OT 640 Debriefing

Peer-Reviewed Journal Article - OT's Role in a Criminal Justice Setting

The article I have chosen to write about for this blog post is entitled, "The Scope of Practice of Occupational Therapy in U.S. Criminal Justice Settings." The article discussed the current roles and practices of OTs in the criminal justice system in the United States, and how OTs specifically can help with the alarmingly high percentage of inmates that are re-incarcerated each year. The article also talks about the demographics of inmates who are re-incarcerated; the common trend for repeat offenders is those who are economically and socially disadvantaged. The purpose of the study was to establish a baseline inventory for training, describe OT's scope of practice in this setting, and to form a network of OTs working in this setting. Many of the respondents of the study used group interventions to address areas primarily in communication and problem-solving skills, but also concentrated on coping, stress management, goal setting, employment, leisure, wellness and fitness, financial management, developing community living skills, and work/job-related skills.

OT in the criminal justice system is currently an emerging area of practice. Just recently, I have begun watching a new docuseries on Netflix entitled, "Girls Incarcerated", which follows the journeys of teenage girls who are incarcerated, their progress throughout their various programs while in prison, and being reintegrated back into their communities. Before OT school, I never thought jails or prisons could be a setting in which an occupational therapist could work. After reading this article and watching the docuseries, I am more informed and educated on the desperate need for OTs in this area of practice.

Many individuals who re-enter society after being incarcerated do not have the skills they need to be a successful, functioning adult. An astonishing number of people lose their communication skills and coping mechanisms because of the context and environment they are in. It is difficult for them to have an outlet for releasing stress and anger, and many of them have anxiety worrying about how they are going to survive when they are released. "How am I going to find a job? Why would anyone want to hire me? Where am I going to live? Will I ever get custody of my kids back? How do I better myself so I don't end up back in here?." Many inmates ask themselves these questions, and more, every single day. OTs have an excellent opportunity to help these individuals succeed in life through group interventions related to the areas I have listed above. Many benefits would come from placing OTs in these settings; one in particular would be improving the economy.

If you think about it, if OT in prisons became a more popular practice area, we could help people reintegrate back into the community, decrease the amount of inmates in our jails, reduce readmission rates, save taxpayers money, and improve the economy overall. The important point is not about the numbers, though; the point is that all of these individuals are human. They all have hearts, souls, feelings, and emotions just like everyone else. If we continue to treat them like animals and keep them locked up in cages, then this problem will only get worse. We have to meet them where they are and help them get back to being productive members of society. Maybe, just maybe, one day they will want to pay it forward and help someone else that is in the position they were once in. Think about how much different this world would be...

I could go on and on about this topic, but I will wind it down. I have never really been interested in this until recently, but I think there is such a dire need for OTs, group therapy, and interdisciplinary collaboration with psychologists and social workers in this setting. It is my hope that in the next 10 years this practice area develops even more and OTs can help these individuals find their purpose again so that they can live the best quality of life possible.

12-Step Meeting Attendance

Last night, Haleigh and I attended a Narcotics Anonymous (Nar-Anon) meeting at a church in Bartlett, TN. My expectation going into this meeting was that I would hear personal accounts of individuals who have a drug addiction. However, when Haleigh and I first walked in the room, I noticed the facilitator, 2 couples, a single dad and a single mom. The facilitator asked if we were family of, and we replied no, and stated that we were there to witness a real-life group facilitation. They were very accepting and welcoming of us into their group. The group began by stating the 12 steps and traditions; every person went around the room and said each one until everything was said. The facilitator played a facilitative/hands-off role in this group. He started the discussion by talking about he and his wife and their experience with their adult daughter, who is addicted to drugs. He talked about distancing himself from her, and devoting more time to himself and his wife, and finally being able to be happy and live his life again.

The facilitator asked the members to share something they liked from their readings in the Nar-Anon book, and then he asked them to share about what they have learned or experienced from attending Nar-Anon meetings. He didn't push or pressure anyone to answer questions or share, but he encouraged that anyone who wanted to was welcome. I was interested to learn that the members at this particular meeting were not addicts, but family of addicts; mothers and fathers. Interestingly, many of the members had adopted their children, and had little knowledge about their children's home lives before they adopted them. The environment was set up so that the tables made a "C" shape in one of the Bible study rooms. Everyone was able to make eye contact and face each other in a circle, which made the meeting more comfortable for the members.

In my opinion, this group was very therapeutic. One member was in the very beginning stages of his journey, coping with the aftermath of his 20-year-old daughter's drug addiction. Others had multiple children that had been addicted to drugs for many years or were currently in rehab programs or living in a sober living facility. One of the mothers was teary-eyed when she talked about her son and how she can still see the sweet little 8-year-old boy in him. Another member, a father, was more realistic about his son's addiction, and didn't show as much emotion as some of the other members. Either way, members were able to get their point across in a respectful and appropriate way, without fear of judgment or ridicule from others.

