http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/default.aspxThis group serves as a haven; a source of inspiration and information for OT practitioners working in psychiatric rehabilitation. en7.x Productionhttp://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/t/16427.aspxTue, 23 Apr 2013 23:43:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:92f75b16-976b-4674-b4b2-a2971fc16c9emacaulaykoehn Hello - I really enjoyed reading everyone's posts.  Lovely to hear what everyone is doing.  I really enjoy doing the skills groups.  I let the patients choose what they want to focus on each day (bearing in mind that I do not want one or two people to monopolize the group, and I do have guide lines, eg stress management/ healthy life styles/ anger management) I use a white board and write down the 'problem' - and then get the group to work out the 'solutions'  and the outcomes of these solutions good and bad.  I try to have little input - just asking how, why, etc., and pretty soon the group will come up with a solid conclusion!  I also do verbal and non-verbal communication - and have the patients role play.  We work on body language etc - it works well. Thoughts on DBT - I don't feel that it can be done in isolation - I think that the whole treatment team need to be 'on the same page'.  Pts with a dx of  BPD are very good at splitting and unless the team provides a united front - there can be chaos!               Best wishes all!              Diana  OT/R http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/b/psych_rehab_ot-blog/archive/2013/01/28/successful-and-schizophrenic.aspxMon, 28 Jan 2013 16:54:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:c9a4d704-fbec-4faa-ba3f-b55364ce4d18David M. Merlo By Elyn R. Saks  New York Times  January 25, 2013 THIRTY years ago, I was given a diagnosis of schizophrenia. My prognosis was “grave”: I would never live independently, hold a job, find a loving partner, get married. My home would be a board-and-care facility, my days spent watching TV in a day room with other people debilitated by mental illness. I would work at menial jobs when my symptoms were quiet. Following my last psychiatric hospitalization at the age of 28, I was encouraged by a doctor to work as a cashier making change. If I could handle that, I was told, we would reassess my ability to hold a more demanding position, perhaps even something full-time. Then I made a decision. I would write the narrative of my life. Today I am a chaired professor at the University of Southern California Gould School of Law. I have an adjunct appointment in the department of psychiatry at the medical school of the University of California, San Diego, and am on the faculty of the New Center for Psychoanalysis. The MacArthur Foundation gave me a genius grant. Although I fought my diagnosis for many years, I came to accept that I have schizophrenia and will be in treatment the rest of my life. Indeed, excellent psychoanalytic treatment and medication have been critical to my success. What I refused to accept was my prognosis. Conventional psychiatric thinking and its diagnostic categories say that people like me don’t exist. Either I don’t have schizophrenia (please tell that to the delusions crowding my mind), or I couldn’t have accomplished what I have (please tell that to U.S.C.’s committee on faculty affairs). But I do, and I have. And I have undertaken research with colleagues at U.S.C. and U.C.L.A. to show that I am not alone. There are others with schizophrenia and such active symptoms as delusions and hallucinations who have significant academic and professional achievements. Over the last few years, my colleagues, including Stephen Marder, Alison Hamilton and Amy Cohen, and I have gathered 20 research subjects with high-functioning schizophrenia in Los Angeles. They suffered from symptoms like mild delusions or hallucinatory behavior. Their average age was 40. Half were male, half female, and more than half were minorities. All had high school diplomas, and a majority either had or were working toward college or graduate degrees. They were graduate students, managers, technicians and professionals, including a doctor, lawyer, psychologist and chief executive of a nonprofit group. At the same time, most were unmarried and childless, which is consistent with their diagnoses. (My colleagues and I intend to do another study on people with schizophrenia who are high-functioning in terms of their relationships. Marrying in my mid-40s — the best thing that ever happened to me — was against all odds, following almost 18 years of not dating.) More than three-quarters had been hospitalized between two and five times because of their illness, while three had never been admitted. How had these people with schizophrenia managed to succeed in their studies and at such high-level jobs? We learned that, in addition to medication and therapy, all the participants had developed techniques to keep their schizophrenia at bay. For some, these techniques were cognitive. An educator with a master’s degree said he had learned to face his hallucinations and ask, “What’s the evidence for that? Or is it just a