This is my OT 640 FW debrief video!  I look forward to hearing more about all of your fieldwork experiences, and hope that this succinctly explains my two week experience in the skilled nursing facility.

-Lauren Leiser 

Article Summary

     The article journal I chose to review examined the Effectiveness of Activity-Based Group Work in Community Mental Health: A Systematic Review.  This study was a systematic review of  136 potential articles, and a full text review of 27 articles.  After reviewing the final 27 articles and adhering to the inclusion and exclusion criteria, only 3 articles were left to use for this review.  In the introduction of the study, the researchers discuss how all occupational therapists serving in mental health that they surveyed responded stating that they all used group interventions in their practice, which were more often than not activity based group interventions.  This journal article advocates for community mental health, and for the lack of research that has been done to prove how truly effective activity based group interventions can be for clients with mental health in an occupational therapy group.

     The study identified three qualified articles after the systematic review was conducted.  For me the most important part of this study is that each article had the same thing in common, which was activity based groups are more effective than verbal based groups but for different reasons such as: improving self-perceptions of social interaction skills, improving social behavior, providing greater symptom reduction, and increasing levels of community functioning.  The results of the studies also showed a statistical significance in social interaction skills for the group members.  This study strives to collect relevant, valid, and reliable articles to support the evidence of activity based intervention groups in occupational therapy. 

 

     Having read this article, as I move into my 3 month mental health rotation (now set to be in a court/justice system) I further feel it is important to acknowledge the importance and power that activity based group interventions may have on our clients.  I now know moving forward as a future practitioner that thinking, planning, and executing an activity based group, I can refer to this article to remind/inform myself and my employers of the benefits that activity based interventions may have.  I know often outsiders that look into our activity based groups think that we are just using "another worksheet" or "making another craft" however this research is showing that activity interventions are more effective than simple verbal groups for our clients with mental health diagnosis.  Having research to support this will assign reason to the activity for the individuals that are not occupational therapists.  If we could prove nothing more from this article, we could prove that activity based interventions increase and positively support social interaction skills.  Many mental health disorders present with an occupational barrier of social interaction skills, and to identify that activity based group interventions help support the goal of social interaction is huge for OT!  Moving forward, I will keep this article readily available to evidence my future practice in fieldwork (and possibly my future job)! 

References 

Bullock, A., & Bannigan, K. (2011). Effectiveness of activity-based group work in community      mental health: A systematic review. American Journal of Occupational Therapy,65(3), 257-266. doi:10.5014/ajot.2011.001305 

12 Step Meeting Experience

     On Sunday evening, 2/24/18, I attended a Narcotics Anonymous (NA) meeting at Hope Church accompanied by one of my classmates, Katelyn Grammes.  This was a rich OT student experience for me because this was the first 12-step meeting I have attended.  I had the opportunity to not only see how a real life group meeting is conducted, but further had the chance to hear the group members personal stories, struggles, and successes.  There was a great sense of community during this meeting, bringing an element of comfort to each group member.  I watched most every group members occupational role shift during the session from identifying as a narcotic user to the role of a friend and a group member.  The group members did a great job identifying why and how narcotics have effected their occupational performance and daily roles, and how without the narcotics their quality of life is much greater and more productive.  

     The group leader used a facilitative group leader style.  He began by discussing what would be covered during the session and then preceded to hand out the reading materials to group members, got the names and information of the new attendees, and then he took suggestions for the group topic(s) for the session.  I feel like he handed out the materials to group members that he felt would be comfortable reading out loud and would participate without being embarrassed or hesitant.  The assigned group members then read the papers (ground rules and other materials) to the rest of the group members.  The group leader let the group members go around and freely speak out and say what topics they wanted to talk about.  From there he said, "Ok, this is your meeting, with these topics".  He then turned the group meeting over to the members to run until the end, and then he wrapped up the session and asked for any announcements the members may have.  The members showed a sense of community by sharing who had been "clean" or "sober" for x amount of time, celebrating my saying congratulations or cheering when they heard the news.  Kate and I chose not to speak up because upon our arrival we discussed with one of the group leaders that we were there to observe.  He said it was an open meeting, and that would be fine, but to not introduce ourselves or to participate in the discussion.  I think this was our best choice because the other group members may have felt like they were being "spied on" or judged by us if we announced to the group session what we were there for and we were just "observing". 

     The environment was relaxed!  They made coffee for the group members before their arrival, which I thought gave the environment a coffee shop vibe in a church helping it seem less judgmental .  The chairs were set up in a circle in the middle of the room for anyone who wanted to sit there, and there were also many other chairs in rows to choose to sit in (this is where Kate and I sat, along with the majority of the other group members).  I observed the more regular and secure group members were the ones to sit in the circle (maybe 8 people).  Where the group members sat did not influence how much or little they spoke, members from within the circle and the rows both spoke equally. 

