Thandoluhle Ngema

FIELDWORK BLOGS

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Navigating Challenges and Cultivating Compassion

Community block, a challenging yet pivotal way to begin the second semester. As a module introduced at the final stage of my degree, it has proven to be one of the most complex and demanding to navigate. The days have felt longer, weekends shorter, and at times, my motivation has wavered. However, I recognize that this training is crucial in shaping the path of a successful occupational therapist, one who is prepared to tackle challenges head-on and achieve meaningful outcomes. With just two weeks remaining until its conclusion, here are the key insights I've gained, ones I will carry over to community service.

Reflecting on my first day, I realize that my lack of preparation set the tone for the entire week. Failing to look at the handover, I found myself overwhelmed and unprepared, a consequence of my own oversight. It was a reminder that I am now only months away from becoming a qualified occupational therapist with my supervisors and lecturers soon to be my professional colleagues, a reality that once seemed distant but is now rapidly approaching. The impact of my initial unpreparedness was evident, not only in my performance but also in the lasting impression it left on my supervisor, an impression that still resonates in this fourth week. Beginning the block without the necessary equipment only added to the challenges, and I was deeply aware of the expectations placed upon me. Despite this rocky start, the first client I encountered was a male with nerve injuries to his hand, a case I had never managed before. It had been over a year since I last worked directly with a physical client, and the unfamiliarity of the situation only heightened my anxiety. This initial experience set the stage for the entire block, where I found myself navigating patient care with limited confidence, yet always committed to upholding ethical practice. As I continued to deal with the demands of the block, I began to see my unpreparedness not just as a setback but as an opportunity for growth. This journey has led me to reflect on the nature of learning itself. True learning is not confined to the classroom, it occurs in the unpredictable and often uncomfortable moments where theory meets practice.

Kenville Sea Cow Lake has been a unique and enriching community to engage with. The diversity within this community, a blend of cultures, religions, and nationalities, has provided a rare opportunity for a truly holistic approach to OT. Unlike previous experiences, this block has highlighted the importance of cultural humility in practice. Cultural humility, which involves entering into relationships with others in a way that honours their beliefs, customs, and values, has been crucial in my work there (Stubbe,2020). Interacting with individuals from Islamic, Zulu, and Hindi backgrounds required me to be mindful of how my advice and interventions might intersect with their cultural and religious beliefs. This awareness informed my practice, ensuring that the intervention I provided was respectful and supportive of their values, fostering more effective and meaningful therapeutic relationships. This conceptual understanding of cultural humility will continue to shape my approach to community service, where respecting and honouring the diverse backgrounds of those I serve will be paramount.

During my earlier years of study, I developed a strong interest in becoming a paediatric occupational therapist. This block has offered me a unique perspective on paediatric care, one that differs significantly from my previous experience during the Paediatric block at Inkosi Albert Luthuli Regional Hospital. The children we encountered at the hospital and on campus, who were primarily from middle-class backgrounds, presented challenges that were distinct from those faced by the children in the Kenville community. In this community, I’ve had the opportunity to work with a wide range of paediatric clients, from newborns to Grade 1 children, and even teenagers participating in expressive groups. With the infants, I provided much-needed stimulation that they were not receiving at home, while educating their mothers on developmental milestones such as sitting, head control, and techniques to encourage crawling. The high influx of children at the clinic allowed me to impact many families, equipping mothers with crucial information they might not have otherwise received. This preventive approach was particularly important after observing a significant number of children displaying delays in basic concept development by the time they reached primary school (Case-Smith et al., 2014). Recognizing that these children often lack access to toys and educational materials, which leaves them at a disadvantage when they start school, I aimed to bridge that gap through my interventions. Additionally, working with pre-teens and teenagers on Fridays provided a creative outlet for them to express the challenges they face within their community. These sessions focused on enhancing their self-awareness, self-esteem, and consciousness through role play and other forms of artistic expression. This experience has underscored the importance of shaping the younger generation, who in turn have the potential to uplift and transform their community.

Although this block has presented challenges that have often made me feel inadequate in certain areas, the support of the group of colleagues I've spent the past two blocks with has made these difficulties more manageable. We've made a positive community that, despite our cultural differences, encourages hard work and mutual support. This friendship has been particularly beneficial for me in managing my anxiety, which has previously caused panic when reporting on clients, responding to academic questions from supervisors, or speaking in front of a crowd. This growing confidence has also empowered me to advocate and collaborate more effectively for my clients as taught in the community module. I've found the courage to collaborate with nurses when necessary, overcoming my fear of speaking up due to past experiences of feeling dismissed. This was used when following up on resources required for my client with CVA who is bedbound and also following up with her disability grant which finally got approved. Additionally, this newfound confidence has helped me to stand firm in my beliefs during non-academic discussions with my supervisor. While I deeply value her wisdom and passion for philosophy, which has greatly enriched my understanding of many topics, I’ve learned to maintain my own beliefs and values, ensuring that they remain intact during these insightful conversations.

This block also showed me how individuals' social, economic, and political situations affect their engagement in rehabilitation. Many people in the community were unfamiliar with what we do and were hesitant to talk with us, which often led to missed appointments. Working from a mobile clinic van and a gazebo in poor condition made our services seem less important to some. This experience taught me to work with the resources we have and be creative to ensure we provide effective interventions. Furthermore, the high crime rate in the area, compounded by the lack of a nearby police station, affects clients' safety and well-being, leading to trauma that influences their occupational engagement. I would also like to acknowledge our driver, Mr. Ngidi, who demonstrated exceptional selflessness. His dedication, willingness to go beyond his responsibilities, and ability to create a joyful atmosphere greatly enhanced our experience.

