Reflection from Level I FW C

Here is my reflection from my rotation an inpatient psychiatric hospital!

12-Step Meeting: Nar-Anon Family Group

My oldest brother Wesley has been an addict for over 10 years, so every now and then I will accompany my mother to a Nar-Anon Family Group.  I have been to a handful of these, but I am going to refer to the most recent one I attended.  On January 17th of this year, I attended a one hour session with my mother in a classroom at Hope Church.  This group is not affiliated with any religion: Hope graciously allows them to hold their group there.  In this specific session, we discussed the concept on enabling.  In our Groups OCP class, we have also talked about what enabling means; however, in that context ennabling someone meant helping them get to their full potential.  In the context of addiction, enablement means that you are encouraging a loved one to participate in a dysfunctional behavior.  In this session we learned that in most cases, enablement comes from good intentions, but it something you must will yourself to resist in order to ultimately help the one you love overcome his/her addiction.  The leader of this group is a father of an addict who is now sober and he assumes a role of a peer.  Since this group is a mature group that (usually) consists of cognitively unimpaired adults, the group leader simply acts as one of the group who casually leads the discussion.  He never acts as if he has all the answers and typically allows the other group members to provide answers to questions given by other group members.  He encourages dialogue within the group by creating an inviting environment: coffee is provided and everyone is in a circle. The room is rather open so we never feel trapped or claustrophobic.  The most calming thing about the environment is the fact that we are amongst those who know the struggle of loving an addict.  It is a "safe" zone to let out your frustration or anger and not feel guilty for it.  I have never encountered any type of judgment in this setting before.  Sometimes, there are individuals who tend to take all the "spotlight" and overshare.  The facilitator will remedy this problem by directly asking other people to share their thoughts about the subject.  I would definitely consider this experience to be therapeutic.  At my angriest points, I feel understood and my tank has been filled with encouragement and empathy.

Specifically, this session in January resembled a Cognitive-Behavioral group.  Many people who have addicts in their family will give them money (which they ultimately spend on drugs), allow them to stay in their homes, or just simply take on the negative consequences that the addict has created.  We do this because we think we are helping them, but we are not actually helping anything.  Part of the problem is that addicts have a "warped" mindset and blame us if we do not "help them out".  It is truly a terrible spot to be in.  This theory was used in this group session because in order to change the enabling behavior, we must first change our thoughts about what enablement really is and the harm it can cause ourselves and those we love.  This is a hard mindset to break and cannot be done overnight.  Accepting the fact that we are not the ones who can help the addicts in our lives is the most useful thing I got out of this session.  The addict is the only one who can make the first step to recovery.

What I have learned from these experiences is that sometimes I feel like my family was dealt the worst hand with Wesley, but that is not the case.  I hear the stories of these other individuals and I see that they struggle just like we do (if not more).

Fortunately, as I have said before, Wesley is now at the Warriors Center which is a rehab for men.  He is making great progress there.

Thank you for allowing me the opportunity to share on this aspect of my life.  I don't often get the chance to.

Article Reflection: Effectiveness of a Sensory-Enriched Early Intervention Group Program for Children With Developmental Disabilities

Blanche, E., Chang, M., Gutierrez, J., & Gunter, J. (2016). Effectiveness of a sensory-enriched early intervention group program for children with developmental disabilities. American Journal of Occupational Therapy, 70(5). doi:10.5014/ajot.2016.018481

The purpose of this article was to observe how effective a group program called the Interdisciplinary Sensory-Enriched Early Intervention (ISEEI) for children who have developmental delays.  ISEEI was designed in part by occupational therapists and can have up to 12 children in a group.  Ideally, the ratio of adult to child is 1:3.  This program involved consultations in the home, excursions to parks or places of recreation, and courses designed to train parents of those with developmental delays.  The children in this study attended the group program 2-3 times for week for 3 hours each time. The protocol for this group involved addressing themes such as social interaction, motor development (gross and fine), development of cognition, and communication/language skills.  For this study, each child was given individual goals based on assessment, medical history, and concerns of the parent.  Progress was recorded every 3-6 months.  The clinical bottom line for this study is that results showed that this protocol demonstrated statistically significant improvement in all developmental areas for those with sensory processing disorder(except fine motor skills).  Those without sensory-related difficulties showed significant advancements in language/cognition.