     This was a thriving therapeutic group and setting!  I was delighted that the group leader allowed the group members to decide which topics they wanted to chat about.  The members would use one another as support during therapeutic conversation by making eye contact, shaking their heads in approval, and beginning a new discussion or thought off of another group members thoughts or comments.  The group members appeared to leave with full hearts and weightless minds like they had been refueled and motivated for another week until next weeks meeting. This therapeutic group used a Cognitive Behavioral approach, focusing on changing and shaping the way the group members thought about narcotic use.  The group members were beginning to change their thoughts towards narcotics as one of harm versus pleasure.  The group members were focused on changing their occupational performance patterns from no longer using narcotics, to pursuing a fulfilling life without the narcotics and with the hope of creating new roles, routines, and patterns moving toward a narcotic free life. 

     

     

OT 532 Post Group Facilitation Reflection #2

I give myself a 9/10 on my introduction.  It was chaotic at 11 am when the facilitation was supposed to begin, and I had came from a 10:30 am meeting directly before the facilitation.  When beginning the group I did not give (in my opinion) a clear introduction of what we would or should cover during the session at hand.  The warm up, time frame, and clear communication went well.

I give myself a 9/10 on the main activity.  I feel like the activity was explained clearly and accomplished the goals I set in the protocol, but I would still like to have a more creative way in the future for the group members to design their physical activity routines (such as a board game or a fun way to motivate them to fill out the routine).  I did ask the group for feedback on the exercise options I provided them, and received great feedback on what to add and possibly take off for future groups I may have.  I feel as if the timing, materials, and environment were appropriate for the given activity.

I give myself a 10/10 on sharing.  I feel like we went even a little over time because the group members seemed comfortable and enjoyed sharing their thoughts, routines, habits and goals with me which made me feel good as a facilitator.  I tried to make good eye contact with each group member when sharing as well as I tried to provide examples of my weaknesses and bad habits in relation to physical activity.

I give myself a 10/10 on processing.  When I asked each group member to fill out the habit worksheet and share what habit or barrier could keep them from engaging in their physical activity routine, each member was able to process through their thoughts and share.

I give myself a 9/10 on generalizing.  I would have liked to have spent a bit more time discussing with each group member one activity that they could do at home (more occupation-context based) to help them generalize that physical activity can be free and be vacuuming and doing laundry that day.  It does not have to always be structured and jogging or doing zumba. Overall though, I know we did discuss in the group that physical activity could be things as simple as walking your dog, or doing some squats at home.  The group members seemed to be catching on to the generalization during this session.

I give myself a 10/10 on group motivation.  I would use the term for Fridays sessions Fri-yay to describe the feeling of my group.  I began with a high energy warm up to hope to provide the group with a positive feeling and morale.  Everyone was excited that it was Friday and to have the weekend ahead of them! They were motivated to not only complete the warm up and main activity but also to engage in discussion pertaining to the activities and their interests.   

Limit setting I give myself a 10/10.  I feel like I stayed on track with timing and allowed each group member more than enough time to share and I tried to not cut anyone off when they were talking.  I as well tried to not let the group stray off topic for more than one minute, directing the attention to the next group member sharing. 

I give myself a 10/10 on application.  I used many examples (including personal) and showed how physical activity can relate to everyday life.

 I give myself a 9/10 on summary because sometime I feel awkward repeating back to my classmates what we covered and why it is important.  Although I know these are not my "peers" but they are group members during my facilitation, it can be tough sometimes to role play with my peers.

Overall I gave myself a 86/90 because there is always room for improvement.  I will give feedback and say designing a group protocol and then facilitating it in a group was intimidating and difficult, but rewarding once it was over.  I really think this is a great class to prepare us as students for our mental health field works and feel more empowered and comfortable looking toward my 3 month mental health rotation.  Thank you both for helping me and my peers through this process, and it all really is starting to make sense! 

Leadership Summit Lauren Newell Leiser

     I did my leadership summit with Lauren O'brian and Katherine Manning.  We both facilitated on the same date, and we thought that would be a good group to bring together for this summit.  During my time with Lauren and Katherine, we discussed the FoR, activity ideas, and narrowed down topics for our group facilitations.

