This semester, I am taking a class about leadership in the field of occupational therapy. One of our assignments for this class was to create a web page that we can update throughout the semester. Lucky for me, I already have this one established! My previous post, about my strengths, was just a small piece of this course. We have learned a lot about ourselves so far this semester, and I am looking forward to sharing some things about myself and my leadership skills in this post.
Who am I as a leader? I have always been praised in the past for leading by example. I was a pretty quiet person and I took pride in doing the right thing, even if others weren't. In high school, this leadership style won me the captain's award and a $1,000 scholarship for swim team my senior year. Once I got to college at Ohio State, the lead by example style got lost in a crowd of 50,000 people. If I wanted people to notice me at all, I had to step up and make myself known. I joined a sorority, and held two positions over my three years as a member. This was barely notable at the huge university, but the experience did a lot for me. It was there that I finally learned more outward leadership skills. I was able to get experience standing in front of a group of people, organizing events, and carrying through with real responsibilities.
My leadership roles as an OT student. Although Shawnee is a much smaller environment than Ohio State, I have been able to step into several leadership roles. I am currently the treasurer of the Student Occupational Therapy Association (SOTA). I have helped to organize fund-raising efforts and design t-shirts for the group. I have also taken on a major leadership role in the organization of my group research project. I truly believe that my sorority positions helped me achieve the confidence and initiative necessary to take on these roles.
My leadership roles outside my professional live. Since I moved to Portsmouth, I have found little opportunity to get involved outside of school/the occupational therapy profession. While I do not currently hold any official leadership positions, I do feel as though I lead by example with my friends and classmates. I give advice when I can, I make sure to make schoolwork a priority, and I do my best to keep people around me relaxed and stress-free. I hope that I can serve as a role model or mentor for a friend or classmate in some way or another.
Leadership Resources. The American Occupational Therapy Association (AOTA) - www.aota.org. This is the profession's national organization. It keeps me updated on major events in the community and current research in the profession. The Ohio Occupational Therapy Association (OOTA) - www.oota.org. A more local professional network. Local chapter events and state conferences are posted on this website. The Strengths Finder 2.0 - A book written by Tom Rath, paired with a website (www.strengthsfinder.com). The system looks for an individuals strengths, and teaches him or her appropriate ways to use them in their professional development (See previous post for my list of strengths). The Seven Habits of Highly Effective People by Steven Covey - The book has taught me a lot about taking charge of my life and getting exactly what I need to be happy. A great resource! The Ohio State University Alumni Magazine - Keeps me updated on what is going on with the university and how students and alumni alike are making a difference for themselves and their communities. Extremely inspiring!
Leadership Roles in the Future. As you can see from my Strengths Finder results, I am very "futuristic." I spend a lot of time thinking about what my future will hold. The wheels are always turning. My previous posts about "Where OT is calling me" prove this. How many times have I changed my mind? I wish I could do it all! In my minds eye, I will do it all. Maybe I won't work at a place like Passion Works (see previous post on 9-7-10), but I might volunteer over the summer if I work in the school setting. I could also spend my summers running a small hippatherapy business at my home. Or, if I end up working at an inpatient rehab facility, or an adult MRDD day program, I might be able to implement a passion-works-esque program for the clients or residents. I am not sure where I will end up, but I do know that I want to start something new. I want to be innovative and creative, and I want to make my career - or at least part of it - my own.
Another think I know for certain is that I will continue to lead by example in the professional world. I am going to end this post with my Professional Mission Statement. This will reflect how I plan to live my professional life, once my career is established.
"I, Brittany Wolf, as a Registered Occupational Therapist in the State of Ohio, will strive to provide the best treatment possible for all of my clients. Each treatment plan will be client-centered, evidence based, and well prepared. I will remain ethical in all decision-making, follow AOTA's professional rules and standards, and treat my coworkers with respect at all times. I believe strongly in the importance of passion in the workplace, and I will hold myself to that standard when considering job options."
Friday, October 1, 2010
Monday, September 13, 2010
Strengths Finder 2.0
My Top 5 Strengths, according to Strengths Finder 2.0 by Tom Rath.
Strategic
“The Strategic theme enables you to sort through the clutter and find the best route. It is not a skill that can be taught. It is a distinct way of thinking, a special perspective on the world at large. This perspective allows you to see patterns where others simply see complexity. Mindful of these patterns, you play out alternative scenarios, always asking, ‘What if this happened? Okay, well what if this happened?’ This reoccurring question helps you see around the next corner. There you can evaluate accurately the potential obstacles. Guided by where you see each path leading, you start to make selections. You discard the paths that lead nowhere. You discard the paths that lead straight into resistance. You discard the paths that lead into a fog of confusion. You cull and make selections until you arrive at the chosen path – your strategy. Armed with your strategy, you strike forward. This is your Strategic theme at work: ‘What if?’ Select. Strike.”
Futuristic
“’Wouldn’t it be great if...’ You are the kind of person who loves to peer over the horizon. The future fascinates you. As if it were projected on the wall, you see the detail what the future might hold, and this detailed picture keeps pulling you forward, into tomorrow. While the exact content of the picture will depend on your other strenghts and interests – a better product, a better team, a better life, or a better world – it will always be inspirational to you. You are a dreamer who sees visions of what could be and who cherishes those visions. When the present proves too frustrating and the people around you too pragmatic, you conjure up your visions of the future. They want a picture that can raise their sights and thereby their spirits. You can paint it for them. Practice. Choose your words carefully. Make the picture as vivid as possible. People will want to latch on to the hope you bring.”
