Occupational therapy - Case Study Example

? Case Study Report: Occupational Therapy CASE STUDY REPORT: OCCUPATIONAL THERAPY Psychosocial Influences to Occupational Performance Major depressive disorder, MDD or clinical depression is a disorder of the mind whose manifestations includes an all round low mood, lack of interest in activities that one initially enjoyed, and low self-esteem (Beck, 2009). MDD is a condition that disables its victim’s health, eating and sleeping habits, school and work life, as well as family. Approximately 4% of victims end up committing suicide, while 65% of those committing suicide suffered from MDD or some other form of mood disorder (Beck, 2009). The patient’s experiences, reported by them, friends or relatives, as well as examinations aimed at mental status are the major diagnostic basis for the disorder. Depression is most likely to afflict individuals aged between twenty and thirty years. This may however peak towards the late thirties. Treatment is done using antidepressants together with counselling and psychotherapy (Creek & Lougher, 2008). In cases where the disorder has brought on self-neglect, the patient requires hospitalization. The disorder has no fixed course and may last for a week or stretch to a lifetime punctured by episodes of major recurrences (Beck, 2009). This paper aims to present a case study for a patient suffering from depression and the role to be played by an occupational therapist. Mary-Scott is a twenty-year-old married woman of mixed race. She visited her physician with major depression disorder symptoms. She was suffering from sleeping difficulties, recurrent suicidal attempts, psychomotor retardation, significant energy loss, anhedonia, and sad feelings (Beck, 2009). She denied the existence of previous medical issues of significance and reported that the symptoms had begun after she caught her daughter having an affair with her stepfather seven months earlier. She revealed that she had been experiencing these symptoms on and off for the past six months and that they had greatly altered her ability to enjoy her marriage and be effective as a bank clerk. She is currently suspended from work for disruptive behaviour and increasing isolation, with her boss referring her to the physician. Upon the physician’s inquiries, she did not mention any previous pharmacological or psychiatric treatment aimed at treating these disorders. Her hypertension and obesity had recently increased due to her inactivity and bouts of binge eating. Major depression disorder may affect the occupational performance of the patient. It affects the following aspects: Task performance: major depression disorder makes it difficult to manage responsibilities at work and in her daily tasks (So?derback, 2009). Social interactions: patients who suffer from major depression disorder tend to avoid human contact, including friends and family. They become defensive since shunning communication makes conflict resolution more difficult. When it becomes impossible to avoid communication and they are forced to interact, conflicts are the result, causing frustration and anger (Stein & Cutler, 2008). Depression can also lead to memory difficulties and loss both in the long and short term, making of decisions, and loss of concentration (Willson, 2008). Depression also makes it difficult for the patient to enjoy their day-to-day life. Individuals will shun common fun and leisure activities that they enjoyed, leaving them isolated (Willson, 2008). Depression is also a major cause of disrupted sleep patterns and reduction in the levels of energy. This leaves patients tired and easily distracted (Willson, 2008). Occupational therapists have come up with strategies to help individuals with this disorder using various assessment tools to gauge just how best to help the patient. One tool that is applicable for MDD is OPHI-11 (Binswanger et al, 2011). This is an interview on history intended to give a detailed and broad appreciation of the patient’s life history, direction the patient wishes to take their life, and the impacts of the disorder (Binswanger et al, 2011). Occupational settings, occupational competence, and occupational identity are identified and explored with the aim of giving a richer and fuller picture of the client. It was designed to be used in conjunction with a patient seeking occupational therapy who is capable of responding to an interview on their life history (Binswanger et al, 2011). The occupational therapist is helped in the conductance of the interview by recommended flow charts and recommended questions. The obtained numbers measure the client’s environmental impact, competence, and identity. OPH1-11 keys possess the following advantages (Cara & Macrqae, 2005): Conversion of ordinal data levels to interval data levels sans computer analysis. Allow for calculation of measures even in the instance that data is missing. The therapist is warned in time when a client rated on the scales starts to deviate away from the usual ratings pattern. In the management of the disorder, two long-term goals can be set: 1. The first one is maintaining stability of emotions, which aims at achieving diminished major depression symptoms (Cara & McRae, 2005). Short-term goals a) The occupational therapist should work toward ensuring that the client attends her therapy sessions on time. This should take approximately six months to start achieving results. Intervention: Occupational therapists should encourage the client to express her depressed feelings verbally to her therapist. b) Encourage Mary-Scott to report all the symptoms that were worsening to her psychiatrist or social worker (Binswanger et al, 2011). These symptoms include fatigue, changes in appetite and sleep patterns, anhedonia, and depressed emotions and mood. Intervention: The OT should be on the lookout for any changes in behaviour and challenge her to comply with her psychiatrist. If this is done effectively, the client should begin to show improvement. c) Proper use of psychotropic drugs like Neurotin, Lexapro, and Doxepin prescribed to them and reporting of any negative side effects (Binswanger et al, 2011). Intervention: aid the client to comprehend the importance of compliance with psychiatric medication by reviewing past cases worsened by poor drug regimen. 2. Psychotherapy as a Long Term Goal Short-term goals include cognitive, behavioural therapy, interpersonal psychotherapy, and dialectical behaviour therapy. These treatments are short-term measures and the result of their use can be measured (Cara & McRae, 2005). These therapies involve the recording of specific thoughts by the therapist and the client with the aim of correcting themes that have been distorted by the major depression disorder (Cara & McRae, 2005). These short-term goals also involve experimentation with non-distorted and new ways of thought. The client is given weekly assignments to take home. Interventions: the occupational therapist’s role has to do with education, maintaining a relationship of positivism between them and the client, and shaping new behaviours and thinking (Cara & McRae, 2005). The family and spouse should also be utilized as reporters of the client’s positive changes. While aiding in maintaining positive relationships throughout the period of therapy, the occupational therapist also acts during sessions as active participants (Cara & McRae, 2005). Interpersonal therapy’s basis is on the premise that the symptoms being exhibited by the client are because of rocky relationships with those around them (Cara & McRae, 2005). Interventions are thus done via family work in order to improve home skills at communication. Therapists act as information sources by utilizing social skills training and building the client’s courage, and advocating for them. References Beck A. T. (2009). Cognitive therapy of depression. New York: : The Guilford Press. Binswanger R, Spindler I, & Therapists, W. F. (2011). Occupational therapy today- tomorrow; its present position and the possibilities of development. . Basel, New York,: Karger. Cara E, & MacRae A. (2005). Psychosocial occupational therapy : a clinical practice. Clifton Park, NY: : Thomson Delmar Learning, . Creek J, & Lougher L. (2008). Occupational therapy and mental health. Edinburgh ; Toronto: : Churchill Livingstone/Elsevier. Long C, & Cronin-Davis J. (2006). Occupational therapy evidence in practice for mental health. Oxford, Angleterre ; Malden, Mass: Blackwell Pub. So?derback I. (2009). International handbook of occupational therapy interventions. Dordrecht ; London: Springer. Stein F, & Cutler S. K. (2008). Psychosocial occupational therapy : a holistic approach. Albany : Delmar publishers. Willson M. (2008). Occupational therapy in short-term psychiatry. Edinburgh : Churchill Livingstone. Read More