perception problem?” Another participant said, “I hear derogatory voices all the time. ... You just gotta blow them off.” Part of vigilance about symptoms was “identifying triggers” to “prevent a fuller blown experience of symptoms,” said a participant who works as a coordinator at a nonprofit group. For instance, if being with people in close quarters for too long can set off symptoms, build in some alone time when you travel with friends. Other techniques that our participants cited included controlling sensory inputs. For some, this meant keeping their living space simple (bare walls, no TV, only quiet music), while for others, it meant distracting music. “I’ll listen to loud music if I don’t want to hear things,” said a participant who is a certified nurse’s assistant. Still others mentioned exercise, a healthy diet, avoiding alcohol and getting enough sleep. A belief in God and prayer also played a role for some. One of the most frequently mentioned techniques that helped our research participants manage their symptoms was work. “Work has been an important part of who I am,” said an educator in our group. “When you become useful to an organization and feel respected in that organization, there’s a certain value in belonging there.” This person works on the weekends too because of “the distraction factor.” In other words, by engaging in work, the crazy stuff often recedes to the sidelines. Personally, I reach out to my doctors, friends and family whenever I start slipping, and I get great support from them. I eat comfort food (for me, cereal) and listen to quiet music. I minimize all stimulation. Usually these techniques, combined with more medication and therapy, will make the symptoms pass. But the work piece — using my mind — is my best defense. It keeps me focused, it keeps the demons at bay. My mind, I have come to say, is both my worst enemy and my best friend. THAT is why it is so distressing when doctors tell their patients not to expect or pursue fulfilling careers. Far too often, the conventional psychiatric approach to mental illness is to see clusters of symptoms that characterize people. Accordingly, many psychiatrists hold the view that treating symptoms with medication is treating mental illness. But this fails to take into account individuals’ strengths and capabilities, leading mental health professionals to underestimate what their patients can hope to achieve in the world. It’s not just schizophrenia: earlier this month, The Journal of Child Psychology and Psychiatry posted a study showing that a small group of people who were given diagnoses of autism, a developmental disorder, later stopped exhibiting symptoms. They seemed to have recovered — though after years of behavioral therapy and treatment. A recent New York Times Magazine article described a new company that hires high-functioning adults with autism, taking advantage of their unusual memory skills and attention to detail. I don’t want to sound like a Pollyanna about schizophrenia; mental illness imposes real limitations, and it’s important not to romanticize it. We can’t all be Nobel laureates like John Nash of the movie “A Beautiful Mind.” But the seeds of creative thinking may sometimes be found in mental illness, and people underestimate the power of the human brain to adapt and to create. An approach that looks for individual strengths, in addition to considering symptoms, could help dispel the pessimism surrounding mental illness. Finding “the wellness within the illness,” as one person with schizophrenia said, should be a therapeutic goal. Doctors should urge their patients to develop relationships and engage in meaningful work. They should encourage patients to find their own repertory of techniques to manage their symptoms and aim for a quality of life as they define it. And they should provide patients with the resources — therapy, medication and support — to make these things happen. “Every person has a unique gift or unique self to bring to the world,” said one of our study’s participants. She expressed the reality that those of us who have schizophrenia and other mental illnesses want what everyone wants: in the words of Sigmund Freud, to work and to love. Elyn R. Saks is a law professor at the University of Southern California and the author of the memoir “The Center Cannot Hold: My Journey Through Madness.” www.nytimes.com/.../schizophrenic-not-stupid.html http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/m/psych_rehab_ot-mediagallery/120771.aspxThu, 17 Jan 2013 03:44:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:27dcb1a8-a29d-4e11-b191-2beea00076c9Allison Taylor Hi -  Please check out the attached post-graduate training announcement (not fieldwork) at the Durham VAMC in North Carolina for Psychosocial Rehabilitation. A great way to get additional training in mental health and start a career in the VA healthcare.  Thanks, Allison Taylor http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/p/15720/120827.aspx#120827Wed, 19 Dec 2012 23:30:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:da5b46f3-9b19-48fc-ab12-cbca2accb999Michelle Hi Dana, Who funds the treatment?  