This week, we have started to work on the assessments of client. Although we have practiced with classmates at school before, carrying out the assessments with clients was still challenging. When we were practicing with classmates, we were cooperative and familiar with the test so that the assessments could carry out smoothly. However, there are many precautions and strategies to carry out the assessments with patients in the clinical practice. I have done the work assessment (Valpar) with a patient who has schizophrenia, and he was a slow learner with poor attention span.
I remembered that after I gave instructions, he showed puzzled and made mistakes in the practice session. In this session, I have learnt that besides reading the manual thoroughly, we needed to get a clear concept on the criteria tested in the assessment. For example, VCWS 8 is used to check the productivity of client in assembly work, but not focused on the learning ability, so we need to ensure the client’s understanding on the steps before test. On the other hand, as the patient was easily distracted, I would like to draw his attention and urged him to focus the assessment frequently.
However, the encouraging words would affect the validity of the standardized test. In the future, I would put emphasis on the validity of the assessment in my mind as wordings of tester would affect the results that reflect patient’s performance. Beside the work assessment, I have also conducted some scales and checklists with patients. Although these types of assessments can be self-rated, I used to complete the scales together with patients as I want to get more details by the elaborations of each item.
The point that I would like to bear in mind is the consistency of the format in an attempt to maintain the validity of the scale. Reflection on activity plan Therapeutic activity is a key element of OT services for clients. We need to utilize our clinical reasoning to decide a tailor-made activity for our client and think of the activity as a mean or as an end. On the other hand, upgrade and downgrade is the area that we usually miss.
As the functional level of each client is different, we need to downgrade the activity for the patients with more symptoms and upgrade the activity to sustain the involvement of patients with higher functional level. We should also prepare the contingency plan so that we can provide therapeutic activity for our clients when they are in different mental state. Future expectation After passing through four weeks of placement, I was so glad that we could interviewed and carried out assessments with patients in different mental state.
Attaching in the Gap Rehab team shows me the recovery process of cases after the treatment by OT and the training in the MOT. Not only recovery of controlling symptoms, but also helping patient in reintegration in the community. The improvement of patients is my motivation and urges me to face the challenges in the future. There is a big room of improvement such as the interview techniques, the consistency of the assessment procedures and the report writing. I understand that it is unacceptable for a clinician to have careless mistakes and I hope that I can rectify the mistakes and be responsible for my professional.