week 6 Flashcards
Assessment of communication and interaction skills
ACIS overview:
- Observational assessment based on communication and interaction skills section of the MOHO
- Focusing on communication & interaction skills in the context of occupational participation
- Population and setting: any clients who have difficulty with communication & interaction skills
- 3 domains: physicality, information exchange and relations
Using the ACIS:
Four point rating scale: 1-4 (analogous to FAIR used in other MOHO-based assessments)
4 = Skill supports ongoing social action
3 = Questionable skill, however, there is no disruption in ongoing social action,
2 = Ineffective skill which impacts ongoing social action and
1 = Deficit skill which causes an unacceptable delay or breakdown in social action
Time required: variable (observation may be short or long, rating 10-20minutes)
Tips: take notes during observation (if possible/appropriate
Model of Human Occupation Screening Tool (MOHOST): assessment of occupational participation/patterns
Assesses participation and patterns of occupational engagement:
- The MOHOST is an assessment that addresses the majority of MOHO concepts (volition, habituation, skills, and environment), allowing the therapist to gain an overview of the client’s occupational functioning.
- MOHOST includes letter rating scale labels :
F= Facilitates occupational participation,
A= Allows occupational participation,
I= Inhibits occupational participation,
R= Restricts occupational participation.
whats forensic care
Forensicare is Victoria’s leading provider of forensic mental health care. We work to meet the needs of consumers with serious mental illnesses across the justice system, mental health sectors and the community.
Our services deliver a range of mental health programs targeted at patients with different needs at different stages of recovery; from early intervention and prevention, inpatient care, rehabilitation and community transition support.
These services are delivered through:
> Thomas Embling Hospital, a 134 bed, secure hospital.
> Prison Mental Health Services, including bed-based services in 4 prisons
> Community Forensic Mental Health Service
> Court Liaison, Court Reports and Specialist Assessment Services
multidisciplinary team members in forensic services
– Nursing
– Psychiatry (Consultant Psychiatrists & Medical Registrars)
– Psychology (including Neuropsychology)
– Social Work
– Occupational Therapy
– Allied Health Assistants
– Art therapist
role of OT in forensic hospital environment
OT roles include:
- Contributing to multidisciplinary assessment & planning
- Working to minimise/address harm from occupational & sensory deprivation
- Supporting people to adjust to prison and establish healthier routines
- Helping people access services & referrals
- Supporting people to prepare for community release & reintegration
- Specific interventions around living skills, communication & social skills, sensory modulation, vocational goals etc.
intervention in forensic care
• Individual
– Providing individual therapy on bed-based units and within the outpatient settings
– Supporting community re-integration including developing skills for community living
• Group (unit or campus)
– Providing group-based treatment on bed-based units and within the outpatient settings
– modules and series to address a range of occupational needs
• Service wide (population)
– Liaising and providing treatment options with the wider MDT and other key stakeholders (education, programs staff, correctional staff etc. )
– Educating and enhancing clinical and non-clinical team’s understanding of the role of OT in each setting
– Project work e.g. transitioning to smoke free, introducing COVID-19 responses
evaluation in forensic care hospital
Of individual patient progress
– using MOHOST as an outcome measure, readministering assessments
Of programs
– observations and reviews, feedback, surveys
On the run
– using reflection, supervision and peer support to evaluate and improve practice
Occupational therapists within prison services:
- Provide cost effective solutions for prisoners’ care (single-handed care, telecare, prison design advice).
- Forge partnerships with prison healthcare services to identify current and unmet needs of the prison population living with long-term conditions.