I had picked MOHO and PEO as my FoR's for Health Management and Maintenance, and at the time I had not decided on physical activity for my group session.  Thus we spent our time brainstorming on how to fit all of health management and maintenance within an hour group session.  After talking to Katherine and Lauren, I realized that narrowing down my topic may be in my best practice because trying to work on sleep, stress, mental health, physical health, and nutrition in an hour would be too much for myself as the facilitator and for my group members.  We discussed doing a questionnaire for my protocol, but I could not find online a good holistic questionnaire for physical activity, and I wanted the group members to leave feeling empowered and not bad about themselves from my group session. Thus I opted for no questionnaire.  I as well gave suggestions to Lauren to have each member go around and verbally communicate their stress levels at the beginning of her session and I told Katherine that a questionnaire or inventory for her session may be a good idea.  Katherine's session was over leisure and Lauren's was over stress management.  My protocol was in the baby stages when we met, so I never shared with them the activities I did for my group facilitation.

     Ultimately, I found this to be a rich experience.  I enjoyed hearing about what my peers ideas were for leading their group activities, and it really helped me to look at FoR's through another students lens.  I appreciated the girls time and honesty as I was developing my protocol and feel like it helped me form a productive and successful group facilitation for the other group members.  I would recommend keeping the leadership summit for future students, and also like that you both provided us with time during class to meet together for this summit if needed. 

OT 532 Professionalism Co-facilitation Group Evaluation

     Valerie and I were the facilitators for the group, Pursuing Positivity!  I would give myself a 9/10 on the introduction section.  The time and planning put into the introduction was a 10/10, but the way the day played out effected the efficiency of the intro.  The intro started off a little unfocused, and we had a warm up planned.  Several of our group members had a tough (hectic morning) and reflecting back on the introduction phase of our group session, it would have been a good choice to give the group 5 minutes to each go around and say how they were doing, and why they were good or bad that day.  We opted to begin the group with an ice breaker warm up, which was the feelings m and m game.  Everyone seemed to enjoy it, but were still a bit distracted with their own thoughts (noticeably). 

     I give myself a 8/10 on the main activity, the positivity petals.  I think that the activity was a good idea, but we should have gone around in a circle and asked each person to share what their group members wrote about them.  This would have required each group member to be present in the moment, and to take a moment and be proud of how their peers view them.  Having our group members speak out loud about their flowers could bring a positive spirit/nature to the group, and we did not have them do that.  The best part about this activity was to take a moment as the facilitators and look around at each group member and see them smiling down at their flower and what other people said about them.  The down fall to this activity is that someone could say something hateful, or fail to be able to find something nice to say to another group member in a different clinical setting or environment.  This may be an activity that is best for a cohesive and established group moving forward (as our group is). 

     I give myself and our group a 10/10 on sharing.  As facilitators we were patient and calm, thinking on our toes if the group was not responding to the questions that we asked.  We understood that thinking positively on a Monday may be difficult, and sharing your feelings can take time to become comfortable doing.  Ultimately, I was very impressed at how everyone around the middle of the group session began opening up and sharing their own stories and feelings towards the questions and topic of the day. 

     I give myself a 9/10 on processing.  We went into our group session with 3-4 good questions to help process through each group members feelings and thoughts.  I do not think we could have been anymore prepared with the questions,  I would have liked to have seen a little more depth in the feedback and responses shared, and there is space always to improve so this is why I gave myself a 9/10. 

     I give myself a 10/10 on generalizing.  We took the time to specifically ask our group members which technique or strategy they can use to build self confidence and ultimately use positive thinking daily.  This was a slow start to being answered, but I feel like each group members response was meaningful and authentic and they really thought through either the strategy they do or could use moving forward to deal with negative thoughts. 

     I give myself a 9/10 on group motivation.  Sometimes I struggle with wanting to be too positive or "cheerleader type of motivation", when in all reality I accepted the conditions on Monday.  Like several group members shared, they had experienced a tough morning, and we had picked fieldwork locations not even an hour before the group session was held.  Asking the group members to transition quickly from (what could have been a negative experience for each member depending on if they got the FW they wanted) was asking a lot.  I did try and motivate the group, but I am sure deep down I was thinking about the stresses of the week as well.  I always feel like I can improve on being present for all moments 100 percent. 

     I give myself a 10/10 on limit setting.  I try and always hear each group member, and offer a meaningful response, smile, eye contact, or nod for them to know I am hearing them and they have my undivided attention.  Valerie and I did stay on schedule, and we did not let the conversation veer off topic onto other topic and we kept the group busy, focused, and challenged with questions. 

     I give myself a 9/10 on application.  I think it could have been nice to have a question directly stating for each group member to say one area in their life they can "apply positive thinking" now that I reflect back on the group session.  This would be a client centered question, allowing each of them to answer they way it was most applicable to their lives. 

     I give us a 10/10 on summary.  We summarized what we covered during the session, why it was important, and even gave the group members one last chance at the end to say anything else that was on their mind before we officially wrapped up the session. 