Empathy
“You can sense the emotions of those around you. You can feel what they are feeling as though theif feelings are your own. Intuitively, you are able to see the world through their eyes and share their perspective. You do not necessarily agree with each person’s perspective. You do not necessarily feel pitty for each person’s predicament – this would be sympathy, not Empathy. You do not necessarily condone the choices each person makes, but you do understand. This instinctive ability to understand is powerful. You hear the unvoiced questions. You anticipate the need. Where others grapple for words, you seem to find the right words and the right tone. You help people find the right phrases to express their feelings – to themselves as well as to others. You help them give voice to their emotional life. For all these reasons other people are drawn to you.”
Maximizer
“Excellence, not average, is your measure. Taking something from below average to slightly above average takes a great deal of effort and in your opinion is not very rewarding. Transforming something strong into something superb takes just as much effort but is much more thrilling. Strengths, whether yours or someone else’s, fascinate you. Like a diver after pearls, you search them out, watching for the telltale signs of a strength. A glimpse of untutored excellence, rapid learning, a skill mastered without recourse to steps – all these are clues that a strength may be in play. And having found a strength, you feel compelled to nurture it, refine it, and stretch it toward excellence. You polish the pearl until it shines. This natural sorting of strengths means that others see you as discriminating. You choose to spend time with people who appreciate your particular strengths. Likewise, you are attracted to others who seem to have found and cultivated their own strengths. You tend to avoid those who want to fix you and make you well rounded. You don’t want to spend your life bemoaning what you lack. Rather, you want to capitalize on the gifts with which you are blessed. It’s more fun. It’s more productive. And, counterintuitively, it is more demanding.”
Communication
“You like to explain, to describe, to host, to speak in public, and to write. This is your Communication theme at work. Ideas are a dry beginning. Events are static. You feel a need to bring them to life, to energize them, to make them exciting and vivid. And so you turn events into stories and practice telling them. You take the dry idea and enliven it with images and examples and metaphors. You believe that most people have a very short attention span. They are bombarded by information, but very little of it survives. You want your information – whether an idea, an event, a product’s features and benefits, a discovery, or a lesson – to survive. You want to divert their attention toward you and then capture it, lock it in. This is what drives your hunt for the perfect phrase. This is what draws you toward dramatic words and powerful word combinations. This is why people like to listen to you. Your word pictures pique their interest, sharpen their world, and inspire them to act.”
Tuesday, September 7, 2010
Passion Works
Passion Works Studio, located in Athens, Ohio, is an art studio which provides an atmosphere of collaboration between artists with and without developmental disabilities. Founded in 1998, their website features a variety of artwork, including jewelry, ornaments, flowers, and greeting cards. The studio provides means for gainful employment for approximately 40 artists with disabilities. Among the items for sale on the studio's website, my favorite is the "Passion Flower" (pictured left).In my opinion, the studio represents the basic essence of OT. I can't believe an OT isn't behind the whole operation. I mean, their vision statement alone SCREAMS OT.
"To create and live out a best practice model for collaborative art making between artists with and without developmental disabilities. This new mind set demonstrates that creativity is innately a part of all people and recognized that art enhances the quality of life and strengthens communities."
Next semester, we are required to take a grant-writing class. Last year, students in this course wrote a grant for a local business, won the grant, and made a job for herself with the funds. How amazing would it be if I could pull that off for Passion Works! Art + OT = my dream job! I need to do more research on what types of grants are available, and maybe take a trip to passion works to see if there is a need for OT services. The wheels are turning... and it's all because of this book we are reading for our leadership class, The Element by Ken Robinson. I'll post my writings on the book at a later date, but I'll give you the nutshell version real quick: A person's "element," is the place where "natural aptitude" meets "personal passion." Basically, you will be the happiest doing what you are good at and what you love to do. Not one or the other, but both.
Check out the Passion Works website by clicking on the title of my blog above. Pretty amazing stuff.
Thursday, September 2, 2010
Multiple Sclerosis Research
In a desperate attempt to find people to participate in our aquatic therapy study, my research group called the local newspaper to find out about advertising prices. To our surprise, they wanted to do a story on us! We were featured in last Sunday's issue of the Portsmouth Daily Times. I am typing the article here because it is not yet available online.
Students Seek People with MS for Aquatic Study
Five graduate students at Shawnee State University are looking for participants to help them complete a 12-week study of multiple sclerosis patients and aquatic exercises.
Each year, students enrolled in the Master of Occupational Therapy (MOT) program at Shawnee complete a study of MS patients under the guidance of Associate Professor Ed Kehres. This year's team is Jessica Holbrook, Amanda Hill, Aaron Brooks, Brittany Wolf, and Sarah Conetsco, and their study focuses on the use of aquatic therapy.
"According to the research, fatigue is probably one of the most commonly reported symptoms with MS. Research has shown that exercise, aerobic or strength training, has shown to help reduce fatigue a little bit. So we want to see if we do it in the pool, will it make it a little easier," Brooks said.
The participants are divided into two groups - one group that participates in the aquatic exercises and a controlled group who did not participate in the exercises.
"Being in the water helps a lot because you're pretty much weightless in the water. People who can't walk on land can walk in the water. Some people with severe MS are in wheelchairs, and it's just another way to get them to move around and do more exercise," Wolf said.
The first six weeks of the study will be used to establish a baseline of each participating patient. The second six weeks will monitor physical changes in patients participating in the exercise group. The findings of this study will be submitted for publication.
