Exam 1: OT in MH and Recovery Model

OT in MH practice involves use of _________________.

OT in MH practice involves use of occupations as means and end

Settings for OT MH services for adults include ___________

acute inpatient hospital-based services

-forensic settings

-homeless

partial hospitalization

community case management

primary care

Acute inpatient hospital-based services

limited number of beds and short length of stay (2-3 days)

A reduction in MH hospital beds results in an increased number of individuals with mental illness in settings such as _____________.

forensic settings and homeless

(people with mental illness are less likely to be hospitalized and, when they are, they typically stay in the hospital for only a few days)

What do OT's work on with individuals in acute MH hospital-based settings?

-involved in assessment to facilitate discharge planning

-work with patients on problem-solving current challenges

1) What do forensic settings include?

2) What services do OTs provide in these settings?

1) jails, prisons, and forensic hospitals

2) training for life skills that are important for transition back to the community

T or F: OTs provide skills training services to individuals in homeless shelters/transitional housing.

true

Partial hospitalization programs

provide intense short term treatment for clients who are well enough to go home every night and who have a responsible person at home to provide support and a safe environment

In partial hospitalization programs, OTs target ____________.

specific occupational performance deficits

Community case management

-a process or method for ensuring that a person is provided with needed services in a coordinated, effective, and efficient manner

-similar to social work, no tx involved but rather just ensuring the client is completing the things they need to be doing

With _____________, OTs have the opportunity to work with clients in real-life environments. However, there are limited positions for OTs.

community case management

Primary care now focuses on _________ and is a setting in which OTs can provide client-centered care.

integrating care for mental health, substance abuse, and physical health-care services

Settings for OT MH services for infants, children, and youth include ___________

early intervention

school-based practice

after-school programs

wraparound services

Early intervention programs

-provide family-centered care within the child's natural environment

-OT provides services to families w/ infants and toddlers

T or F: in school-based practice and after-school programs, OTs promote inclusion and MH literacy in classrooms, cafeterias, recess, and playgrounds.

true

Wraparound services

-a philosophy of care for working with children and families with mental illness

-services typically provided to youth with complex mental health needs

a service delivery model in which needs are met through collaboration of many agencies and systems (education, mental health, social services, community).

Recovery

deeply personal, unique process of changing one's attitudes values, feeling, goals, skills, and or roles

SAMHSA defines recovery as

a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential

10 guiding principles of recovery model

1. hope

2. person-driven

3. many pathways

4. holistic

5. peer support

6. relational

7. culture

8. addresses trauma

9. strengths/responsibility

10. respect

4 dimensions of support recovery (SAMHSA)

1. health (well-being and symptom management)

2. home (maintenance of a safe and stable place to live)

3. purpose (meaningful daily activities)

4. community (relationships and social networks)

Health

overcoming or managing one's disease(s) or symptoms and for everyone in recovery, making informed healthy choices that support physical and emotional wellbeing

Interventions for health include

-social support group focused on building coping skills

-creation of a medication management plan (health management)

-peer wellness coaching to encourage physical activity

Abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has an addiction problem is an example of what dimension of recovery

health

Jill attends a social support group focused on building coping skills and engages in peer wellness coaching to encourage physical activity. What dimension of recovery is she working on?

health

Home

-having a stable and safe place to live

-includes a stable and safe community that is supportive of the person in recovery and offers a social group that is part of the home and daily activity options that lend themselves to meaningful role development

-concepts of a home are uniquely defined by the individual

Interventions for home include

facilitating skill development to maintain a home such as

-bill paying

-home maintenance

-cooking

-IADLs

Purpose

-meaningful daily activities, such as a job, school, volunteerism, family caretaking or creative endeavors and the independence, income, and resources to participate in society

-found through engaging with others and meeting expectations of valued roles

Interventions for purpose include

promoting community participation through returning to these valued roles or exploring new ones

An occupational therapist is working on building money management skills for a client who is currently unable to pay the full price for a gym membership. They utilize resources in the form of a coupon found in a local newspaper to access the gym at a more affordable rate. What dimension of recovery is targeted here?

purpose

An occupational therapist is working with employers to reduce the stigma associated with hiring individuals in recovery. What dimension of recovery is targeted here?

purpose

Community

-relationships and social networks that provide support, friendship, love and hope

-includes the ways the individual engages, participates in, and gives back to the community

Interventions for community include

helping individuals identify interests, and then developing skills necessary to participate or create a supportive environment so the individual can participate

-skills training

Wellness Recovery Action Plan (WRAP)

-an individualized plan developed by a person in recovery to identify strategies for maintaining wellness and addressing concerns as they arise; including crisis planning

-empowers and helps mitigate or prevent intrusive feelings or behaviors

-helps develop a planned response

What principles does the WRAP focus on?

hope

person driven

personal responsibility

self-advocacy

education (informed choices)

support of others

T or F: Training is required to be a WRAP facilitator.

true

-you need personal experience using the WRAP and certification

What is included in a WRAP?

wellness tool-box

maintenance list

triggers

warning signs

action plan

Wellness tool-box

-things you have done in the past, or could do, to help yourself stay well

-things you could do to help yourself feel better when you are not doing well

Maintenance list

-things you do daily, weekly, monthly, periodically, yearly to help yourself stay well or feel good about yourself

Triggers

-the external events or circumstances, mostly out of our control, that when or if they happen, will make you feel uncomfortable

-situations, people, and events that cause a person to feel an emotion

Warning signs

-things that can help determine if you are experiencing a crisis or going to experience a crisis

ex: lack of sleep, not showing up for work, not answering phone, not exercising

Action plan

a set of directions that help you stay on track, or help direct what to do/where to take you when you are in a crisis