfore, it is important to make sure to take time in discussing his options, giving Ben a chance absorb and fully understand the information given before any decisions are made (Blue book).
Set the stage:
At this point, the OT will continue to build rapport with Ben, as this is a crucial step that enables the client to express their beliefs, values and expectaions with the therapist, while also establishing a collaborative therapeutic relationship (Bryant et al., 2014, pp 351).
During this stage, the OT will also interview Ben using an individualised outcome measure such as the COPM (law et al, 1994). By administering the COPM to Ben, The OT will gain a clearer undertsanding of Bens occupational performance problems along with the areas that he would like to address during the course of his work with the OT (Duncan). After completing the COPM, Ben identifies a number of occupational issues in his life, such as social withdrawal, isolation from his family and professional support, his difficulty eating healthily and also his increased smoking to date. Ben then identifies areas that he would like to work on or address throughout intervention. At this point, after recognising isolation as Bens main occupational problem, The OT would recommend a variety of different support groups that are run by the community mental health team that would facilitate socialisation and communication among those suffering from mental health difficulties in the …show more content…
community. It is also important at this point to negotiate ground rules and expectations of the client and therapist, including their roles and responisibilies throughout intervention. One of the OT’s responsibities will be to provide the client with the information they need to make a decision. They will also be responsible for obtaining consent to proceed with each session. Obtaining consent will also encourage communication between the client and therapist as the client will feel confortable sharing information with the OT (Townsend and Polatajko, 2007).
Assess/ Evaluate:
In order to establish the personal, environmental and occupational factors that are contributing to Bens occupational problems, an assessment must be carried out by the OT. Assessment at this stage is vital, as it will identify Bens occupational status, dreams and his potential for change. Assessments such as The Meyers lifestyle questionnaire (Mayers 2005) and the COPM (Law et al, 1994) (Bryant et al., 2014) could be used by the OT, as they enable the client to identify their own occupational performance problems. Furthermore, this will enable the OT to collaborate with Ben in establishing an intervention plan which will be specific to his needs while being client centred (McColl and Pollock). The Meyers lifestyle questionnaire was developed for those with enduring mental health issues and would be used to identify and prioritise any issues that is affecting Bens quality of life to date (Mayers, 2003). This questionnaire could also measure Bens potential for change, as it will allow him to set goals which will address the main occupational challenges he faces. The OT would carry out this questionnaire with Ben before an intervention plan is achieved. In order to achieve client participation, it is vital that Ben is recognised as an active participant in all discussions and decision making about his needs and aspirations throughout the course of therapy (Townsend and Polatajko, 2007). The OT would use simple language rather than medical terms, as medical terminology can be confusing to clients, giving them the impression that the professional is in a position of power over the client, hindering client centred practice and client participation (Sumsion, 1999). Spirituality would be assessed by the OT by listening closely and taking note of the clients expressed needs, cultures and values (Sumsion, 1999).
Objectives and Plan:
Bens priority occupational issues could include isolation from his friends, recent weight gain along with spending an increased amount of time in bed, which indicates that he may have abandoned his love for painting, previously mentioned in the video.
By setting goals in collaboration with Ben, he will be able to change vague ideas of what he wishes to achieve to into more concrete ways into managing his problems and achieving change (McCullough, 2014). Both long and short term goals could be set with Ben.
Short term goals:
• In 1 week, Ben will choose and attend a task based group in his community
• In 3 weeks, Ben will have prepared and cooked a healthy meal without assitance using recipie cards provided by the OT.
• By week 5 Ben will have learned and practiced the various CBT techniques with help from the OT.
Long Term Goals:
• In 3 months, Ben will cook a healthy meal five days a week.
• In 6 months, Ben will be able to manage his unhelpful thoughts using CBT techniques without prompting from the
OT.
Goals will be set with Ben in the second session of therapy, after his occupational issues have been identified and prioritised using the COPM. The OT will help Ben to come up with a list of short term goals which will enable Ben to achieve his long term goals that are mentioned above. The OT and Ben will discuss a realistic timeframe in which these goals should be achieved, which will enable the OT to establish the duration and number of sessions that will be required to achive Bens needs. Client participation will be addressed in this stage as Ben will be actively involved and in control of what short term goals will enable him lead a more meaninful life. By feeling that he is an active participant in the plan to improve his quality of life, Ben will be motivated to enage in all aspects of the intervention and to attend each session throughout the agreed timeframe. Power sharing will be adressed in the stage as drawing up goals will be joint effort, as the OT will provide guidance and reasoning for each goal, while Ben justifies how a goal will help him.