Occupational therapists needs to keep in mind the psychological and psychosocial components in order to care and rehabilitate patients diagnosed with HIV/AIDS and substance abuse. The psychological component focuses more on self concept, values, and interests; and the psychosocial components deals with the skill and ability to balance roles in life, social interactions, coping abilities, and even modifying behavior with regards to the environment.
It is also advised that with HIV/AIDS there are no typical stereo-type that can be affixed to any patient who has been diagnosed with HIV/AIDS this eliminates pre-judgmental and unwarranted misconceptions during the care of the patient and enabling the occupational therapist to providing a respectful and dignified care to the individual (Williams 1990, p. 55-67). Such strategies and interventions have been developed for individuals who have been diagnosed with this disease to help them to evaluate and change their life and values.
Occupational therapists prevent dysfunction and maintain and restore function for people with HIV/AIDS in the areas of work, self-care, and play/leisure. These occupational areas are assessed and treated from psychosocial, physical and environment perspectives. (Pizzi 1990, p. 125-137) A mentioned by Pizzi, people with HIV/AIDS do need the assistance and care of occupational therapists to cope with their day-to-day lives. People who have been diagnosed with HIV/AIDS do a lot of change to cope up with. Their way of living, social skills, and even cognitive process are affected for them to try living a normal life.
A person knowing the fact that there is no cure for this virus may very well go straight onto depression. As well as what actions that he needs to take for those they dearly love be not affected by this disease. Coping mechanism or even a defense mechanism may be put into place inadvertently. With the assistance of occupational therapists, they can alleviate the grief and sorrow that curtails with having the virus. Guilt, loss, and the search for meaning are spiritual aspects that the HIV/AIDS patient goes through daily.
The goal of the occupational therapist in this situation is to attain optimal health achieved by their charge. This includes reaching spiritually to the patient and combing occupational performance to enhance the quality of life. Substance Abuse and Occupational Therapy Patients with substance abuse disorder may become a danger to themselves and to the community. As mentioned before, these patients may have their cognitive process impaired due to the repeated and prolonged use of illegal substances. Motor function skills and even, thought process may be impaired up to an extent depending on the exposure to illegal substances.
An extreme case may call for all four frames of reference in order to help rehabilitate the patient. The theoretical base that can be used here are cognitive psychology; biological psychiatry; occupational behavior; and general systems. This theory base takes one characteristic from each frame of reference the reason is taking a holistic view-point on assisting, teaching, and rehabilitating a person diagnosed with substance abuse. The theoretical base focuses on the general system of the patient while modifying their behavior and their urges to be weaned away from substance addiction – to live functional, normal lives.
The occupational therapist needs to help teach the patient with the abilities to cope up with external and internal influences. The three major dysfunctions are: 1) the patient would have an occupational dysfunction that hinders him to lead a fulfilling life; 2) due to the harm that the substance has inflicted on the patient, the process of cognition may be restricted, thus obstructing routine tasks; 3) identifying their role within in the society that they are in.
Three major function continuum which this theoretical base would focus on are: 1) teaching the patient their roles within society, social skills, and habituation; 2) guiding the patient into a fully functional cognitive process in order to perform rudimentary yet routine tasks; and 3) making sure that the patient can be acclimatized to the changing internal an d external influences found within their immediate environment. Depending on the extent of damage that substance abuse has brought on to the patient, it readily affects the bodily function and cognitive processes of the individual.
With regards to the first continuum: basic social skills and societal roles are soon lost on the further onset of this disorder. The patient loses the ability to interact with the environment and society around him as he only focuses on fulfilling his urge to the substance that he is addicted to. The second continuum focuses on preventing atrophy by bringing back the use of major muscles via performing routine/daily task of the patient. As for the third continuum, on the onset of rehabilitation, withdrawal symptoms will be observed and needs to be checked upon.
This is the stage where the patients’ body craves for the addictive substance and may force the patient to do erratic, irrational, and extraordinary actions. This step also may induce the cognitive process of the patient to rationalize the irrational. Medications and certain restrictions may be used in the manner in order to facilitate the rehabilitation process of the patient. A detailed analysis and assessment is needed for the occupational therapist to assess their charge. This would let them know what actions to take in order to proceed with the rehabilitation process.
As mentioned before, the occupational therapist needs to know what culture, background, environment, and other factors that are needed to establish a form of trust and a well as any approach that may be needed to proceed in assisting the patient achieve their goals. Knowing what substance was used by the patient would let the occupational therapist know what to avoid and what to use during the rehabilitation process. Knowing what medications, the client may need, is detrimental to this process. The setting of the rehabilitation would need to be in a controlled environment.
Having the patients’ full consent and cooperation during the rehabilitation process is a key factor for a successful outcome. Without the patients’ consent and even a hundred percent cooperation with the occupational therapist – progress would be hindered. A strong bond of trust needs to be made between the occupational therapist and the patient. As the patient would progress from one level of rehabilitation, exercises, to a more skilled level, the mental and physical strain would become evident as challenges would arise before any goals are achieved.
Rehabilitation does not finish even at the end of various and numerous exercises and therapy. Rehabilitation continues on beyond those sessions where the real test of progress begins, this is the time where follow-up care and support be given. Depending on the final assessment of the occupational therapist on their charges, the occupational therapist should look into the lifestyle of their patients to see if they are continuing their efforts to change their lifestyle as well as see the progress that they are making.
Occupational therapists should strive and learn more about the patients that they treat and rehabilitate. Occupational therapists need to seek to understand their patients in order for them to have a strong working client-therapist relationship in order to understand the specific needs of each and every individual patient. Such factors that the occupational therapist needs to take into account the culture and background that the patient was exposed to as well as to the various influences of the environment, families, colleagues, etc.
With regards to treating patients with substance abuse disorder and even those with HIV/AIDS, an occupational therapist can greatly improve the quality of life for these individuals. With an effective and distinct approach to assessing and planning the rehabilitation process of these patients, the occupational therapist can give them a helping hand in renewing and enhancing the occupations of their patients.
References
Casper College (2000). Occupations. Retrieved February 9, 2008, from http://wind. cc. whecn. edu/~mwonser/OCTH2000/unit5. html Encyclopedia Britannica (2008).Occupational Therapy. Retrieved February 9, 2008, from Encyclop? dia Britannica Online: http://www. britannica. com/eb/article-9373853 Molineux, M. (1997). HIV/AIDS: a new service continuum for occupational therapy. The British Journal of Occupational Therapy, 60, 194-198. Pizzi, M. (1990). Occupational therapy: Creating possibilities for adults with Human Immunodeficiency Virus Infection, AIDS related complex, and Acquired Immunodeficiency Syndrome. Occupational Therapy in Health Care, 7(2/3/4), 125-137. Presti, H. L. (1990). AIDS: the spiritual challenge. Occupational Therapy in Health Care,
7(2/3/4), 87-102. The American Occupational Therapy Foundation (2002). Pandemic: Part 2 Occupational Therapy and HIV/AIDS. Retrieved February 9, 2008, from http://www. aotf. org/html/pandemic2. html Valentin, C. (1993). SIDA et Ergotherapie a Domicile. World Federation of Occupational Therapists: Bulletin, 28, 24-30. Williams, J. K. (1990). Values and life goals: clinical interventions for people with AIDS. Occupational Therapy in Health Care, 7(2/3/4), 55-67. World Health Organization (2008). Substance Abuse. Retrieved February 10, 2008, from http://www. who. int/topics/substance_abuse/en/