Esteem team to the rescue!

I was extremely nervous to begin my psychosocial field work.  I learned we would be working with children, but despite my prior experience this was "nerve racking". The children I would be working with were a 'tad bit' different from the children I previously worked with.  They are homeless.  I had no idea about what exactly a homeless person felt, let alone a child who not only has to deal with the "normal"  children issues, now to add such a traumatic experience to  the mix.  What could I possible teach them?  Well, more than I knew.  After discussing with my teacher and group members about ideas of themes we should focus on, self-esteem was the best answer. So, I ran my first session.   The children were instructed to find pictures and words out of magazines that described themselves or depicted something they enjoyed to do.  It was through this activity that I realized how damaged the self-esteem was of some of the participants.  This gave me something not quite tangible, but a baseline to work with. Although our time is limited,  I look forward to working with this group in creating or improving self-esteem.  If I could atleast help just one child feel better about his or herself and realize that they are important and can do things exceedingly beyond their expectations I will be satisfied. 

http://www.fhfund.org/_dnld/reports/SupportiveChildren.pdf

IT CAN BE DONE

      To began, this penguin shows exactly how I was feeling going into my first fieldwork session.  I was nervous and absolutely weak to the knees. You don't really know what to expect. Unlike many of my classmates I chose to be placed on fieldwork with children that does not have apparent mental disabilities but struggle from so many other issues. Although I am a mother and can identify with the needs of children; no one could have prepared me for the setting of my fieldwork site.  I don't know what I was expecting but after my first visit I can tell you what I wasn't expecting which was the impact children can have on each other. I was surrounded by children that had little to call their own but yet the enjoyment that sparkled in their eyes just from a little game of "Simon Says" help me to realize just how thankful I should be for all I have.
      Although my first session was a little rocky, I had a chance to see just how much impact an individuals environment can have on them. I seen the kids fight for attention using different tactics such as name calling, yelling, hitting, using others as scapegoats, fighting, and pushing mentally to see how far they could go before we would stop them.  And although I had never been put in a situation like this, my first thought was "How can I use myself to impact these children for a lifetime?" Its amazing to know that we have the power to impact lives of people on a daily basis, this fieldwork has open my eyes to know that I am on the right path in my life
     My second session was more structured because we had a chance to observe what type of personalities we would be facing.  Just the little change in our position and structure in the activities gave such a completely different response from the group compared to the first session.  Seeing the difference in the children and responses to the different activities shows me that it can be done.  You sit in the classroom for 2 semesters awaiting for this moment but its nothing like you anticipate,  it is so much more fulfilling.  This has shown me I CAN DO THIS!!!!

this is only a test

testing testing 123

Fieldwork 101

I don't know what I thought fieldwork would be like before my first day, but it certainly has been challenging to say the least. I've been working at a facility where the population works all day, and my team and I come to engage them in recreational activities with them.  If I were working with a population that was working on the same cognitive level then it would be easier to plan therapeutic activities for them, but some have a lot less attention span and memory retention than others. That means that some of them loose interest quickly, while others don't remember the instruction they were given at the start of the activity. Others will refuse to engage in the activity when asked, but will join after they see the activity being done, or if they are asked multiple times.

So what have I learned so far?

I discovered quickly that we should plan multiple activities as well as activities that can be can be easily modified for the various members.

We also learned that this population truly enjoys the activities that we plan for them, even if they don't fully understand the activity. 

I also learned that you should probably ask the staff which members members don't like to be touched (and might hit you!) before you pat them on the back for a job well done!

How does it feel...to be real?

So here we are, really doing it--the work we are striving for each and every day. Sitting in the OTA classroom is child's play compared to being out in the real field. And I thought these tests were tough! The tough stuff is thinking on our feet and rolling with the punches when things don't necessarily go according to plan. Because I have a natural aversion to disorder and an affinity for routine, I am learning a lot about being flexible as an OTAS. When working with clients who have survived a Traumatic Brain Injury (TBI) the practitioner must be able to lead by example and follow along with differences in pace, attitude, and functional skill level. A seasoned OTA would probably not think twice about this but as a beginner, I have found myself challenged in new and exciting ways already.
So far my clients have surprised me with their humor and honesty. At times they speak freely about the accidents that caused their TBI, they discuss their past occupations, they share wishes for the future. It has been priceless to see them complete a difficult task with creativity and enthusiasm, only to get even more excited at joining them in their pride over a job well done.
Being part of this program and working with clients who actually suffer from a mental illness is giving me such a sense of gratitude and motivation--gratitude that I have chosen a field I can be truly passionate about and the motivation to work even harder to be of service to others. To succeed as a student and to become a certified OTA I will need to adopt and manifest the qualities I see in my clients every time I work with them--perseverance and an undying hope and faith in the future. Just as they strive to get better, to function as independently as possible, and to achieve more than they thought they could; so too will I learn valuable lessons from them if I pay attention and show up ready to work hard. 

Odd Man Out

Odd Man Out

Background:  This is my first fieldwork experience in the OTA department at Durham Tech.  I am assigned to a traumatic brain injury (TBI) center for people who are mildly/moderately affected by their injury.   All of the clients are mobile and can communicate to varying degrees.

