west Flashcards
What does Occupational Therapy mean to you? Why did you choose OT?
- OT is such a versatile career path, and there could be a lot of reasons for someone to see an OT, but I say the main goal of that relationship with your therapist is to encourage and facilitate independent living and engagement in daily life as much as possible. For me, that was what drew me to this career path. I value keeping busy, I value my independence, I value my connections to the community, I value being able to achieve the goals that I set for myself, and I value the occupations that I partake in that help me to maintain my identity and my sense of self. OT means to me that I can help people also see the value in these things, and learn about the challenges and experiences of people from all walks of life.
There is something for everyone in Occupational Therapy. It’s not exclusive, it’s a wholesome field filled with people who want the best for others, and that’s why it has become so important to me and something that I am a very passionate advocate for. I know that one day it will help the people I love so much, and I know that I can be the person that creates that difference for another individual and their family.
How do you incorporate the values and principles of Occupational Therapy in your own life?
I value occupation; I appreciate and understand the importance of doing. For me especially, I know that I prefer to be a busy person on the go, rather than someone who spends a lot of time at home doing unproductive things. I like routine and tradition, I go for a walk almost every day, even if it’s just a short one because I know that it makes me feel better mentally and physically and I understand through my studies, that it’s important to do something that makes you feel a sense of achievement and enjoyment regularly.
Something that resonated with me throughout all of my degree was the importance placed on someone’s environment in terms of their occupational engagement and sense of fulfillment. I started to see how my surroundings affect what I was participating in or how I felt. I know for me that I like to be connected socially and be part of a team, and I thought a photo of my soccer club was the best way to represent this. I’ve nee involved in soccer all my life, and have played in the collegiate league for 5 years now. I value the feeling of being part of a team, being a part of something social, the exercise aspect of it, and the routine of it.
I also understanding that person-centred care is one of the core values of OT practice, and I practice this every day. I am a patient, understanding and kind-hearted person that has always valued my relationships with people that can be very different from each other. I do not discriminate and I see the unique value of every body and I would say this is the main principle of OT that I incorporate into my daily life, is understanding and aiming for the best interests of others.
What sets you apart from other applicants?
- I have a set of strong set of personal attributes that are well suited to the requirements to succeed in this position. I am an empathic person with a vested interest in the wellbeing of others. My personal values relating to occupational engagement, community involvement, routine and satisfaction from daily life roles allow me to intertwine these values into my everyday work to achieve the best outcome for the consumers that I work with. I have particularly received feedback on my ability to appear approachable to the consumers of the service. In my first week working with the Port Team I was taken to meet a well-known consumer that would be on my caseload, and received positive feedback from another team member saying that it had been a while since they had seen someone have such a relaxing and seamless interaction with that consumer, and noticed that the consumer responded really well to this and was a lot more open than they traditionally would be with a new person.
- PCP project – explain. Then —-
This project makes me unique in that my knowledge of the resources available to both metropolitan and rural south Australians is stronger than I imagine many other applicants, and more importantly, I have had a deep look into the perceived barriers to help-seeking behaviours regarding mental health.
The outcome of this project demonstrates that I take pride in producing quality work, and that I am capable of working efficiently in a team. My choice to participate in this project emphasises that I am someone that is not afraid of a challenging conversation, or afraid to confront a sensitive topic. It shows that I am capable of engaging and connecting with new people; it shows that I am capable of producing an outcome that directly addresses an identified need.
- I would also like to add that through my work as a private support assistant for a teenager with ASD and clinical depression, I have seen first hand the impact that mental illness and associated behaviours can have on am individual and their family. I plan to bring this unique understanding to this position to always acknowledge the carer’s opinion or input, as often they can provide insight into an individual’s journey and experience with mental illness that no one else can.
- MHAHPPP participant – worked hard to be accepted into this program that has allowed me the opportunity to attend various professional development days across the year and hone in and develop on a variety of skills relevant to the position – elaborate further
- Lastly, I am currently employed as an OT with the West team. I know the team well, knowing the people here as individuals and as a team as a whole. I have an understanding of team dynamics, team processes and what is important for the team to provide as a service. I enjoy working with the team, and have felt extremely supported in this environment to develop as a new therapist, and have been complimented on my ability to slot into the team so well and take on a new caseload with confidence as a new graduate.
