Emmy Vadnais https://emmyvadnais.com Holistic Occupational Therapist Fri, 26 Jun 2020 16:40:02 +0000 en-US hourly 1 https://wordpress.org/?v=5.4.2 Exploring Healing in Racism in Health Care https://emmyvadnais.com/exploring-healing-in-racism-in-health-care https://emmyvadnais.com/exploring-healing-in-racism-in-health-care#respond Fri, 26 Jun 2020 16:39:34 +0000 https://emmyvadnais.com/?p=3299 On the Healing Connections Podcast, Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness. Sheela Ivlev, MS, OTR/L is interviewed by Emmy Vadnais, OTR/L about “Exploring Healing Racism in Health Care.” Sheela shares terms commonly used in the topic of racism, provides education, and explores ways […]

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On the Healing Connections Podcast, Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness.

Sheela Ivlev, MS, OTR/L is interviewed by Emmy Vadnais, OTR/L about “Exploring Healing Racism in Health Care.” Sheela shares terms commonly used in the topic of racism, provides education, and explores ways that racism can be healed in health care. Watch on YouTube or listen on Apple Podcasts and Spotify.

Read article “Racism in Healthcare and What We Can Do About It” by Sheela Ivlev, MS, OTR/L
Sheela is an occupational therapist who specializes in wellness and mental health. She is committed to removing the barriers to care that keep people from accessing services for health and wellness. Music by Steven C. Anderson: “The Cradle” from the album “Healing Piano.” Learn more about Sheela and ways to heal racism at OTBayArea.com.

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Coaching for Health and Wellness https://emmyvadnais.com/coaching-for-health-and-wellness https://emmyvadnais.com/coaching-for-health-and-wellness#respond Thu, 14 May 2020 16:07:05 +0000 https://emmyvadnais.com/?p=3285 On the Healing Connections Podcast, Emmy Vadnais, OTR/L interviews Ana Hernando, OTR, MOT, MBA about “Coaching for Health and Wellness.”  Ana shares what coaching is, how it can benefit a person in all areas of their life, what to look for in a coach, and why occupational therapists may have the most unique set of […]

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On the Healing Connections Podcast, Emmy Vadnais, OTR/L interviews Ana Hernando, OTR, MOT, MBA about “Coaching for Health and Wellness.” 

Ana shares what coaching is, how it can benefit a person in all areas of their life, what to look for in a coach, and why occupational therapists may have the most unique set of skills to provide coaching for the mind, body, and spirit.

Ana is passionate about complementary and integrative health. She holds several certifications including Sensory Specialist, Level III Reiki provider, Self Talk Speaker and Trainer, Life Coach and Chair Yoga for Seniors provider. Ana focuses on empowering people to reclaim their health from the inside out. She is the creator of the 12wks2wellness program. She holds a Bachelor’s Degree in Kinesiology, a Master’s Degree in Occupational Therapy and a Master’s of Business Administration.

She has conducted continuing education seminars for several years and has been a guest speaker for America Airline Professional Women in Aviation, Texas Autism Conference, MOPS International, Mothers of Multiples, and The Lions Club International. Ana lives in a suburb of Dallas and currently consults for The Center for Cardiovascular Health as well as owns and operates her private practice, Holistic Solutions focusing on wellness and health promotion. Visit DoctorAna.net.

Interested in learning more about coaching and occupational therapy?
Emmy & Ana are offering a class “OT and Coaching: Skills and Confidence for OTs as the Original Life Coach” in September. Learn more here. 

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The Intuitive Mind https://emmyvadnais.com/the-intuitive-mind https://emmyvadnais.com/the-intuitive-mind#respond Wed, 22 Apr 2020 15:46:51 +0000 https://emmyvadnais.com/?p=3276 On the Healing Connections Podcast Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness.  The Intuitive Mind We all have intuition. It’s something that can be developed so you can listen to it. Emmy Vadnais, OTR/L interviews Jeffrey Mishlove, PhD about “The Intuitive Mind” on the […]

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On the Healing Connections Podcast Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness. 

The Intuitive Mind
We all have intuition. It’s something that can be developed so you can listen to it.

Emmy Vadnais, OTR/L interviews Jeffrey Mishlove, PhD about “The Intuitive Mind” on the Healing Connections Podcast.

Jeffrey is host and producer of the New Thinking Allowed channel on YouTube. He is author of The Roots of Consciousness, Psi Development Systems, and The PK Man. He is the recipient of the only doctoral diploma in “parapsychology” ever awarded by an accredited university (University of California, Berkeley, 1980). Between 1986 and 2002 he hosted and co-produced the original Thinking Allowed public television series. He is also past-president of the non-profit Intuition Network, an organization dedicated to creating a world in which all people are encouraged to cultivate and apply their inner, intuitive abilities. Subscribe to his YouTube Channel at NewThinkingAllowed.com.