As I move forward into community service, I carry with me the lessons learned from this block—the importance of preparedness, cultural humility, adaptability, and resilience. I am reminded that true learning occurs in moments of discomfort and challenge, where we are forced to confront our limitations and grow

REFERENCES

Stubbe, D. E. (2020). Practicing cultural competence and cultural humility in the care of diverse patients. Focus, 18(1), 49-51.

Tervalon, M., & Murray-García, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117-125. https://doi.org/10.1353/hpu.2010.0233

Case-Smith, J., & O'Brien, J. C. (2014). Occupational therapy for children and adolescents (7th ed.). Elsevier Health Sciences.

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"Enhancing Community Health and Well-being in Kenville: Strategies Beyond the Classroom"

Kenville is a community facing significant socio-economic challenges, which was quite an eye-opener for me, even though I grew up in what is considered a low-class area in the north of Durban. While the experience was initially surprising, my roots have taught me to keep my composure and maintain a sense of resilience. My chosen profession has further equipped me to tackle challenges that others might shy away from. Despite the hurdles, I see immense potential at the heart of Kenville and I'm eager to work towards unlocking it. But how?

With poverty being the most pervasive issue affecting most of its residents, the high employment rate among them further exacerbates this issue. This has resulted in financial insecurity and a decrease in opportunities for the community to advance and grow. The Sustainable Development Goals that speak a lot to this issue would be (Goal 1) which is No Poverty and the other (Goal 8) which is Decent Work and Economic Growth. These goals are currently being practiced by us students for the community as part of our projects. Such as the implementation of vocational training programs aimed at equipping young people with practical skills that enhance their employability. The change that would be made towards this project would be looking into programs tailored to local markets' needs as the community has a prevalence of informal businesses. This would include training them on customer service and how to advertise their business which would order doors and broaden their sustainability. Additionally, using what the community already has would increase their volition to attend the programs and empower other individuals to start their own businesses. These initiatives not only alleviate poverty but also stimulate local economic activity, creating a ripple effect that benefits the entire community.

Education is another critical area of concern in Kenville, directly linked to the community’s economic challenges. Many children struggle with basic concepts like colors, numbers, and alphabets, partly due to the prevalence of informal creches that often lack the resources and training necessary to provide quality early childhood education. Most if not all the creches are just shelters mothers leave their children in to be cared for while they are at work or school. Addressing these educational gaps aligns with Quality Education (Goal 4) of the SDGs. We have put in the work for providing intervention at these creches weekly which allows us to gauge their limitations, required training and gaps needed to be filled. While working with the children of those creches, using sustainable methods that the caregivers can take in and easily practice even in their lack of training has had benefits. We found that most of the creches with the least amount of resources like charts, stimulating games, and strict routines had evident effects on the children as they progressed to primary school. With this, I would put together high school children already in the community to draw up charts which can be copied that are sustainable that the caregivers would get training on first before implementing education on the children. This would ensure that children receive a strong educational foundation, essential for their future success in primary and high school which has also shown the rippling effects of the informal creches. Additionally, I would get the caregivers at the creches to support one another by creating a social media platform where they can share tips and strategies that work well with their children. Platforms like WhatsApp groups allow caregivers to exchange ideas and insights on effective educational resources, fostering a community of learning and collaboration. This initiative encourages caregivers and also strengthens the goal of providing quality education to the children in their care.

Health and well-being are crucial to the overall development and the community faces significant challenges, including high rates of teenage pregnancy and a lack of follow-up in health and education services. Good Health and Well-being (Goal 3) of the SDGs provides a framework for addressing these issues. There has already been an implementation on comprehensive sex education by other initiatives that regularly visit schools and the LO subject. The children of the schools have been assessed to have the fear of going to the clinics for sex-related assistance which worsens the prevalence of teenage pregnancy as they fear the judgment of wanting contraceptives. To counteract this experience, bringing in regular programs at the local high school would be beneficial for them as they better express themselves when in groups. This would lessen the stigma. Mobile health clinics can bring confidential healthcare services directly to the community, making them more accessible for those who do not have the means to come to the clinic. This would further aid in more frequent home visits which are desperately needed by some members of the community. I would do this by advocating at the clinic and being in the Department of Health and have this implemented at least twice in a month.

Community engagement and attendance issues further challenge Kenville, as clients often do not attend follow-up sessions for booked appointments. Addressing these challenges involves leveraging strategies related to Good Health and Well-being (Goal 3) and Quality Education (Goal 4). Community outreach programs can utilize health workers or volunteers to remind and encourage clients to attend follow-up sessions, offering transport assistance if needed for those clients that are deemed as critical. Implementing incentive schemes that reward regular attendance, such as discounts on clothing from KITE or educational materials, can further motivate clients to participate. Offering flexible scheduling options can accommodate clients’ needs and improve attendance rates, ensuring that individuals receive the support and services they require. By fostering a culture of accountability and engagement, these can reinforce the impact of health, education, and economic programs, creating a supportive and interconnected community environment.

The most prevalent issue in the community is poverty, a significant effort to combat Zero Hunger(Goal 2) is the soup kitchen held every Monday for primary school children. However, to sustain and expand this valuable service, additional support is needed. One critical area where help is required is in securing more food supplies. The municipality could play a role by providing food parcels and other essential items to ensure the soup kitchen can continue to operate effectively. I would research and request assistance from local government bodies can help address these needs by accessing resources and support available at the municipal level. Additionally, partnerships with local businesses, such as grocery stores located in Springfield and food distributors, would be contacted for donations or discounts on food supplies. Though this might seem like a long stretch, it is being done in other communities and is very feasible. Furthermore, community engagement is crucial for the long-term success of the soup kitchen. Mobilizing local volunteers to help with food preparation and distribution can increase the kitchen’s capacity to serve more. Seeking grants and sponsorships from non-profit organizations and charitable foundations can also provide financial support to cover operational costs and improve the quality of the meals offered.

