Structured observation reports at the Activity Center

1. Structured observation reports at the Activity Center • A developmental project at the RPA-S • Background

2. Design • Observation reports • Assessment tasks – workshop and kitchen

3. Silver

4. How to make a silver ring • 1. Decide on size and width • 2. Mark length and width directly on the sheet metal • 3. Use the saw and cut along the outlines marked on the metal • 4. File the edges smooth • 5. Stamp the sheet metal (place of assay, silver content, year)

5. Wood

6. Textile

7. Textile cont’d.

8. Textile cont’d.

9. Textile cont’d.

10. Textile print

11. Ceramics

12. Kitchen tasks • Prepare a meal • Bake a cake • Make coffee

13. Observations • Comprehending instructions • Attention • Concentration/patience • Motor skills • Execution • Social/emotional • Compulsive behaviour • Questions asked when performing kitchen task • Conclusion

14. Example ”Anna” • Young woman (”Anna”) diagnosed with Asperger syndrome. The final opinion of the examination team was that she was suffering from a severe mental disorder.

15. Comprehending instructions/attention • Instructions; - ability to read and understand - ability to remember - ability to follow the instructions and do things in the right order • Ability to stay flexible if plans are changed

16. Concentration/patience • Ability to focus on the task at hand. Signs of impaired memory and/or attention problems? • Easily distracted by external stimuli? Distracted by thoughts, emotions and physical sensations? • Ability to work independently and ask for help only when it is needed

17. Motor skills • Gross/fine motor skills • Coordination • Fast/slow • Ability to use sharp objects in a responsible way

18. Execution • Skills • Accuracy • Ability to understand concepts such as weight and volume • Work motivation • Earlier experiences (workunits/kitchen) • Tidiness (workunits/kitchen)

19. Social/emotional • Behaviour before, during and after completing the task • Behaviour towards staff/other clients • Additional observations: characteristic personality traits; sadness, ’hyper traits’, suspicious

20. Compulsiveness • signs of compulsiveness: repeated cleaning and washing hands, ritualized behaviours (e.g. praying, counting, repeating words), unwanted obsessions • perfectionism and preoccupation with details, rules, order and symmetry; problems finalizing a task • difficulties to cooperate and ask for help when things are not going exactly his/her own way • rigid thinking, stubborn

21. Kitchen task: questions to ask • How does the client deal with similar situations in his/her every day life? • Is he/she used to follow food recipes? • What does the client think of his/her own performance? • Ability to estimate time allowance • Ability to briefly summarize the instructions

22. Summary ”Anna”

23. Evaluation - method • Survey to the examination team • Opinions from the staff at the Activity Center (positive/negative) • Forensic psychiatric examinations May – November 2009 - in how many cases were the observations from the Activity Center taken into account?

24. Survey • ”deeper, more nuanced view of the client” • ”the observations at the Activity Center have become a more integrated part of the forensic psychiatric examination” • ”the information has both emphasised and questionned diagnoses that I have evaluated” • support/do not support the results from the test

25. Statements from the Activity Center • Positive feedback • Negative feedback • Areas for development

26. Conclusion • Many staff members positive about the project and the new routines • Severe mental disorder (SMD) and the forensic psychiatric examination • Future aims

27. Want to know more? • lena.holmberg@rmv.se • annethe.bergholtzjohansson@rmv.se • lars.henriksson@rmv.se • helena.bohlin@rmv.se