What are the clients' payor sources? http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/w/psych_rehab_ot-pages/default.aspxWed, 21 Nov 2012 17:59:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:e1a71707-c5f5-418d-a19c-18e33204bc7aUnknownhttp://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/t/15720.aspxWed, 21 Nov 2012 17:59:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:9604ea71-8168-4682-a987-c7a14e87a0f7Dana I am wondering if anyone can provide me with information regarding reimbursement by third party payers for OT services in mental health?  I am currently working for a state agency and am not able to bill for any of the OT services I provide, even evaluations.  Looking for anyone (especially in Connecticut) who might have more information about billing for OT services.  Thanks! http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/p/15519/111429.aspx#111429Tue, 13 Nov 2012 14:32:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:d92677c8-5b94-4012-a0f9-0707288a57basgaalaic Hi Rachel, I'm a student in Springfield, MA (about an hour away from Albany) and I was wondering what specific type of setting you're looking into.  It sounds like you want to work with a specific subset of consumers like you might find at a women's shelter.  If that's what you're thinking, check with your FW coordinator to see if that would give you a breadth of experiences that will benefit you for your board exams (we're not allowed to go to specialty clinics for that reason).  If you're thinking more generally, try locating a substance abuse rehab center, TBI rehab center, or even a hospital MH ward and you'll find that many of these individuals experienced abusive trauma in their chart history.  Other places that we have gone for level I include a correctional facility, day rehab center, clubhouses, etc. If you can't find these settings in your area, here are some setting my classmates are traveling to for level II: St Mary's Hospital, Waterbury, CT Sheppard Pratt, Towson, MD Institute of Living, Hartford, CT ServiceNet, Inc is a mental health and human service provider in western MA and they may have a program that would be interesting for you as well. Hope this helps.  Good luck! http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/p/13977/109969.aspx#109969Thu, 08 Nov 2012 19:53:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:600ea59d-db13-47b1-9e7a-bc25270a723eConnie Schitoskey Thanks for passing this along. I have posted this onto my facebook page as well. -Connie http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/t/15519.aspxFri, 19 Oct 2012 15:25:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:7379ae40-1abf-413b-b84a-fd3dde30d440rachelnorah Hello! I decided to post to get some advice, ideas, contacts, or pointed in some sort of direction for a fieldwork. I'm interested in doing a level two fieldwork in a setting that would give me the opportunity to work with survivors of abuse or domestic violence. Does anyone know of any OTs who are working with this population and might be willing to take a level two student? I currently live in Albany, NY, but I do not mind traveling, or a temporary move to get some experience with this population. Thank you for the taking the time to look at this post! Rachel http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/b/psych_rehab_ot-blog/archive/2012/09/04/anti-stigma-project-seeks-presenters.aspxTue, 04 Sep 2012 21:52:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:d4f7913b-b1aa-4738-a90f-3c15e0a562f7David M. Merlo The Department of Psychiatric Rehabilitation & Counseling Professions of the University of Medicine & Dentistry of NJ is seeking folks with lived experience of mental illness to act as peers to young adults in hopes of reducing stigma.  This exciting new project, “It’s Okay to Talk About It”, is made possible by the Mental Health Foundation of Albany, NY and their Young Adults Programs to improve access to mental health-related education and services. For several years, our previous Anti-Stigma program (funded by the NJ Division of Mental Health Services) presented information throughout NJ to high schools, colleges, and community groups about recovery from psychiatric disabilities.  We are now requesting people to participate in our free training and speak throughout neighboring states such as New York, Pennsylvania, and Massachusetts.  You will: Receive free training and as-needed feedback & supervision Utilize our educational presentation materials Present to young people (high school, college, etc.) in your region Share your personal story of recovery & wellness Impart hope about recovery and integration in communities Provide resources and information about available services & support To secure resources for this project, the Department of Psychiatric Rehabilitation & Counseling Professions worked closely with the Foundation of UMDNJ, which raises money for much-needed scholarship, research, education, and patient care. For information contact:     Lue Ann Librera, Clinical Instructor     (908)889-2439     librerlu@umdnj.edu http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/p/5957/97531.aspx#97531Fri, 24 Aug 2012 20:11:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:2d429e37-2c87-40ef-8489-c3425964f501anne I use the SEALS books alot...my patients aren't always young but they can benefit from them with a little tweaking...SEALS stands for self esteem and life skills http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/p/5957/97501.aspx#97501Fri, 24 Aug 2012 12:25:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:31185fde-474d-44d4-b68f-10a17fd512f0rlewietcp Rick, Do you happen to have any sample lesson plans or information that you give to the patients with any of your groups?  