     In conclusion, I know that Professor Sasse already covered this with Valerie and I in person (which I appreciated).  Professor Sasse acknowledged that Monday (especially right after FW selections were picked was a tough time) to have a group session, especially about positive thinking.  I also know that she acknowledged that we had to work extra hard at times during our session to get out group member motivated to engage and talk with us.  I would be false if I said I walked away from our session feeling 100 percent, but I will say I feel like it was a real life situation.  This group session helped me see the reality of what group session will/may be like during my community health rotation, and for this I am grateful.  I am welcome to any feedback on things I can do better, things you directly saw were weaknesses, and strengths of my group leadership style.  The feedback will only help me moving forward to be the best practitioner I can be.  I give myself an overall score of 84/90 points on my leadership evaluation. 

      

My Beautiful Broken Brain-Neuro Note 5

     My Beautiful Broken Brain was a documentary film about 34 year old Lotje Sodderland's personal journey after having a stroke. I chose to watch this film to learn more about strokes, what our clients experience physically and emotionally when they occur, and the inspiring journey of what life will look like for many following their diagnosis. I watched this film and took notes on her behaviors, experiences, emotions, and stay at the neurology center.  This helped me to note important barriers and challenges that Lotje experienced.

     Lotje was a perfectly normal and healthy individual, when one evening she woke up experiencing flickering of lights, terrible pain in her brain, confusion, euphoria, fear, and as she says during the movie she was "lacking her clever".  Lotje was actually experiencing a inter-cerebral brain hemorrhage at this time and she did not know it.  She traveled to a local nearby hotel and crashed in their bathroom, waking up to find herself very confused and scared in a hospital room recalling nothing that happened before her injury.  They announced at the end of the movie that Lotje had a pre-birth malformation of blood vessels in her brain, and this was the unique cause of her incredibly young age of having a stroke.

     Lotje is such a beautiful young lady inside and out!  From the first second I started watching this  movie, the way she was always smiling, laughing, and positive on how she was going to get her "clever" back was incredibly inspiring for me to watch.  Lotje experienced a severe amount of dysphasia, due to damage to the left side of her brain. For her to output language was the hardest part I noticed, which is referred to as Broca's aphasia.  To be honest, I am not sure how she kept such a positive and happy attitude.  When I was watching this film I was getting frustrated for her because she was clever and smart and to not be able to articulate what we are feeling and thinking has to be one of the most un-empowering and helpless feelings we can feel.

     "Within your own self is a treasury, an ocean of pure bliss, consciousness, intelligence, creativity, love.  We are not defined on limitations but endless possibility."-Mr Lynch.  This is Lotje's motto that she follows through her recovery process.  I love that she sees her new situation as one that is what you make it, one that still has a lot of beauty, intelligence, and love.  I hope as a therapist I can take her advice that she gives us as future therapists in the film which is to " Focus on the things the patients find along the way".  For Lotje, her discoveries along the way were that through typing she could form complete sentences and thoughts which was a huge milestone for her.  She felt like she got back some of her normal and that was such a beautiful moment of communication and her finding some normal that she used to have.

     Overall, I think I realize from watching this movie that first, life and health are so so short.  They can be taken for granted quickly.  We tend to move through our days acting as if they are chores and forgetting to laugh, smile, and celebrate that some people would kill just to be able to articulate and write a paper again.  Many people would be enthused to be able to have a husband to argue with, or a rent to struggle to pay.  I think this is an important concept to grasp especially as we prepare for our rotations as future practice as a therapist.  Our problems often aren't even problems in their opinion.  Their problems are basic, yet life altering.  Focusing on our clients with a self less practice will be necessary.  If we don't, I think they will be able to feel that.  They make have had a stroke, but I often think when one strong sense is taken away from you, other senses may be heightened just like Lotje's.   After her stroke she had very strong sense of feelings, and the feelings of those around her.  As always, I finished this film with a sense of gratitude, and a motivated and excited heart to make a difference in my little corner of the world soon.

Reference

Robinson, S. (Producer),  & Robinson, S & Sodderland, L.  (Director).  (March 18th, 2014).  My   

     Beautiful Broken Brain [Motion picture].  London.

SLUMS Sim Lab Reflection

     This was such a rewarding and beneficial experience for us as future ot's!  I love that we are offered these SIM labs before our fieldwork begins.  I was laughing so hard when I watched this video, especially when I first walked in the door and had to pat my hands dry on my pants.  I would give myself a good on this SIM lab simply because I am not sure if I did something wrong since the majority of the class finished the assessment and in less than 10 minutes and I did not!  I do think that I used good eye contact, tried to listen to her briefly before I tried to bring her back on topic, smiled, and tried to use the best therapeutic use of self I could.  I as well had gone through the assessment instructions several times and practiced on friends before walking into the SIM lab, I felt as well prepared as one could be before the experience.

