Most of us familiar with rehabilitation know that occupational therapists are problem solvers who devise solutions to unprecedented problems with carrying out day-to-day tasks. But not everyone is aware that mental health also falls into the OT’s domain.
In celebration of Occupational Therapy Month, we’d like to highlight a lesser-discussed role of occupational therapy: assessing the patient’s mental health and addressing the psychological component of rehabilitation.
In a Q&A, RehabCare
Occupational Therapist and Clinical Performance Specialist Allen Johnson explains how OTs approach mental health issues and overcome psychological barriers to recovery:Q. How do OTs motivate patients to engage in therapy?
A. Getting a patient interested in participating can be challenging. The best approach is to actively listen and demonstrate sincere compassion for the issues the patient faces. Find out what aspects of daily life they value and develop the Plan of Care in collaboration with the patient. If the patient feels they have been heard and that goals have been developed with their input in mind, they will be motivated and engaged.Q. How do you uncover what will inspire patients to do their best during treatment?
A. The things that bring meaning to our lives inspire us. If you can get a patient to share what’s meaningful and valuable to them, you have an opportunity to incorporate that into your treatment approaches. The patient will strive to do their best if they feel the treatment activities have purpose.
Q. How much of a difference does a patient's attitude make?
A. A patient’s attitude toward therapy is shaped by what they’ve experienced in the past. If someone has had poor therapy experiences, they are going to expect the worst and have a poor attitude. We have a chance to change that by making their current therapy experience a positive one. Allowing the patient to express their concerns and addressing them with a solution-oriented approach makes a difference in the way a patient perceives their therapy experience and how successful it will be.Q. Working with patients with dementia and other cognitive impairments presents a unique set of challenges. What are some of the hardest things about working with this population?
A. The initial challenge is identifying what impairments the patient may have and what abilities they have retained. Once we learn these things, it’s a matter of determining how to best help the patient and their caregivers capitalize on retained abilities. The latter requires good caregiver training on what strategies the patient or loved one will respond to effectively.
Q. What are some helpful strategies for bringing out the best in these patients and keeping frustrations at bay?
A. First, we must understand that patients with cognitive deficits will be mostly impaired due to communication issues. They experience delays in understanding and processing of information communicated to them. Make certain you have their attention through eye contact and speak at a normal rate and tone. Offer small amounts of information at a time and allow them to process what you’ve communicated. Then seek confirmation that the patient understands what you are trying to convey. Using this simple strategy will minimize the isolation, confusion, and agitation a patient with cognitive impairments feels when their communication capacity is limited.Q. How do OTs uplift patients after a life-changing illness, surgery or accident?
A. OT’s offer patients a frame of mind that is hopeful: Just because someone now may have a physical or cognitive impairment does not mean that their functional limitation has to be permanent. Occupational therapists teach patients how they can recover the quality of life they are accustomed to either by rehabilitating them back to their prior level of functioning, training them how to compensate for lost function or identifying ways to adapt their environment so that they may retain a level of independence.Q. How do you provide a perspective that helps people adjust to a new set of circumstances?
A. We best provide perspective by showing folks the way. We demonstrate for the patient how by modifying the way they do things – even if just slightly – they can adapt to their new circumstances without compromising their quality of life.Q. Can you share a few "a-ha" moments patients have had upon learning a new way to do something?
A. There are “a-ha” moments every day in occupational therapy. These epiphanies can be as simple as patients realizing they can use a dressing stick, sock aide or long-handled shoe horn when they’ve had a lot of anxiety about how they will dress themselves. Patients who’ve recently suffered a spinal cord injury worry they may never drive again, and there’s a big “a-ha” when their OT shows them an adapted van with a wheelchair lift and hand controls.
Thank you to all of our talented occupational therapists who take the time to listen and implement patient-centered solutions.