12-Step Meeting Attendance OT 532

I attended a Narcotics' Anonymous (NA) meeting on 2/28/18 with another classmate. The title of the meeting was You + Me = We and was held in a room on the second floor of a church building. The group members and facilitator sat around a table so everyone was able to see each other. I think the environment may have had a small impact on the session. You could hear planes taking off and landing because of the location's close proximity to the airport, so sometimes when someone was speaking it could be hard to hear what they were saying and could be distracting. There were 4 members who attended the meeting and 1 facilitator. The facilitator began the group by having each member recite the serenity prayer, read the purpose of the group, how the group works, and the 12 rules of the group. The facilitator's role was more advisory because he only offered his experiences and assistance when needed but there wasn't much structure or goals for the group. He asked the group what they wanted to talk about today, and one of the members said she wanted to talk about meditation. The facilitator shared his story first, which I think encouraged other members to open up and share their feelings and insights. I think the session was very therapeutic because the members were able to open up and share their difficulties and temptations they've had to use drugs. They were also honest about their experience with the 12 steps and how they felt they were progressing. The group members were supportive of each other and were able to relate to each other when it came to certain situations. The group was very spiritual and the facilitator allowed moments of silence and meditation. I think this was a psychodynamic group because the discussion was focused on expressing emotions and how members felt which required insight, as well as spirituality.

Post-Group Facilitation Reflection #2: Life Skills OT 532

Lauren O'Brian
2/23/18
"Managing Stress"

Written Group Plan: 10
Introduction: 9
Activity: 10
Sharing: 9
Processing: 9
Generalizing: 9
Group Motivation: 8
Limi Setting: 10
Application: 9
Summary: 10
Total Leadership Score: 93

The group I facilitated was about stress and what strategies could help with managing stress. I started by having the group members introduce themselves and say what their current stress level was on a scale of 1-10 and why. Next, the group members participated in a warm-up activity that involved the group members standing in a circle and tossing around balls to each other in a sequence. This activity helped the group members reflect on what stress can feel/be like sometimes. For the main activity, the group members made dreamcatchers. I asked the group to think about stress areas they have or currently have in their life and to write/draw them in the center of their dreamcatcher. Group members had the opportunity to share their stress areas if they were comfortable. Then the group members "trapped" their stress areas by gluing down strip of paper over the center of their dreamcatchers. I then asked the group members to think about strategies to help manage or relieve stress and write/draw them around the outside of their dreamcatcher. Group members had the opportunity to share their strategies with the rest of the group if they were comfortable. I then asked the group members to discuss how to keep situations from becoming too stressful in the first place and what strategies they could use to remind themselves to use stress management techniques in their daily lives. I think this group facilitation was good for me to grow in some of the areas I felt I was weaker in in my first group facilitation. I think some of my strengths were explaining the purpose of the group and the activities and listening to what the group members had to say. I also feel that I improved in applying and generalizing what happened in the session. I think I could still improve when it comes to facilitating the group discussion and pointing out similarities and differences in the group members' responses. Overall, I think this was a great experience and I look forward to learning more and improving my ability to facilitate groups.

Leadership Summit OT 532

I met with Katherine and Lauren Leiser to discuss our ideas for our group facilitations. I told them my ideas I had so far for activities to do with the group. I explained that I thought about having the group make stress balls or play a game with stress balls as an icebreaker, and then for the main activity having the group write down things that were in there control and things that were out of there control and discuss how to manage stress. Both of them had great suggestions! They both suggested that I start out by asking the group to introduce themselves and state their current stress level and explain why. Lauren said she thought that a questionnaire related to stress may be a good activity to do. Lauren's topic for her group facilitation is health management and maintenance, and she was still tossing around ideas of what to do. I suggested having the group write down health risk behaviors and then identify strategies to avoid those health risk behaviors. Katherine's topic is leisure participation and exploration. She was researching different activities to do, and I tried to help by also searching for leisure activities she could do with her group. For me the most significant aspect of our leadership summit was listening to their suggestions and hearing their different perspectives about how the group could be facilitated. After our meeting, I changed and modified some of my activities to include their suggestions.