In the spring, the group was awarded $5,000 from the SSU Research and Study grant to assist their project. They were given an additional $1,000 from the Student Undergraduate Research grant.
"It's like start-up money for research projects," Kehres said.
THe MOT is one of the growing number of graduate programs now offered at Shawnee State University. Brooks, Wolf, and Conetsco each came to the program from other cities across the state.
"I'm from Mansfield. I went to Ohio State to do my undergrad. So coming from a big school down here, it's really nice finally getting one-on-one attention from faculty," Wolf said.
Kehres said the program offers a unique experience for students that allows them to closely interact with their faculty and other departments.
Anyone with MS - and living within 30 miles of Portsmouth - who is interested in participating in the study should contact Ed Kehres at (740) 351-3473 before Sept. 30. Participants will be supplied with free support group meeting, free "easy on/off" bathing suit, free aqua shoes, free exercise twice a week, and the possibility for lessened fatigue and improved quality of life.
Students Seek People with MS for Aquatic Study
Five graduate students at Shawnee State University are looking for participants to help them complete a 12-week study of multiple sclerosis patients and aquatic exercises.
Each year, students enrolled in the Master of Occupational Therapy (MOT) program at Shawnee complete a study of MS patients under the guidance of Associate Professor Ed Kehres. This year's team is Jessica Holbrook, Amanda Hill, Aaron Brooks, Brittany Wolf, and Sarah Conetsco, and their study focuses on the use of aquatic therapy.
"According to the research, fatigue is probably one of the most commonly reported symptoms with MS. Research has shown that exercise, aerobic or strength training, has shown to help reduce fatigue a little bit. So we want to see if we do it in the pool, will it make it a little easier," Brooks said.
The participants are divided into two groups - one group that participates in the aquatic exercises and a controlled group who did not participate in the exercises.
"Being in the water helps a lot because you're pretty much weightless in the water. People who can't walk on land can walk in the water. Some people with severe MS are in wheelchairs, and it's just another way to get them to move around and do more exercise," Wolf said.
The first six weeks of the study will be used to establish a baseline of each participating patient. The second six weeks will monitor physical changes in patients participating in the exercise group. The findings of this study will be submitted for publication.
In the spring, the group was awarded $5,000 from the SSU Research and Study grant to assist their project. They were given an additional $1,000 from the Student Undergraduate Research grant.
"It's like start-up money for research projects," Kehres said.
THe MOT is one of the growing number of graduate programs now offered at Shawnee State University. Brooks, Wolf, and Conetsco each came to the program from other cities across the state.
"I'm from Mansfield. I went to Ohio State to do my undergrad. So coming from a big school down here, it's really nice finally getting one-on-one attention from faculty," Wolf said.
Kehres said the program offers a unique experience for students that allows them to closely interact with their faculty and other departments.
Anyone with MS - and living within 30 miles of Portsmouth - who is interested in participating in the study should contact Ed Kehres at (740) 351-3473 before Sept. 30. Participants will be supplied with free support group meeting, free "easy on/off" bathing suit, free aqua shoes, free exercise twice a week, and the possibility for lessened fatigue and improved quality of life.
Tuesday, August 17, 2010
After a loooong summer break...
It's back to school time! Yesterday was the first day of my last year of school. It's crazy to think that I have been in school non stop since I was 5 years old. Two short semesters and I will be out on fieldwork - half scared to death, half excited beyond belief. Pretty soon here, I have to turn in my letter requesting fieldwork locations. I have been doing a lot of thinking about what I am going to put in this letter, and I think I have finally narrowed it down.
I know I want one of my placements to be in an inpatient spinal rehab facility. After doing some web browsing, I found a site that ranked the spinal cord injury rehab facilities in the United states. According to that site, the Rehab Institute of Chicago was number one. It just so happens that I have two possible places to live in Chicago. Perfect.
For my second placement, I would like to work in the school system. Though I have become really interested in spinal rehab over the last year, my heart originates in pediatrics. One of my friends from undergrad is moving to Nashville, and offered me a room (FOR FREE). I love the city and part of me has always wanted to live there.
When again in my life could I move, risk free (better yet commitment free), to a big city? I know I will settle in Ohio. But I think I can handle six months away from this state. Part of me thinks I could use six months away. I'm starting to get really excited! It's only 8 months away!
Side note - The above photo is of myself and my roommates, attempting to cool off in the hot Portsmouth sun, in our $6.00 baby pool purchased from the local K-Mart. :)
Monday, May 10, 2010
Re: Where is OT calling me?
In one of my previous posts, I wrote about "Where OT is calling me." The post was originally an assignment for a class which touched on new practice areas emerging in the field. At the time I was wrote about transitioning high school students with developmental disabilities to jobs. Lately however, I have been leaning more toward working with individuals with SCIs. Because OT is such a broad field, even after my first year of grad school, I am not completely sure of specific treatments we might use with these patients. However, back in November, a boy who graduated from my high school a few years behind me was in a car accident and sustained a spinal cord injury. I think of him occasionally, and check out the Mansfield News Journal website for updates. Today I came across photos of him with his OT in Mansfield. Below is the link:
http://www.mansfieldnewsjournal.com/apps/pbcs.dll/gallery?Site=B7&Date=20100420&Category=NEWS01&ArtNo=4200803&Ref=PH&Params=
As sad as I am for him, this kind of thing makes me excited to begin my career. I only have to wait a year and a half now!
http://www.mansfieldnewsjournal.com/apps/pbcs.dll/gallery?Site=B7&Date=20100420&Category=NEWS01&ArtNo=4200803&Ref=PH&Params=
As sad as I am for him, this kind of thing makes me excited to begin my career. I only have to wait a year and a half now!
