CRITQUE ANALYSE OF A MENTAL HEALTH/MEANINGFUL OCCUPATION STUDY

In order to support what I have said about the use of meaningful occupation and mental health, I am going to analyse and critique an article that supports and relates to the topic.

Goldberg, B., Brintnell, S., & Goldberg, J. (2008). The relationship between engagement in meaningful activities and quality of life in persons disabled by mental illness. Occupational Therapy in Mental Health, 18(2), 17-44.

Critique Analyses: From Evidence Based Practice Class, I thought I would bring my skills in ensuring this article is reliable and appropriate. In regards to the authors, they have involvement in either mental health or occupational therapy practice. The title and information within the article relates to the use of meaningful occupation and benefits this has on mental health individuals. The article was published in 2008; therefore it is a current and up to date resource. Within the method, they use test-retest reliability and Cronbach Alpha to analyse results. Use a range of theorist to support opinions and findings.

Aim: The aim of the study was to identify the relationship between engagement in meaningful activities and quality of life.

Participants: The participants were individuals with a mental illness living in the community and attending programs at a private, non profit mental health agency in a large western Canadian city. Sixty three individuals were selected at random from approximately 235 who met the criteria for being severely and persistently mentally ill. They were also required to be between the ages of 18 and 65 and diagnosed for at least two years.

Method: All individuals chosen at random were sent a letter describing the project and requesting that they consider participating. The research assistant made a follow up call to these individuals using a standardised script for guidance with answering questions. Those who agreed to participate were scheduled a time at their choice of location either at home or the agency. Participants signed informed consent. Three measures were administered including: the Engagement in Meaningful Activities Survey (EMAS); the Quality of Life Interview; and the symptom Checklist-90. The interviews lasted on average 79 minutes. Following a two to 10 week interval, 15 participants repeated the EMAS in order to obtain data on its test-retest reliability.

Results: The results from the data analysis clearly showed that there is a relationship between engagement in meaningful activities and quality of life demonstrating a significant correlation of (p < .05).

Conclusion: Occupational therapists working in community mental health should ensure that it is the client who must determine what is meaningful for them, and include activities that increase feelings of control and that provide the right amount of challenge to be encouraged.

ACTIVITY: Go onto the research databases such as google scholar, Cinahl, OT seeker etc and find articles that support the use of meaningful occupation in mental health. This will help with your clinical reasoning in present and future practices and enable you to become an  evidence based occupational therapist. Let me know how you get on!

YOU TUBE VIDEO: OCCUPATIONAL THERAPY, OCCUPATION AND MENTAL HEALTH

THE USE OF OCCUPATIONAL THERAPY AND MEANINGFUL OCCUPATION IN MENTAL HEALTH

Now let's learn about the use of meaningful occupation in mental health and how an occupational therapists implements this into practice to enhance the recovery on mental health individuals.

Mee and Sumsion (2001) state that “the closure of long stay institutions has resulted in mental health services being organised within the community providing opportunities for occupational therapists to reassess the value and meaning of occupation from their clients own perspectives” (p.121). Now occupational therapists can use their skills, knowledge and experience to enable mental health individuals to engage in their meaningful occupations within their specific environments.

The profession of occupational therapy supports the assumptions about the relationship between occupation and health as follows;

-          People are occupational beings

-          Engagement in occupation is healthy

-          People need a healthy balance of occupation

-          There are links with purpose and meaning

-          Occupation is a tool for healthy participation in life

(Creek and Lougher, 2008, p.26)

The value of meaningful and purposeful occupation is fundamental in occupational therapy. In regards to mental health, occupational therapists can engage clients in occupation that is meaningful and purposeful in order to improve the health and well being of a client throughout their progress in recovery by enabling them to overcome their effects of their difficulties. It is central for individuals to experience living a balanced and contented lifestyle (Mee, Sumsion and Craik, 2004). “Through doing, people are confronted with the evidence of their ability to function competently and take control of their lives as far as they are able” (Creek and Lougher, 2008, p.26). As a result of participating in occupation, clients “personal dignity and beliefs are enhanced and a sense of sense worth is developed” (Creek and Lougher, 2008, p.26) as through the use of occupation individuals can demonstrate and identify their potential. Therefore by developing a sense of self, individuals are influencing in controlling and mastering the environment that surrounds them (Mee, Sumsion and Craik, 2004).

(Picture from google images)

Individuals are more motivated in engaging in occupations in which they find meaningful. Therefore by using meaningful occupations in treatment intervention will initiate and motivate clients to participate and therefore enable them to enhance their physical health and well being. As a result, this increases the clients progress in their recovery (Goldberg, Brintnell, and Goldberg, 2008).