I believe this group was geared around the Developmental Frame of Reference, specifically talking about the mastery of skills and coping mechanisms, the interruption of growth, and the impact of the trauma related to the actions made by the addict.

OT 532: Individual Facilitation of a Group Session (How to Care for Your Pet)

For my second group facilitation (the first that I did on my own), I led a life skills group that discussed caring for pets, including the different tasks involved, as well as different perspectives and personal experiences of pet owners. 

Introduction: I started out by introducing myself and had everyone else introduce themselves by stating their name as well as their pet's name. We also did an ice breaker which involved a memory chain of stating names and pets' names, so that the person at the end of the line had to state their own name and pet's name, and the previous group member's name and their pet's name all the way back to the beginning. It was a great way to open up the group and I think it gave everyone a good laugh trying to remember all of the names. 

Activity: Next, I had the group members brainstorm about what the various tasks are that make up pet care. They ended up naming several more tasks than I had originally thought of; I loved their originality and creativity. The main activity was called "Learning to Expect the Unexpected". This involved pairs of group members each receiving a scenario in which an unexpected circumstance regarding pet care took place. Each pair of members had to brainstorm and come up with a solution to their scenario and act it by role playing or discussing it with the group. 

Sharing: Each of the group members shared their personal experience about their own pets and how they got them, what it is like to have their pet and their pets' quirks/personality, or a funny story about their pet. 

Processing: I asked the group members if their perspectives on pet care for their own pet changed after they completed the activity. I also asked if they would respond to one of the other group member's scenarios differently, and they gave positive feedback or alternate solutions to the scenarios. 

Generalizing: I discussed the many benefits of owning a pet, including stress relief/therapeutic benefits, teaching responsibility, and companionship. I asked the group members to discuss other ways in which responsibilities included in pet care could carry over into other aspects of care taking (i.e. caring for an elderly parent, grandparent, or younger sibling). 

Application: Lastly, the group members identified how they could apply the knowledge they learned from the group into their daily lives and other aspects of care taking. 

Summary: Thanking the group members for attendance and participation, and closing of the group session.

For me, the most important thing that I learned after facilitating this group was that sometimes I can be my own worst enemy. I had it set in my mind that my group was going to be a flop, it was going to get totally derailed by the other group members, or I would talk so fast because of nerves that my group would not last an appropriate amount of time. Before leading this group, I was terrified that I would stumble over my words, or that the group members would catch on to the fact that I was nervous. I realized at the end of the session that I was probably overthinking it way too much, because several people came up to me afterwards and told me they really liked my group, that it was fun, and it made them laugh. I did the best I could to make the session fun and interactive, and I was so worried that the members wouldn't be engaged because it was at 4:00 in the afternoon, but everyone seemed to enjoy it. Sometimes I get so caught up in judging myself that I forget I am in the same boat as my peers, and we are all just trying to do the best we can. I learned that I am a competent group leader, and even though I was pushed out of my comfort zone, I will be a better practitioner in the long run because I "embraced the gray". :) 

After leading this group and hearing from the other members about their pets, I can better relate to the struggles they face on a daily basis with pet care, as we discussed with our scenarios. Sometimes life happens, and the dog may need to go to the vet while you're in the middle of class. Or you come home and find your living room destroyed because they got out of their kennel. Sometimes it might not be possible to go let the dog out on your lunch break because you live an hour away from your school or workplace. The other group members also discussed tasks associated with pet care that I would have never thought of, such as ordering food online instead of picking it up at the store, or changing out cat litter instead of picking up waste with a doggy bag. It also broadened my perspective on different types of pets because I have owned mainly dogs, with the exception of a few cats, in my lifetime. It was very interesting to hear about the experiences of the members that owned a bearded dragon and a hedgehog! As I look to the future for other groups I might lead, I will remember not to be so hard on myself and to just go with the flow, because sometimes my perceptions of myself are not always right. I was very thankful for this learning experience and for going outside of my comfort zone to lead this group, and I hope to continue to build on further improving and fine-tuning my communication skills in the future. 

OT 532 Leadership Summitt

For my second group facilitation, I am leading a group on how to take care of your pets. This is a topic that I have a lot of knowledge on, since I grew up with cats, dogs, fish, and even a turtle (just for a day) and I have been raising my dog all on my own for nearly 2 years. I love animals, especially dogs, so I was very interested to hear about other people's pets and what they do to care for them. I will be honest, I had a difficult time coming up with an activity to do for this group. I knew what frames of reference I wanted to use, and what I wanted to talk about, but I couldn't think of a fun, interactive activity that would draw members in. I researched a lot of ideas on Pinterest, but they were more appropriate for Kindergarteners, not graduate students. I received a lot of helpful advice and feedback from the other group leaders on their various topics, and I was able to provide input for other group members as well. It was very interesting to me that I was able to help someone else brainstorm ideas for their topic, which was totally the opposite of what I was doing, and others who had very different topics from myself had lots of great input. It just goes to show that we can always rely on our peers to help us out, and that we should ask questions to our future OT colleagues and colleagues from other disciplines to get a different perspective from our own.