Monday, April 26, 2010
Occupational Therapy Songs on Youtube!
Friday, April 16, 2010
An Ethical Dilema: Do Not Resuscitate Orders
Type of Dilemma: Do not resuscitate orders (DNRs), are orders found in patients’ medical charts, which tell health care practitioners not to perform cardiopulmonary resuscitation (CPR) (Braddock, 1998). A patient with a DNR order in his or her chart has either personally chosen not to be resuscitated, or a family member has chosen for them in the event that they are not capable of making the decision independently (NYS Department of Health, 2010). The main dilemma surrounding DNR orders lies within the issue of autonomy, or an individual’s right to make decisions for him or herself (Crabtree, 1999). More specifically, most cases may involve a conflict between professional autonomy and client autonomy; that is, the health care professional’s knowledge and thoughts on what is best for the patient may differ from those of the patient (Crabtree, 1999). For the professional, underlying principles of justice, veracity and duty may also apply depending on the specific case.
Relevant Information: Typically, when an individual goes into cardiac or respiratory arrest, health care practitioners will resuscitate him or her to restore function of the arrested system (Cleveland Clinic, 2010). Not only does this include manual CPR, but resuscitation drugs, artificial airways, respiratory assistance, cardiac monitoring, and others are considered forms of resuscitation (Cleveland Clinic, 2010). However, CPR has been minimally successful with certain diagnoses and conditions, and patients may choose to sign DNRs based on this information. See Table 1 for more information:
Table 1:
| Diagnosis or Condition | Probability of Success |
| Septic Shock | 0% |
| Acute Stroke | 0% |
| Metastatic Cancer | 0% |
| Severe Pneumonia | 0% |
| Hypotension | 2% |
| AIDS | 2% |
| Renal Failure | 3% |
| Homebound Lifestyle | 4% |
| Age Greater Than 70 | 4% (Survival to Discharge) |
(Braddock, 1998)
The problem: The problem again, lies within the concept of autonomy. With end of life care, there will always be conflicts between the autonomy of the professional, the patient, and the patient’s family, all of which can potentially have different views of how the issue should be handled. A patient may be ready to let go, or he or she may be determined to fight until the end. The family’s feelings on the issue can range across the same continuum. These views will greatly affect the patient/family’s willingness to sign a DNR order. Under the principle of autonomy, the clients should be the ultimate decision makers, choosing what is best for themselves or their loved ones. For the health care professional, a much more complicated ethical dilemma is involved with DNRs. First, the professional has a duty to disclose accurate information about the patient’s condition to him or her. This duty lies under the ethical principle of veracity, which is truth telling (Crabtree, 1999). The professional also has a duty to respect the autonomy of the patient, allowing him or her to make decisions on his or her care if possible. Yet another duty of the professional is to allocate healthcare resources effectively and efficiently, demonstrating the ethical principle of justice (fairness) (Crabtree, 1999). For example, an individual who is not likely to survive cardiac or respiratory arrest should not receive CPR as it may be a waste of precious healthcare time and dollars. DNRs are complicated ethical dilemmas; each differs greatly depending on the case. Doctors and Nurses work closest to DNRs, however, therapy professionals may be involved in DNR dilemmas as well.
Type of Setting or Practice: Because DNRs are used to prevent unnecessary and unwanted end-of-life treatment, they will most likely be seen when working with the elderly populations. Therefore, occupational therapists would most likely encounter DNRs in skilled nursing facilities and inpatient rehabilitation settings. Therapists working with these clients need to be aware of whether their patients have or have not signed DNR orders. If a therapist were to ignore a DNR order or neglect to resuscitate an individual who has not signed a DNR, a serious malpractice lawsuit might ensue.
Six Step Process for Ethical Decision Making: Purtilo’s (2005) six step process for ethical decision making provides therapists with a process for making appropriate decisions in ethical scenarios. The six steps are as follows: gather relevant information, identify the type of ethical problem, analyze the problem using ethics theories or approaches, explore the practical alternatives, act, and evaluate the process and outcome (Purtilo, 2005). This process allows therapists to slow down, think through their actions, and make the best choice for themselves and their patients.
Braddock, C. H. (1998). Do not resuscitate orders. Ethics In Medicine. Retrieved from http://depts. washington.edu/bioethx/topics/dnr.html.
Cleveland Clinic. (2010). Policy on do not resuscitate. Retrieved from http://www.clevelandclinic.org/ bioethics/policies/dnr.html
Crabtree, J. L. (1999). Ethics of culture in rehabilitation. In M. Royeen & J. Crabtree (Eds.), Culture in rehabilitation: From competency to proficiency (59-71). Upper Saddle River, NJ: Pearson.
NYS Department of Health. (2010). Deciding about CPR: A guide for patients and families. Retrieved from http://wings.buffalo.edu/bioethics/dnr-p.html
Purtilo, R. (2005). Ethical dimensions in the health professions. 4th ed. Boston: Elsevier Saunders.
