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Archive for category: Occupational Therapy At Work

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The Role of Occupational Therapy in Adolescent Eating Disorders

Guest Blogger: Carolyn Rocca, Student Occupational Therapist, 2017

According to Statistics Canada, in 2012 over 130,000 Canadians over the age of 15 years old reported that they have been diagnosed by a health professional as having an eating disorder. Considering these high rates, and the likely underestimation of reported diagnoses, eating disorders remain a form of mental illness that are not openly talked about.

Eating disorder is an umbrella term for several categories of diagnoses, with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified being the most common. Although symptoms vary based on the diagnosis, some overall symptoms experienced with eating disorders include a pre-occupation with body weight, body dissatisfaction, behaviours to prevent weight gain, perfectionism, emotional dysregulation, depressed mood (including suicidality), anxiety, and low self-esteem. Naturally, these symptoms can lead to secondary impacts such as physical adverse effects, social isolation, and a compromise of occupation in the areas of self-care, daily living, leisure, and productivity (NCCMH, 2004).

The treatment and recovery of adolescents with eating disorders involves the collective work of many healthcare professionals including physicians, dietitians, nurses, psychiatrists, psychologists, social workers, teachers, child and youth counselors, and, yes, occupational therapists (Norris et al., 2013). Each of these team members works collaboratively to deliver the best practice approaches of pharmacotherapy, nutritional rehabilitation, and psychosocial interventions, including cognitive behavioural, dialectical behavioural, interpersonal, and family based therapies, among others (APA, 2006; NCCMH, 2004). Several of the healthcare professionals working with adolescents with eating disorders can deliver these therapies, including occupational therapists.

This means that occupational therapists work effectively with several disciplines to deliver best practice approaches, while also integrating their unique focus on occupational functioning to the team. Occupational therapists’ unique contribution is their ability to holistically address the physical, cognitive, behavioural, and psychosocial aspects of adolescent eating disorders through occupation-based approaches to improve adolescents’ self-worth and self-esteem (Kloczko & Ikiugu, 2006). As mentioned previously, eating disorders commonly have a substantial impact on adolescents’ function in the areas of leisure, self-care, daily living, and productivity (NCCMH, 2004), meaning many youth have difficulty balancing their family and social lives, education, employment, extra-curricular participation, ability to regulate their own activities, and thus overall health.

Occupational therapists have the expertise to work closely with adolescents and their family to help them with their goals around succeeding in school, work, leisure, and overall re-engagement in meaningful activities. In fact, Occupational Therapists are skilled at using meaningful activities as a vessel to get to the underlying problem of the eating disorder.  Sessions don’t focus on eating, food or binging behavior, but on being productive, enjoying life, and accomplishing things that matter.  The indirect influence is better choices in other areas (including diet) and recognizing the link between mental and physical health, quality of life and wellness.

If you know a teen (or adult for that matter) that may be dealing with an eating disorder, encourage them get help.  There is a team of professionals, including occupational therapy, that are skilled at assisting teens to recover from these, and other mental health issues.

 

References & Resources:

American Psychiatric Association (APA). (2006). Practice guideline for the treatment of patients with eating disorders (3rd ed). Retrieved from https://www.guideline.gov/summaries/summary/9318/practice-guideline-for-the-treatment-of-patients-with-eating-disorders

Kloczko, E., & Ikiugu, M. N. (2006). The role of occupational therapy in the treatment of adolescents with eating disorders as perceived by mental health therapists. Occupational Therapy in Mental Health, 22(1), 63-83. doi:10.1300/J004v22n01_05

National Collaborating Centre for Mental Health (NCCMH). (2004). Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. Retrieved from https://www.nice.org.uk/guidance/cg9/evidence

Norris, M., Strike, M., Pinhas, L., Gomez, R., Elliott, A., Ferguson, P., & Gusella, J. (2013). The Canadian eating disorder program survey–exploring intensive treatment programs for youth with eating disorders. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22(4), 310.

Statistics Canada: http://www.statcan.gc.ca/pub/82-619-m/2012004/sections/sectiond-eng.htm

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Don’t Dismiss the Basics– Handwriting is Still Important

Though we live in a digital age we should not simply dismiss the things that generations before us used to communicate:  such as face to face conversation, pen and paper, and handwriting.  Handwriting, though taught less frequently across the globe, has many benefits beyond the simple development of motor skills.  Take a look at the following from The New York Times that discusses why handwriting is still an essential part of learning, growth and development.

The New York Times:  Why Handwriting Is Still Essential in the Keyboard Age

Additionally learn how Occupational Therapists provide solutions for printing and handwriting success in the following OT-V episode.

