Level 1 FW C Debrief Video

Hi friends!

Below is my Level 1 FW C debrief video. I cannot wait to hear about everyone's fieldwork experiences.

Have a great summer!

Ethics

            As a future occupational therapy practitioner, it is imperative to abide by the AOTA Code of Ethics. Providing the best, safe, and fair treatment to our clients is at the forefront of our profession.

            The AOTA Code of Ethics has 6 principles that should be followed and that can guide therapists when they face a situation involving ethics. These principles include: beneficence, nonmaleficence, autonomy, justice, veracity, and fidelity (American Occupational Therapy Association, 2015). Ethical distress and dilemmas are similar yet different and can interfere with upholding these principles. Ethical distress deals with day-to-day problems in which the person knows the right thing to do, but they are unable to follow through with it due to other obstacles (Canadian Nurses Association, 2003). An example of ethical distress would be gossiping. If on fieldwork I heard several of the OTs participate in gossip about clients, this would cause me ethical distress. I would choose to not participate in or listen to the gossip and even change the subject if possible. On the other hand, an ethical dilemma is where there is a clear violation of the code of ethics.  An example of an ethical dilemma would be noticing that an OT student at the same fieldwork site as you listed their credentials as OTR instead of OTS. You would have to make the ethical decision to confront them about this issue and inform the correct personnel. The principle being violated would be veracity.

            On level 1 & II fieldworks, we are evaluated on our performance and ethical decision-making. One of the first standards that we are required to meet is obeying the code of ethics. This means following and respecting all 6 principles listed above. Remaining confidential, using our best judgment for safety, knowing when to say when/call for help, billing/documenting, and supervising others are all tasks that need to be performed as a level II fieldwork student. It will be important to know the standards ahead of time to prevent an ethical dilemma from happening.

References

American Occupational Therapy Association. (2015). Occupational therapy code of ethics. American Journal of Occupational Therapy, 69(3), 6913410030. http://dx.doi.org/10.5014/ajot.2015.696S03

Canadian Nurses Association.(2003). Ethical distress in health care environments. Ethics in Practice for Registered Nurses, 1480-9990. Retrieved from https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_pract_ethical_distress_oct_2003_e.pdf?la=en

Flick, J. (2017). Conflict, Ethics, & Legal….Oh My! [Word Document]. Retrieved from www.blackboard.uthsc.edu

Post-group Facilitation Reflection #2

I facilitated my group session on the topic “leisure exploration” yesterday.  As a whole, I feel like the session and activity took longer than expected, but I think that the members in my group enjoyed it.  Kiera even took a picture of her vision board and posted it on her social media!  I was much more calm and relaxed this time despite leading the session alone. This is a huge improvement because I usually am so nervous and mess up my words. It also made me feel good when Professor Sasse told me that this was a great activity and that making collages is a good idea for group sessions.

 I began the session by stating the purpose of the session and introducing myself. I made sure to outline the whole session and tell all of the members what would be occurring in the session before we began. I bought magazines in advance, and I set up all of the materials in advance. I adapted a leisure inventory checklist and printed these in advance for the group as well.  After outlining the session, my group participated in a warm-up activity.  Next, we completed leisure inventory checklists, shared some information about them, and then completed the main activity. Members shared their vision boards, and we had a quick discussion.

I think the most important part of my activity was the application portion.  I tried to make this activity relevant to the member’s current life but also wanted to make it useful to their practice as OTs in the future. After sharing all of the vision boards, I asked members how they would encourage leisure or adapt leisure activities for their clients in the future. My group members came up with some good ideas of leisure activities that can be adaptable such as gardening, cooking, and walking. I wish that we had more time in my group session to examine the similarities and differences between the group members and explore more activities that can be adapted. 

To improve this group session, time management could have been monitored more closely. The activity took way longer for some members than for others, so I needed to come up with something for the group members to do while waiting for everyone to finish. I really wish we had more time to have a longer discussion at the end, but it was important for members to share their vision boards.  Some of the strengths of the session were that I was prepared for the activity, and my members enjoyed it.  However, I feel like I could have made sure that members were more on task to get through the activity faster.

            Despite the time management issue,  I think my life skills group session went well.  One goal I had from the last group facilitation was that I clearly state the outline of the session upfront. I made sure that I did this, and I think that my public speaking improved. In the future, I will make sure that I use more time management skills and adapt the activity so that we can touch on all aspects of the activity without running out of time.

