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What does this mean for my occupational therapy practice?
What does this mean for my occupational therapy practice?
From my personal experiences:
Meet people where they are at
Build therapeutic rapport with the client
Listen to people lived experience.
Intercultural Knowledge
Intercultural Knowledge
definition: an understanding of multiple worldviews, experiences, histories, and power structures.
From my personal background of being Swiss-American and lived in both California and Switzerland I feel competent in intercultural knowledge in Europe and the United States but I learned specific cultural items about Ireland thanks to this course. I've have a double life between these two places my whole life and thus have understood the implications of different cultures on a person's occupational engagement. I understand more about the meaning of having a cultural identity, as I have grown up speaking Spanish in school due to a Spanish immersion program but am not from a Spanish speaking county yet I still feel a cultural meaning towards Spanish speaking cultures.
Geographically Ireland can fit in California 7 times. Ireland's population is 4.8 million and California's is 36.6 million people. (Google, 2019; McCarthy, 2019)
the size of these two locations are vastly different with different healthcare, societal systems or even religion and education.
Ireland has a catholic context in society which offers perspective on their thoughts on morality. For example in the Magdalene Laundries if women were pregnant outside of wedlock they'd be taken in and their newborn would be taken away and they were shunned inside this institution until a man of her family asked to release her.
California has various religions within it's population, creating a challenge for uniformity other than a democratic vote.
It in theory is easier for a smaller country like Ireland to try alternative practices or new realms of practice or a prototype of a business as the are less people and it may be easier to influence society. Smaller countries may have more power to change the world.
What did I learn from Ireland's mental health services?
What did I learn from Ireland's mental health services?
Stigma and Sanism is deeply in our developed countries societal perspective
Documenting objectively and in the persons words is more valuable than documenting what we deem to be our clinical thinking.
from the case studies at St. Patrick's Mental Health Services
In order to understand a system, one must listen to someone's lived experience to be authentic and accurate
listen to the people! - @Jigsaw @St. Patrick's
Support people where they are. Free supported communities that are accessible, available and reliable. Analyze people's contexts and how that impacts their occupational engagement.
Jigsaw's mission: "We advance mental health of young people in Ireland (aged 12-25) by influencing change, strengthening communities, and delivering services through out evidence- informed early intervention and prevention approach"- (Lowry, personal communication, 2019)
"What does ____(diagnosis)___ mean to you?"- Jigsaw
"The right help, at the right time, in the right place"- Jigsaw client
Educating the general population: providing accessible knowledge to undeserved populations on what they want or need
Jigsaw attempts at changing society's perspective on mental heath in the youth by providing workshops for both young people and adults
Anew Support Service: homeless day program for mothers to be, new mothers or mothers seeking help have peer-lead groups
Having a limit to your services can drive motivation to work on goals and also sets boundaries for both client and staff
Jigsaw- 1-8 sessions
Sli Eile - 18 months
St. Patrick's Hospital 36 days
If an OT does their job- they are obsolete in the client's life because you have taught them how to OT themselves. - Eoin and Karen
Interdependence: independence with a supported community
Eoin advocates for interdependence rather than independence as we strive with the support of not being lonely.
Trans disciplinary teams in Jigsaw creates a equal work environment of all working in a team for the client's goals
Laura Hess discussed this in Peds 1 course at Dominican as a strength for practice but challenging to execute in practice because every profession has a large caseload thus making scheduling meetings for each client difficult.
Sli Eile's supported self- directed living
Irish Guy in Galway: Main takeaway from Ireland is the sense of community. Whether it is religious, cultural, language, perspective, age, occupations, there is a sense of working together towards a common goal.
Collectively we try new approaches in the intention of no harm but that is not always the outcome
Women's trauma of not being able to be with their newborn and create a life or the grief of a life they never could have. They have the trauma of being locked away until a man "saves you". - Laundries
Authoritarian people in the medical model can be wrong
Eoin's 10 different diagnosis labels
Doctors try to "do no harm" yet prescribe medication with more side effects than benefits
Psychiatrist there only to diagnose and "tick off" if the person is able to make decisions on their own or not.
Forensic OT where people in prison or the justice system serving people who committed a crime due to their diagnosis or they had a diagnosis and the crime was a response to it.