I'm new to the mental health field, and are working with a similar Young Adult in-patient group.  Any information would be great! Rob http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/b/psych_rehab_ot-blog/archive/2012/07/27/life-after-aurora-commentary-by-dr-mark-ragins.aspxFri, 27 Jul 2012 16:48:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:8ca46d04-34d3-4c45-8ac5-60bf09aaa46cDavid M. Merlo The following editorial appeared in the LA Times and Denver Post by Dr. Mark, Ragins, psychiatrist and proponent of the Recovery Model. Please share this rational response to the recent Colorado shooting. A good article to discuss students and colleagues.    Life after Aurora Posted:   07/27/2012 01:00:00 AM MDT By Mark Ragins Special to the Los Angeles Times Murders — especially random mass murders — are frightening. And when we're frightened, we look for explanations that will restore some sense of safety to the world. That's one reason so many people are speculating about whether James Holmes, the suspect in Friday's horrific Colorado shootings, is mentally ill. In some ways it would be reassuring to find out that he is. Then we could begin figuring out new ways to keep ourselves safe. Some people would argue for better outreach to the mentally ill, for providing more and better mental health services or strengthening involuntary commitment laws. We would have something to blame and something to do to prevent this kind of thing from happening again. But those things wouldn't necessarily help. I'm a psychiatrist who has spent my life working with people who have severe mental illnesses, and murder is no more sensible in my world than in yours, and it's just as frightening. Murder is unpredictable, extraordinarily rare and shocking. That's as true in those with mental illness as it is in those without it. I know about this firsthand. Twenty-three years ago my closest friend at work, a social worker named Robbyn Panitch, was murdered by a homeless man with schizophrenia whom she was trying to help. It doesn't help to know that statistically, those with mental illness are no more likely than anyone else to commit violent crimes, and that they're more likely to be victims than perpetrators. Or that, although it sometimes seems like we're in the midst of a murder epidemic, in fact violent crime has dropped dramatically across the nation in the last 20 years. Those things may be true, but as we just saw in Colorado, horrible things still happen. And the media are more effective than ever at linking the billions of humans in the world, so we all have front-row seats at these stunningly rare events. Whether or not the overwhelming violence in Colorado had anything to do with mental illness, the healthiest approach to dealing with the fear is the one we teach to rape victims. We have to acknowledge that there is violence in the world and that we can never be truly safe. We shouldn't be reckless, and we can take precautions, but the chance of encountering violence can't be completely removed. But if we hide away and don't go on with life, then we let fear win. That's the message that should be sent now by public officials and mental health professionals alike. This isn't the time to lobby for more money. It's the time to promote resilience. We all need healing and acceptance, forgiveness and community. When we're a little calmer, it might be reasonable to ask whether our current funding levels for mental health or our current gun laws or our current mental health services on college campuses are effective or not. But we have to examine these issues knowing two things: that nothing can make us truly safe, and that such large-scale violence is extremely rare. Policies that grow out of fear aren't always rational, and they can have unintended consequences. The way to actually be safer and less frightened is not to separate and hide; it's to reach out to one another and take care of one another. Remember the spirit of community right after Sept. 11 or after Hurricane Katrina? People came together and offered prayers, practical help and sympathy. Those things made us feel better. If we don't go see "The Dark Knight Rises" or the next blockbuster movie premiere, or if we don't let the next "loner" into college or avoid him, we'll be giving in to our fears instead of facing them and learning to live with them. In the end, there's one way to make it through this: together. Mark Ragins is director at the Village, a program of Mental Health America of Los Angeles. Read more: Life after Aurora - The Denver Post http://www.denverpost.com/opinion/ci_21167843/life-after-aurora?IADID=Search-www.denverpost.com-www.denverpost.com#ixzz21qH3tMoT http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/t/14938.aspxMon, 16 Jul 2012 14:38:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:c8ce7bf8-f64f-4632-93aa-4065eca449d9KFireline There is a .6FTE mental health job opening for an OTR at Memorial Epworth Center in South Bend, IN.  