Contemporary Models of Occupational Therapy in Community Mental Health

Clinical Reform, Case Management and Occupational Therapy

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InsideOut Occupational Therapy Group Therapist Jordana Kaiser along with colleagues Carmen Stobie, Thaysa Ramos, Emma Ketley presented the following presentation on Contemporary Models of Occupational Therapy in Community Mental Health: Clinical Reform, Case Management and Occupational Therapy at this years Occupational Therapy Australia conference.
A summary of the abstract has been presented below. For any further information or clarification, please contact Jordana Kaiser.


Occupational therapists working in North Metropolitan Area Mental Health in Perth have undergone significant changes to models of service delivery, as a result of clinical reform in the last 2 to 3 years. Now, our colleagues in South Metropolitan Area Mental Health are undergoing a similar process.

The occupational therapists at Stirling Mental Health have found the process challenging, as have most staff, however have supported each other through regular individual supervision, peer supervision and staff development opportunities.

The focus on case management within multidisciplinary teams has led us to develop more contemporary models of providing occupational therapy to our clients.

The mental health service model providing more acute and sub-acute treatment, has also reduced the focus on clinical rehabilitation with many teams, with the focus now on Non-Government Organisations (NGOs) or Community Managed Organisations (CMOs) to provide the majority of  rehabilitation services.

In Stirling Catchment we also have occupational therapists employed in less traditional roles including Community Development (CDO), General Practitioner Liaison Officer (GPLO), Community Supported Residential Units (CSRU) Liaison Senior OT, and Dialectic Behaviour Therapy (DBT).

We wish to share with you how we have provided a more contemporary approach within the context of clinical reform, recovery and case management, and how we have supported each other to maintain our professional skills and provide occupational therapy to our clients and their families. We hope that this will inspire others to continue to support each other, our new graduates and students.

Our current practice provides evidence that occupational therapy remains a vital part of a person’s mental health recovery.


 

Play Therapy

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In the process of growing up, most children experience difficulty adjusting at some time. Some children may need more help than others in certain areas. Children have a hard time sitting in a big chair, and talking about what bothers them. They don’t know the words to describe what they are feeling or what they are thinking, so sometimes they need to act out or show how they feel.play-therapy-dolls_sml

In play therapy we provide toys and art / crafts for children to use, to say with toys what they have difficulty saying with words. In the play therapy experience, toys are like the child’s words and play is the child’s language. When children can communicate or play out how they feel to someone who understands, they feel better because their feelings have been released.  You have probably experienced the same thing when you were worried about something and told someone who really cared about you and understood, then you felt better and were more equipped to cope. Well, play therapy is like that for children. They can use the dolls, puppets, clay, paints or other toys to say what they think or how they feel. Child Centred Play Therapy is a non directive, humanistic therapeutic process which allows children work through difficult feelings, memories and experiences at their own pace, ensuring the therapeutic environment is both safe and respectful.

How children play and what they do in the playroom is very important. Play Therapy differs from regular play in that the therapist helps children to address and resolve their own problems. Play therapy builds on the natural way that children learn about themselves and the relationships in the world around them. Play provides a safe psychological distance from the problems and allows expression of thoughts and feelings appropriate to their development.

 

How Does Play Therapy work?

 Play Therapy is a well-researched and effective form of counselling for a wide range of childhood emotional, behavioural, social and psychological difficulties.  Play Therapy can help children learn how to express their thoughts and feelings in
constructive ways, to control their behaviour, to make decisions, and to accept responsibility. Play therapy allows trained mental health practitioners to assess and understand children’s play; the focus is on the child and not the problem. As the child works through their difficulties, they are able to find healthier solutions. Play therapy allows children to change the way they think about, feel toward, and resolve their concerns.

 

Commonly Asked Questions

What should I tell my child about why they are coming to Play Therapy?

 You can tell your child that they will be coming to a place with a special playroom and that they will be seeing Nina there. You may like to tell your child that the playroom is a place where they can do most of the things they want to do. If your ch
ild asks why they are going, you could say something like, when things are hard at school, home, with friends, or when things are changing at home etc it can help to have a special place to play. With older children, I will spend a bit of time at the beginning of the first session with you present, talking about why they are coming for play therapy sessions.

I’m very sensitive with children in relation to talking about this and want to create a positive experience for your child coming into play therapy. If there’s been a traumatic incident in your family/household, I like to let the child know that I know about this, during this first meeting. I will not expect a child to respond or talk about what has happened, it is just to let your child know, that it is not a secret.

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How long and how frequent are play therapy sessions?

 The play therapy sessions are usually scheduled on a regular basis for 50 minutes. Sometimes with a very young child or children with particular special needs, the sessions may be shorter. The sessions are generally weekly. Where possible, I like to have a regular time scheduled for you and your child. This becomes your child’s special playtime and this predictability and consistency is important to the play therapy process and will help your child to feel secure. Like therapy with most adults, play therapy with children is a process. It is not a quick fix. Sometimes adults leave a therapy session feeling great, but sometimes they leave a session feeling emotionally offkilter, and children are no different. Some children change faster than others, and predictions for your child’s pace in therapy is very difficult to provide.