- Working across two teams – managing two caseloads, experience two different team environments and demonstrating that I am able to adapt to different settings. Completing placement in the East also means I have experience in 3 of the 4 teams in CALHN.
Why do you want to work in mental health?
I have always had a strong interest in mental health and mental illness, an interest that only grows with the more that I learn about it.
I am someone that seeks challenges and new opportunities, and believe these are quite fitting attitudes to work in a mental health setting.
I was fortunate enough to complete a nine-week placement with a community mental health team this year, and my interest in working in mental health only grew with each day and with every new consumer I met.
I feel there are a lot of ways an Occupational Therapist can be of service to these individuals, and was specifically drawn to the relationships that the therapists in the team had been able to develop with their clients, and the uniqueness of every single day in a mental health setting.
I am interested in the barriers to everyday life experienced by people with ‘invisible disability’, and in some cases a disability that is invalidated by others. OT can help by
I hope to use my strengths as a great communicator, an organised person, and someone who develops a vested interest in the well-being of others to develop relationships with people who experience mental health issues that facilitates their independence and community engagement, and overall quality of life as much as possible.
Can you tell us about your understanding of the MOHO and relevant recovery frameworks in Occupational Therapy?
I understand that it is a model used in mental health practice that considers both aspects of human behaviour and the physical and emotional environment on choice and performance of occupation by individuals. I chose to study the MOHO and it’s application within community mental health settings as part of a professional development assignment in my final year of study, and was able to understand more on the four main concepts covered in the MOHO, and how these become concepts that can be analysed in occupational assessment to guide intervention and goal setting. I have experience in writing occupational therapy reports based on the MOHO using the model of human occupation screening tool, and through this experience was able to solidify my understanding of how the broken down components of the model interact to guide choice and engagement in occupation. I find this breakdown of looking into the motivation and pattern of occupation fascinating, and this is something I have enjoyed doing as part of my current role. It’s my opinion also that the MoHO enables therapists to view occupational strengths and barriers of an individual in a way that allows for good, precise and clear communication of occupational issues and recommendations for other professions and for other services.
Through researching ahead of applying for this position and preparing for this interview, I also came across the framework for recovery-oriented rehabilitation in mental health care published by SA Health. I especially resonated with the description of a recovery approach involves us as occupational therapists or mental health workers to value and strive to reach the potential of each individual consumer. In a mental health setting, everyone you come across is entirely different and have often come from more complex backgrounds that sometimes lead them to believe that their mental illness defines them. I aim to use a recovery approach in my practice to assist consumers to see as much as possible, that they are still a unique person with a unique history, unique interests, unique goals and a unique future ahead of them and that their mental illness does not have to be the only thing they know about themselves. I also resonated with the importance of an active and collaborative relationship with a consumer to promote recovery; I place a high level of importance on incorporating consumer interest and values in their recovery journey and this was something I enjoyed doing as part of my clinical placement this year.
How do you anticipate you will navigate the risks associated with working in mental health?
Navigating risks is something that I have really developed on in both my student placements and in my first year of work. I was confronted with the reality of the complex lives and background many of our consumers have for the first time on placement. Coming from a rather sheltered, supportive and wholesome upbringing I was confronted with a lot of unfamiliar things throughout the placement, specifically drug abuse, domestic violence and sexual and emotional abuse. My supervisor would always offer support and someone to talk to, and even though I felt I did not require a debrief about these sensitive topics, she taught me the value of always checking in with others and having the confidence to speak to someone yourself if you are concerned about how you’re coping with something you’ve seen or heard. I’m also aware of the Employee Assistance Program that is available to all SA Health employees and I think this is a great and really important service to have in place. Even if I do not use the service myself, it’s great to know it’s an option and it’s also something I can promote to other staff members that don’t know it’s there.