Monday, April 12, 2010
Spinal Cord Injury Case Study
I was assigned a number of large projects this semester on the topic of spinal cord injuries. I am interested in working in the field, so I chose the topic hoping to learn more about it. We had to interview an individual with our specific disability and do a psychosocial case study presentation on him or her. Along with the presentation, we had to write a paper, which is the main topic of this post. The man I chose was an acquaintance of mine, who was injured in a body surfing accident 6 years ago. He had a strong pre-injury identity as an athlete, and misses that piece of his life quite a bit. The paper I wrote below shows just a small part of my presentation: one intervention that I chose to help improve this loss of identity. It's also a good way for my few readers to get an idea of what OT can do in the mental health setting.
Spinal Cord Injury Psychosocial Intervention Paper
Client Diagnosis: C4/C5 incomplete lesion spinal cord injury
Psychosocial Need: Loss of identity as an athlete after spinal cord injury
Sample Goal: Client will be able to participate in half of a wheelchair rugby game after 8 therapy sessions and extensive practice outside of therapy.
Occupational Intervention:
Therapist will provide client with practice of wheelchair rugby ball handling skills. Based on the results of range of motion and manual muscle testing, therapist will determine the client’s approximate wheelchair rugby classification and accompanying maneuvers (according to the International Wheelchair Rugby Federation, www.iwrf.com). The client being seen is most likely at level 0.5, and practice maneuvers will be as follows:
• Trapping direct passes on lap
• Batting close-range passes into lap
• One-handed under-hand “volleyball” pass
• Two-handed side “scoop” pass
(International Wheelchair Rugby Federation, 2010a)
As client masters the above skills, therapist will practice maneuvers with weighted balls of similar size. Supplies needed are as follows:
• One manual wheelchair (preferably of lighter, athletic style)
• One volleyball (beach ball if first time practicing)
• Medicine balls of light weights (2-4lbs, depending on the results of manual muscle tests)
• Ample space for physical activity
Theoretical Basis of Intervention:
The client’s previous identity as a collegiate athlete and his lifelong hobby of playing sports provide the rationale for this intervention. According to the Model of Human Occupation (MOHO), volition, habituation, and performance capacity are the three interacting components to an individual’s occupational well-being (Keilhofner, 2009). Volition is an individual’s motivation or desire to participate in a specific occupation (Keilhofner, 2009). Habituation, which consists of a person’s roles and habits, refers to the way in which an individual organizes actions (Keilhofner, 2009). The third component, performance capacity, is the individual’s actual ability to perform a task, physical or mental (Keilhofner, 2009). Due to his injury, the client at hand has extensive physical limitations, and no longer has the performance capacity necessary to play football. Before his accident, however, his role as an athlete was his main identity, and several other active sports filled his leisure time. This fact alone creates in the client a strong desire to be involved in competitive sports again, a void he wishes to fill with wheelchair rugby, a fast-paced, full contact sport for those who have impairments in all four limbs.
Objectives of Intervention:
By practicing ball-handling skills with the client, which are appropriate to the sport of wheelchair rugby, the therapist hopes to instill a new sense of self confidence in the client. The opportunity to fill the void left by football in the client’s life is motivating to the client, and once the new set of rugby skills are acquired, the client should feel empowered to get involved with the sport competitively. The therapist would like to see the client act on this confidence by becoming familiar with the sport, becoming part of a competitive team, and competing in officiated games.
Diagnostic Considerations:
The intervention itself is purely physical, using modified techniques to allow the client to catch and pass the ball. It addresses the following symptoms:
• Muscular weakness
• Muscular coordination
• Decrease/lack of muscular function
However physical, the intervention also addresses the psychological symptoms listed below, as it is a large contributor to the client’s perceived quality of life.
• Depression
• Loss of identity
• Anger
• Low self-esteem
• Loss of friends/social supports
Precautions:
Safety concerns include client’s limited ability to manage physiological responses to physical exercise, such as body temperature and respiratory functions. Client is unable to sweat below the level of injury, and may experience excessive sweating above (Atchison & Dirette, 2007). The client also may display respiratory impairments, such as shallow breathing (Atchison & Dirette, 2007). The therapist will watch for signs of overheating and provide ample water and rest breaks. Also, because of the level of injury, the client has limited to no trunk control (Atchison & Dirette, 2007). The therapist will make sure his manual chair fits appropriately and that he is properly strapped in. Also, practice of ball handling will begin with the wheelchair brakes locked and will not proceed until the client has practiced.
From a psychosocial standpoint, it will be important for the therapist to inform the client of the amount of time and effort it will take to gain the skill needed to play in a competitive rugby game. The client needs to be given the opportunity for small successes, building up his confidence over time. This will keep him from being discouraged and giving up on the sport all together.
Methods and Interpersonal Strategies:
Because this intervention and the ultimate goal are so important to the client, the therapist will employ Taylor’s (2008) collaborating mode during treatment. This will allow the client to feel as though he is a part of the therapy process, making him accountable for the results of his therapy (Taylor, 2008). It will also allow the therapist to receive feedback from the client, giving her the information she needs to keep therapy client-centered (Taylor, 2008). The therapist may also need to employ Taylor’s (2008) encouraging mode, in times when self-esteem is low and the client becomes discouraged.
Relationships:
The client would expect to experience a collaborative relationship with his therapist. He is a highly motivated individual who knows exactly what he wants to do. He is merely lacking the skills to do those things and therefore needs the assistance of the therapist. Although he would like to have control over his therapy plan, he is a respectful individual who will take the advise and expertise of the therapist seriously. Aside from personality, several other factors may affect the therapist-client relationship in this case. Among those factors are age and gender. The therapist and client are of similar age and opposite sex, which in some cases may entice inappropriate relationships to form. It will be important for the therapist to address the client as a peer, being sure to set boundaries where necessary, keeping the relationship professional.