OT 532: Co-Facilitation of a Group Session (Using Your Time Wisely)

For the first group co-facilitation, Cameron, Gracie, and I lead a group targeting professionalism, specifically dealing with time management skills.

Introduction: We started out with an icebreaker activity where the group members had to line themselves up from youngest to oldest, without talking. Then we had the group members identify things they do that they consider wasting time, as well as a strategy that they currently use to manage their time wisely.

Activity: Next, we gave the group members $86,400 in "pretend money" that represented the number of seconds in the day, which translated to how much time they spent

Sharing: Each of the group members shared what they could "buy" with their money, such as paying off loans, putting a down payment on a house, or buying a car.

Processing: This translated into how the group members spent their time, and lead to a discussion of what they learned from the activity, and what they learned about how another person spent their money.

Generalizing: The co-facilitators listed specific examples of how time management skills are important to have as OT students, and asked group members to give their own examples.

Application: Lastly, the group identified how they could apply the knowledge they learned from the group into their daily lives.

Summary: Thanking the group members for attendance and participation, and closing of the group session.

For me, the most important thing that I learned after helping to facilitate the group session was that I spend my time in very similar ways as my peers. Before leading this group, I thought I was the only person that spent way too much time watching Netflix, or perusing social media when I should be studying. This might be because I am so worried about myself and what other people think of me, that I don't tend to focus on what other people think of themselves. This is similar to how I view my level of productivity in general, because I feel like I am never doing enough, or that I could be doing more, and that everyone is so much more productive than I am. I learned that everyone struggles to be productive and manage their time in one way or another, and that I am not alone.

After helping co-lead this group and hear from my peers about the same struggles they have with managing time, I can better relate to my peers and realize that I am more similar to my peers than I previously thought. This makes me feel human, because no one is perfect, and we should give grace to every client we work with. Our clients are human too, and they may face many similar, or even radically different struggles than we do as practitioners. Moving forward, it is important to remove biases and judgment from the way we view our clients so we can see our clients through a clearer lens, and we can treat them the way the would like to be treated - just like everyone else.

Neuro Note #5: (TedTalk) Can the Damaged Brain Repair Itself?

While searching for something to write my last neuro note on, I came across this TedTalk from Dr. Siddharthan Chandran, "Can the damaged brain repair itself?", discussing how the brain can spontaneously repair itself by using its own stem cells. This was fascinating to me, because I have been interested in stem cell research for some time. Dr. Chandran opens by talking about the devastating effects of neurological conditions, such as multiple sclerosis and Huntington's disease, and how they affect the people diagnosed with them. He says that thirty-five million people are living with a neurological condition, while the annual cost of these diseases is around 700 billion dollars. The number of people living with neurological conditions today is rising because these diseases are age-related, and people are living longer.

Dr. Chandran made an interesting point in his presentation; the brain can repair itself, but it just doesn't do it well enough. When damage is made to brain cells, it is manifested as disease. This makes sense, because when nerve cells become demyelinated, this can lead to the manifestation of multiple sclerosis. Spontaneous repair can occur from human stem cells in the brain which lays down new myelin over damaged nerves. In one study, Dr. Chandran discusses a patient's shrinking optic nerve as a result of multiple sclerosis. He found that after placing new stem cells in the brain, over a twelve month period, the optic nerve began to repair itself and increase in size. I think it is pretty amazing how our bodies can repair themselves, even after incurring damage.

The topic of stem cell research has been heavily debated in the last ten years, so I think it is difficult to say how many doctors, researchers, and patients would actually be on board with this type of treatment. I believe that there can be many benefits from the use of stem cells, since they have the potential to be generated into basically any type of cell that is needed, such as bone, liver, or nerve cells. I would like to further my knowledge on this topic by looking into more studies, such as the one mentioned by Dr. Chandran, to see how this intervention can affect individuals with other types of neurological conditions. Dr. Chandran's message gives hope to people who live with neurological conditions, and hopefully there will be cures one day for these awful diseases.

You can access Dr. Chandran's TedTalk at the link listed below:

Chandran, S. (July 2013). Can the damaged brain repair itself? [Video file]. Retrieved from:
https://www.ted.com/talks/siddharthan_chandran_can_the_damaged_brain_repair_itself#t-939196