In terms of managing more practical and physical risk in the field, some experiences with a particular consumer on my caseload this year comes to mind. On two occasions this consumer was quite threatening and violent towards myself on other staff on home visits, and then went on to threaten completing suicide if we were to home visit again. Although confronting at the time, these experiences have taught me a lot about analysing risk and ensuring appropriate measures are in place to ensure the safety of myself and other team members, as well as that of the consumer. After discussing in review, a plan was put in place to always visit with SAPOL. I used these visits to encourage the consumer to consider come into the clinic for his depot, so that the team didn’t have to come out with police. He didn’t like the depot, so I explained the benefits of not having traumatic experiences associated with the depot at his home, the place where he feels most comfortable. He came in independently for two depots after that, and a medical review. I feel that this not only demonstrates an awareness of risk assessment and appropriate action taken, but also demonstrates my ability to develop trusting and collaborative relationships with consumers that encourage them to make the best decisions for themselves.
Risk assessment writing, risk review, discussing risk in clinical review.
How can you incorporate trauma informed care?
I think it’s firstly important to validate the trauma of that individual and what they have experienced, and to not place any expectations on the way that individual behaves regarding their trauma. It’s important also to have an understanding of the coping strategies employed by that individual, so that you can accommodate them if they begin to show signs of distress in certain settings or when discussing certain topics. Trauma informed care is also a strength-based concept, it is important to remind the consumer of their strengths and use these to develop new skills and promote occupational participation. I would be practicing trauma-informed care continuously throughout my phase of a care with a consumer with a trauma background, to ensure that they feel safe and feel that I am trustworthy.
I would also incorporate sensory modulation into the care of a consumer with a history of trauma. I would explain that sensory modulation is learning to self-regulate by seeking and participating in activities/behaviours that engage the senses. I would introduce them to grounding and relaxing activities that they could use to self-regulate when they feel they become distressed, and assist them to implement sensory modulation into their everyday lives.
What Occupational Therapy assessments relevant to mental health have you completed in the past?
Through my experience of the care coordination role, I had the opportunity to undertake numerous mental health assessments, such as mental state and risk assessments, and received positive feedback on my ability to effectively communicate ideas derived from these assessments succinctly and logically, both in the written form of reports or case notes, or verbally in the form of case presentations.
More specific to occupational therapy, my placements in mental health and rehabilitation settings have enabled me to greatly develop my skills in independently completing functional occupational therapy assessment, such as the MOHOST, with consumers, and provide recommendations regarding intervention such as activity scheduling, graded activity programs, referral for psychosocial group programs, or sensory intervention. I also have skills in providing consultation specific to occupational therapy frameworks and models, regarding occupational performance strengths and limitations. I undertook numerous independent functional assessments with consumers, including shopping and cooking assessment, and completed assessment report and recommendations based on my observations. I also guided consumers to complete the occupational self-assessment tool to guide goal setting and intervention with consumers.
Prioritise workload
Previous superiors have commended my ability to effectively manage my own time, as well as communal team resources, and this is a skill set that will assist me in my journey toward independently providing consumer care of the utmost professional standard. I have learned through all of my academic studies, previous employment and specifically my final year placements, both clinical and my community project, the importance of prioritizing tasks and being aware of deadlines. I have always been an organised person. I would prioritise a workload based on consumer risk analysis, the phase of care that the consumer is, of course keeping all consumers in mind but ensuring to contact the consumers requiring a higher level of intervention. I would also therefore prioritise any report writing according to the level of urgency stated in the referral, and seek support from a supervisor or senior team member if I am ever unsure of what consumers or tasks I need to be prioritising.
Please explain the importance of clinical reasoning in mental health care, and talk specifically on types of reasoning you see yourself practicing?
Clinical reasoning is important as it encourages the therapist to be self-conscious in reflection of their practice, and leads to a better ability to explain rationale for decision-making.
PROCEDURAL REASONING
Fleming (1994b) describes procedural reasoning as the process used by a therapist to define a client’s problem and select the intervention procedures. In some occupational therapy literature, Fleming’s conceptualization of procedural reasoning has been described as thinking about the physical problems of a client (Alnervik & Svidén, 1996; Roberts, 1996; Schwartzberg, 2002). In the study reported here, the discussion of procedural reasoning is not limited to reasoning about physical problems.