The most interesting and useful aspect of this study was that it broadened my knowledge of who the groups process can be useful for.  While in this class, I usually associate group interventions with people who have mental health related diagnoses; however, it is true that any population can benefit from group intervention.  The children in this study were in between the ages of 18-36 months which means that the role of the facilitator was most definitely directive.  This article does not explicitly say which frame of reference they used, but I mostly associate this population with Allens Cognitive Levels because those with cognitive impairments closely resemble the mental capacities of children in most cases.  In my Perspectives of Adulthood class, we were first introduced to the concept of Allen's Cognitive Levels.  We were taught a way to remember what the characteristics of each level is to think of the age group it resembles.  For example, Level 1 resembles the cognitive abilities of someone 0-12 months and level 3 is associated with someone 18 months to 3 years old.  That being said, the Developmental theory closely applies because the purpose of the study was to develop age-appropriate skills for each child.

One thing I learned from this article is that groups can also involve the caregivers as well.  When we made our group protocols for this class, we always had to keep in mind the client population; however, there are some cases in which we will involve the caregivers into the group process and their needs must be taken into consideration.

I enjoyed this experience because every time I read an article, I get one step closer to being a well-rounded, evidence-based practitioner!

Group Facilitation - Exploring Volunteerism

On February 26, 2018, I facilitated a group entitled "Exploring Volunteerism".  During this group, I was given the opportunity to facilitate on my own and bring a protocol that I created to life.  During the introduction, I believe I was not very sure of myself and I am sure my voice was a bit shaky (this tends to happen when I speak in front of others); however, when we moved on to the first activity, I became more comfortable with my group and it evolved into more of a dialogue.  The first activity was my favorite because the handprint craft allowed a more relaxed and informal setting and elicited a more open conversation between group members.  My second activity, the Volunteer Match website, went much better than I anticipated.  I was pleasantly surprised when my group members said they would use this tool in the future and might even use it for their own clients.  I think the Blue group is very unique because we all give input and participate to the best of our ability in these groups, and that was definitely true with the one I facilitated.  I anticipated this group to not be as exciting as the others because we are all required to get volunteer work for the MOT program, so volunteerism is not a foreign thing to any of us.  Despite that, my group shared and processed the information in a wonderful way.  I believe this group session went by effortlessly and lasted the appropriate amount of time.  My biggest take-away from this group facilitation was that I became more comfortable being in a position of authority and speaking in front of other people (which, will no doubt be a part of any occupational therapy setting I eventually become involved in).  Ultimately, I believe this facilitation was very beneficial for my learning.

Leadership Summit

Leadership Summit with Lauren Murphy and Audrey Robertson

Today, I met with Lauren and Audrey to discuss our individual group facilitations for life skills.  Since I have already turned in my rough draft for my group next Monday, my plan as already completed. I discussed this plan with the group and they gave me feedback.  They liked my activity ideas and provided specific suggestions on how to tweak them to make it better.  Lauren and Audrey had not yet turned in their respective rough drafts, so we also spent some time brainstorming about activities they could do and possible theoretical approaches they could take.  The most useful aspect of this group was getting my peer's input on how to approach my facilitation using my theoretical approach.  I told them how I could tie in the Cognitive Behavioral Approach and they gave me more insight as to how I could further defend my theoretical approach when the time came.  Since Audrey and Lauren both chose Allen Cognitive approach for their theoretical basis, they were given the opportunity to discuss strategies and critique one another based on their chosen approach.  This experience helped further refine my group skills and aided me in my process of putting the final touches on my group protocol.  