Family and Significant Others:
The person closest to the client’s medical care is his mother. She lives in the same city and visits often. She has been involved in his medical care since the accident, however, unless the client gives permission, the therapist is legally obligated to keep all information about care confidential. If the client approves, then it will be important for the therapist to keep the client’s mother informed and collaborate with both of them on treatment options, goals, and progress.
The therapist will also need to keep in mind the client’s family history and other related issues when providing treatment. The client’s mother and father are divorced and his sister passed away from a car accident just a few months before his own accident. The family has experienced a lot of trauma and is most likely struggling to adjust, even five years later.
Cultural Factors:
The client is a Caucasian man, who values education, hard work, and leisure time. His whole life has revolved around on his athletic career, so this intervention and the possible results coincide with his values. His mother has always been supportive of his athletics, and made it a priority to make it to his games. The opportunity to compete again will provide the pair with new opportunities to bond and reminisce.
Environment:
This specific intervention requires a relatively large amount of open space, ideally with appropriate hard flooring to allow for wheelchair mobility. The client’s apartment is small, and it would be difficult for him to practice ball handling at home. The client currently lives in a community with ample resources for individuals who are interested in adapted sports. However, because he does not drive, he struggles to find transportation to facilities where he can access these resources. The therapist may be interested in researching and recommending driver rehabilitation for the client, which will be able to fit him for an adapted vehicle. In the meantime, the university he attends has an accessible recreation facility that is close enough to the client’s home for him to access without a car.
Expected Outcome:
Upon receiving this practice (ball handling), the client will experience an increase in strength and ability to perform the sport. However, this alone will not allow him to play in an actual wheelchair rugby game. The therapist will also work with him on maneuvering his manual wheelchair, and establishing a regular exercise routine which will help him improve and maintain upper body muscle strength. Along with these physical interventions, the therapist will provide other psychosocial interventions, which will help the client develop and improve the communication and interaction skills he needs to be part of a team or start up his own team. The ultimate goal of all of these interventions is to fill the void left by football in the client’s life. He will build the strength, endurance, and confidence necessary to compete as an athlete again.
Curious about wheelchair rugby? Watch the movie "Murderball." It is intense (as you can only imagine by the title). The film is a documentary featuring the USA Paralympic Quad Rugby Team. It is full of amazing input on society and disability and spills over with inspiration. I own it if you would like to borrow it. Pictured right is Mark Zupan, one of the main characters from the movie.
Spinal Cord Injury Psychosocial Intervention Paper
Client Diagnosis: C4/C5 incomplete lesion spinal cord injury
Psychosocial Need: Loss of identity as an athlete after spinal cord injury
Sample Goal: Client will be able to participate in half of a wheelchair rugby game after 8 therapy sessions and extensive practice outside of therapy.
Occupational Intervention:
Therapist will provide client with practice of wheelchair rugby ball handling skills. Based on the results of range of motion and manual muscle testing, therapist will determine the client’s approximate wheelchair rugby classification and accompanying maneuvers (according to the International Wheelchair Rugby Federation, www.iwrf.com). The client being seen is most likely at level 0.5, and practice maneuvers will be as follows:
• Trapping direct passes on lap
• Batting close-range passes into lap
• One-handed under-hand “volleyball” pass
• Two-handed side “scoop” pass
(International Wheelchair Rugby Federation, 2010a)
As client masters the above skills, therapist will practice maneuvers with weighted balls of similar size. Supplies needed are as follows:
• One manual wheelchair (preferably of lighter, athletic style)
• One volleyball (beach ball if first time practicing)
• Medicine balls of light weights (2-4lbs, depending on the results of manual muscle tests)
• Ample space for physical activity
Theoretical Basis of Intervention:
The client’s previous identity as a collegiate athlete and his lifelong hobby of playing sports provide the rationale for this intervention. According to the Model of Human Occupation (MOHO), volition, habituation, and performance capacity are the three interacting components to an individual’s occupational well-being (Keilhofner, 2009). Volition is an individual’s motivation or desire to participate in a specific occupation (Keilhofner, 2009). Habituation, which consists of a person’s roles and habits, refers to the way in which an individual organizes actions (Keilhofner, 2009). The third component, performance capacity, is the individual’s actual ability to perform a task, physical or mental (Keilhofner, 2009). Due to his injury, the client at hand has extensive physical limitations, and no longer has the performance capacity necessary to play football. Before his accident, however, his role as an athlete was his main identity, and several other active sports filled his leisure time. This fact alone creates in the client a strong desire to be involved in competitive sports again, a void he wishes to fill with wheelchair rugby, a fast-paced, full contact sport for those who have impairments in all four limbs.
Objectives of Intervention:
By practicing ball-handling skills with the client, which are appropriate to the sport of wheelchair rugby, the therapist hopes to instill a new sense of self confidence in the client. The opportunity to fill the void left by football in the client’s life is motivating to the client, and once the new set of rugby skills are acquired, the client should feel empowered to get involved with the sport competitively. The therapist would like to see the client act on this confidence by becoming familiar with the sport, becoming part of a competitive team, and competing in officiated games.
Diagnostic Considerations:
The intervention itself is purely physical, using modified techniques to allow the client to catch and pass the ball. It addresses the following symptoms:
• Muscular weakness
• Muscular coordination
• Decrease/lack of muscular function
However physical, the intervention also addresses the psychological symptoms listed below, as it is a large contributor to the client’s perceived quality of life.