    

     I was proud of my self for not letting Francis completely distract me, for quickly bringing her back on topic, and I noticed that I actually did ask her what she prefers to be called (I didn't remember doing this), and I did smile!  My biggest struggles were trying to be kind & empathetic and still completing the full assessment in ten minutes, answering if she will or will not go to a nursing home (of course I didn't know), and trying to explain what occupational therapy was to her without her getting sidetracked.  When Francis said "no" to me when I said, " I see here that you have been having some issues with your memory", this threw me for a loop.  She was completely unaware of her cognition issues and I had a hard time telling her what the assessment was after she said she didn't have any memory issues and still make her feel special and not like I was trying to psychoanalyze her.  We agreed that it was a sort of game of questions and answers.  I am not sure if that was an appropriate way to approach this, or how to introduce the assessment after someone says they do not have any memory issues.   

     Many improvements could be made!  I even said in the video, there is your wrist bracelet, but never checked it, and said her name.  I need to always check the wrist bracelet.  I am also not sure if I gave false hope by telling her good job, or saying no to specific things or by saying ok as I filled out the assessment.  I am not quite sure what to do in those situations.  I am a very responsive and nice person, and I never want my clients to feel like I don't care or I am being curt or short by saying ok next, next, next, with the assessment and never showing any positive enforcement.  Maybe you can provide me some feedback for this question.  

     My takeaway was that no matter how many times you read the client's profile they will always surprise you with what interaction they provide you when you walk in the room.  From this experience, I may be able to develop a good way to answer what occupational therapy is for the clients that we assess for dementia, a way that leaves the client little questions to ask to decrease distraction and I may be able to develop a plan on how to move through the assessment more quickly and effectively after watching this video.   

Just a phone call away-neuro note 4

     In Max Little’s Ted talk, A Test for Parkinson’s With a Phone Call, Max discusses his background as a mathematician and his vision to provide a cheap and effective objective tool to detect Parkinson’s disease, and a way to then measure Parkinson’s progression. Max states that when we have an objective measure, this is when disease detection and progression can be determined.  I am interested in Parkinson’s disease as a student, and I am excited to hear what Max is doing with a piece of technology that is moving more universal daily. Max is making a strategic play on assistive technology, and this assistive device could benefit all healthcare, including occupational therapy clients. By listening to Max’s talk, recording what he says during his talk on a word document, and then reflecting on his thoughts and how they can positively impact OT have been my active learning experience.

     Max proposes that limbs and vocal chord organs are both effected by Parkinson’s disease.

Vocal chords begin having tremors, rigidity, and weakness at the same rate as the limbs.  A client with Parkinson’s speech becomes more quiet and breathier as the time goes.  Thus, Max and his team

developed a cheap and simple tool that uses precise voice analysis software to detect Parkinson's with

99 percent accuracy.  Max has set up through the www.parkinsonsvoice.org a way for anyone healthy, who is questioning if they have Parkinson’s, or an individual with Parkinson’s, to have a chance to call in and have the test done.

             

     Occupational therapy practitioners could utilize this device to calm the nerves or fear of their

clients that may wonder if they have Parkinson’s.  There is just as much emotional as physical stress that accompanies a neurological condition or expectation of one.  If the therapist’s clients have a family history of Parkinson’s we could provide them with this app/device to keep up with their health and or have a way for early detection/diagnosis.  Another way the voice detector can be used in occupational therapy could be used on clients we are currently working with that have Parkinson’s.  It is a quick and simple way to see their progression as we progress rough our therapy sessions with our client’s.  This would be an economically positive device as well, because although many people that do not have insurance or may lack the money to go to the doctor and have the 300$ neurological test done for Parkinson’s, they do have a phone or could borrow a friend or families phone to do the test for cheap and would be able to detect their Parkinson’s despite their socioeconomic status.   For countries that may have a lower socioeconomic status, the doctors office or clinic could have 1 phone donated.  This same phone could be free to the public for use or could be used as a free diagnosis option for those that come into the clinic with possible symptoms or questions about Parkinson’s disease.  I absolutely love Max’s approach to this, and hope that it effects many in a positive way.

Little, M.  (2012, June).  A test for Parkinson’s with a phone call [Video file].  Retrieved from

https://www.ted.com/talks/max_little_a_test_for_parkinson_s_with_a_phone_call

               

Ronald Reagan's Case Study Review

     I had such a nice and attentive group!  I feel like it went well, they seemed to understand what my interventions were and enjoyed the idea of making a video for a treatment activity (especially since they were both previous actor/actresses)!

