OT 640 Debrief

Give me 12 steps

Man, I was so thankful to be a part of this meeting. It was such a human experience. Everyone removed their mask; Mr. Dunbar would be proud.

Anyway, here are the points that need to be stamped and addressed.

The role of the facilitator was hands-off. The two of them just assigned each member a portion to read-I was asked to read the preamble- set up a tentative skeleton for the flow of the group, and let that bird go! 

There was only one case of a different personality. One of the guys there, Mark, was not bashful about telling me that the 12-step members did not like us being there. The group leader responded by saying that I was welcome and that they were glad I was there. He encouraged inclusion by modeling the inclusion himself. I understood where Mark was coming from, though; I hadn't walked a mile in anyone's shoes but my own, and admittedly, mine were an arctic shade of white when juxtaposed with the others. Who was I to judge them? Mark had a point, but I assured him I had no gavel, only an open mind. Plot twist: Mark and I ended up hugging at the end and getting along really well. I think through our conversation I earned his welcome. Humility goes a long way.

The environment can impact the session in a myriad of ways. The first, second, and third of which are the personnel. Every group member's comments, actions, and body languages are interdependent on the others. Similarly, the group facilitator serves as a model and a guide for the flow of the group.

Was the group therapeutic? Of course! For everyone there-including me. Each person there was willing to spill their soul to everyone. As I said before, the whole session was just so human. Each person revealed who they were below the surface. They felt they had nothing to lose by doing so, and, in fact, they knew that this would help them grow. I think I, and we as a culture, would benefit from our own venture into vulnerability. 

In regards to what type of group this was, I believe it to be a population group. This population is made up of individuals battling with and/or recovering from addiction. I believe this is true because being from the same population is integral to success of the group. No one, I mean no one, wants to listen to me speak about addiction when I have none to speak of. People do, however, want to be with others who are on the same journey and encountering similar obstacles. Without the synergy created from this, I believe the group could not be nearly as successful.

 

Research Article Summary Thoughts

Article Summary (The boring stuff)

This article titled: "The short term effect of a group drumming intervention on aggressive
behavior among adolescent girls diagnosed with conduct disorder" utilized a experimental, randomized pre-test post-test control group design to look at the effect of drumming on aggressive behavior. The instrument used to measure the change in aggression was a self-rated measure called the Aggression Scale (AS)39. The participants of this study were 26 girls between 13 and 18 years old who were previously diagnosed with a conduct disorder. 13 of the girls were given the drumming intervention while the other 13 continued with their daily regular program. 10 drumming sessions were spread over the course of three weeks. Each girl was given a set of African Djembe drums for the duration of each drum session. After the drumming intervention, the median aggression score for the girls in the experimental group decreased from 20 to 7.

My thoughts on the study (The, hopefully, less-boring stuff)

So, from a researcher standpoint, the sample size was small, there could be other reasons why their aggression decreased (they enjoyed spending time with peers, etc.,) yada yada. So, technically, there isn't much concrete evidence here to speak of...

BUT- yes I started this sentence with a conjunction- I think that the decrease in aggression could be due to the drumming AND the socialization, AKA group therapy. This is interesting for a couple reasons: first, it shows the effectiveness of music as an emotional outlet. This is something I experience every time I pick up my guitar or sing a note. This aptitude for being an emotional outlet is not exclusive to music however; any leisure occupation has this same potential. Conveying the importance of leisure to a third-party payer may be a cumbersome process, but choosing to ignore a client's leisure pursuits and interests is a far more grave concern. Second, as illustrated by every 12-step program since Noah took Mr. and Mrs. Goat off the ark, there is strength in numbers! The synergy created by individuals working toward a common goal, in my opinion, just can't be matched by individual therapy. We are relational beings; it's the fabric of each of us. We should allow that to augment every aspect of our lives-including and especially our therapeutic practices.