• Depression
• Loss of identity
• Anger
• Low self-esteem
• Loss of friends/social supports
Precautions:
Safety concerns include client’s limited ability to manage physiological responses to physical exercise, such as body temperature and respiratory functions. Client is unable to sweat below the level of injury, and may experience excessive sweating above (Atchison & Dirette, 2007). The client also may display respiratory impairments, such as shallow breathing (Atchison & Dirette, 2007). The therapist will watch for signs of overheating and provide ample water and rest breaks. Also, because of the level of injury, the client has limited to no trunk control (Atchison & Dirette, 2007). The therapist will make sure his manual chair fits appropriately and that he is properly strapped in. Also, practice of ball handling will begin with the wheelchair brakes locked and will not proceed until the client has practiced.
From a psychosocial standpoint, it will be important for the therapist to inform the client of the amount of time and effort it will take to gain the skill needed to play in a competitive rugby game. The client needs to be given the opportunity for small successes, building up his confidence over time. This will keep him from being discouraged and giving up on the sport all together.
Methods and Interpersonal Strategies:
Because this intervention and the ultimate goal are so important to the client, the therapist will employ Taylor’s (2008) collaborating mode during treatment. This will allow the client to feel as though he is a part of the therapy process, making him accountable for the results of his therapy (Taylor, 2008). It will also allow the therapist to receive feedback from the client, giving her the information she needs to keep therapy client-centered (Taylor, 2008). The therapist may also need to employ Taylor’s (2008) encouraging mode, in times when self-esteem is low and the client becomes discouraged.
Relationships:
The client would expect to experience a collaborative relationship with his therapist. He is a highly motivated individual who knows exactly what he wants to do. He is merely lacking the skills to do those things and therefore needs the assistance of the therapist. Although he would like to have control over his therapy plan, he is a respectful individual who will take the advise and expertise of the therapist seriously. Aside from personality, several other factors may affect the therapist-client relationship in this case. Among those factors are age and gender. The therapist and client are of similar age and opposite sex, which in some cases may entice inappropriate relationships to form. It will be important for the therapist to address the client as a peer, being sure to set boundaries where necessary, keeping the relationship professional.
Family and Significant Others:
The person closest to the client’s medical care is his mother. She lives in the same city and visits often. She has been involved in his medical care since the accident, however, unless the client gives permission, the therapist is legally obligated to keep all information about care confidential. If the client approves, then it will be important for the therapist to keep the client’s mother informed and collaborate with both of them on treatment options, goals, and progress.
The therapist will also need to keep in mind the client’s family history and other related issues when providing treatment. The client’s mother and father are divorced and his sister passed away from a car accident just a few months before his own accident. The family has experienced a lot of trauma and is most likely struggling to adjust, even five years later.
Cultural Factors:
The client is a Caucasian man, who values education, hard work, and leisure time. His whole life has revolved around on his athletic career, so this intervention and the possible results coincide with his values. His mother has always been supportive of his athletics, and made it a priority to make it to his games. The opportunity to compete again will provide the pair with new opportunities to bond and reminisce.
Environment:
This specific intervention requires a relatively large amount of open space, ideally with appropriate hard flooring to allow for wheelchair mobility. The client’s apartment is small, and it would be difficult for him to practice ball handling at home. The client currently lives in a community with ample resources for individuals who are interested in adapted sports. However, because he does not drive, he struggles to find transportation to facilities where he can access these resources. The therapist may be interested in researching and recommending driver rehabilitation for the client, which will be able to fit him for an adapted vehicle. In the meantime, the university he attends has an accessible recreation facility that is close enough to the client’s home for him to access without a car.
Expected Outcome:
Upon receiving this practice (ball handling), the client will experience an increase in strength and ability to perform the sport. However, this alone will not allow him to play in an actual wheelchair rugby game. The therapist will also work with him on maneuvering his manual wheelchair, and establishing a regular exercise routine which will help him improve and maintain upper body muscle strength. Along with these physical interventions, the therapist will provide other psychosocial interventions, which will help the client develop and improve the communication and interaction skills he needs to be part of a team or start up his own team. The ultimate goal of all of these interventions is to fill the void left by football in the client’s life. He will build the strength, endurance, and confidence necessary to compete as an athlete again.
Curious about wheelchair rugby? Watch the movie "Murderball." It is intense (as you can only imagine by the title). The film is a documentary featuring the USA Paralympic Quad Rugby Team. It is full of amazing input on society and disability and spills over with inspiration. I own it if you would like to borrow it. Pictured right is Mark Zupan, one of the main characters from the movie.
Monday, March 22, 2010
I Passed the NBCOT Exam!!!
Now, I know the subject of this post sounds really exciting...but I didn't actually pass some big test. But I do have good news. Today in class, our professor handed out a copy of an email sent from a recent Shawnee State University OT graduate who passed his NBCOT (National Board for the Certification of Occupational Therapists) exam on the first try! Passing this exam is REQUIRED for therapists to practice in the state of Ohio, so this is a pretty big deal. As you can tell by my lack of updates, I've been pretty unmotivated lately...feeling pretty crappy about being in school and wondering why I chose two more years of it. This letter put me in a great mood tonight. It made me feel really good about my school work, my field of choice, and the "second-choice" institution I just happened to end up at because my Alma-mater didn't accept me.Greetings Dr. Scurlock,
I wanted to take this time to thank you and your faculty for providing me with an outstanding foundation in Occupational Therapy. I was able to take and PASS the NCBOT exam the first time on 3/15/09. Prior to taking the exam, I used a variety of material to prepare. I studied approximately 1.5hrs a day, 5 days a week, for 1 month. The books I used were as follows: National Occupational Therapy Certification Exam Review and Study by Rita P. Flemming-Castaldy, Occupational Therapy Registered Certification Examination published by NBCOT, and the Occupational Therapy Examination Review Guide 3rd Ed. by Johnson, C., Lorch, A., and DeAngelis, T.