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“Raise Your Vibration” Daily Meditations – March 23-27 https://emmyvadnais.com/raise-your-vibration-daily-meditations-march-23-27 https://emmyvadnais.com/raise-your-vibration-daily-meditations-march-23-27#respond Tue, 17 Mar 2020 17:19:58 +0000 https://emmyvadnais.com/?p=3254 Be supported with your self-care by Emmy Vadnais, OTR/L to raise your vibration to joy and peace, and support your immune system.  This was recorded March 23-27, 2020 in light of fear and worry around COVID-19 and social distancing. Access the recording of 5 one-hour meditations to assist you with: Peace & Relaxation Joy Compassion Love […]

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Be supported with your self-care by Emmy Vadnais, OTR/L to raise your vibration to joy and peace, and support your immune system. 

This was recorded March 23-27, 2020 in light of fear and worry around COVID-19 and social distancing.

Access the recording of 5 one-hour meditations to assist you with:

Peace & Relaxation

Joy

Compassion

Love

Creativity

Intuition

Register Here

Please join in an area free of distraction where you can rest comfortably, and not driving a car.

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Keep Calm & Call a Holistic OT – COVID-19 https://emmyvadnais.com/keep-calm-call-a-holistic-ot-covid-19 https://emmyvadnais.com/keep-calm-call-a-holistic-ot-covid-19#respond Mon, 16 Mar 2020 17:25:21 +0000 https://emmyvadnais.com/?p=3243 Yes I am open. In the midst of uncertainty with COVID-19 I am keeping my doors open and am offering telehealth––phone or live video appointments to help you destress and continue to assist you with your goals in your life, and online classes and consultation sessions for health care professionals. As you may know, the better […]

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Yes I am open. 
In the midst of uncertainty with COVID-19 I am keeping my doors open and am offering telehealth––phone or live video appointments to help you destress and continue to assist you with your goals in your life, and online classes and consultation sessions for health care professionals.

As you may know, the better you can manage your stress and the more enjoyment you can find the better your immune system can function, and the more likely you can prevent disease.

Here’s an article I wrote for HolisticOT.org “Keep Calm and Call a Holistic OT” full of tips to stay well and happy.

Social interactions are the life blood of being human, as well. So, I hope you find ways to stay connected to loved ones in a safe way. 

Please let me know if I can assist you with your health, spirituality or intuition.

Wishing you Love and Light!
Emmy

P.S. If you are a health care professional looking for holistic continuing education classes now might be a good time to take one of my home study courses

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Acupressure and Your Health https://emmyvadnais.com/acupressure-and-your-health https://emmyvadnais.com/acupressure-and-your-health#respond Fri, 21 Feb 2020 20:55:07 +0000 https://emmyvadnais.com/?p=3224 Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness.  Acupressure and Your Health Marilyn Zurwaski, OTR/L and Carroll Noel-Mozer, OTR/L were interviewed by Emmy Vadnais, OTR/L about “Acupressure and Your Health” on the Healing Connections Podcast episode 19 on 2/17/20. Marilyn Zurwaski is the Co-President for […]

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Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness. 

Acupressure and Your Health

Marilyn Zurwaski, OTR/L and Carroll Noel-Mozer, OTR/L were interviewed by Emmy Vadnais, OTR/L about “Acupressure and Your Health” on the Healing Connections Podcast episode 19 on 2/17/20. Marilyn Zurwaski is the Co-President for Soul Lightening International. Marilyn is a Soul Lightening certified practitioner for Clinical Acupressure and Process Acupressure, and teaches several of their acupressure courses. Marilyn is an occupational therapist, and for the past 25 years she has been in private practice providing occupational therapy in Middleboro, MA.

Carroll Noel-Mozer is an occupational therapist at Spaulding Rehabilitation Hospital’s outpatient site in Wellesley, MA. She has more than 35 years of experience in neurological and orthopedic disorders. Carroll is Neurodevelopmental Technique trained and has taken several acupressure courses that she uses extensively in her practice. Visit SoulLightening.com and TotalApproachTherapy.

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I Am Successful https://emmyvadnais.com/i-am-successful https://emmyvadnais.com/i-am-successful#comments Wed, 29 Jan 2020 16:33:19 +0000 https://emmyvadnais.com/?p=3197 How does it feel to say this to your self? “I am successful.” What thoughts come to mind, feelings or emotions? Does if feel strange or good to say that. Do you believe it? The desire for fame and fortune is likely about feeling love, safe and accepted. We are often conditioned in Western culture […]

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How does it feel to say this to your self? “I am successful.”