References

Elize, J. R., Rialda, H., Cornel M, v. R., Monique B, C., Carina, v. M., Lucinda, P., & ... Tarina, B. (2016). The short term effect of a group drumming intervention on aggressive behaviour among adolescent girls diagnosed with conduct disorder. South African Journal Of Occupational Therapy, (2), 16. doi:10.17159/2310-3833/2016/v46n2a4

Leadership Summit

Eric, Lauren Leiser, and I all chose exercise for our group facilitation topic. Discovering this was a "duh" moment considering we see each other at the gym every day. My communication with Lauren was very brief and I just briefly touched on my plan for the group, though it was still in its infancy. Eric and I collaborated a bit more, once in class and another time while playing basketball. We talked about the various frames of reference that could fit into a group about exercise; MOHO, PEO, and PEOP seemed to be the most logical. I talked to him about my activity idea at the time and we talked about his plans for the session. It was nice to have an objective party to share my ideas with to check and see if they were any good. Coworkers are your friends.

Life Skills Small Group Reflection

Yesterday, I got the privilege of facilitating a small group on health management and maintenance- more specifically on exercise. Exercise is near and dear to me, so this choice was a natural one for me. As with my last group facilitation experience, I thoroughly enjoyed the conversation that transpired during the session. I enjoyed getting to hear the various perspectives each member had on exercise- i.e., what it looks like for them, what makes it difficult and/or easier to do, etc. Though public speaking makes me very nervous, I do think assignments like this one are very beneficial. I need to get more group experience under my belt for when I go to Greenhouse ministries on my level 2 fieldwork, and maybe when/if I decide to work in a mental health setting. Mental health is definitely a setting I could see myself in, but only time, and well, fieldwork, will tell.

Here's my evaluation of my performance.

Introduction: I let the group know what the topic for the session would be, and had the members perform a warm up activity where they drew the biggest barriers to exercise for them. I think I communicated the purpose of the group adequately, but there was room for improvement!

Activity: I did feel adequately prepared for the activity, but I soon found out that I did not do a good job articulating directions for the activity. I should have been more clear and checked to make sure each group member understood before beginning. It's funny (not) that active listening was what my last group experience was over. Maybe I should heed my own advice.

Sharing: Luckily, my group was not one I had to pry words out of; however, I did my part to give structure to the sharing and provide both verbal and non-verbal feedback to each member when they were speaking. So, I did help facilitate this, but my group's conversation was a well oiled machine before I lifted a finger, or lip to speak.

Processing: I think I succeeded in digging deeper to the emotions behind what each member was saying, but the conversation did not get into deep territory by any means. Future sessions certainly could though as the emotional components of exercise, like body image, could certainly come up.

Generalizing: I pointed out the common barriers that the group members had to exercise as well as the common motivators for them to exercise. For example, two members said accountability helped them while Netflix was a hindrance. I think this has the potential to create comfort and cohesion within the group.

Group motivation: There was no shortage of this here, and I don't think that was because of my doing. It's hard to comment on this for that reason; however, I do think that I fanned the flame once it began, but discussion was hot already. Bad joke.

Limit setting: I can't comment on the other groups, but the green group really has great chemistry.  This fostered a really positive environment, but also made side conversations and distractions much more likely and plentiful. I think I could have done more to be directive, but I think it could have possibly done more harm than good.

Application: I had each group member discuss how they can overcome the barriers to exercise they listed earlier in the session. I also talked about how exercises could be modified based on a client's diagnosis. I think I could have made this a larger part of the conversation though.

Summary: I could have done a better job summarizing what we learned and what goals were met at the end of the session. I did so briefly, but there was definitely room for improvement. I think my nerves could have definitely contributed to this.

Professional Development Group Reflection

Today, Macy and I facilitated a professional development group on the topic of active listening. I really enjoyed this assignment and the discussion it stimulated. What I found most memorable about the group is how organic the conversation felt- despite the talking technically being for an assignment. To me, this made this assignment so unique. I wasn't just spitting info back out onto a worksheet or test sheet. I was putting my didactic boots on the ground and actually getting to see my education in action. All of the words I had been seeing on powerpoint slides began to form a cohesive story, and I was the main character. It all felt very natural to me which is saying something because I am a very nervous public speaker. This experience will help me as an ot, and, even sooner, at Greenhouse Ministries during my Level II FW this fall.