By addressing these issues through targeted strategies aligned with relevant SDGs, Kenville can make significant strides toward improving the quality of life for its residents. Each strategy not only tackles immediate challenges but also lays the groundwork for sustainable development, fostering a community where every individual has the opportunity to thrive.

Berrone, P., Rousseau, H. E., Ricart, J. E., Brito, E., & Giuliodori, A. (2023). How can research contribute to the implementation of sustainable development goals? An interpretive review of SDG literature in management. International Journal of Management Reviews, 25(2), 318-339.

How To Apply For Sassa Food Parcels 2024 - Apply Online

SASSA Food Parcel is an excellent initiative by the government to offer help to underprivileged and deserving families amidst increasing foo

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"Mastering Community Practice: Is UKZN’s OT Curriculum Up to the Challenge?"

"Not everything that is faced can be changed, but nothing can be changed until it is faced." — James Baldwin. These words resonate deeply as I open my community module in the final year, giving me a glimpse into my future career. Going to a community in any particular area different from the one you grew up in will always be a culture shock. As a health practitioner, openness and understanding are crucial to exploring what and who makes the community. Are we as future practitioners equipped to meet community and primary healthcare challenges effectively? Let's discuss.

The OT curriculum is structured so that foundational knowledge, practical skills, and specialized areas are all met over 8 semesters. This allows for a broad knowledge base with a crucial understanding of human development, behaviour and physical function. This foundational knowledge is structured to assure effective assessment and intervention which prepares a wide range of needs within community practice (UKZN School of Health Sciences, 2023).

The Community Studies module in the first year was meant to give students a basic understanding of community practice. However, it was not a major focus in the middle years and only came back into focus in the final year. This raises two questions: Was this done so that practical fieldwork could provide real community experience, or was it to allow all the earlier learning to come together in the final Community Theory and Fieldwork 4 module? This approach has had both positive and negative effects. On the positive side, waiting until the final year has helped integrate earlier learning with practical experience, leading to a deeper understanding of community practice. On the negative side, the long gap between the first-year and the final-year module has made it harder to connect what was learned earlier with practical experiences. This delay has affected the ability to effectively apply knowledge in community settings (Wilson & McCabe, 2020).

The re-engineering of Primary Health Care (PHC) in South Africa offers a practical example of how community health practices are evolving. The Green Paper on National Health Insurance (NHI) outlines a re-engineered PHC platform with four key components: Municipal Ward-based Primary Health Care Outreach Teams (WBPHCOTs), the Integrated School Health Programme, District Clinical Specialist Teams, and contracting private practitioners (South African Government, 2023). WBPHCOTs are particularly relevant, as they are designed to assess health status, provide health education, and facilitate referrals to appropriate facilities. This referral system ensures that patients receive comprehensive care across different levels of the health system.

It's no secret that the broader community often doesn't receive the attention it deserves from today's occupational therapists. Many prefer the familiarity of hospital settings, where their unique skills are sometimes underutilized, or they find themselves invading the roles typically filled by physiotherapists. But community? Community is where the skills of an occupational therapist are truly put to the test. During my practical experiences in hospitals around Durban, I've observed how occupational therapists often struggle to maintain departments, be occupation-based, and miss opportunities to engage with surrounding communities through home visits. And when in those types of hospitals whether being there for physical or psychosocial block, anything community practice-based has not been given attention, this has made a significant impact and overwhelm now being placed in a community in the final year.

One might think that the required 1000 hours of practical work should be enough to prepare students to become competent practitioners. I believe this is generally true. The 1000 hours, which include electives, typically provide sufficient experience. In practice, we often accumulate more than the required hours due to the structure of the fieldwork. This extended exposure not only provides a safety net in case some hours are missed but also provides extensive experience in hospitals, rehabilitation centres, and other settings where occupational therapists work. By the fourth year, students would have interacted with a diverse range of people from different communities and backgrounds. This broad exposure helps prepare for community practice by familiarizing with various social contexts and client needs.

According to a study done by Deshni Naidoo, the UKZN Occupational Therapy curriculum has both strengths and challenges. Participants noted insufficient exposure to preventive therapy and various age groups and felt unprepared for hospital politics and inter-professional teamwork which is important in community practice. They also desired more focus on government procedures and administrative duties. However, the program was praised for providing strong theoretical knowledge and clinical skills, effective service-learning experiences, and a solid orientation to ethical practice and research skills, which positively impacted their work in both hospital and community settings (Occupational therapy graduates' reflections on their ability to cope with primary healthcare and rural practice during community service, 2017)

While the curriculum includes an intense community module in the final year of study, this timing has its cons. Community healthcare practices are rapidly evolving due to technological advances, urbanization, and globalization. Migration and globalization have led to more multicultural communities like the one in Kenville, creating both opportunities and challenges for integration and cohesion (Brown & Harris, 2019). Economic shifts and diverse community engagements add further complexity. Modern challenges, such as digital divides and social isolation, present new opportunities for engagement and collaboration (Smith, 2022). Placing the community module at the end of the curriculum allows for tackling these current issues and application of knowledge to contemporary community practice, making the timing of this module more relevant. Looking at the application of Assets Based Community Development, which is taught in the community module, the curriculum being structured like this may allow to apply these principles to current and relevant community contexts, reflecting the latest trends and challenges faced by communities. "Opportunity is missed by most people because it is dressed in overalls and looks like work." — Thomas Edison. This quote emphasizes that early opportunities, which might require effort and preparation, are often overlooked. It underlines the importance of recognizing and seizing opportunities before they’re fully realized. Something the OT curriculum may benefit from.

As we venture into the world of community and primary healthcare, the journey isn’t just about clocking hours or ticking off modules. It’s about diving into the vibrant diversity of communities, embracing the chaos and charm of new environments, and using our skills to make a real difference. After all, the real adventure begins where theory meets practice, and that’s where we’ll discover the true impact of our work. Ready to jump in? The community awaits!