 

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OT Success at the LAT

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

For those working in the personal injury and medical-legal fields, you will be familiar with the new License Appeal Tribunal (LAT)This LAT, effective April 1, 2016 was FSCO’s solution to long wait lists in the previous SABS mediation process whereby insurers and claimants essentially try to resolve disputes about claimant’s benefits, rehabilitation, or other denials and discrepancies. 

Recently, we received one of those “feel good” emails from a lawyer that was able to successfully argue for a client at the LAT – because of the information they received from the treating occupational therapist.

The email read like this:

…[the OT] prepared an attendant care comparison report for us, which we fully relied on at a LAT case conference today.  The client was also put under surveillance and [the OT] was able to extensively rebut all their findings, which we also relied on today at the case conference.  I truly believe we were successful today because of her hard work.”

I am biased, but occupational therapists are generally pretty awesome.  Where lawyers speak “legalese”, insurers speak “SABS ease”, doctors speak “medical ease”, occupational therapists speak “functional ease”.  We work hard to make sense of things – for our clients and our customers.  We want to help the client be understood and for others to know the true impact that an accident or illness has had on their day to day ability to manage important activities.  Chronic Pain, Depression, or even a broken leg does not really equate to much unless it is in the context of what that means for that person: for Mr. X, chronic pain means they can’t walk their kids to school, or assist them with homework, for Ms. Y her depression has resulted in her dropping out of her post-secondary program, losing her scholarship, for Mr. Z his broken leg is preventing him from working at both of his jobs and as a result he is unable to afford his housing and food for his family….

Sure, lawyers and insurers can put things into context without an occupational therapist, but I would argue that we are trained to ask different questions – questions that get to the heart of disability and dysfunction, while at the same time helping people to tell their story from a place of vulnerability and honesty.  We strip things down to be simple, but yet impactful in explaining what disability means to that one person.

We still find that some lawyers don’t involve an occupational therapist early enough.  They wait until the client is several years post injury to see if it is “needed”.  But guess what?  It was often needed the entire time, and waiting so long only served to leave the impression that the client was “functioning fine” because there would be little practical or functional data or evidence to indicate otherwise.  Have you seen doctor’s notes?  “Back pain, off work X 3 months”….not enough to explain the context of disability.

Occupational therapy is greatly important in the recovery, rehabilitation, medical-legal and personal injury domain.  And if we can’t help your client to live, manage or function better, at the least we can provide the information and evidence to help you to be successful in other areas of the claim, including at the LAT. 

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Helpful Tool for Managing Chronic Pain

Pain is a common occurrence following an injury, illness, or traumatic event like a motor vehicle accident. While pain does play an important role in alerting us to potential dangers, injury, or an impending problem, it can also become a significant barrier to function as it can often continue long after the dangerous situation resolves.

Chronic pain is difficult to treat and manage because of all the different factors that contribute to its intensity, frequency, and the many variables that can make it better or worse. Stress, depression, feelings of loss of control, pressures at work or home, and other mental or emotional factors affect pain perception.

Occupational Therapists often recommend keeping track of the intensity of your pain and the activities and/or variables which may have contributed.  Use this printable pain diary to help you and your healthcare provider monitor and manage your chronic pain.

Learn more about how Occupational Therapists help provide solutions for people living with Chronic Pain in our post:  Chronic Pain a Problem? Try OT

For more helpful tools visit our Printable Resources page.

 

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Take Heart– OT’s Provide Solutions for Living with Heart Disease

February is Heart Month and while many of our blog posts will focus on prevention through good health habits, we want to also provide you with some tips for recovery.

Heart disease has a major impact on an individual’s quality of life. It can lead to discomfort or chronic pain, activity limitations, disability and unemployment. “An estimated 345,000 Canadians aged 35 to 64 reported living with heart disease. More than a third (36%) of these reported needing help with household tasks or personal care” (Heart and Stroke Foundation of Canada, 1999). Heart disease requires lifestyle changes to prevent progression of the disease, further cardiac events and activity restrictions.

An occupational therapist, in conjunction with other team members, will help you determine what activities you can safely perform and how to modify activities to decrease the amount of energy required.  Learn more about the solutions an Occupational Therapist can provide in the following infographic.

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Solutions for Living with Spinal Cord Injury

The number one cause of spinal cord injury is car accidents, but falls in the elderly are also rising as precipitating factor.  Those suffering from a spinal cord injury struggle with mobility, bowel and bladder control, muscle spasms, and many other secondary effects of being unable to walk or use their upper body.  Occupational Therapists are integral to the process of adjusting to life post spinal cord injury as we look at all areas of function and promote independence through creative solutions to immobility.