It is about a mile from the University of Notre Dame, 45 minutes from Lake Michigan, and the schedule is negotiable M-F about 24 hours/week. Go to QualityOfLife.org, pull-down Jobs at Memorial, then New Applicants. I work there and LOVE it!!!!!!!!!!!!! http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/b/psych_rehab_ot-blog/archive/2012/05/09/survey-results-says-fieldwork-led-students-to-mental-health-practice.aspxWed, 09 May 2012 14:25:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:aea894a4-15a2-4d79-be60-d8e722d31cf0David M. Merlo Although less than 15 percent of occupational therapy education programs currently require level-II fieldwork in mental health, about 42 percent of students in a small nationwide survey that represented 48 programs have completed or are completing it now. And of 177 practitioners who took the same survey — more than half of them with over 15 years in the field — 62 percent believe level-ll affiliations in mental health settings should be required in occupational therapy education. READ MORE ... http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/p/13977/88389.aspx#88389Sat, 28 Apr 2012 15:42:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:bbbfa66b-32bd-498c-874d-7585c915e8caAnonymous Thankyou for posting this and for all you do to see that OT is recognized for what we can do in the behavioral and mental health arena. http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/t/14298.aspxSat, 28 Apr 2012 15:40:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:fb78350e-79f7-4fe2-a57e-b54308476a7dAnonymous  I work in acute care. I have in the past worked IPR,outpatient and work rehab. I saw the chronic disease component and told myself, I'm going to go to the acute phase to do what I can in the acute stage to Prevent these issues from becoming chronic if possible, and when they do become chronic, have compassion and think outside the box for a multi-disciplinary plan of care involving the environment and support system as well as the person and their immediate health and family support system. I live near a joint air force  /army base. I am seeing a great need there to help both the returning soldiers and their familes, while they are deployed and when they come back. Right now I am volunteering my time through my church to help the children through these transitions and it is very helpful as OT's have just the right skill set for this. I found that when I offered to volunteer for the Give an Hour program to help wounded warriors they told me they do not consider Occupational Therapists to be valuable in that area, they were looking for social workers, psychologists and psychiatrists. I think OT has a lot to offer the soldiers as far as coping , resiliency, and community re-integration strategies. If anyone is going to AOTA conference and attending mental health classes can you let me know if they would consider that? (Recognizing the Behavioral Health Certification & advocating with the Give an Hour organization to recognize OT's as specialists that can assist returning VETS?) http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/t/13977.aspxWed, 28 Mar 2012 19:39:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:c5c3bbfb-23ad-41e5-a268-ae7795deb35aDavid M. Merlo Please go to the following link to lend your support to the proposed law H.R. 3762: "To amend the Public Health Service Act to include occupational therapists as behavioral and mental health professionals for purposes of the National Health Service Corps." Takes just a minute! https://www.popvox.com/bills/us/112/hr3762 http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/b/psych_rehab_ot-blog/archive/2012/03/28/urgent-support-the-occupational-therapy-mental-health-act.aspxWed, 28 Mar 2012 18:59:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:d0e40e3d-bb20-49f6-996f-328e804d937eDavid M. Merlo Go to the following link to led your support proposed H.R. 3762: "To amend the Public Health Service Act to include occupational therapists as behavioral and mental health professionals for purposes of the National Health Service Corps." Takes just a minute! https://www.popvox.com/bills/us/112/hr3762 http://otconnections.aota.org/more_groups/practice_areas/psych_rehab_ot/f/1745/p/13868/86830.aspx#86830Mon, 26 Mar 2012 19:35:00 GMT9079418d-4ee6-4590-87f3-c0cc4c3814cd:87f7c89b-bc42-4348-91eb-0c6026755479Colleen Zane You might also look at the OT Advance magazine that also recently published their salary survey results.  I think it was published last week. As a OT in community behavioral health, my salary in comparison to this and the AOTA document  was below average.  That said, for the area of practice my salary is above the average of non-OTs. Hope that helps. Colleen