References

Smith, J. (2022). Understanding Community Evolution. City Press.

KZN School of Health Sciences. (2023). Bachelor of Occupational Therapy Curriculum Overview. Retrieved from [UKZN website link].

Brown, J., & Harris, J. (2019). Community Health and Development: Current Trends and Challenges. Health Press.

Wilson, L., & McCabe, A. (2020). Connecting Theory and Practice in Occupational Therapy: Insights from the Field. Occupational Therapy Review, 32(2), 157-168

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Maternal and Child Health: A Cornerstone for Our Future

Maternal and child healthcare is crucial, not just for physical health but also for the incredible bond between a mother and her newborn. Imagine the joy of welcoming a baby! Now, imagine that joy mixed with a bit of panic because, in most communities, a new baby is seen more as an extra expense than a bundle of joy. Picture a mother thinking, “Oh great, another mouth to feed!” instead of “Oh great, another reason to smile!” This mindset can lead to stress and uncertainty, making strong support systems for expectant mothers more important than ever. According to the World Health Organisation, more than 800 women die every day from complications in pregnancy and childbirth.

There is then a notable need for the rise and importance of improving the well-being of mothers during pregnancy and after they give birth. The Millennium Development Goals (MDGs) were established to significantly lower maternal and child mortality rates and address various health challenges by 2015. Despite these global efforts, maternal and child health remains poor in many developing countries. South Africa, despite being a middle-income country, is also struggling with these issues (King, Mhlanga, & De Pinho, 2006). This situation makes us consider the role of occupational therapists. Though our numbers are small, we strive to make a difference, especially since many international programs don't always fit the specific needs of our country.

Now, let’s delve into what exactly OTs can do, never mind the fact that most South Africans aren’t even sure what we do. Despite our vital role in addressing complex needs for daily functioning, we often get blank stares or confused nods when we mention our profession. It’s quite amusing when you think about it. Imagine trying to explain that we help new moms and babies thrive, and they respond with, “So, you babysit?” Well, kind of, but there’s so much more to it. This can begin with education and support while the mother is still pregnant, informing them of all possible outcomes after giving birth. Though they can never be fully prepared for such a change, teaching them about physical and emotional changes can be just a push in a healthy direction for their well-being. Stress management, coping strategies, and healthy habits can be the advocacy needed by new mothers.

Another factor we can look at is the prioritization of other health sectors in our communities making maternal health often receive insufficient attention. Limited health resources exacerbate this issue, making it challenging to prioritize pregnant mothers. As a result, many mothers miss out on crucial education on prenatal care, childbirth, and postnatal issues, leading to increased risks during pregnancy and childbirth. This raises the question of how this affects society as women are the foundations of our communities.

Healthy child development is the outcome of maternal health. Maternal depression or anxiety symptoms are linked to various child outcomes, including brain structure and connectivity, temperament, socioemotional and behavioural issues, cognitive abilities, academic performance, and the risk of developing psychopathology. Studies in low- to middle-income countries have also found that maternal depression correlates with poor postnatal growth and overall physical health (Phua, Kee, & Meaney, 2020). This then means that having a healthy mother positively contributes to economic stability making it very important to our society.

REFERENCES

King, J., Mhlanga, R. E., & De Pinho, H. (2006). The Millennium Development Goals and health: Progress and prospects in South Africa.

Phua, D. Y., Kee, M. Z., & Meaney, M. J. (2020). Positive maternal mental health, parenting, and child development. Biological Psychiatry, 87(4), 328-337.

World Health Organization. (2019). Maternal mortality. Retrieved from https://www.who.int/news-room/fact-sheets/detail/maternal-mortality

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Shining a Light on Shadows: Mental Health Challenges in South Africa

As an occupational therapy student, I've been closely observing the concerning rise in anxiety and depression rates in South Africa. The impact of these mental health issues on individuals and communities is substantial, and it underscores the importance of my role as a future healthcare professional.

The increase in anxiety and depression in South Africa, as in many parts of the world, has been exacerbated by various factors, including economic challenges, social isolation, and the ongoing stress of the COVID-19 pandemic. South Africa, like other countries, has seen a flow in mental health problems, with a higher prevalence among vulnerable populations, such as those living in poverty or experiencing ongoing violence and trauma. The first step in my role as an occupational therapy student is to acknowledge the gravity of these mental health issues and understand the unique context of South Africa. Occupational therapy is a holistic approach that focuses on improving individuals' ability to participate in daily activities and enhance their overall well-being. This is particularly relevant when addressing anxiety and depression.

One important aspect of our intervention is recognizing the impact of social determinants on mental health. Poverty, lack of access to education and healthcare, and systemic inequalities can contribute to anxiety and depression. Therefore, interventions should consider the broader social and economic context in which individuals live.

The COVID-19 pandemic had amplified existing challenges. The uncertainty, fear, and social isolation brought on by the pandemic had taken a toll on people's mental well-being. Lockdowns, restrictions on gatherings, and economic hardships had led to increased stress and social isolation, contributing to anxiety and depression. Moreover, the loss of loved ones and the inability to conduct traditional mourning and burial practices had added an additional layer of grief and sorrow.

In South Africa, the prevalence of mental health issues, particularly anxiety and depression, presents a complex challenge. This challenge is magnified by the country's unique sociocultural and economic context. South Africa is a nation with a history of apartheid, which has left deep scars of trauma and inequality. The legacy of apartheid, coupled with ongoing socioeconomic disparities, contributes to the mental health issues the country faces today.

In conclusion, the increased rate of anxiety and depression in South Africa is a significant concern, shaped by a complex interplay of historical, social, economic, and public health factors. As an occupational therapy student, my role is to provide support and interventions that are tailored to the unique needs of individuals and communities in South Africa. We operate within a client-centered and holistic framework, aiming to empower individuals to live fulfilling lives while advocating for social change to address the root causes of mental health disparities.