The most relevant book that I felt was most like the examination was the Occupational Therapy Registered Certification Examination published by the NBCOT which has 150 sample questions. The font and content is as close to the exam as possible, meaning the way the questions are worded and key terms such as "MOST IMPORTANT" in bold to help the test taker really identify what is asked.
My feeling about the OT program at Shawnee State is that it really prepared me for the exam. I really felt I had a great foundation and was well prepared to take the exam. By studying for the exam, I basically reviewed everything I learned within the program. I did not learn any new material from these books that I did not already learn in class. It was just a matter of repetition.
I am currently working in the Spinal Cord Injury Unit at the VA located in Cleveland. I was competing against a Cleveland State University graduate for the same position that i believe would have had the upper hand since one of his field work assignments was at this location. Needless to say, I scored exceptionally higher in the "performance based interview" and was offered the team position in the Spinal Cord Injury Unit.
I thank you again for all that you have done to get me to this point and hope future students feel as prepared and confident as I did when I took the exam. Please feel free to contact me anytime.
Sincerely,
Brittany Wolf (I'm signing this with my name because I hope I will be able to send an email just like this 1.5 years from now)
*Sigh of relief*
P.S. Above photo is of the OT gang taking a break from homework on St. Patty's day. Work hard, play hard...right Dad?
P.P.S. I will be asking for those books for Christmas in case any of my readers would like to take note.
Tuesday, January 12, 2010
Where is OT calling me?
One of our introductory assignments this semester was a discussion post answering the following question: "Where is OT calling you?" Because OTs can wind up in a wide variety of settings, I figured that not many people really have a clue what I am hoping to do with this degree. So here is my answer...
As of yet, I am not sure exactly which direction OT is calling me. At least once a week, I learn about another area in which
OTs can be of service. I am really looking forward to my level two fieldwork assignments so that I can explore some of these areas. Ever since the beginning of my “OT journey,” I have been interested in neonatal OT. I love the idea of helping tiny babies get a good start at life. I am worried, however, that I will not be able to handle the inevitable heartaches that come with working with NICU patients. Another area that I am highly interested in is in the school system. More specifically, I would like to work with high school students with developmental disabilities, helping them to transition into adulthood, the work place, and an independent life. Summers off wouldn’t be bad either! Especially because I am interested in hippatherapy as well. This is the one area I am sure that I would like to delve into. I want to start up a small therapeutic riding center on the side – no matter what I end up doing for the big bucks! First I wanted to be a veterinarian, then a physical therapist...hippatherapy is the perfect “in-between.” I am really excited to be a part of this profession, and I cannot wait to get out there and start working!
As of yet, I am not sure exactly which direction OT is calling me. At least once a week, I learn about another area in which
OTs can be of service. I am really looking forward to my level two fieldwork assignments so that I can explore some of these areas. Ever since the beginning of my “OT journey,” I have been interested in neonatal OT. I love the idea of helping tiny babies get a good start at life. I am worried, however, that I will not be able to handle the inevitable heartaches that come with working with NICU patients. Another area that I am highly interested in is in the school system. More specifically, I would like to work with high school students with developmental disabilities, helping them to transition into adulthood, the work place, and an independent life. Summers off wouldn’t be bad either! Especially because I am interested in hippatherapy as well. This is the one area I am sure that I would like to delve into. I want to start up a small therapeutic riding center on the side – no matter what I end up doing for the big bucks! First I wanted to be a veterinarian, then a physical therapist...hippatherapy is the perfect “in-between.” I am really excited to be a part of this profession, and I cannot wait to get out there and start working!
Friday, January 8, 2010
Fresh Start
Welp, this morning topped off my first week of my second semester of OT school. I underestimated how much work I would have to do and how little time I would have to update this blog. I am hoping that I will do a better job this semester.
We have a couple exciting experiences coming up... Myself and 2 other class mates will be running a life skills education course at the local homeless shelter in Portsmouth. I am looking forward to working on that. In another class, we have been placed in teams with occupational therapy assistants (OTA) students and will be visiting a mental/behavioral health facility in Lucasville, Ohio. I have never been in either setting, so I am looking forward to learning from both experiences.
We will also be working on an aquatic therapy research project for individuals with MS. More details to follow.
I will do my best to update this thing as often as possible. I have been told that this will be our most difficult semester... Here goes nothin'!
We have a couple exciting experiences coming up... Myself and 2 other class mates will be running a life skills education course at the local homeless shelter in Portsmouth. I am looking forward to working on that. In another class, we have been placed in teams with occupational therapy assistants (OTA) students and will be visiting a mental/behavioral health facility in Lucasville, Ohio. I have never been in either setting, so I am looking forward to learning from both experiences.
We will also be working on an aquatic therapy research project for individuals with MS. More details to follow.
I will do my best to update this thing as often as possible. I have been told that this will be our most difficult semester... Here goes nothin'!
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