Occupational Therapy and Meaningful Occupation

1. Occupational Therapy and Meaningful Occupation Stephanie Hayes September 14, 2006

2. What is occupational therapy?

3. Occupational Therapy • Occupational therapy is the “art and science of directing an individual’s participation in selected tasks to restore, reinforce, and enhance performance, facilitate learning of those skills…that are essential for adaptation and productivity,…and to promote and maintain health. (AOTA 1972) • It includes using assessment by means of skilled observation or evaluation through administration and interpretation of standardized or non-standardized tests or measurements. (AOTA 1994)

4. Explaining Occupational Therapy • Occupational therapy is skilled treatment that helps individuals achieve independence in all facets of their lives. Occupational therapy assists people in developing the "skills for the job of living" necessary for independent and satisfying lives (www.yahoo.com) • At Positive Directions, we focus on the skills in which the clients need to improve to move from transitional housing to independent living

5. Housing Education Employment Time Management Leisure Pursuits Medication Management Household Management Transportation / Community Mobility Computer Skills Shopping Skills Cooking Skills Financial Management The OT Focus at PD

6. Occupational Therapy Interventions • Facilitate adaptation, develop role competencies, and increase the client’s ability to function productively and independently • Centered on and directed by the individual's belief of that which is meaningful • Assist in rebuilding identity through the tools of engagement in meaningful occupation

7. What is meaningful occupation?

8. Definition of Meaningful and Occupation • From the dictionary • Definition of Meaningful • Having significance, purpose, function, or value; purposeful; significant • Definition of Occupation • That which occupies or engages time and attention • The principle business of one’s life- vocation, employment, calling, trade (www.dictionary.com)

9. Dictionary Definition: Meaningful Occupation Something significant or purposeful that occupies or engages time and attention or is the principle business of one’s life

10. Occupational Therapy Definition: Meaningful Occupation • Activities… of everyday life, named, organized, and given value and meaning by individuals and a culture. Occupation is everything people do to enjoy themselves including looking after themselves, enjoying life, and contributing to the social and economic fabric of their communities. (Law et al. 1996) • Chunks of culturally and personally meaningful activities in which people engage (Clark et al. 1991)

11. Characteristics of Meaningful Occupation • Meaningful occupations are not simple things • Have emotional, cognitive, physical, temporal, and contextual dimensions (AOTA Position Paper 1995) • Example- Financial Management • Emotional: Does it make you feel good to hold on to money or to spend it? • Cognitive: Personal thoughts: Is saving money important? / do you live in the present or look to the future? / What is the thought process when you have / don’t have money? • Physical: Budgeting worksheets used / act of getting or holding the money • Temporal: The day of the week or month may determine your view on money or managing money • Contextual- Cultural views of money or managing money

12. Characteristics of Meaningful Occupation (cont.) • Shaped by culture • Purpose and meaning are located with the client not the activity • Unique to an individual • Expression of identity and values

13. Using Meaningful Occupation Therapeutically • To develop rapport • Ex. OS • To facilitate the development of skills and abilities • Ex. JJ • To demonstrate and realize their potential • Ex. AL • As the goal to be achieved • Ex. EB

14. The Goal of Using Meaningful Occupation Therapeutically • The “Just Right Challenge” • An optimal fit exists between the demands of the person, occupation, and the environment • Causes clients to be motivated to continue or repeat their experience • Contributes to greater life satisfaction (Rebeiro & Polgar 1998)

15. When the “Just RightChallenge” is Not Achieved • Absence of optimal experience causes a lack of satisfaction in the task • When challenge is greater than client’s skills- Anxiety can result • When client’s skills are greater than the challenge- Boredom can result • If either situation occurs, the client may become apathetic or frustrated, and eventually shut down • Multiple absences of optimal experience can lead to a lack of satisfaction in life (Rebeiro & Polgar 1998)

16. How To Achieve the “Just Right Challenge” • Evaluate the person, environment and occupation to determine current capabilities • Modify either the environment or the occupation to fit the person’s current capabilities • Making the overall job as enjoyable and successful as possible

17. SB and Room Organization • Person: Physically capable of cleaning his room; understands that his room is messy; doesn’t know where to begin; easily distracted • Environment: Extremely messy, overwhelming, many distracters, very stimulating • Occupation: Cleaning trash off the floor, organizing clothes and shoes, organizing papers, finding places to store his things • Modification to Environment: Shut the door in his room so he can’t get distracted by outside stimuli (phone) • Modification to the Occupation: Help him find a place to start; cue him as to what should be next • Most Important: Always let him do the work himself and feel proud of his job

18. Acts as a motivator Provides a sense of achievement and accomplishment Allows people to personally express themselves Reconnects people into social networks/ build relationships/ bring sense of belonging Builds self- esteem/ developing self identity Develops skills necessary for independence Helps organize time Develops ways to cope with stress Discovers previously unknown capabilities Benefits When the “Just Right Challenge” is Achieved (AOTA Position Paper 1995); (Bryant, Craik, and McKay 2004); (Christiansen and Baum 1997- Allen et al 2000); (Eschenfelder 2005); (Mee and Sumsion 2001); (Mee, Sumsion, Craik 2003)

19. Importance of Meaningful Occupations • Purposeful use of time is biological necessity • Brain slips into constant chaos and confusion unless we constantly use it for activities worthwhile to us • Having occupations can result in finding ultimate meaning in ones self and life (Mee and Sumsion 2001)

20. Importance for Our Clients • People with mental health needs are prone to experience occupational deprivation (Mee and Sumsion 2001) • When illness or disability enters a person's life, his sense of self or identity can be threatened or lost and an his capacity to engage with the world can be challenged. Problems may stem from personal constraints such as thoughts, feelings, or actions, or environmental or socio-cultural constraints. For many, this experience is difficult to deal with as they first deal with the loss and then begin the journey to rediscover or redefine themselves. Participation in meaningful occupation is an important part of redefining themselves. (Department of Occupational Therapy University of Texas Medical Branch) (Henare 2003)

21. Continued Loss Of Meaningful Occupation • Causes absence of opportunities • Causes a sense of estrangement • Prevents people from trying or doing things • Causes loss in social relationships • Causes a decreased self-esteem

22. From Start to Finish • EB and Employment