South African Society of Occupational Therapists (SASOT). (2021). Occupational Therapy Guidelines for the COVID-19 Pandemic.

Pitout, H. (2020). Occupational Therapy's contribution to addressing South Africa's mental health crisis. South African Journal of Occupational Therapy, 50(2), 14-20

[thandoluhlengema]

THE OTHER SISTER (through my eyes)

As a student there is a lot of exposure to various aspects of the OT profession which can range from theory to application. The experience of watching a movie of this nature which I’ve never watched has impacted my understanding of OT profoundly. “The Other Sister” is a heartwarming film directed by Garry Marshall, offering a unique perspective on individuals with intellectual and developmental disabilities which I have only been exposed to in this current semester. It provides valuable insight into those living with ID and how they live their lives, their struggles, and aspirations. About to follow are my reflections and lessons learnt from the field and how they have influenced my growth as an OT student.

"The Other Sister" shows Carla Tate, a young woman with a mild intellectual disability, and Daniel McMann, a young man facing similar challenges. Their characters highlight that people with disabilities have a wide range of abilities. Carla's determination to live independently, pursue education, and have a romantic relationship demonstrates the strengths and capabilities of individuals often misunderstood due to societal biases of those with disabilities. In OT, I've learned the importance of recognizing everyone's unique strengths, regardless of their disability. This movie emphasized that each person is special, and we shouldn't limit their potential based on preconceived ideas. It taught me to approach clients comprehensively, focusing on their strengths rather than weaknesses, and to tailor interventions accordingly.

Carla and Daniel strongly desire independence. They want to live on their own, make choices, and chase their dreams. As an OT student, I've learned how important it is to help clients, encourage independence and autonomy, regardless of their limitations. The movie highlights the significance of helping individuals with disabilities in developing life skills, social skills, and the ability to make choices. In my third year of OT, I've explored various theoretical frameworks like the Person-Environment-Occupation (PEO) model and the Model of Human Occupation (MOHO). These models stress the dynamic relationship between the person, their environment, and their meaningful occupations. The film reminded me that promoting independence isn't just about an individual's abilities but also about creating a supportive environment that enables and accommodates those abilities.

Carla's family, especially her mother, initially struggled with accepting Carla's desire for independence. But as time passed, they realized how important it was to let Carla lead her own life and make her own decisions. This part of the movie aligns with the idea of family-centeredness and collaboration in occupational therapy. This showed me the importance of involving family in interventions and allowing for open communication so there is understanding of not only the induvial but all dynamics that are impacted. Carla and Daniel's love story serves as the emotional core of the movie. It beautifully portrays the challenges and joys of their relationship, demonstrating that individuals with disabilities can have meaningful and fulfilling romantic lives. This confirmed the importance of addressing emotional and social needs as part of holistic intervention.

To end, "The Other Sister" has been a significant influence on my growth as an OT student. It has motivated me to challenge stereotypes, advocate for independence and autonomy, involve families and partners, and consider the emotional aspects of disability. The movie has motivated me to approach my future practice with empathy, compassion, and a dedication to enhancing the well-being and independence of all individuals, regardless of their abilities or disabilities. I will continue aiming to create a positive impact on the lives of those I serve.

Reference

Hole, R., Schnellert, L., & Cantle, G. (2022). Sex: What is the big deal? Exploring individuals’ with intellectual disabilities experiences with sex education. Qualitative health research, 32(3), 453-464.

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MIMIC POSIVITE ACTION

The phrase "therapeutic use of self" typically denotes the deliberate actions taken by therapists to enhance their interactions with clients (as noted by Cole & McLean in 2003 and Punwar & Peloquin in 2000). The most commonly referenced modern explanation of this concept characterizes it as a therapist's intentional utilization of their own personality, insights, perceptions, and judgments as integral components of the therapeutic journey (Punwar & Peloquin, 2000, p. 285) which is cited by Taylor, R.R(2009).

The psychosocial block of therapy/treatment can evoke both the emotions of the client and those of the therapist. This occurs because the mind encompasses various cognitive and psychiatric processes, such as perception, memory, and reasoning (executive functions), which are inherent in all of us but may vary in degree (CogniFit, 2023). Below, I will describe how I've employed my comprehensive self to provide holistic care to my patients.

The paramount aspect of working in such a field/block is being able to build trust and rapport with the ones you are working to treat. Establishing a strong therapeutic relationship by being empathetic, nonjudgement and genuine is of utmost importance. The truthful openness I gave my clients meant that the comfortability for them to share their experiences and emotions came at ease. This would help them recognise that they are not so different as society has made them to be yet just altered in their unique perspectives and experiences.

The necessity of not just listening with just ears but also through keen observation is a crucial component of crafting customized interventions. Allowing for optimal observation, paying attention to the physical components brought more understanding to what is being said by the clients and what their thoughts are. This has allowed for empathetic communication by validating the feelings of the client through their body language as well. Consequently, being self-aware of my own body language and emotional reactions makes or breaks the clients trust, ultimately influencing the intervention.

Role modelling by showing appropriate behaviour and demonstrating healthy habits can show a client that you’ve built a rapport with positive things to take away from sessions without you as a therapist even knowing. This was consistently demonstrated in sessions involving effective communication and appropriate social skills when interacting with colleagues and facility staff. As the clients I worked with had difficulties in replicating coping strategies, demonstrating these strategies illustrated the potential for adopting specific behaviours. Consequently, this aligns with the encouragement provided to the client, which can be practiced independently even when the therapist is not present. Prioritizing and maintain own personal physical and emotional self-care shows a being a well-balanced therapist worthy of providing constructive feedback allowing for the client to increase their insight and recognize their progress in problem areas.