- Promote an enabling ethos within care and support plans for prisoners with long-term conditions
recovery pyramid
step 1 (bottom)- denial
step 2 despair, hopelessness
step 3-birth of hope, initial motivation
step 4-acceptance, adaptabilty
step 5 willingness, egar to move forward
step 6- responsible action, initiate actions
step 7- meaningful life, ongoing with or without syptoms being part of the community
Victorian mental health act (2014):
- Forensicare is a designated Mental Health Service under the MHA 2014
- A person can become a patient of Thomas Embling Hospital under a Secure Treatment Order, a Court Order or a Civil Order (ITO
Secure Treatment Order criteria:
- the person is in prison and has mental illness
- because the person has mental illness, the person needs immediate treatment to prevent serious deterioration in their mental or physical health or to prevent serious harm to the person or another person
- immediate treatment will be provided if the person is made subject to a Secure treatment order
- there is no less restrictive means reasonably available to enable the person to receive the treatment
- (In Victoria, hospital is considered more restrictive than prison).
Metnal health consumers who are subject to involuntary treatment have the right to:
(a) be informed of their rights and responsibilities as expressed in this statement
(b) be informed of the reasons for the involuntary treatment
(c) be provided with an explanation of their condition and plans for the management of the condition, including after admission
(d) participate in all treatment and care decisions 16 | Mental health statement of rights and responsibilities 2012
(e) have their wishes and preferences taken into account
(f) contact support persons, carers, advocates, families and friends, if they so choose
(g) have available to them someone independent who will represent them and whose task it is to advise them and protect their rights
(h) be clearly informed of and offered the availability of representation
(i) be supported to make an unhindered and informed decision about whether to accept representation
(j) a timely, independent and impartial review as soon as practicable after they have been admitted for involuntary treatment and at regular intervals thereafter
(k) be ensured continuity of care
Mental health act 2014: core principles and objectives:
how it influences OT practice
- assessment and treatment are provided in the least intrusive and restrictive way
- people are supported to make and participate in decisions about their assessment, treatment and recovery
- individuals’ rights, dignity and autonomy are protected and promoted at all times
- priority is given to holistic care and support options that are responsive to individual needs
- the wellbeing and safety of children and young people are protected and prioritised
- carers are recognised and supported in decisions about treatment and care.
whats sensory modulation theroy
• Sensory modulation theory is what the sensory rooms are based off. It suggests that by learning and using self‐control, and regulating responses to stimuli, patients may prevent agitation building up and distress escalating to aggressive behaviour (
whats in a sensory room
What’s in a sensory room?
- To create an atmosphere they like, patients can change the sensory room to a range of colours through a strip of LED (light emitting diode) lighting and choose from various calming projector images including a green forest scene or fish and bubbles, which roll across the walls.
- The room contains a surround sound audio system
- Seating options of a couch or beanbags.
- Sensory items include soft toys, scented moisturizers, weighted items, aromatherapy oils and bubble mixture, among others.
- Items are not permitted to be taken from the room, and the cupboard must be locked and unlocked by a staff member.
- Sensory rooms in mental health treatment facilities typically contain various items and furnishings to provide sensory input (e.g. stress balls, weighted blankets, rocking chairs).
- What are the safety and security issues that you would need to consider when planning a meal preparation intervention session?
Intervention
1. kitchen safety.
Pete will be introduced to the safety precaution in the kitchen, such as the way of use the First aid kit and dealing with hazard
2. Equipment handling in kitchen
To educate Pete that he needs to put the containers and cutleries back to the original location after using them, need to be careful when doing this step (maybe some challenging behavior, history of crime)
3. Oven, stovetop and microwave use and time management
To teach Pete how to use the oven, stovetop and microwave safely, including using gloves when handling food when using the oven and microwave. Furthermore, educate him on how to adjust the temperature and manage the time of cooking.
4. Educating
To begin with, start with simple food preparation, for example, making a sandwich and tea/coffee.
Then after a few sessions, Pete will be asked to prepare some foods under our instruction with all the instructions, steps and ingredients needed for preparation. Also, educate Pete to use the measuring equipment for cooking, such as measuring cups, weighing scales.
- Clean-up and food storage
Teach Pete how to place used cutleries, utensils in the dishwasher. Also, educate Pete to place the unused food back to their original location as well as how to dispose of waste.