Now, onto the evaluation of my performance.

Introduction: I explained the purpose of the group, and did a warm up activity where each group member talked about their strengths and weaknesses, but I definitely could have been more clear in communicating expectations and outlining the structure of the group.

Activity: I did feel adequately prepared for the activity, gave clear directions, and used appropriate timing, environment and materials.

Sharing: I ensured that each member shared, showed engaged non-verbal and verbal communication and empathized with them.

Processing: I feel that I did good job eliciting the feelings on each group member and facilitating conversation between them.

Generalizing: I pointed out difference and similarities between group members, i.e., one group member chose to withdraw when she felt not listened to, while another group member chose to try harder to get the audience's attention.

Group motivation: I felt that Macy and I both did a good job of spurring group interaction and slowing it when the train got off the rails.

Limit setting: Because my leadership style was supposed to be more directive in nature, I think I could have been a little more, well, directive! However, I think side conversations were kept to a minimum, and the humor from these conversations fostered comfort in the group.

Application: I had each group member discuss how being a good active listener will help them as future occupational therapists.

Summary: I ended the group on time, but I think I could have done a more thorough job summarizing at the end and commending each group member's performance.

My reflection on the SIM encounter

First, I would just like to say that learning experiences like the SIM encounter are, to me, fantastic. Actually performing an assessment really helps us as a class to better understand them!  So, how do I think I did? I would describe my administration of the test as good, but not very good; I'll explain. I think that I did well being friendly and comforting- that's probably what I'm most proud of. I would say that my lack of nervousness was also a plus, albeit a surprising one. My main downfalls, or struggles, were three-fold. I didn't remember to apply germ x before beginning, my verbal and non-verbal communication gave away whether she got questions correctly, and I did not ask her if she had any questions/requests for me as I left. If I could do this assignment over I would make sure to apply germ x, be more neutral in my feedback to her responses, and ensure that I asked her if she had any questions or needed anything before leaving. As for surprises or things that triggered my curiosity, my client's chasing of rabbit trails was funny and presented a surprising challenge! Being a talker myself I had to make sure I didn't follow her to far down; I am well-versed in the world of rabbit trails!

As a whole, this experience taught me a lot, and there are several things I can hang on to from this. Two of those things are: prepare, but be yourself. You can learn the playbook cover to cover, but you have to be adaptable once it is game time- I think I did a decent job at that. Second, be encouraging, but not so much so that they feel patronized and/or your feedback gives answers away. I could have definitely done a better job at that. I look forward to future SIM opportunities.

Takeaways from May 24th

Caroline's grandmother Ruby started experiencing the symptoms of Alzheimer's in her early 70's, was  soon diagnosed, and lived around another 7 years. What makes Alzheimer's so exceptionally hard is that the individual's  loved ones not only watch the progression of their family member's disease, but  also have to experience their spouse, mother, father, etc., forgetting who they are. Caroline's grandmother was no exception. Though an OT would certainly help with ADLs  and optimize the fleeting executive function of their client, I think a BIG role for the therapist is family education. Therapists must help their client's family achieve the impossible of not taking things personally when  their loved one  genuinely seems to lose the memory of their lifelong relationships.. It's so sinister that relationships are forgotten in old age, when those relationships have had time to become so deeply rooted and produce so much beautiful fruit. Alzheimer's stinks.