To sum up, the concept of therapeutic self-use in occupational therapy can be characterized as the deliberate utilization of our inherent qualities and personal insights as therapeutic tools to support our clients in achieving their occupational objectives. This approach is highly adaptable, placing a strong emphasis on self-awareness, empathy, and the ability to adjust one's approach in interactions and interventions to best serve the client’s needs and goals.

REFERENCE

Taylor, R. R., Lee, S. W., Kielhofner, G., & Ketkar, M. (2009). Therapeutic use of self: A nationwide survey of practitioners’ attitudes and experiences. The American journal of occupational therapy, 63(2), 198-207.

CogniFit. (2023). What You Should Know about Your Mind. https://www.cognifit.com/mind

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Will the shoe ever fit

Mental health, often referred to as the Cinderella of healthcare, is a statement that reflects the historical neglect and stigmatization of mental health issues within the broader healthcare system. Just as Cinderella was marginalized and mistreated in her own family, mental health has long been marginalized and underfunded in comparison to physical health. This critical discussion will delve into the reasons behind this characterization, the consequences of such neglect, and the evolving efforts to change this narrative.

Like in the story of Cinderella, mental health has been taken as the extra weird child compared to physical health. The stigma associated with mental diseases is quite strong all across the world. Yet, one in four persons will encounter mental health issues, indicating the prevalence of such problems. Discrimination and stigma are major obstacles that rob people of their dignity. Mental health conditions have long been stigmatized and misunderstood, which has resulted in their exclusion from healthcare systems. Because mental health has frequently been ascribed a lesser value than physical health, this stigma has influenced the Cinderella comparison.

As we know that she ends up marrying a prince that took care of her, the mental health system just requires those that will take importance in it and see the potential of their change in it on those that need the awareness and help. Not all fairytales come true which is why the journey of awareness has taken its number of years. But the final happiness is also closer than we know.

I believe that it is critical for health care practitioners to apply their skills in both physical and mental health equally. Considering the areas, funding and availability of resources, specialized treatment, and public awareness on which physical health receives the most adequate attention, it will require the utmost enthusiasm from practitioners to create awareness not only among outside people but also within facilities. This is the transformation I anticipate will be brought about by the generation of health practitioners who are still cooking and in the works as they receive more visibility, acceptance and relate more with mental health.

The characterization of mental health as the Cinderella of healthcare reflects the historical neglect and stigmatization it has faced. However, the tide is turning, with increasing efforts to prioritize mental health as an integral part of overall well-being. As we move forward, it is crucial to continue challenging stigma, advocating for equitable access to mental health services, and integrating mental health into mainstream healthcare to ensure that it is no longer relegated to the shadows but rightfully takes its place as an essential component of healthcare.

It is crucial to point out that in recent years, there has been progress in acknowledging the importance of mental health. Some gaps in mental health care have begun to be addressed as a result of increased public awareness, advocacy, and legislative changes (Usmani, 2022). Cinderella wins at the end after all.

REFERENCE

Usmani, S. S., Sharath, M., & Mehendale, M. (2022). Future of mental health in the metaverse. General Psychiatry, 35(4).

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The many doors to success.

“Opportunity does not knock; it presents itself when you beat down the door”- an inspiring quote by Kyle Chandler. I truly wish the start of my relationship with occupational therapy was as smooth as coming out of high school and studying my dream degree. But no, I had to go through trials and tribulations, kick down a few doors then finally find myself where I’ve always imagined being. This voyage has been rather rocky, as evidenced by the pounding and kicking down of numerous doors, so settle in as I walk you through my yet to be reached dream destination.

Up until my senior year of high school, I had no desire to become an occupational therapist. Because my mother is a midwife, I have always been captivated by the job of healthcare professionals. The only occupations I was ever exposed to during my early years and in primary school were that of a doctor and a nurse, so those were the only real options I had as I entered my senior year of high school. When the time came to submit applications to different universities, I made the decision to research the various careers available in a hospital setting, which is how I came across occupational therapy and fell in love with it. As I conducted additional research, my passion grew.

According to a study, those who are mentally impacted by the pandemic exhibit signs of depression, anxiety, and/or stress (Chandasiri, 2020), which is a hardship I personally had to deal with when I began a brand-new course during a global pandemic and realized that my previous study routines would no longer apply. Because I wasn't even pursuing the degree of my choice in that same year, the difficulties proved to be mere steppingstones to the door that still needed to be broken down (being accepted to internally transfer to OT). Oh, but the light at the end of the tunnel, shinning so bright, so inviting yet being just another door needing a hammer.

Still walking with me and kicking down doors? Good. Now we get to the 1st year of my pursuit to be an occupational therapist, not knowing or being aware of what exactly that meant. Having too much freedom meant that recklessly not study would be at an all-time high as we are still under contactless studying. Until parts of 2nd year where now everything has been reinstated, the true difficulty of studying is visible. The emphasis is on assessments, both standardized and unstandardized, which are intended to collect every bit of information about the client and their diagnosis. This practice then evokes the exploration of the client's environment by accompanying them on their journey through tests and conversations leading to observations (Finn, 2020).  It has been challenging to fully understand a great deal of the material and develop into actual therapists due to the difficulty to maintain attention for extended periods of time and the relentless pursuit of submissions, the hardest door to now break down, it is even in the colour red at this point and that always means danger. I feel cognitively and emotionally exhausted as a result of the stress of trying to succeed. I sometimes struggle physically and can't complete my tasks, but I persevere since nothing worthwhile ever comes easily.

Now we stand on the edge, reflecting on the past years and seeing the colour green on the last door before the door to the white belt and plenty of occupational lives yet to be saved. As per American occupation therapy association, Intervention is the focal point as this stage which are occupations and activities, interventions to support occupations, education and training advocacy interventions and group interventions. A life of fulfilment will be attained because as future occupational therapist we know that hope still glimmers in the darkest hour or even when a door is closed.