Post-Group Facilitation Reflection: Professionalism OT 532

Group Title: Getting Motivated
Date: 2/12/18

Leadership Evaluation
Written Group Plan: 10
Introduction: 9
Activity: 8
Sharing: 8
Processing: 7
Generalizing: 8
Group Motivation: 9
Limit setting: 10
Application: 8
Summary: 7
Total Leadership Score: 84

This group session was facilitated by me and two other classmates. Our topic was getting motivated and we started by having the group members discuss their favorite motivational movies as an icebreaker. Then we went in to the main activity, which was having the group members identify a problem/challenge they have in their life and write a goal based on that. We had group member think about and discuss actions and behaviors that could limit motivation in their problem area, what motivates them (intrinsic and extrinsic motivation), and strategies to stay motivated to achieve their goal. For me the most significant aspect was getting to facilitate a group session for the first time. I think this was a good learning experience in helping me realize what some of my strengths and weaknesses are as a group leader. I think some of my strengths were listening and paying attention to what each group member had to say, having everything organized before the group session started, and communicating expectations clearly. Having experience leading a group session I now will work on areas I feel I can improve upon as a group facilitator. In the next group session I facilitate I want to  generalize and apply what happened in the session more effectively. I also want to work on sharing and processing by pointing out similarities in group member responses and providing more prompts and questions to stimulate the discussion.

Neuro Note #5: The Crash Reel

     For my last Neuro note I watched "The Crash Reel," which is an HBO documentary about a popular snowboarder named Kevin Pearce. Kevin was training for the 2010 Olympics in Vancouver when he had a traumatic brain injury. Before his injury, Kevin was an up-and-coming snowboarder who had just signed with Nike and was Shaun White's biggest rival. Kevin was shaking and unconscious after his injury; he was out for 30 minutes and had blown his left pupil, which is a sign of massive head trauma. Kevin spent 26 days in neuro critical care before he was moved to neuro acute care. He started to make a lot of progress once he was moved to acute care. He wasn't able to speak, but you could tell he understood when his family was talking to him. You could really see how much Kevin's family hurt and struggled after his injury. Kevin's mom said she wanted to hear all the things that would be good, and not have anyone feel sorry for them. As OT's, it is important that we are also there for our client's family to educate and help support them. Kevin's biggest goal was to get back to snowboarding, even though his family and doctors protested. At his 1 year evaluation, the neurologist said that his brain was healing, but there was only so much force it could handle. Any concussion could cause a fatal brain bleed at that point. Kevin still had a lot of trouble with memory, confusion, and fatigue. He said he felt impulsive and that there could be a sensory overload at times. Kevin had nystagmus, so he had surgery to fix both of his eyes. After that surgery, he broke down and said he felt like his situation was never going to get better. At 2 and a half years, Kevin still felt like he couldn't get past his TBI. His memory was only at 4%. All his friends and family tell him that he said inappropriate things and could be irritable, so he hated the way he came across. His double-vision was also still bad, so he had trouble with running into things. At the end of the documentary, Kevin realized that he shouldn't go back to competitive snowboarding after visiting a former snowboarder who had two TBI's. He now speaks about traumatic brain injury and how to prevent it.
     This documentary was eye-opening to what not only a client with a TBI can go through, but their family as well. In learning about TBI in class, I could see the role of OT in many of the challenges that Kevin was facing. An OT would work with him on balance, improving strength and endurance, and addressing social-emotional and behavioral changes. OT would also have helped Kevin with his cognitive functioning, perception of self, and interpersonal relationships. After watching this documentary, I feel I will be able to better sympathize with clients who have a TBI. I would highly recommend watching this documentary.