     I did mention in my presentation that I should have only directed the goals set towards Reagan.  Although I know that when clients do have dementia they seem helpless at times, I should not put all of the goals or even half of the goals off onto Nancy because Nancy could die at any point of Reagan's diagnosis and he should be able to achieve them by him self.

     Altogether, this was an enjoyable learning process!  Making the goals and interventions proved to be quite challenging, but I know it will get easier and come more naturally along the way.

Session 8A-MS case study Meghan

     Richard Pryor's occupations were comedian, actor, and social critic. His roles were marrying 7 times to 5 different woman and father of 7 children.  He was diagnosed in 1986 ith a MS diagnosis. He lit himself on fire due to depression, yet he is fine.  He had around the clock caregivers and a often sad because most of his friends did not come and visit after his diagnosis.

     I found Meghan's information about memory recollection activities/intervention's very interesting for more than MS!  I would be interested to research what other areas it is used in as well.  Meghan was well prepared and did a wonderful job executing her presentation!  I enjoyed it.

Doctor Remy Hadly-Lauren Murphy's Case Study Review

     Doctor Remy Hadly is a character from the show House.  She was 35 years old when she was diagnosed with Huntington's disease.  Her occupations were mainly all work oriented. Her hobbies were exercising and gardening. Several of her roles were being a physician and a friend. Long term goals for her is to maintain independence at work as long as she can, work on ADL's for eating, documenting, and memory skills.  HD is fatal, and due to secondary causes will eventually result in death anywhere from 15-30 years after diagnosis.

    She had a brief period of drug use in 2009.  She has anxiety which was diagnosed in 2006. Her mother died from Huntington's as well did her brother.  Her brother had a planned suicide death.  She was tested positive, and her symptoms began with shakiness and dropping things.  HD effected her balance. She lives in a one story home by herself and has 2 stairs entering her house.

     Challenges-feeding and drinking coffee without spilling it.  She would like to not spill things and work on her coordination.  Tremors make documentation at work difficult.  Her priority was to continue to be a physician as long as she can.

     Be careful with exercise due to fatigue, although exercise is a wonderful way to deal with HD if not overdone. Some assertive technology devices we may use are: weighted utensils, cups with lids, and a speaking tool for documentation.

     Lauren Murphy did an excellent job planning and explaining the intervention, goals, occupations, roles and HD in general!  She was well prepared and willing to answer any questions we asked her.  I enjoyed her presentation and learning more about Huntington's Disease.

     

TransFatty Lives-Neuro Note 3

     TransFatty Lives is an artistic, well articulated, emotional, and surreal piece of art that Patrick O' Brien humbles himself to give to us.  The name TransFatty comes from Patrick's undying love for donuts and is as well associated with his career as a popular NYC DJ.  Patrick has a passion for filmmaking also, but when his diagnosis took his life for a quicker turn than he was prepared for, he turned the camera and production on himself.  This documentary allows us to follow Patrick's journey from his first symptom mentioned, to his last muscular movement he makes before he makes the choice to live and depend on the Tobi for his main form of communication.  I am incredibly intrigued by ALS, and do not regret the chance to watch Patrick's journey and to note symptoms, emotions, and his change of focus as ALS changed his world.  These recordings will facilitate my empathy and knowledge on ALS and how it quickly will effect our clients.

     Patrick's diagnosis is Amyotrophic Lateral Sclerosis, ALS, and he was 30 when he was diagnosed with  it. During the documentary, it shows Patrick and how very quickly  he loses control of his lower body limbs. They become to weak to even allow him to walk, climb stairs or shower.  One of the moments in this documentary when I realized how difficult it would be to lose those daily functions, such as bathing, is when Patrick's dad was trying to help him lift each leg up into the tub, and Patrick could barely lift one leg up and into the tub without fatiguing.  After that scene, everything happened so quickly to Patrick it was hard to keep up with.

     Patrick met a lady along his ALS journey, whom he fell in love with after he had began using his electronic wheelchair.  She loved him for his personality and his unique view on life.  They dated for a while, and a fun fact is that although many of Patrick's muscles did not work during their time dating, his reproductive one did!  His girlfriend ended up getting pregnant with his baby, and this became the reason of this documentary he says. Patrick says that he wants his child to know who he is before and after ALS.  Patrick and his girlfriend ended up ending their relationship because it was impossible for her to take care of the baby (Sean, now 8 years old) and Patrick.  Patrick chose to go to a home in Massachusetts for individuals with ALS to take the stress off of his family.  Patrick was such a selfless guy, making that decision for his girlfriend and family, yet keeping himself alive solely in hopes to keep in contact with his son while building awareness and funding for ALS.

