Effective Mental Health Treatment for Occupational Therapy

Role A1. Expert in Enabling Occupation

Occupational therapists work holistically. Therefore, a person’s mental health is of utmost importance to the OT whether the person has been referred for assistance in this area or not. This project provides the learner with the opportunity to develop competency in the area of mental health treatment.

1. Support with ease and efficiency the occupational therapist who is the expert in enabling occupation.
2. Demonstrate an understanding of role of occupational therapists and

3. Demonstrate understanding of occupations, occupational performance, and occupational engagement in practice with clients.
4. Demonstrate understanding of the occupational therapy practice process.

1. Demonstrate understanding of the client’s occupational therapy plan.
2. Implement assigned service components of the occupational therapy plan with ease and efficiency.
3. Establish positive therapeutic relationships with clients.
4. Observe, monitor and report the client’s performance.
5. Work effectively with individuals, families and groups.
6. Respond to change in status of the client.
7. Complete assigned data gathering elements using a range of tools to support the occupational therapy evaluation process.

1. Apply relevant and current occupational therapy knowledge to the practice area.
2. Ensure client and personal safety in the performance of assigned components of service delivery

1. Complete all of the following case studies using material from the library and/or through Internet research. Be sure to reference any material you use from websites or textbooks. (APA referencing style)

2. Submit your responses to Dropbox upon completion.

3. I am looking for thoroughness, problem solving, ability to apply knowledge to practice.

Mary is a 38-year-old married woman with 2 children, aged 14 and 16. For 2 months prior to admission to an inpatient unit, Mary complained of constant fatigue and being unable to sleep at night. She began to stay up late to avoid tossing and turning and to decrease the chance that her husband would want to have sex, something she no longer enjoyed. Mary works part-time in a school library, a job she always said she loved. She now says that “the job hasn’t been the same lately” and reports that she called in sick frequently over the past 2 months and knows that her work performance has deteriorated. Lately she has been preoccupied with thoughts that she will be fired, although her supervisor has always been pleased with her work.

 

In the past Mary’s interests were broad, including doing things with her husband and children such as attending church, going on picnics, and participating in school social events. She bowled in a neighbourhood league with her husband and socialized with a group of friends on a regular basis. Mary also enjoyed cooking and playing cards. When she started feeling tired all the time, she discontinued all of these interests except attending church, explaining to everyone that she was not feeling well and had to save her energy for work.

A2 Work to enable occupation with specific populations and occupational performance issues in a range of practice contexts

 

At home, Mary started to pay less and less attention to her usually immaculate house. When her children and husband offered help, she reacted with tears and accusations that they didn’t think she was capable of anything. Mary used to dress stylishly. Lately her clothes have not matched and she rarely applies makeup. She says it doesn’t matter anyway because nobody cares how she looks.

 

Mary’s relationships with friends and family have also changed. Her children complain openly that she is “not fun anymore”. Her husband has gently tried to discuss the situation, but Mary always begins to cry, accuses him of not loving her anymore and of having an affair. He is starting to stay away from home, often working late.

 

For 2 weeks prior to coming to the hospital, Mary often found herself crying for no apparent reason. She was unable to get out of bed for several mornings and only went to work twice. Her husband brought her to the emergency department because she said she couldn’t breathe and felt like she was dying.

1. What diagnosis or diagnoses is Mary likely to receive? (DSMV)

2. Develop a problem list of 3 occupational performance areas and their components/skills that you feel are most important to target at this time. (Use your Early textbook for definitions)

3. What types of intervention/treatment activities would you consider and why (try to include adjunct, enabling, purposeful, and occupation activities)? Minimum of three

4. Outline how you would grade each of the treatment interventions you have chosen.

5. What are some of your concerns and/or challenges in working with Mary?

6. What symptoms/behaviours are likely to impact your treatment sessions and what strategies would you use to ensure that you help the client reach the goals of the sessions?