Create a strong rapport and therapeutic use of self in order to gain the client's trust to work together on goals
personal Fieldwork experience
Eoin
DCU Student Support & Development Lecture
Give people occupations and things to do with meaning
Though Sli Eile said they only had an OT for a few months they gave their people occupations to do with responsibility a sense of community with the Saturday Market and the bonding experience of people going through similar challenges and creating something they can be proud of. This gives them confidence - Sli Eile
Listen to people's lived experience to elicit change
@ Jigsaw
Lived Experience sharers & movies & books & articles or webpages like Mad in America
Mary Maddock's book
Global Interconnection & Global Citizenship
Global Interconnection & Global Citizenship
def: refers to the societal philosophy of being part of a larger community and responsible for challenges faced across border lines and oceans. (Google, 2019)
def: an articulation of one’s role as a global citizen and a recognition of diverse and potentially conflicting positions vis-a-vis complex social problems (McCarthy, 2019)
We live on one common earth. Everyone has that in common, they look at the same sun, the same stars and thus we are already all connected. Some common issues are preventing coral reef deterioration, climate change, poverty, mental health in youth, free healthcare, and using sustainable resources.
I've always considered myself a citizen of the world. I've lived in Switzerland and California and traveled to other corners of the world to learn about their world but I have realized that OT around the world are working in unison. I want to have a fieldwork in each language I speak.
Education System
Though the education system is slightly different, we learn the same material.
In order to become an occupational therapist in Ireland one must qualify a high number on the secondary school (high school) leaving certificate (exam taken in order to qualify for college). Once in a university, the course sequence takes 3 years for a bachelors including fieldwork. (DCU student support & development, 2019)
In general university in Ireland cost up to 5,000 Euros per year unlike Dominican costing 62,000$ at most per year. (DCU student support & development, 2019; DUC Website) Bachelor degrees in europe are generally 3 years whereas in the United States it is more likely to be 4 years.
When discussing OT issues like the lack of Mental Health care with the UCC students it reminded me that even though these students are embedded in a context that is half way around the world, we are challenged by similar issues.
The girl, Nicolette had gone to Denmark for her fieldwork 2 and I find it more common in Europe to do Eramus, or the study abroad organizer in Europe for studies or internships. The idea of completing a fieldwork 2 abroad had already been a goal of mine but hearing this reminded me to put in the effort to plan it.
The world is small. There are many common experiences across borderlines and oceans. Each person has a story to tell and rather than our countries limitations be our own, we must share our human experiences with the world.
The world is small. There are many common experiences across borderlines and oceans. Each person has a story to tell and rather than our countries limitations be our own, we must share our human experiences with the world.
Influence of people on society & vice-versa
We do control our society but it takes longer to change what society thinks. We have more influence now than ever before because of social media and the strong relationships people can have with distance. The global effort to work together is present in well developed countries among the elite but is sparse outside of that. Because different countries have different cultures it is the more efficient way to create a prototype business or society influence to observe and reflect on it's effect on people. For example in the United States it takes longer to change societal thinking due to the large population. Ireland's context of religion for example is limiting to progressive women's rights or LGBTQ+ openness. For instance the last laundries in Ireland closed in 1990.
The environment and it's context are made for specific expectations in people without accommodations but the environment is faulty if it does not include all of the components in it's context. The environment is faulty not the person. We create coping mechanisms to deal with the events in our lives that impact the person's engagement in occupations. The Person-Environment- Occupation (PEO) model represents the occupational performance. Someone's life success can be altered with those components in order to make a more well rounded occupational performance fit in the middle.
(Law, Cooper, Strong, Steward, Rigby, & Letts, 1996 )
PTM Framework (January 2018)_0.pdf(Johnstone, L. & Boyle, M. (2018))
The Power Threat Meaning Model discusses "the identification of patterns in emotional distress, unusual experiences and troubled or troubling behavior, as an alternative to functional psychiatric diagnosis" (Johnstone, L. & Boyle, M. (2018)) This alternative model examines the coping mechanisms and emotional responses to a trauma from someone's context or environment. It depicts the environment to limit the person's full engagement in their occupations.
Trying to get accommodations at DU vs DCU for dyslexia
DU:
Section 504 allows for access to accommodations but not support with them
appointment only
have to diagnosed in the last 5 years in the USA
can be stigmatized- I was accused of being stupid
DCU:
support with college experience
can register at anytime- drop in or appointment
no need of diagnosis letter
Why is it so stigmatized to get accommodations?
Future plans...
Future plans...
Mental Health is a Social Justice Issue that matters and needs to be addressed to take away the stigma of taking care of your mental health. I like this graphic by Instagram account @alyseruriani and how it's visualizes the work to be dug up for change.
Short Term:
Fieldwork Level 2 experience in 3 languages: French, Spanish, and English
Ireland (check!), Ecuador (Level 2 Pediatrics in 2021) Mexico (adults and pediatric experience in 2020) more to come!
Travel OT after graduation? Project Abroad summer internships?
Advocating for WFOT
Advocating and educating others on sanism
celebrate neurodiversity with Mad Pride
Long term:
I want to provide wellness services to parents to be or new parents to provide them with the best access to a well transition into parenthood.
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