     Due to this being a real life documentary, many symptoms of ALS were shown.  It began with a skipping or shaking of his leg that would not stop.  Next came constant tripping or falling with Patrick's walking.  This caused balance issues as well.  Not long after Patrick went and visited his doctor, did he begin having more and more issues climbing the stairs and bathing.  Eventually, Patrick lost use of his lower limbs.  He still had decent function in his upper body limbs, and that is how he began documenting and helping produce the movie.  One of my favorite OT moments in this movie, is when Patrick knew that his loss of his hands was almost coming to an end.  He decided to try and have a "funeral for his hands" which upset me, but I can see from an OT point of view how important it was for Patrick to constantly except the change and challenges ALS were appointing him.  I do not think I would ever have the strength, courage, or humor that he exuded as he knew the fate of ALS.  I do not think Patrick wants us to feel bad for him, I think he wants to start a riot and show others what it is in hopes for future funding and a cure.

     In closing, I feel as if this documentary was a beneficial learning experience.  This prompted me to take notes as the documentary progressed, and at the end I had the opportunity to compare his symptoms with the ones I had from class.  They were accurate, but brought a sense of pain to watch them come along. Sometimes it seems so black and white when we learn of the neurological diagnoses in class, but the truth is, it is hard.  People's lives are effected.  Emotions are involved, "hand funeral" moments do happen, and the question we should ask ourselves at the end of this film is, how will I best enhance my client's with ALS's lives and what can I do to increase their quality of life for as long as that may be. 2 years or 10 years.  I would recommend this movie either in class or outside of class!

References

Brien, P (Producer), & Brien, P (Director).  (2015).  TransFatty Lives [Medium].  USA: Handsome

     Cargo.


    

Take it away-foundations

     Foundations was so much fun!  I feel like after this course I understand and am able to clearly define what OT is, what OT's do, which settings they work in, the history of OT, how to do an activity analysis, occupational profile, and how the OT process works.  I as well have a better understanding on what the OTPF does, the domain and process of it, and how each section applies to the application in the field.  Of course I have learned much more from this course, but these are my main OT take-a-ways I can think of currently!:)

     I look forward to learning about more theories in future courses, and having hands on or simulated experience on doing the OT process, especially doing the occupational profile on someone other than myself!  You did a wonderful job prompting us with learning experiences and assignments/tests to facilitate this!  

     I love that you always try and develop our OT think, and credit us when you see us using our OT hearts.  During the first semester of school, with all of our classes and assignments and struggles to have a life balance, it is nice when you receive a compliment or are told you are thinking like an OT.  Some of us may not be straight A students, or may freeze on tests, but you, as well as I, know that this does not make you a "good" OT.  We have learned that much of being a good OT is developing our therapeutic use of self and using the variety of characteristics to best suite our clients.   I look forward to continuing our journey together in this OT world, and appreciate all of the time and concern you show your students.

Until tomorrow...

This quote reminds me a lot of you, and is fitting for OT I feel!

Andy Griffith-Alexa Tooker Case Study

     Guillain Barre Syndrome moves from the legs and move towards the upper body.  Andy had severe debilitating pain and of course suffered through some depression.  OT will help Andy with pain management, helping him with his ADL's, acting,  and managing his guilt from not being able to participate in occupations and  he will be depressed.  He had limited use of feet and legs, they think this GBS was caused from an allergic reaction to the viral infection of the flu.  Andy needs constant supervision, and is fully dependent on his wife for daily ADL's.  He is hopeful to return to full health and to be able to live without assistance and to get back to acting.  Returning to acting, and sustaining his career for 10 or more years was a goal of Andy's!  Their main  goal for Andy is pain management techniques. Their secondary goals were to manage his feelings and figuring out how to cope with his pain, depression, and guilt and to work on leg muscle strength.

     Alexa did a wonderful job explaining GBS and focusing on Andy's initial goals, and thus tying those into his primary and secondary goals of the intervention.  The goals were both fitting and realistic!  You can tell Alexa was well prepared and had previously done her research to best inform us. I enjoyed it!

Autonomy and Confidentiality-foundations blog

     Autonomy and confidentiality are one of the seven principles of the AOTA Code of Ethics.  I find all of the ethics important, but I find this one the most commonly broken.  Although many people probably do not know that they are breaking it, they are.  Talking at the restaurant to your friends that evening about your clients and maybe not using a name but telling them the whole entire dialogue and session is still breaking the autonomy and confidentiality ethic.

