Applies the domain of occupational therapy in gathering, evaluating, setting goals, planning and implementing occupational therapy
Behavioral and community health applies occupational therapy differently compared to other settings. For instance, at the skilled nursing facility (SNF) we focused on basic activities of daily living (BADLs) like bathing, toileting, feeding, and transferring from surface to surface. Services were provided to an individual, therefore, goals were set to the needs and wants of the individual. Whereas in mental health, the focus was more on acquiring and maintaining functional skills and social skills to reintegrate into the community. Clients received occupational therapy services in a group format once a week for one hour. Each client has his or her own goals concerning community reintegration skills. These skills are addressed in the group therapy sessions. However, if the clients sought a one-on-one session with me or the occupational therapist to work towards his or her goals, then this was an additional form of implementation of occupational therapy. Additionally, goals were established between the client and the social worker upon admittance to the program.
I took into account all the clients’ goals when preparing the group protocol to ensure progression towards each person’s goals. These goals often encompassed problem-solving, decision-making, assertiveness, time management, medication management, money management, impulse control, and social skills. These were foundational skills that all the clients needed to work on to eventually obtain a job or return to school.
Group protocols focused on these foundational skills through an activity as well as an engaging discussion.
Each week I provided my fieldwork educator one group protocol that built on the previous week’s group protocol. Some topics were covered more often than others, but it was due to the clients poor progression in their goals and requiring extra attention to start making progress.
When I prepared a group protocol, I had to gather information about the topic I was addressing through evidence-based research as well as other sources for information. Once I found enough information that would address the needs of my clients, I determined an activity that would incorporate the topic well while also keeping my clients engaged throughout the session. After I created a general guideline of the group session expectations, the activity itself, and what the activity works on to achieve the group session’s expectations, I then had to evaluate if the activity could be adapted for my clients who may struggle with a particular task in the activity. I provided potential examples of down-grading a task to simplify the activity for clients while also not singling them out in front of the entire group. On the other hand, I also provided examples of up-grading a task to challenge the clients without drawing attention to their abilities. Additionally, I prepared examples of adaptations for this population. For instance, “Impaired Senses: Members with schizophrenia have an impaired sense of direction which could inhibit their ability to participate in passing the beach ball a certain direction and may require multiple cues to be successful.” Then I set goals for myself as well as my clients. For myself, I set time goals because I wanted to get better at managing my time while running a group. Originally, I had feared I would never make a group last longer than 20 minutes so I made the group activities more involved and eventually went over on time on multiple occasions. My learning goal was to find the right balance in how much time should be allotted per task and stick to that time schedule. I also wanted to make sure that the topics and material of my group sessions aligned with each of my clients goals. To work toward this goal, I implemented the SMART goal-writing format: specific, measurable, achievable, relevant, and time bound. For example, during a self-image and self-esteem group therapy session, the goal of my group was, “By the end of group, participants will have provided at least one verbal cue to another team member during the activity.” This is a SMART goal. It also specifically addresses functional skills that all the clients needed to work on, including social interaction skills, assertiveness, and time management. If each client accomplished my SMART goal, which was designed to help them work towards his or her own personal therapeutic goals, then I knew that my intervention had helped him or her move in the right direction of accomplishing his or her overall goal. Of course my fieldwork educator had to approve my group protocol prior to the group session. Once that was done, I had to plan and prepare the materials required for the activity. As I was preparing, I also had to plan for a group of 13-15 people because the attendance was so inconsistent that you never knew who may show up for your group activity. Lastly, I would implement my group protocol and often take note of what was popular, what was not, who struggled with the activity even after the prepared gradations, and who found the activity to be too easy even after a more challenging gradation was applied.
I took into account all the clients’ goals when preparing the group protocol to ensure progression towards each person’s goals. These goals often encompassed problem-solving, decision-making, assertiveness, time management, medication management, money management, impulse control, and social skills. These were foundational skills that all the clients needed to work on to eventually obtain a job or return to school.
Group protocols focused on these foundational skills through an activity as well as an engaging discussion.
Each week I provided my fieldwork educator one group protocol that built on the previous week’s group protocol. Some topics were covered more often than others, but it was due to the clients poor progression in their goals and requiring extra attention to start making progress.
When I prepared a group protocol, I had to gather information about the topic I was addressing through evidence-based research as well as other sources for information. Once I found enough information that would address the needs of my clients, I determined an activity that would incorporate the topic well while also keeping my clients engaged throughout the session. After I created a general guideline of the group session expectations, the activity itself, and what the activity works on to achieve the group session’s expectations, I then had to evaluate if the activity could be adapted for my clients who may struggle with a particular task in the activity. I provided potential examples of down-grading a task to simplify the activity for clients while also not singling them out in front of the entire group. On the other hand, I also provided examples of up-grading a task to challenge the clients without drawing attention to their abilities. Additionally, I prepared examples of adaptations for this population. For instance, “Impaired Senses: Members with schizophrenia have an impaired sense of direction which could inhibit their ability to participate in passing the beach ball a certain direction and may require multiple cues to be successful.” Then I set goals for myself as well as my clients. For myself, I set time goals because I wanted to get better at managing my time while running a group. Originally, I had feared I would never make a group last longer than 20 minutes so I made the group activities more involved and eventually went over on time on multiple occasions. My learning goal was to find the right balance in how much time should be allotted per task and stick to that time schedule. I also wanted to make sure that the topics and material of my group sessions aligned with each of my clients goals. To work toward this goal, I implemented the SMART goal-writing format: specific, measurable, achievable, relevant, and time bound. For example, during a self-image and self-esteem group therapy session, the goal of my group was, “By the end of group, participants will have provided at least one verbal cue to another team member during the activity.” This is a SMART goal. It also specifically addresses functional skills that all the clients needed to work on, including social interaction skills, assertiveness, and time management. If each client accomplished my SMART goal, which was designed to help them work towards his or her own personal therapeutic goals, then I knew that my intervention had helped him or her move in the right direction of accomplishing his or her overall goal. Of course my fieldwork educator had to approve my group protocol prior to the group session. Once that was done, I had to plan and prepare the materials required for the activity. As I was preparing, I also had to plan for a group of 13-15 people because the attendance was so inconsistent that you never knew who may show up for your group activity. Lastly, I would implement my group protocol and often take note of what was popular, what was not, who struggled with the activity even after the prepared gradations, and who found the activity to be too easy even after a more challenging gradation was applied.