Mental illness is a disease and impaired psychosocial function is a disability, thus, procedural reasoning is a good descriptor for discussing the reasoning about these problems and the planning for intervention in psychosocial dysfunction.
Interactive Reasoning
- Interactive reasoning leads to an understanding of clients as people and how they experience illness
- collaborative nature of interactive reasoning where the therapist is concerned with clients’ experiences of their disabilities in order to actively engage them to “work hard as partners in the therapeutic process”
She has delineated elements of the interactive reasoning process used to understand clients in the therapeutic situation as: “(1) active listening, (2) being genuine and empathetic, (3) building an alliance, (4) observing cues and clarifying meaning, (5) giving and receiving information, and (6) reality testing” (p. 24).
Conditional Reasoning
- a therapist thinks about clients’ whole conditions, the personal, social, and cultural contexts of their lives
- A therapist thinks about how a client was in the past and projects an image of the future for the client. It is this kind of reasoning that is employed when a client has experienced change because of disability and the therapist is imagining how the client will now fit into his or her world with the changes.
- In some cases, conditional reasoning contributes to a client’s reconstruction of self.
Narrative Reasoning
Narrative reasoning is the method by which therapists create images in their minds about how clients could be in the world. It is the story a therapist constructs, which gives direction (plot) and temporal meaning to a client’s life and the clinical situation. When therapists construct their clients’ stories in their minds, “this picturing process gives them a basis for organizing tasks” (Mattingly, 1994, p. 240).
Pragmatic Reasoning
- the thinking that addresses the larger context of practice, beyond the therapist–client interaction.
- includes the consideration of factors such as availability of space and equipment, reimbursement guidelines, the organizational culture in which practice takes place, and the therapist’s personal motives and professional skills The purpose of this paper is to present a study of clinical reasoning in group psychosocial occupational therapy practice.
Tell us about yourself.
I am a very motivated and enthusiastic person, and have always been someone eager to learn new things. I love to keep busy with study, part time work, exercise and a social life. I love to travel; the experiences and the lessons that you learn about yourself, others, and other cultures are invaluable. I have grown a lot through the travel I’ve done. I’ve played soccer for as long as I can remember, and love to use this as an avenue to keep fit and social, and I really value being part of a team. I come from a big family and really value those relationships. I am an empathetic and understanding person, and will apply these values whole-heartedly when working with people with complex mental health needs.
More relevant to the position, I am a graduating Occupational Therapist from UniSA and I’ve completed two mental health related placements. One being a clinical placement with the eastern community mental health team, and one being a PCP project which I elected to complete in Whyalla this year. My peers and myself worked towards developing a men’s mental health initiative through one of the local football clubs there, and I found this to be an extremely rewarding experience.
I also have paid employment experience as an allied health assistant in the disability field, in which I have honed in on my communication skills with complex individuals, and in which I have had the experience in working as part of a multi-disciplinary team mainly comprised of physiotherapists, social workers and OTs. I also have previously been employed as a home support worker for a teenage boy with ASD and was responsible for implementing a home program designed by his OT, and taking part in evaluation and goal setting as part of that process. This was also work that I really enjoyed, but had to stop due to placement commitments. Organisation and being a dependable person are particular strengths of mine, as well as priding myself on my professionalism and communication skills
Describe your strengths relevant to this position.
- Demonstrated competence to manage two caseloads as well as take on OT assessments, time management is a strength of mine and case management has allowed me to continue to develop on this skill even further.
- I have been able to complete OT assessments in a timely manner and to a good standard. This links into another strength of mine being confident to seek assistance or assurance when needed, and to recognise the limitations of my own knowledge expertise and practice. An example of this was just recently when I was allocated an OT assessment to complete, that became to be more complex than initially thought, and also became a time sensitive assessment. I arranged with senior OT to accompany me when I completed the assessment, as I was also still developing my skills in using the Allen’s Cognitive Screen. I also worked with the senior OT in writing out recommendations that would be most appropriate for the consumer given the complexity of their situation.