Neuronote 4

A couple weeks back, I attended the RKS art show and got to see the artwork of dozens of individuals. One of my favorites was called (I think,) "Dinosaurs Rock." Yes, yes they do! The artist used plastic gold stars for the spikes of their stegosaurus. Another painting was done entirely with someone's nose, and it was incredibly detailed with symmetry between strokes and leaves that took a very calculated effort. Another picture, which spoke to me the most, illustrated the process of someone deciding to rid themselves of their wheelchair and run freely away from their prior mode of transportation. You can't help but wonder how often thoughts like those run through people's minds when they are in a wheelchair. As someone who loves and participates in different types of art, I can't help but smile when I think about the opportunities that art affords us. Though some physical and neurological conditions may impede our human abilities,  art always finds an alternate route. Our pens, paintings, and perceptions will find alternate paths, and the outcomes, like the paintings at this art show, are beautiful. I look forward to encouraging and implementing art of various types in the therapy of my clients one day, and I hope to find ways to, like the RKS art show did, share that art with the rest of the world.    

Takeaways from class (May 22nd)

As a man who grew up with 4 brothers, Jonah and Emory's story was extra special to me. Though they may never get to experience the brotherly fights, the collective running away from home, and  other brotherly mischief, they will get their own unique experiences. Most importantly, they'll get to do it together. The innately strong brotherly bond will be emboldened by the connection they share through their M.S. No one will understand their struggles more than each other, and I think they will be a huge support to each other.

My takeaways

From doing this case study I learned about Hungtinton's disease including its etiology, symptoms, prognosis, etc. The devastating 50/50 heritability statistic makes Huntington's especially lethal. What makes it so hard is the decision of whether not to get tested. Do you wait it out or do you find out and  stress more? I would certainly choose the latter so I could be proactive about preparing. That's what Heather (ficitiously) decided to do. I'm kind of surprised that 90 percent of people elect not to find out-not that there's anything wrong with them for that. My mind, as with most all of these diseases, goes toward finding a cure. If I could have a hand in that one day, I would love to.

Takeaways from foundations

First off, you have done an awesome job. I thoroughly enjoy your classes and the climate(s) that you create within them.

The main info I picked up in this class are: the history and origin of OT, the skeleton of the OTPF, and what it means to be an OT. The OTPF was a bit daunting at first, but you did a great job explaining it all. If the info wasn't retained, it wasn't because you didn't deliver it correctly. Regardless of what we covered, it was always placed in the context of who we are as OTs, and it was never presented info for rote memorization. This class was an excellent first class to have to acclimate us to what exactly we're going to be doing in a couple years.

You can tell that you care about each student deeper than a grade book level, and it comes out in every class that you teach. Thank you.

P.S your clothes DO match

Neuronote 3

In March, I volunteered for a special needs event at Hope church. It was a St. Patrick's day party (for which I could not find the name online,) specifically for adults with clogging, bingo, food, etc.; it was awesome. One question that I had when I left is: Why is there little cultural focus on adults with special needs? Much of the programs and events in our culture for those with special needs are tailored to kids. Though I definitely think those programs should continue and ideally grow, there needs to be a relatively equal amount of programs for adults. Regardless of age, people thrive on relationships and interactions. I saw that first-hand at this event. The adults that came in shy were engaged and joy-filled by the end of the event. Kudos to Hope for putting on events for the adults. More programs like that are certainly needed. I can't fathom the loneliness that a lot of those awesome adults must feel when their social interaction activities are limited so much, and that's the passion that prompted me to choose this for my neuronote assignment. It would be awesome to be involved in planning and facilitating events like that.

Kristen Graham

A sad irony is the combination of Kristen's profession and the effects of her illness. Fine motor deficits and being a hair dresser do not mix. It's also sad how young she was when it started. It's hard to hear news like that when you have so much of your life ahead of you. I think the bright side is that she has so much time to find new passions. For OT, relaxation techniques could definitely be enjoyable and beneficial. I would also spend time trying to help her find new passions that she can still perform despite her MG

Characteristics of a good OT 4

Too often, we listen just to respond, or we don't listen at all because our minds are on 2940 other things at any given moment. Guilty as charged.
Good listening is crucial, though. Being a good listener might be a more important quality than being a skilled conversationalist, or an absolute genius. Being able to listen, really listen, to our clients will not only help us build the trust necessary for the therapeutic relationship, but also help us figure out what treatments are or aren't working for them; they will tell us if we ask the right questions and really listen to them. The same thing goes for our superiors and co-workers. If the physical therapist tells us that they really worked a client hard in their therapy session, we probably should take it easier on the client when we see him or her. We wouldn't know that, however, if we were distracted and not listening. In the world of unlimited distraction, we have the focus on our clients, and to do that we must be intentional.