  

What clothes should my child wear to play therapy sessions?

  Please dress your child in old clothes so that they do not have to be worried about getting paint, sand or water on clothes and shoes. If you’re coming straight from school please bring another set of clothes your child to get changed into. This helps children feel less anxious in the playroom and can help children feel able to be play freely.  Please ensure that they have used the bathroom if required and they are not hungry or thirsty. There are public toilet facilities located on the first floor of the building.

  

Do I need to stay with my child whilst they are in the play therapy session?

  Yes, this is important so that your child knows that you are in the waiting room and can come and check should they become anxious.

 

 What should I say to my child when they finish the play therapy session?

  I recommend that you do not ask your child how it was in the playroom or if they had fun today. If your child wants to tell you about what they did or what happened, then this is fine and I suggest responding to your child in a positive way, not asking questions but showing interest in what your child is telling you. Sometimes children do not want to talk about what has happened. It is best if you can follow your child’s lead with this. If your child brings a painting or a picture out of the play therapy session, rather than praising your child or the picture, please try to respond more generally. For example,” you have used a lot of different colours on your picture” or” looks like you took a lot of time doing that picture-seems it is really special for you”. If your child does choose to draw or paint, then whatever it is they have produced is of great value regardless of its appearance. It is special because it is come from your child.

 

My child has difficulties at school. Can you speak with the teacher and other professionals involved with the family/my childballs-in-basket about the play therapy and about my child?

  I am happy to speak with your child’s teacher and discuss ways
that the
school can support the play therapy. It can also be very helpful for me to speak to the teacher and any other professionals involved with your child, to get a picture from their viewpoint on how your child is going educationally, emotionally, psychologically and socially. I will need to get your written permission to speak with the teacher and/or other professionals involved with your child and family. I will ask you to sign a consent form at our first interview. I will talk with you about what I am looking at discussing prior to any meetings or phone contact with any other professionals involved, to make sure that you are comfortable with this. I will also give you feedback afterwards about what was discussed.

 

How do I pay for play therapy sessions?

 We have payment facilities at the clinic. I will give you an invoice and a receipt and enabling you to can then claim any rebate that you are entitled to from your private health insurance company or Medicare.

 

What sort of contact will I have with you about my child’s play therapy sessions?

I will phone you after the first play therapy session to let you know generally how your child went and to check and see how they were after the first session. We will have contact through meetings every 4 or 5 weeks (or phone calls in special circumstances). If something arises in a play therapy session that I feel is important to talk with you about, I will phone you. If anything happens between sessions that are traumatic, worrying or potentially disruptive or very positive for your child, I would appreciate you letting me know this by phone or email. When you bring your child to play therapy sessions, this is their special time and I would ask that you do not discuss with me what is happening or has happened for your child during the week at this time. You are welcome to phone or email me with any concerns or questions that you have.

 

Can you tell me exactly how things will go for my child in play therapy and will you tell me all about what my child plays?

Every child is different and my work with your child will be focused on their experience and who they are. We do see stages generally in the play therapy process and I will discuss these with you as they relate to your child. I will also talk with you about themes I am seeing in the play therapy sessions. We will also look at ways that you can assist your child linked with the play therapy process. In this play therapy approach called child-centred play therapy, we do not generally talk about a child’s specific play as this can interfere with your child feeling free to express themselves. This form of play therapy is about your child’s inner growth and development. I will do all I can to foster and nurture this through the play therapy process and my time together with your child.

If you have any questions please feel free to contact Nina Fitch.

Inside Out Therapist Presents at Out-Of-Home Care Conference

Amy Nicolson DCP

One of our Senior Clinicians, Amy Nicolson recently had the privilege to present at the Out-Of-Home Care Conference held by the Department for Child Protection. In 2015 Amy collaborated with the Department for Child Protection in one of their residential houses to support and facilitate self-regulation from a sensory based approach within a residential setting. Amy continues to work very closely with house manager, staff, clinical psychologist, directors and young people to ensure trauma-informed work was also sensory-informed work.

Recent research is making the link between sensory arousal and regulation difficulties in children/ young people who have experienced significant trauma in their lives, Research highlights the essential services occupational therapy can offer to support young people and the significant caregivers in their lives. The collaborative work that is being done with Inside Out OT and The Department for Child Protection is providing young people with sensory based activities, to help them to re-connect with their bodies as well as their emotions. This in turn provides another avenue of self-regulation strategies, which will ultimately have a positive impact on their capacity for therapy and healing.

 

Nedlands Clinic Now Open

Inside Out Occupational Therapy Group are proud to announce the opening of a clinic in the Nedlands Wellness Centre in Nedlands.
Refer to our Contact Us page for clinic location.

Nedlands Wellness Centre

Murdoch Clinic Now Open

Inside Out Occupational Therapy Group’s Murdoch Clinic is now open on Level 3, Suite 49 in the Wexford Medical Suites.

Kathleen (shown below at the centre) has opened and begun practising at the clinic.
For any enquires or appointments at this clinic, please contact Kathleen (refer details on our Contacts Us page.

Kathleen WexfordWexford Medical Suitesmurdochlogo