Leadership Summit Blog Post

Last week, I met with about 3 other classmates who are also leading their life skills group facilitation this week. It was an extremely beneficial experience, and I was able to collaborate with other leaders. I was not only able to give advice to other individuals who had different topics than me, but I also received feedback about my own ideas. For example, Whitney was having some difficulty deciding how to generalize her topic of health maintenance and management.  I helped her figure out some ideas in order to complete this part of her protocol, such as having us participate in goal writing at the end of the activity. In addition, I was able to ask for advice about which frame of reference to use with MOHO for my topic. By talking about it with other individuals and discussing my topic, I decided on MOHO+ PEO. I was torn between PEO and EHP, but based on my discussions with my classmates, I feel like PEO is more fitting for my topic on leisure.

For me, the most useful aspect of this experience was when I received feedback regarding my main activity for my topic. I wanted to have the members complete an activity that was enjoyable, and I had some trouble thinking of what to do. I was able to bounce ideas off the classmates that I met with, and they helped validate which idea I should do. When I was explaining the activity I was planning to Kiera, she said, “Oh! So like a vision board?” Previously, I didn’t even think to incorporate my idea into making a vision board for leisure activities, but essentially, my activity was actually making vision board. I also decided to involve client populations that they may treat as OTs into my activity to help my peers in expanding their "OT toolbox." This idea was a result of my leadership summit and talking about my ideas with my peers.

Going forward, I realize how beneficial it is to collaborate with other leaders and classmates. As an OT in the future, collaboration will be a vital aspect of my job. It is necessary to receive feedback and work together as a team with other individuals.  In addition, meeting with my classmates during class also allowed me to feel more confident about my activity and about leading my group this week.

Peer-Reviewed Journal Article Summary Blog

For this blog post, I found the peer-reviewed article titled "Individual and Group Treatment for Patients with Acquired Brain Injury in Comprehensive Rehabilitation" (Vestri et al., 2014). I was interested in reading about how a group treatment would be led for individuals of this population. In the study, the purpose was to test the hypothesis that group treatment would lead to more improvement in individuals with this injury than just receiving individual treatment alone. Since we learned about ABI in our neuro classes, I was intrigued to learn about how group therapy could also help. This retrospective study consisted of 74 patients divided into two groups. One group of participants received only individual treatment while the other group received both individual treatment and group treatments, and the groups were assessed before the intervention and after the interventions. The individual treatment did not have to be OT. It also included speech therapy, social worker meetings, physiotherapy, cognitive rehabilitation, OT, or psychology. The group treatment followed a structured plan including a welcoming phase, an activity phase based on the participant’s level of functioning, and final phase of forming goals and using skills learned. The group treatment allowed modeling, competition, problem solving, and imitation to happen between the members. Following the interventions, the results showed a greater improvement in FIM scores for the individuals who participated in both the group treatment and the individual treatment compared to the group that only received individual treatment.

For me, the most interesting aspect of this study was that the physician determined which setting the participants would be in, which ultimately determined which treatment group they were in. Even though the physician was a part of the multidisciplinary team meeting, he or she was the ultimate determiner of whether or not the participant received group treatment. Initially, I thought that OT would be the best suited to make this decision. I realize that not every individual received OT in this study, and that the physician based his decision off multiple assessments.  Also, the participants were required to have certain abilities such as attention and being able to follow directions before they could participant in group interventions. Another significant aspect of this study was that the group treatment did not follow the seven-step format for group leadership like we learned about in this class, but there was a clear structure and phases in the group treatment. This structure was similar to Cole’s seven steps because it started with a welcoming phase where the participants got to know the other participants in their group and collaborated, while Cole’s process includes an introduction that is similar. In this study, there was also an activity phase and then a final phase that is similar to the application and generalizing phase in Cole’s process. The activity phase included activities such as packing, basket weaving, and woodcarving. In the last phase of the study, the participants focused on a plan for the future and examining the skills attained in the other phases, which is similar to the application phase in Cole’s seven steps.

Having read this study, I now realize just how important it is to have group treatment. The individuals who received the group treatment, in addition to their individual treatment, had better outcomes in function than the individuals who only received individualized treatment. The group treatment allowed for social interactions, teamwork, problem solving, and emotional support. Personally, I think a follow-up study to see if the results still held true between the two groups relating to the client's function would be interesting. The study mentions that group treatment is cost-effective, holistic, and requires a lot of planning. This makes me feel more interested in learning about how to involve group treatment into my interventions in the future.