- MHAHPPP – worked hard to be accepted, professional development days, professional relationships and support from these relationships of professionals in similar positions that I am in in terms of starting a new career etc.
- I am becoming accustomed to making the most of clinical supervision time to also ask questions/seek feedback and clarify any issues. I have received positive feedback from many coworkers on my confidence in starting a new position, and being able to hit the ground running in terms of workload.
- Currently working with the team – have developed relationships with team members, understanding if team dynamics, rapport with consumers developed
- Incorporate the OT perspective and skill set into care coordination – consumer example.
- Other strengths I bring to the position are - Previous supervisors have also commended my ability to take initiative in addressing any knowledge or practice gaps and seek resources to improve where possible, my communication skills with consumers with complex mental health needs, specifically my ability to demonstrate responsiveness to a consumer and provide relatable examples during assessment and general conversation.
- Knowledge required for care coordination – medications, diagnoses, knowledge of legislation such as ITOs and CTOs, available services in the community, risk and mental state assessments, consumer review, evaluation and planning, developing therapeutic relationships with consumers.
Describe your weaknesses relevant to this position.
I have the tendency to take too much on; I say yes to others to avoid conflict or disappointment even when I already have enough work to keep me busy enough. This would eventually lead to a poorer quality of work from myself, and I would become quite stressed and it would affect other team members as well. I have however in the past year or so tried to address this weakness. In my current paid employment positions I am making a conscious effort to be more aware of my own limits and to be more assertive about the workload that I can manage that still ensure work that is of a good quality. I find that I am actually developing in this area quite a bit, and can see the benefits of voicing when I am feeling overwhelmed.
EXAMPLE of how weakness can be addressed, using clinical supervision to address this and have found the team to be supportive of ensuring I am not overwhelmed.
Describe a situation in which you have managed conflict. STAR format.
I was in a situation this year where I managed to resolve conflict between two of my peers while completing our PCP project. Student 1 was becoming frustrated with student 2 for acting withdrawn from our project at times, and stating that they did not want to promote or participate certain activities. I was aware that student 2 found some of the content of our project confronting due to the sensitivity of mental illness and knowing that their family was dealing with some mental health issues back home in Adelaide and they were trying to manage that from a distance, so I knew their coping mechanism would be to distance themselves a little bit at times. I could see that student 1 did not know about this, and was becoming frustrated with student 2 and it was impacting the flow of group work and the project at times. I decided after much deliberation to approach student 2 and ask them if I could tell student 1 about what was going on at home, in as much detail as they wished, so that student 1 would be more aware and the group could run more efficiently. Student 2 gave me that permission, so I spoke to student 1 and from there they were of course a lot more understanding and patient of student 2 and the group was able to be a lot more cohesive from then on.
What can OT bring to a community mental health setting?
- Perspective more relevant to occupational values and goals for consumers, placing emphasised value on independence and community engagement. OT have the skills to increase engagement with services by looking deeper into patterns of motivation, volition and occupation to suggest interventions that are most appropriate for the consumer, that match their occupational capacity and therefore provide them a sense of achievement, recover and therefore motivation to continue to work with the service to improve their quality of life relating to their mental health.
- OTs work well in a team, acknowledging and valuing the input and expertise of other professions in the team. Something that is empathised through uni, in the way the West team works, and an attitude that I hope to continue instilling into everyday practice.
- Example of integrating OT into my caseload? Bol, OT assessment, lacking motivation, suggested linking with IPS program and has agreed to engage in something for the first time I a few years.
- Assessments specific to NDIS, psychosocial supports, living arrangements etc, not forgetting that OT has the knowledge of how a person’s physical environment impacts on engagement in occupation and being able to make recommendations to consumers of other professions workload.
- Sensory modulation and integration in care coordination, could be an example question?
- I enjoy currently working in a community position, because aside from OT specific assessment and recommendation, there is the opportunity to incorporate OT principles into case management. Example above ⬆️