Group Facilitation - Conflict Resolution

Group Facilitation Reflection

Yesterday, Lauren Murphy, Sarah Caldwell, and I facilitated a group on conflict resolution.  I thought this group facilitation was rather painless and quite enjoyable once we were actually doing it.  The planning aspect did not take too long - my partners worked well together and we came up with a written plan within an hour.
Our introduction was unlike many other groups I had been in previously...We started off by explaining the group and expectations; however, we started off by asking them some ways they have handled conflict in unhealthy ways.  We decided to break the ice in a hard-hitting manner.  I noticed that our group members were hesitant to answer initially, but once they started speaking everyone became a lot more comfortable with each other.  Our activity went just as planned - we estimated how long each activity would take beforehand so we would not be crunched for time.  Our activity elicited insightful responses from our group as well.  They shared personal experiences with conflict resolution, which I believed help us build rapport with one another.  After the exercises were completed, we reflected on what we learned.  I thought that the group members were not going to share much of what they learned because as graduate students, I expected them to be well-versed in conflict resolution strategies.  However, all of them contributed to the conversation about that they learned and how they can apply is to real-life situations.  I believe the atmosphere we created encouraged conversation and gave each individual sufficient time to answer the questions.  We did not cut anyone off during their moment to speak and only transitioned to the next question when everyone was done speaking.  Ultimately,  I think our group did pretty well for our first group facilitation experience.  However, I do believe this would be much more difficult if our group members has some sort of disability.

Preventing Alzheimer's

Today I listened to a Ted Talk by Lisa Genova, the author of the novel Still Alice.  In her talk entitled "What you can do to prevent Alzheimer's", Lisa describes the pathology behind the most common neurodegenerative disease and possible ways to protect your brain from it.  She explains that Alzheimer's Disease (AD) is caused by plaques of amyloid beta accumulating within the synapses in a brain.  This phenomenon occurs naturally in the brain as it ages, but it becomes a problem once the number reaches a tipping point and becomes Alzheimer's disease.  Although there is no cure for this disease, Lisa suggests that certain measures can be taken to help prevent these plaques from reaching their tipping point.  Cardiovascular disease and lack of sleep are two examples of health problems that lead to an overgrowth of amyloid plaques in the body. If we make an effort to decrease these stresses on our bodies, then it can significantly reduce the risk of developing AD.  Preventative measures are more effective than trying to treat AD once you have it; however, she goes on to say that the effects that AD have on the body can be reduced through neuroplasticity and creating more connections in what she calls a "cognitive reserve".  For example, learning a new language like Italian will stimulate the brain and therefore create new connections.

I chose this for my neuro note because I have been interested in Lisa Genova's work ever since we discussed her book Still Alice during class.  I think it is remarkable that she is a neuroscientist and a talented author who has the creativity to implement her knowledge through a work of fiction.  After seeing this Ted Talk, I am going to continue my knowledge through reading Still Alice.  She briefly discussed how the main character, Alice, has a rare genetic component that put her at a great risk to develop AD. I also wanted to learn a little more about Lisa's background, so I explored her "About Me" page on her website: http://lisagenova.com/about-lisa/

She appears to be a truly intelligent person.

My main take away from this video was that Alzheimer's Disease is not necessarily inevitable. It seems that if someone lives long enough, he/she will more than likely get this disease.  However, science is making some serious headway with finding preventative measures and hopefully someday, a cure. As an occupational therapist, it might be a good idea to show this Ted Talk to someone recently diagnosed with AD so he/she can begin to facilitate ways to promote neuroplasticity.  This video could bring hope to many people.

Genova, L. (2017, April). What you can do to prevent Alzheimer's [Video File]. Retrieved from https://www.ted.com/talks/lisa_genova_what_you_can_do_to_prevent_alzheimer_s#t-820240