Link to documentary: https://vid.me/x2HU/the-crash-reel

OT 537 Neuro Note #4: Ray's Little Ride

  I read the blog of a man named Ray who was diagnosed in December 2014 with ALS. Ray's first blog post begins with him preparing for a bike ride across the country, which is a dream he had always had. Before the doctor had diagnosed him with ALS, Ray said that he and his wife (also named Rae) had a feeling it was ALS; this is because all other diseases had been ruled out. Ray first noticed subtle changes in his voice the summer before his diagnosis, but he just ignored it. When he began having difficulty playing the guitar, he decided it was time to find out what was going on. Ray was a big family man; his wife, 3 children, grandson Jack, and friends were the most important part of his life. Ray was also a midwife and loved his work. By September 2015, Ray could barely raise his left arm high enough to reach his guitar's neck. There was only one finger on his left hand he had control over. Ray was extremely active; he wrote that he had done 100 push-ups every morning since his early 20's. Ray also loved to cycle; he estimated that he put between 5,000 and 8,000 miles on his bike every year. Riding a bike was like meditation to him.
  In order to prepare him for his bike ride across the country, Ray has some modifications done to help him on his ride. All of his muscles are fasciculation, so he found it harder to ride his bike. Students created wrist and thumb braces to give his left hand stability and keep it from falling off the bike handle. Ray's neck muscles are also weakening, so he used an adjustable head and neck support that clipped on and off as needed to his riding shorts. Ray wanted to use his ride across the U.S. to raise awareness for ALS. Ten months after his diagnosis, Ray got to do the ride of his dreams. While riding through Arizona, Ray hit a curb while riding at a high speed. He fractured 3 vertebrae, 3 ribs, and his humerus; he also had a concussion and a pneumothorax. Unfortunately, Ray did not get to finish his ride, so he asked people to ride and donate the miles he wasn't able to ride and called it "Ride for Ray."
  By December 2015, Ray's wife was noticing significant changes in his voice. He had more trouble eating, and it bothered him that he was always the last person to finish his meal. Ray also had trouble dressing himself and was getting used to letting other people help him get dressed. Ray thinks that being physically active does not dictate the speed of progression of ALS. Ray rode his bike in hopes that it would help his lungs because his respiratory capacity was significantly diminished. Ray is reluctant to use a voice machine because he feels that if he lets go of his voice, it would be gone forever. Ray received a trike to ride around in, which still gave him freedom but more safety.
  In March 2016, the only thing ALS had not affected was Ray's ability to sleep. When he eats he uses chopsticks to get the food to the right side of his mouth where he can chew it. His main form of communication during this time was texting until he got his "eye-gaze" tracking computer set up. By April, Ray's weight was down to 127 lbs. because of his difficulty with swallowing. In May 2016, Ray had a lot of difficulties breathing at night, his gait was becoming more uneven, and he started using a BiPAP machine to help him breathe. Ray wrote that each day was getting harder, and he entered hospice care at the end of May. Ray's last post was one he wrote to be published upon his death. He died in August 2016 from respiratory failure.
  I enjoyed reading Ray's blog. He never lost his sense of humor and bravely faced ALS. Ray shared so many stories of his life, and I really enjoyed reading those. Ray said that getting the diagnosis of ALS was a really lonely moment for him; he felt separated from everything and everyone. I can not imagine getting news like that, and being able to read about the emotions he felt is something I will carry with me. From pictures Ray posted on his blog, you could see how fast the disease was progressing and how much weight loss he had. Ray's main priorities were growing old with his wife, being there for his kids, and having his grandson have memories of him. Ray wanted to live whatever time he had left to the fullest. As OT's,  it is important that we realize what is important to the client and help them achieve their goals and dreams. Ray said that we can't change our problems, but we can change how we face our problems. Ray faced ALS so bravely, and his story is one I won't forget. I would highly recommend reading his blog to see what it is like for someone living with ALS.

Link to his blog: https://rayslittleride.com/category/my-blog/

OT 537 Case Study: Dementia

Pat Summitt was the head coach of the UT Lady Vols basketball team for 38 seasons. She was diagnosed with early onset dementia at the age of 59 and passed away 5 years after her diagnosis. Pat was a coach, mother, author, and spokesperson. She started the Pat Summitt Foundation to fund research for early onset dementia.  Pat had 6 miscarriages and rheumatoid arthritis before her diagnosis; doctors believe that the rheumatoid arthritis may have had a connection to the early onset dementia, but they believed it was mainly related to genetics. Prior to her diagnosis, Pat was completely independent and was coaching full-time. Pat's priorities are her son, Tyler, the Pat Summitt Foundation, basketball, and her dogs. Pat had many first symptoms before her diagnosis. She showed up to one basketball game and left her car running outside. She started calling out the wrong terms during basketball games. Pat said that she felt disoriented when she woke up, and sometime she would start driving and forget where she was going. Pat went to the Mayo Clinic and was diagnosed with early onset dementia. She was in denial at first and continued to coach the Lady Vols for 1-2 more seasons before she was forced to retire. Katherine did her OT intervention in the middle stages of the disease. In the middle stages of the disease, Pat would forget how to do ADLs, sequencing, motor skills, and would need apartment modifications such as locks on the doors. During the middle stages of dementia, there is a lot of confusion, moodiness, and personality changes. Pat lived at the Sherrill Hill Senior Living Facility during the later stages of the disease. An OT would provide resources to help Pat remember appointments and meetings. In the late stages of the disease, an OT would be focused on caregiver education.