Looking back, I was a little anxious about the experience.  The only real exposure I've had to the mentally ill has been the case studies that I'd read in Psychology class or the movies that I'd seen.  To say that the movies were stereotypical is an understatement, and the Psychology textbook only gives you the worst case scenarios.   I'd known some people with developmental delays, but the exposure had been limited.  I had questions about fieldwork.  What would it be like to interact with "real" people? What if I got there and it was too much for me to handle or it was unsafe?  What if it was like the movies???!!!

Let me back up.  Before we went out to the field site, some representatives from the center gave the OTA-180 class a briefing.  They wanted to establish expectations and allay our fears.  The main thing that I took from that session is that behavior is just a means to communicate.  (Keep that thought in the back of your mind when you go on fieldwork.)  They said that in order to better communicate, we needed to establish a connection to our clients so that we could better understand what motivates them.  This connection might enable to us prevent some frustrations which the clients feel, and, in turn, prevent behavioral extremes.

When I got to the fieldsite I was pleasantly surprised.  The center was nothing like what I'd seen on TV.  It was a beautiful place with large spacious rooms, nice/new furniture, and lots of windows to let in the natural light.  Everyone one was friendly.  They came up and shook my hand and introduced themselves.  They were willing to participate in whatever activities my classmates and I came up with.  They came to the table with a refreshing sense of openness and willingness to try new things.  They "jumped in with both feet," and they seemed to genuinely enjoy the activities.  Each time I left there with a feeling like it was a positive experience for both the clients and the OTA students.
 
There are 8 clients that we work with who have suffered from various types of head trauma.  Depending on the location of trauma, they range widely in their degree of difficulties.  A couple are almost completely aphasic, some have dysarticula, a couple have low vision, and a couple have flat affect.  I found myself wanting to communicate with all of them, but those that were expressive aphasic had difficulty talking to me.  I was unsure how much of my words they understood.

[Check out this link to learn more about the symptoms of TBI.
http://www.traumaticbraininjury.com/content/symptoms/severetbisymptoms.html  ]

It occured to me after I left, that the interactions that a client receives in rehab are somewhat affected by the location of  their brain injury.  Humans communicate with both their words and their facial expressions, but after a TBI that capability can be diminished in one or both areas.  I found myself talking more to those people who could understand me and who could express themselves.  I was a little embarrassed to talk to people when I couldn't understand the words coming out of their mouths.  Several times I had to ask them to repeat themselves.  Also, I tried to talk enthusiastically to all the clients, but those with a flat affect couldn't smile at me when we talked, and I didn't find the conversation with them rewarding.  I sometimes broke away from them to go do something else.  For those that could talk, I spent more time with them finding out about their likes and dislikes, establishing a rapport.  It dawned on me that those with better communication capabilities received a "richer" therapeutic experience.  I connected with them.  I came back to check on them more often to see how they were doing.  Since I had a rapport with them, I could make the activity more client-centered or ask them more pertinent questions. 

This realization makes me want to try harder to communicate with the aphasic clients.  They need my attention just as much as those who can communicate well.  Maybe I'll linger a little longer the next time there's awkward pause in the conversation.  And maybe I'll be enriched by the experience.  :-)

Fieldwork Fun

First of all, I cannot believe that we are already out on our first fieldwork! It seems just like yesterday that I was meeting all of my new classmates.

Ok. Here we go. I am actually having a really good time on my field work. The clients are interesting and our supervisor is great. It was a little nerve racking on the first day, but the second day got easier. I still get nervous at times because there are those moments of…crickets, crickets…um, what do I do now? You know, times where there is awkward silence or  times when a client may say or do something inappropriate and I don’t know how to respond. Naturally, I have a tendency to laugh when someone says something funny, but I’ve learned that I have to restrain from laughing sometimes because of the goals that a client from this
population may have.

I’m looking forward to continuing this experience for the next 8 weeks and getting to know each of the clients. It will be a wonderful feeling if I can make a small difference in one of their lives!

MY EXPERIENCE

I expected something totally different then what I saw going into the facility. Seeing how well they were doing on their own, inside the facility, able to express themselves, and very mobile was a surprise. I was happy though, because I was able to widen my activity list. The group is well behaved, but their attention span is short. They are a bit touchy feely, but after giving them other options to express themselves it was a great second and third experience. For example, creating a special hand shake when we see each other helped eliminate a lot of the hugging and touching and grabbing of the arms and hands. I have to admit I was expecting my group to be more dependent on others for simple things, for example turning on the TV, remembering where the bathroom is located, or how to play a board game. I felt as if I was stereotyping a group of people that was nothing like I thought they would be. Some of them were able to remember my name or my face the second or third visit to the facility. I liked that. I don't think the classroom learning really prepares you for the real thing, but it helps by giving you an idea of what it might be like when working with a person with a brain injury. I am a hands on learner anyway, so I really learned a lot by going to the facility and working with the group and seeing what they are capable of doing for themselves.