Reference

Chandasiri, O. (2020). The COVID-19: impact on education. Journal of Asian and African Social Science and Humanities, 6(2), 37-42.

Finn, S. E. (2020). In our clients' shoes: Theory and techniques of therapeutic assessment. Routledge.

American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001

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Cultural Humanity into action.

“I will not permit considerations of religion, nationality, race, politics, gender, social standing, sexuality or personal gain to adversely influence my dealings with my clients and their care providers”, printed as we pledged under Oath. This has shaped the practice of our discipline.

Now how do we define the process of integrating cultural practice as health practitioners? Firstly, the term cultural humility has been used in a variety of contexts, including ethnic and racial differences, gender orientation, social status, transdisciplinary roles, and the health care provider-patient interaction. Openness, self-awareness, ego lessens, helpful interactions, and self-reflection and critique were discovered. Cultural humility has been regarded as a lifetime endeavor (Foronda,2016).

To practice cultural humility, we must always evaluate how the systems with which our clients interact have impacted their lives, belief systems, relationships, sense of self, and the circumstances that have brought them to our services. Comprehending this then helps plan for better interventions and allows for better understanding between therapist and client.

The past week and a half put this idea into effect was when I was given clients of different races than mine, one of the same faith, and one who was fluid in terms of what they identified as. They both shared one trait: they acknowledged and valued their cultural and religious identities without thinking their own was superior. The warm welcome received, allowed for an organic relationship. When both asked to speak about their beliefs and culture, it opened a room for growth in me which allowed me to self-evaluate and self-critic in some aspect of my own beliefs which is the main point of cultural humanity which I would practice for the entirety of my therapeutic interventions.

Interventions never purposely and also rarely go against the beliefs of patients but there are slight chances they do which would then affect the outcome of therapy. It would then be advisable to holistically understand patients before the implementation of therapy and ensuring that sessions are explained to clients thoroughly to lessens chances of confusion and going against beliefs. Fortunately, all clients dealt with during the block were treated accordingly.

It would then come to understanding colleagues' beliefs, resulting in a healthy working environment. Placing myself in a situation in which I did not question or criticize the beliefs of others but only my own. Respecting and enabling myself to learn if necessary while dealing with patients who share my colleagues' cultural values, which intern would enhance my own understanding of the client, contributing to the effectiveness of intervention.

Tyson (2019) listed the principles of cultural humility as to commit to a continuous process of compassionate self-awareness and inquiry, aided by a network of trusted and cognitively diverse colleagues, being approachable and teachable. And lastly, always keeping in mind the social structures that have helped shape reality as it is experienced by our clients. This, together with feedback and research, has shaped the way my clients have been treated during this block.

REFERENCES

Foronda, C., Baptiste, D. L., Reinholdt, M. M., & Ousman, K. (2016). Cultural humility: A concept analysis. Journal of Transcultural Nursing, 27(3), 210-217.

Tyson, C. (2021, April 19). What is cultural humility? 3 principles for Social Workers. Retrieved March 29, 2023, from https://www.socialworker.com/feature-articles/practice/what-is-cultural-humility-3-principles-for-social-workers/.

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EVIDENCE BASED PRACTICE

“Teaching needs an ecosystem that supports evidence-based practice. It will need better systems to disseminate the results of research more widely, but also a better understanding of research, so that teachers can be critical consumers of evidence”. - Author: Ben Goldacre.

Let’s picture this, a client with a brain tumor presenting with unilateral neglect and cognitive fallout. That is just the outline of a picture that needs panting. With research, being it using Google Schoolar, checking with colleagues (supervisor feedback) or reading articles you’ve found a part of your evidence. Understanding the clients aims, context and preferences, being it using assessments or buying in with family. Then lastly using clinical expertise being it knowledge, skills and considering experience. All of these form the colours needed to paint the picture of evidence prior to intervention. Boom! Picasso.

Well, all of those aspects were followed with this client but the very first and important one had a lack which then caused the whole picture turn into a puzzle that now had missing pieces. When it was then followed with a deeper look into the research, the picture puzzle came together. Intervention is now shaped since you’ve found and evaluated on what is most necessary to the client which can be therapeutic exercises, adaptive equipment, modifications to environments and retraining of ADLS. We are occupational therapist after all, that’s our way of intervention.

This will be the most important consideration as more clients are see. Using research, feedback and OT3 skills.

Evidence-based practice has several benefits, including the ability to adapt and individualise patient care, lower patient care costs, and increased medical professional expertise. What a way to ensure therapists put in the most accurate intervention.

REFERENCE

Heneghan, C., Mahtani, K. R., Goldacre, B., Godlee, F., Macdonald, H., & Jarvies, D. (2017). Evidence based medicine manifesto for better healthcare.

Mattingly, C. (1991). What is clinical reasoning? The American Journal of Occupational Therapy, 45(11), 979-986.

Titler, M. G. (2008). The evidence for evidence-based practice implementation. Patient safety and quality: An evidence-based handbook for nurses.

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COLLABORATIVE PRACTICE

It takes a village to raise a child, according to an African proverb, which refers to the constructive cooperation of a group of people for the safe development of a specific something. In our field of work, it then means that it takes multiple disciplines namely physiotherapists, speech therapists, occupational therapists and audiologists, just to name a few, to work together to improve the wellbeing of patients.

Being a team member allows you to share your knowledge and gain insight from others. You can inform the team as an occupational therapist about how patients are doing with their daily activities and how their condition is affecting them. The team may use this information to better plan how to assist patients in getting healthier and living better lives according to their field of work.