Learn more about the solutions an Occupational Therapist provides in the following infographic.

Learn more about living with a spinal cord injury in our previous blog post:  Spinal Cord Injury 101 – Julie’s Picks.

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Goal Planning Guide

To assist you with your goal and resolution planning for the year ahead we present the SMART Goal Planner.  In our previous post, The Complete Guide to New Year’s Resolution Success, we discussed the need to create a SMART goal.  Which means a goal should be:

SMART (Specific, Measurable, Attainable, Relevant, Time-bound) goal setting concept presented on blackboard with colorful crumpled sticky notes and white chalk handwriting

Use this printable worksheet to help you create and achieve your SMART goals in 2017!

smart-goal-planning

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For more helpful tools for both Children and Adults visit our Printable Resources Page.

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Stress Management Tool

In our post from earlier this week, How Stress is Affecting Your Health, we discussed an important and often overlooked piece of the health puzzle:  stress.  Though some stress is natural and can actually be helpful, when too much stress begins to affect you on a daily basis it can become damaging to your health.

Use our following FREE printable worksheet to help you identify stressors, your reactions and to come up with solutions to help you cope.

stress-management-worksheet

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For more helpful tools for children and adults please visit our Printable Resources Page.

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How Stress is Affecting Your Health

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

We know that exercise, sleep and healthy eating are the three most prominent predictors of health.  But in exploring my own health issues of recent, I was reminded of another important key to this puzzle:  stress.  So, I put together my own simple health formula:

Eat well + exercise + sleep – stress = health.

Complicated, I know, but the impact of stress cannot be overemphasized:

In 2013, Statistics Canada reported that 23.0% (6.6 million) of Canadians aged 15 and older reported that most days were ‘quite a bit’ or ‘extremely stressful’, unchanged from 2012.  Females report slightly more stress than males, at 24.6%, to 21.3%, respectively.  That is a lot of stress.

While we know that some stress is good (“eustress”) and causes us to “up our game” and become better, stronger or more resilient, most is bad (“distress”) and can lead to a multitude of health problems including headaches, stomach issues, blood pressure increases, heart problems, diet and sleep disorders.  Further, often stress can resort to poor coping through alcohol and drugs, leading to even bigger issues (WebMD).

Honestly, I get it.  Stress is everywhere.  I feel stress as a mom, as a wife, as a daughter, as an in-law, as a sister, as an entrepreneur, a health professional, business partner, boss, pet-owner, neighbor, friend and honestly a human-being (did Trump really get elected?).  Managing this stress to the point of having a suitable deductible from my health equation is an important priority. 

So how does occupational therapy help?  Well, knowing that stress is a predictor of health, and that it is hard to rehabilitate people who are acutely and chronically stressed, focusing on stress-reducing strategies is one of the key foundations of helping people to function better.  Of course, the nature of the stress-reducing strategy will depend on the person, and how they rate and identify their main stressors.  However, typically occupational therapists help people to manage stress both actively and passively. 

Actively, we want people to identify their stress, work to reduce or eliminate this if possible, and start aligning their time with stress-reducing activities.  Meditation, relaxation exercises, deep breathing, scheduled breaks at work, exercise (even if mild), improved sleep, and changing roles at home or work can start moving stress along the continuum from problematic to manageable.

Passively, there are ways to avoid stress once the triggers are identified.  Proper planning of activities and events, avoidance of stressful situations or people, learning to say “no”, setting boundaries, and having a routine that does not allow stress to move in and start sleeping on your couch can prove helpful.

Ironically, exercise, sleep and eating well work to reduce stress as well, so if you can heavily weight the first half of my untested equation, you can still move things into the health stratosphere.  Parents need to remember too that kids also feel stress (school, sports, worries about this or that) so monitoring their stress is also important because they may lack the skills to identify or manage this themselves.  Play, games, sports, free time, adequate sleep, not taking school too seriously, and creative non-tech outlets are other strategies to help kids (and adults) de-stress and add deposits into their healthy bank account.

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Occupational Therapy Reduces Hospital Readmission Rates

The following article from The Toronto Star explains how important Occupational Therapy is for patients transitioning from the hospital to their home. An Occupational Therapist can help the person to adjust routines and techniques to help with normal activities of daily living, and help them return to doing the things they find meaningful.  Occupational Therapy’s involvement is also shown to lead to lower hospital readmission rates.

The Toronto Star: Doctors’ Notes: How occupational therapists can help with transition from hospital to home

Learn more about the many ways OT provides solutions for living in our OT-V video series.