My thoughts on the article "What Does Disability Really Mean?"

One quote that I loved from this article was: "Because at a fundamental level, what makes something a disability is dependent on nobody else but the person who has it. At the core of me, at the basic essence of who I am, there is no “abled” or “disabled.” There is only me."

The author absolutely nails it. No one chooses to sustain a stroke or spinal cord injury, or in case, to be depressed, but they do choose what it means to them, and what they do with it. Normal is just the most common abnormality, but that doesn't make the smaller pieces of the pie chart abnormal.

Now, this isn't to say that the aforementioned ailments shouldn't be dealt with, but rather to say that they, rather than society, gets to place a name tag on it.

Health Literacy

Professor Jami Flick's lecture highlighted just how big of a problem health literacy is- even in the U.S. Because of my educational background, I often forget that words like hypertension, hypertrophy, and hyperglycemia aren't part of people's common vernacular. This makes most people susceptible to whatever the hottest snake oil on the market is. "Lose 10 lbs a week safely by drinking this smoothie," may sound unrealistic to me, but how can I fault the everyday customer for believing that? Who wouldn't want to do that if it was safe?

This absence of health literacy, I believe, puts the responsibility of educating on my, and other healthcare professional's, shoulders. Answering the questions of your clients, friends, family members, and using patient-friendly terms can go a long way if we all shoulder the responsibility of the people within our circles and our practices.

We wear the mask

In his poem "We Wear the Mask," the great Paul Laurence Dunbar writes:

"We wear the mask that grins and lies,

It hides our cheeks and shades our eyes,—

This debt we pay to human guile;

With torn and bleeding hearts we smile,

And mouth with myriad subtleties."

I couldn't agree more. A few weeks ago, my classmates all shared personal stories, and for a moment, no one was wearing their mask. I'm not sure if this is a predominately western hemisphere problem, but people, myself included, wear their mask(s) so often that we never see who they really are underneath. I can't help but think how much better our relationships could be if we took our masks off and allowed ourselves to vulnerable and true to who we are. 

In a day where social media gives us the opportunity to paint whatever picture we want of our lives, it is easy to fool others. We want all of our "followers"  believing that the highlight reels that we choose to share wholly represent us. But do they? Let's, as people, practioners, classmates, as ourselves, take off our masks. Our faces are more beautiful anyway.

Leading

In my leadership class, we delved into what it means to lead.  What does it mean exactly? Are you a leader only if you have followers that obey your every word? Or, is leading something way more sophisticated? I would argue that leading has more to do with the inside of a a person rather than the amount of people behind him. I think one example that often gets misconstrued is the Bible's depiction of a man leading his household. At face value, many could take this as misogynistic and unfair to the woman within the household, but I would say that that isn't the case. In the same passage that Christ tells women to submit to their husbands, he commands men to love their wives, as Christ loved the church (key part coming up) giving himself over for her. Christ gave his life for the church. So, this isn't leadership in a militant sense, but rather in a sacrificial, protective, servant manner. This, I feel is the best way to lead. If people know that you have their best interest at heart and would sacrifice yourself for them, it is much easier for them to be on board with your decision. This manner of leadership, in my opinion, should be evident in the therapeutic relationship.

Characteristics of a good OT 3

Humility is an essential trait for being a good OT. Humility makes it not sting as bad when progress isn't made in your client's intervention, and it instead causes you to make changes. It makes you more open to new interventions, the input of your client, and advice of your colleagues. It helps facilitate the attitude of "I'm never done learning," and consequently causes you to seek out new knowledge and treatment techniques for your practice. Lastly, humility makes you a much more enjoyable teammate to the other professionals you practice with. Very few people like to work with someone who won't take advice.