Knowing the human body involves more than just what the naked eye can see; it also involves comprehending its systems and functions. When you provide someone holistic care, you take into account their physical, emotional, mental, social, spiritual, and economic well-being. These factors all call for the cooperation of therapists and other practitioners. Examples of treatments that may include a number of therapists may be Pain Management where a Psychologist, Physiotherapist and occupational therapist would need to work together to help that particular patient according to Clinical psychology community UK (2022,).

Being a student in a setting where we have been prioritised by the therapists is our field has made the learning and implementation of knowledge be run smoother which has reflected in treatment sessions with our provided clients.

This week, a lot of difficulties were encountered, including interacting with other student therapists and comprehending the supervisor's feedback. I had to put all the preparation I had done over the previous weeks into practice because it was also the week of my midterm demos. I'm still having trouble comprehending the cognitive and perceptual issue that my client was having due to what my client’s occupational therapist tells me and what my supervisor evaluates after my sessions. Which goes back to the collaborative part of this writing, the importance of working as a team for the purpose of ensuring the improvement and wellbeing of a patient. It is critical for all therapists to communicate so that everyone is on the same page.

 While receiving poor feedback for an intervention can be discouraging, it is critical to use the feedback constructively in order to learn and grow as an occupational therapist. I may become a more successful therapist and provide better care for my clients by obtaining clarification, revisiting the intervention plan, seeking new resources, receiving feedback from lecturers and supervisors, and practicing and refining my abilities. Then I back to the drawing board reading articles about cognition when it comes to neglect and found that Robertson, Nico, and Hood (1995) discovered that whether a patient intended to pick up or point to an object had an impact on spatial discrimination in the context of neglect. Which I realized made neglect more evident if cognition was affected, which is where my intervention focus will be for the following several weeks if I come across this aspect again.

Turmoil developed when students were required to have group sessions concurrently, considering the number of patients at the private facility and having to comprehend that all other disciplines had prioritised therapy to hold. It taught me how to let colleagues remove clients I was working with for what they genuinely believed they needed at that particular time, while also making sure they understood the significance of my work, which would need to be articulated in a way that would be respectful of all parties involved.

Finally, occupational therapy plays an important role in a multidisciplinary team, notably in promoting functional independence and improving the quality of life for patients with complicated medical demands. Occupational therapists can assist patients in achieving greater independence through good assessment and intervention planning, adaptable equipment, and collaboration with other healthcare professionals.

References

Palmer, R., & Gasman, M. (2008). " It takes a village to raise a child": The role of social capital in promoting academic success for African American men at a Black college. Journal of college student development, 49(1), 52-70.

Manly, T. (2002). Cognitive rehabilitation for unilateral neglect. Neuropsychological Rehabilitation, 12(4), 289-310.

Clinical psychology community UK (2022, June 14) Working in multidisciplinary teams [VIDEO] https://www.youtube.com/watch?v=JbIugUsV05A

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WHAT CLIENT CENTRED MEANS TO ME

This week's goal was to grasp the concept of client-centeredness. Formerly, in the second year, the emphasis was on assessment; currently, in the third year, the emphasis is on what has to be implemented in order for the client to be able to return to their occupations and/or improve their functioning. So, what exactly is client-centered, you may wonder? According to Sumsion (2000) client-centred is a specific type of partnership between therapist and client which works on encouraging the client to engage in functional performances in order to fulfil their occupational roles.

After assessing client factors and determining which components were impaired, we were now given the opportunity to work on treating those impairments. Taking into consideration that this was the first of many treatments we would do, panic and anxiety were expected. Thinking deeply about how the client now depends on you to have back their normal lives and get back to their normal occupations before their impairments raised the question if we were fit for such a task. With the support of each other, classmates/colleagues, supervisor and hospital therapist we were able to take on the task a lot easier. Before being able to plan a treatment session, the most important part was being very sure about the accuracy of assessment findings so that when going into treatment, it is clear what the client presented with.

When I started planning my treatment session, I thought about what client factors I wanted to treat/improve then looked like what activity would be able to improve those factors and have the activity be relevant to the client. Having a client that presented with both physical and cognitive impairments meant I had to look into both in depth. When it came to his body functions mainly being neglect of the left side, I struggled with understanding how cognition and visual perception was a big part of that component. My supervisor and I had a bit of a back and forth because she could see I was not doing enough research on it and it showed in my write ups. I went back to my 246 Perception and cognition notes to understand the seven components of visual perception and how their assessments were conducted which I then came back to facilitate with my client. That then gave me a clearer picture to his neglect. Making it easier to understand that I’d have to prioritise those aspect before getting to the physical part which he was able to moderately control with queuing. Another source of learning that made me understand either was watching YouTube videos on each component like individually. Visual-spatial relations being one of his major problems I got to understand that his problem was not being unable to see but him being unable to understand the space his body is in in relation to objects around his.

Shadowing the OT therapist as they performed treatment and having discussions with them where they took what I said into consideration made me feel like I was on the correct track. Whilst some therapists would take away clients and/or equipment while I was using it, which made it more difficult to brush up on some assessments and continue with therapy, it exposed me to the world of work and how to enable myself to understand other personalities. Also understanding we are all working on making the lives of the patients at the hospital meaningful.

The relationship I have formed with my client has made it easier to be able to understand him and his occupations. Making it easier to see which treatment sessions are of higher importance to him. He has been able to open up about different aspects of his life apart of his current impairments and how he wishes to make recovery to go back to his normal living. And that has truly reflected the meaning of client-centredness to me.

REFERENCES

1. Sumsion, T. (2000). A revised occupational therapy definition of client-centred practice. British Journal of Occupational Therapy, 63(7), 304-309.

2. OCTH246 Perception and Cognition notes on Learn

3. greenspanfloortime (2020, July 5) Visual Spatial Processing [Video] https://www.youtube.com/watch?v=Vy1uHBH7VXA