Reference:

Vestri, A., Peruch, F., Marchi, S., Frare, M., Guerra, P., Pizzighello, S., & ... Martinuzzi, A. (2014). Individual and group treatment for patients with acquired brain injury in comprehensive rehabilitation. Brain Injury, 28(8), 1102-1108. doi:10.3109/02699052.2014.910698

12-Step Meeting

On Saturday, February 3, 2018, I attended an open speaker AA meeting at The Old Stone in Evansville, Indiana. While my grandmother is a recovered alcoholic and regularly attends her AA meetings, I have never been. When I found out that we had an assignment to attend a 12-step meeting, I figured it would be beneficial to experience a meeting firsthand, since it has been such an important part of my grandmother’s life.

            When I first arrived at the meeting, I did feel a little out of place. I felt out of my comfort zone. There were clients from a treatment center at the meeting, and it appeared that some of them did not want to be there. The role of the facilitator of the meeting was directive. There was a specific structure for how the group was led. It started with the serenity prayer/a moment of silence, and then volunteers that were predetermined read the traditions, steps, and explained how AA worked. Following this, a basket was passed around for members to contribute donations for the club, and members received their chips for how long they have been sober. The leader then invited the speaker of the night up to share his story and then the floor was open to comments. Lastly, the group gathered in a circle, held hands and recited the Lord’s Prayer.

            Since this particular meeting was not a discussion, there was not much participation from the group. However, there was a little time at the end where the facilitator asked for comments. Only two individuals made comments, and this was fine because the speaker talked for the majority of the meeting. At the beginning, the facilitator said that he had pre-determined volunteers to read the opening information, i.e. the 12 steps, traditions, and how it works.

            The environment was hospitable.  The tables were long like you would see in a cafeteria, and people sat close together.  While the members of the group realized that I was not a “regular,” they were welcoming of me and friendly. The speaker stood on a stage at a podium and gave his speech in a microphone so that everyone could hear him. There was free popcorn provided, and free coffee, which the members seemed to enjoy. I did see some distractions in the room, which may have impacted the session. Personally, I did lose my focus on the speaker because of everything that was happening around me. Many people got up during the meeting to get refills of coffee, and one member was even knitting a hat while the speaker was talking.

            I do think that the session was therapeutic. It is always helpful when you are struggling to hear someone else’s story, which has gone through the same thing. Since this was a speaker meeting, the speaker discussed his story with alcohol, his background, his relapses, and how he came to AA. He spoke encouragement into the audience, and even though I am not an alcoholic, I have an immediate family member who was affected by the disease, and it made me so thankful for this program. It is always helpful to know that you are not alone when you are affected like something like this, and I am sure that the speaker’s story provided hope to some of the treatment center clients.

            I believe that this group follows the behavioral-cognitive theory. The 12-step AA group incorporates the process of how changing one’s thinking will change their behavior. The individuals in the group have accepted their addiction, and want to work on fixing it and remaining sober. Specifically, I think that the internal locus of control comes into play in a 12-step meeting such as this.  It is about taking responsibilities for your actions, but also being willing to make a change. The group provides support and other members to hold you accountable, but it is ultimately up to the individual to make the changes. In class, we learned that this theory is a good one when people have problems with self-control and when the client’s cognition impacts their behavior.

            For me, the most significant aspect of the meeting was how God was the center of it all. Throughout the promises, traditions, how it works, and 12 steps, God is referred to. My grandmother always said that her AA meetings were her “church,” and since God is such a huge component of this program, I don’t believe she is wrong. Before attending this meeting, I had my own judgmental thoughts about what it was and what happened in a session. However, all of my assumptions were wrong. Hearing the speaker tell his story opened my eyes to just how important it is to have programs like this in place, how important it is to have people who support you, and above all, put your faith in God. Going forward, I have a greater appreciation for my grandmother for staying sober for all 46 years, and continuing to attend the weekly meetings. I think that attending this meeting will help me be able to relate to my clients better who are dealing with a disease like this.

Reference:

Lancaster & Sasse. (2018). Notes on Behavioral-Cognitive Theory. [Word Document]