Janice was born in a rural area of northern Ontario. She was the youngest of 8 children. The family lived in poverty due to her father’s low paying job. Janice was a good student compared to her brothers and sisters; however, schooling was not emphasized as her parents did not make the connection between education and wages. Consequently, at age 16, Janice dropped out of school. She took a factory job, met a man nearly 10 years older and was soon pregnant. Her husband was an army man who began to drink. The family moved around a great deal until her husband’s drinking led to his being discharged from the army. He was unable to find other work. Janice left her husband after a year of conflict, becoming a single mother with no child support. Janice took a series of low paying jobs and took evening classes at the local community college. She eventually found a job in a bookstore, but was unable to keep it due to difficulties with record keeping, stocking the shelves, etc.

A3. Demonstrate effective problem solving and judgment related to assigned service components

 

Janice began to have panic attacks. She was far from family and friends and had little money. She became increasingly isolated and started refusing to leave her home. She began having groceries delivered instead of going out to the grocery store. Her doctor prescribed Valium. She began to combine Valium with recreational marijuana in order to help her feel as if she was coping. She had increasing difficulty caring for her daughter. On one occasion she started a fire in her kitchen while trying to prepare a meal when she was high. She became fearful of using the stove again and was not able to prepare meals for her and her child. She began ordering in food, which was more expensive than she could afford, and was starting to have difficulty paying the bills every month. A neighbour took her to the emergency department one night as Janice felt as if she was having a heart attack. She was admitted to the mental health unit.

1. Using DSMV criteria, research and explain several diagnoses that Janice may be given.

2. Determine 3 occupational performance areas and their components/skills that you feel are most important to target at this time when working with Janice.

 

3. What types of intervention/treatment activities would you consider and why (try to include adjunct, enabling, purposeful, and occupation activities)? Minimum of three

4. Outline how you would grade the activities you have chosen.

 

5. What are some of your concerns and/or challenges in working with Janice?

6. What symptoms/behaviours are likely to impact your treatment sessions and what strategies would use to ensure that you help the client reach the goals of the sessions?

Ned, a 38-year-old man, was referred to an outpatient community based mental health program. He had been recently discharged from an inpatient acute psychiatric ward. His sister had taken him to the emergency department after he had come to stay at her home for a visit. During the visit he was restless, anxious, and reported some disturbing events. He was convinced that he was infected with HIV and was sure that his roommate had purposefully infected him with the virus using an infected needle. He was concerned that his sister and family were also in danger of being infected by the same person. He also was worried about his savings and was concerned that his financial planner was being fraudulent and stealing his money. He admitted to his sister that he had been hearing voices in his head for the last 3 months and that it had gotten so bad that he "just couldn't take it anymore", and that the only way to stop the voices was " to jump off the nearest bridge".

 

Ned had previously been hospitalized when he had attended college, although no one in his family had been aware of this hospitalization. Ned had not been taking medication prior to his recent hospitalization but on admission to the community program he was taking anti-psychotic drugs, which were managing his symptoms reasonably well.

 

Ned had been working in computer programming for the last 5 years. He had held one job for 3 years but then went into a cycle of short-term work and unemployment. He had lost 3 jobs in the last 8 months because of poor job performance and poor co-worker relationships. He had lost the most recent job 2 months ago but had not told his family.

 

On admission to the program, Ned was poorly groomed and dressed in dirty clothing. He had poor body odour. He appeared anxious, tense, and somewhat confused. He reported that he heard voices on a daily basis. He had moved and was living alone in a small one-bedroom apartment. Ned had gained 20 lbs in the last 2 months and was overweight. He reported that he wasn't much of a cook. The OT had assessed Ned in his home environment and had reported that Ned had very few pieces of furniture. He had a number of boxes throughout the apartment that still had to be unpacked. There were a number of pizza boxes and fast food bags strewn across the kitchen counters and table. Laundry was strewn across the bedroom floor.

 

1. What diagnosis might Ned be given? (based on DSMV criteria)

2. Determine three problem areas that you would like to target for intervention. (occupational performance and skill areas)

3. What types of intervention/treatment activities would you consider and why(try to include adjunct, enabling, purposeful, and occupation activities)?

4. How would you grade the activities?

5. What are some of your concerns and/or challenges in working with Ned?

6. What symptoms/behaviours are likely to impact your treatment sessions and what strategies would use to ensure that you help the client reach the goals of the sessions?