For example; I use exercise such as walking, dancing to music or zumba to release feelings of stress and anxiety especially around exam time. These are all occupations that are meaningful to me and that help me to maintain my mental and physical well being. I know that I can do these occupations so there is a sense of self satisfaction, worth and achievement when completing these occupations throughout the week.

Here is a link that shows the use of netball as a meaningful occupation with people experiencing mental health difficulties.

In using meaningful occupations in a client’s intervention, this will develop their abilities and skills to their possible highest level. Within doing this, it has the potential to enhance a client’s quality of life and sense of well being, increase satisfaction within their daily living, and improve their involvement and opportunities to be engaged in their daily/weekly occupations. Therefore the outcome of intervention is to aim for the client to be participating in their daily meaningful occupations that will “support recovery, health, well-being, satisfaction and sense of achievement” (Creek and Lougher, 2008, p.37).

ACTIVITY: Have a think when your feeling not yourself, what occupations do you use to help to improve your mental well being? What is it about the occupations that makes you have this effect?

MENTAL HEALTH DIFFICULTIES IN MEANINGFUL OCCUPATION

It was from participating in the humanities course in first year of studying occupational therapy that I learnt being occupied is the essence of being human. However, people who experience mental health difficulties are limited in their ability to engage in their meaningful occupations and which in itself can deteriorate an individual’s mental and physical well being.

They may experience an inability to “occupy themselves in a productive and self-filling manner” (Rebeiro, 1998, p.15). This includes being able to structure and organise their day as well as finding and maintaining their occupations in regards to work self-cares and leisure. Therefore this also demonstrates their lack of occupational balance within their lives (Westhorp, 2003).

Their mental health difficulties can have a negative impact on an individual’s motivation and self-esteem. This can lead to feelings of hopelessness and helplessness and their ability to initiate themselves to participate in their meaningful occupation. Law (1998) states that “withdrawal or changes in occupation for a person have a significant impact on a person’s self-perceived health and wellbeing” (p.89). Stress also has a negative impact on an individual’s health and well being as experiencing feelings of being overwhelmed and anxious can limited an individual’s participating in occupation.

They can also experience difficulty with developing and maintaining relationships with others, and gaining that sense of belonging, therefore may decide not to participate in occupation where a group situation may occur. “Despite the basic human need to feel a sense of belonging, a person with an enduring mental illness can often find it very difficult to form satisfactory relationships and integrate successfully with groups” (Mee and Sumsion, 2001, p.122). For example, in one of my mental health placements, one of my client’s meaningful occupations was rugby. We would go outside on warm days and kick the rugby ball around, and see who could get it over the goal post. However, since he had difficulties being around people, especially a group of people, this limited him in joining a team.

(Picture from google images)

Overall, this means people who experience mental health difficulties also experience occupational deprivation within their lives and therefore significantly impacting on their independence, safety and of courses their quality of life.

MEANINGFUL OCCUPATION

Since we have learnt what occupation is, we can now understand the true meaning of meaningful occupation. It is the fundamental component in occupational therapy.

Doing as such is an important aspect of being human. With meaning, occupation has the impact of enhancing an individual’s quality of life. Mee and Sumsion (2001) states that meaningful occupation can “improve the quality of an individual’s life through doing, not just through thinking” (p.122).

Meaningful occupations are which fulfil a goal or a purpose that is personally meaningful and culturally important. As stated in my previous post, occupations can be categorised as self cares, leisure and productivity, therefore meaning that everyone will have a numerous amount of meaningful occupations within their daily and weekly routines. However as occupational therapists and occupational therapy students, we need to understand that everyone will have different reasons as to why their occupations are meaningful to them.

For example; playing sport such as hockey is meaningful to me because it provides me with enjoyment, social interaction and a challenge, however to another person, they may believe hockey is meaningful to them because it keeps them fit and healthy, makes them feel good, or a way of releasing stress/steam etc. 

(Picture from google images)

There are many benefits people endure through the use of participating in occupations that are meaningful and purposeful to them. Some examples include an increased perceived self efficacy of one’s self such as the sense of mastery and self worth, quality of life and satisfaction, competence in our ability to perform and complete the activity, social interaction, sense of belonging and a way of relating to others etc.

Participation in meaningful occupation “provides opportunities to discover new information, to use capacity, and to create promoting a sense of mastery and self worth” (Goldberg, Brintell and Goldberg, 2008, p.18).

It also provides individuals with routine, control, choice and balance within an individual’s lifestyle.

“People who are engaged in occupation tend to be exhibit a general rhythm to their daily routine, a balance to work, rest, play and sleep activities and display more organised thoughts and actions” (Rebeiro,1998, p.15).

ACTIVITY: Have a think and discuss with a friend: What occupations would you miss if you were told you were never able to do them again? Why would you miss them? What impacts do these occupations have on your life?