     My brother (used to) and mamma still does, work at a pharmacy in my home town as a tech.  They see just about everyone I know in the town, and I have always respected both my brother and mom because never once did they talk about to me the medicine that they handled or who came through the doors of the pharmacy.  They took the ethic of autonomy very seriously!  As comforting as that is, my fiance currently works at a hospital, and shares an office with the PT's and OT's.  He tells me often about how much they say in the office, using the clients names, and situations in front of him, and how bizarre he finds this (he works in Cardiac Rehab).  So with that being said, I want to take all of my ethics seriously, with a strong focus on not breaking the autonomy code of ethics.  If I was in the hospital for any reason whatsoever, I would not want people talking about me to other health care professionals or others in general if it is to just laugh at the situation or gossip.  If there was a benefit to it of course I would accept it, but I would expect it to be handled in a professional and HIPPA respected manner.

Never stop learning-foundations blog

     I find it very interesting and almost challenging when I look towards my future as an occupational therapist.  We currently have our road mapped out for us for 2.5 years, and then it is our turn to grab the map and choose our destination.  Although I know this will be difficult and maybe a struggle at times, I look forward to seeing where my road takes me and what interests will be sparked as I move through my time in OT school and begin my fieldwork.

     I know being a life long learner will be a fun journey!  I love that occupational therapy is a field that never quits evolving, growing, and there are no limitations on where we may venture to next.  I know during class we discussed that being a lifelong learner can stem from our professional development.  We can be intentional and strategic with our professional development, guiding us to our next destination or area of specialty!

     It is important to highlight that without the OT student program, being a lifelong learner in OT would not be possible.  This is a journey, and although it seems to be a short one, it is the next step to becoming the therapists that others are investing in us to become.  I am excited for the future, and will always keep in mind to be intentional with the way I choose my professional development and CEU's to best serve those around me as my client's.

The OT Process-foundations post

     We learned about the OT process and how it is considered dynamic and interactive!  Before the OT process ever gets started, typically there is a screen to see if there is a further need for evaluation.  Then comes the referral, and this will kick off the official first step of the OT process, the evaluation.  During the evaluation the OT profile is developed, and the analysis of the OT performance occurs. This is the initial stage that the client voices what their interest and goals are due to the Occupational Profile.  This is why the Occupational Profile is the most important part of the OT process, it builds trust and rapport and provides the therapist with hearty details.

     Next comes the intervention.  During intervention, there is the intervention planning and the intervention implementation.  There are five intervention approaches: create/promote, establish restore, maintain, modify, or prevent.

     Re-evaluation is next. During this stage the re-analysis of occupational performance and measurement of outcomes is completed.  The review of target outcomes will help guide the therapist in deciding whether they will discharge the client or continue the OT with them and possibly rethink their intervention plan or grade the activities to provide the client with their "just right challenge"!

     Although this isn't the most emotional or heartfelt post, I know it is important to have a blog and documentation for when I begin my rotations and time as a therapist on my own begins.  This will act as a quick guide on how I will use a top down approach and how the OT process generally works!

Use your self-foundations blog post

     I love the therapeutic use of self and all of the fun elements that play a part within it.  Small things that we often do not think about, such as our non verbal communication is huge!  I think my favorite of all the components of the therapeutic use of self is humor!  When I shadowed a therapist for 6 months for an undergraduate internship, that was her go to.  No matter if the situation was getting awkward, intense, or sad, she would always use this technique of humor and it was a game changer.  Not only did it lighten the mood for all of us, but relaxed the client to a state of participation in the activities or goals they had set for the day.  I will strive to involve humor in my future practice, firstly because I am goofy so I would find that as a strength, but even on my bad and non goofy days I want to make my clients laugh and smile.  That's what it is all about at the end of the day for me, their happiness when they walk out of our doors.

Love is culture. Foundations blog post.

     I love OT culture.  The more I learn about my field of occupational therapy, the more I fall in love and look for ways to bloom within it.  OT is rooted in a holistic, mind, body, and spirit sort of feel as a whole.  We love to look at people for who they are and the story they have.

     During our culture lecture, I never really understood how most all OT's posses this empathetic and people first culture, I felt as if a specific sort of individual is drawn to this lifestyle choice.  Although this is somewhat true, I have learned that through professional development hours, the OT school program, practicing as a therapist, or shadowing before hand, field work, journal clubs, SOTA, and the variety of our professors is a big part of developing our already great culture into an extraordinary one.

     I love that we have moved from using the terms cultural sensitivity, tolerance, to saying cultural competence.  I love the "SCRUB" of the way we initially view things.  I know that every OT or future OT has had a bias, racist, prejudice, stereotype, and discriminatory thought of another before.  Although it is not correct, it is the culture WE have been raised in.  It is our generational duty to break that curse not only in our healthcare profession, but as well in our personal lives to make sure we are always using the thought of "We don't know others situations" and loving and respecting all human kind.  I look forward to continue fighting to demonstrate this in my own life and future health care practicing.  I love this quote and thought I would share..



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