What thoughts come to mind, feelings or emotions? Does if feel strange or good to say that. Do you believe it?

The desire for fame and fortune is likely about feeling love, safe and accepted.

We are often conditioned in Western culture that success means primarily financial success, and then anything else we want to add in the mix as secondary and tertiary. Financial success is probably about feeling you have and are enough.

How do you define success?

  • What do you feel you have accomplished?
  • What more do you want to accomplish?
  • Can you be okay with the amount of “success” you have now, however you define it?
  • What is your relationship with money and how can it help you to be successful?
  • How big is your love?
  • What more do you need to have or be to feel successful?
  • Do you feel enough joy?
  • Why do you define it that way?

When looking at my life, I realize I have been taught to strive toward goals. Even when in occupational therapy school we were taught how to make goals in a treatment plan. Yes, that can be necessary to move toward goals and we do need to have them. How about also taking stock of what you have already accomplished, to be okay with you, and to know that you’re enough.

In my healing practice, in over the past 10 years I have been guiding people deep into their own psyche and subconscious, through various forms of guided meditation, guided imagery, mindfulness and EFT (Emotional Freedom Technique a.ka. tapping), energy healing, and art therapy, what always comes up – no matter if it’s a physical, mental or emotional challenge a person is experiencing – are limiting beliefs around self-love, self-acceptance, self-worth, self-compassion and self-esteem. Isn’t that amazing?

Pretty much all of us seem to be carrying around a sense of rejecting ourselves that is usually related to areas in our lives that have challenges. This can manifest as a sore shoulder, back, chronic headaches, foot pain, sleepless nights, struggling in relationships, work/career and so on. Yes, it’s important to address all the ways to help these problems with perhaps exercise, healthy diet and nutrition, sleep, surgery at times, and so on, but the core component often remains until it is addressed.

We can go around blaming others for our internal frustration, lack of affection and love toward us. However, it is usually us who has to make friends with ourselves. Then, relationships with others can be in more harmony or break away.

Years ago, when practicing my new found techniques I guided a person to observe themselves with love and move toward loving themselves. They hesitated a moment, and then replied, “Love? I don’t even like myself.” That person taught me that sometimes we need to take a step toward liking ourselves.

Sure, there may be some situations that have happened in your life where you do not feel very proud of something you have done, or haven’t done. The guilt may still be lingering. What steps can you take to forgive yourself? Can you understand you were doing your best with what you knew at that time in your life? If there is someone you feel you have negatively impacted perhaps you could apologize. If they are dead maybe you could write a letter and/or read it out loud. If there is someone who has negatively impacted you, what steps do you need to heal?

I’m not suggesting that we all move toward narcissistic adoration, because no one is better than anyone else. What I am suggesting is that you make friends with yourself, realize you have done well, accept all parts of yourself, look at areas you want to improve and do better as you go forward. In this way you are successful.

For me it means that I am a beautiful art work in progress (and so are you). It means that the more loving and accepting I can be with myself the more I can be toward others. That means more love in the universe overall, and a happy and healthier world we can all live and thrive in. When I am in a loving place I can more easily listen to my intuition and continue to serve in the ways I feel called to serve. It means I am doing the best I can. It means I can be while also being in action in more of a flow and enjoying this moment now while I create going forward. It means I am respected for the gifts I share. I trust that what I need flows to me. I am joyful. I am learning. I am accepting while taking action for what matters to me. I am peaceful.

Yes, we all need food, shelter, a roof over our heads (Maslow’s hierarchy of needs) and then we can focus on all areas of success, however you define it for yourself in your life.

“Whether one is rich or poor, educated or illiterate, religious or non-believing, man or woman, black, white, or brown, we are all the same. Physically, emotionally, and mentally, we are all equal. We all share basic needs for food, shelter, safety, and love. We all aspire to happiness and we all shun suffering. Each of us has hopes, worries, fears, and dreams. Each of us wants the best for our family and loved ones. We all experience pain when we suffer loss and joy when we achieve what we seek. On this fundamental level, religion, ethnicity, culture, and language make no difference.” ― Dalai Lama XIV, Toward a True Kinship of Faiths: How the World’s Religions Can Come Together

How do you define success? I’d love to hear your thoughts. If you feel you would like more support in any of these areas described drop me an email to schedule an appointment. I am grateful to assist you.

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Occupational Therapy with Integrative Health for Bipolar and Anxiety Disorders: Case Report – Now in Remission https://emmyvadnais.com/occupational-therapy-with-integrative-health-for-bipolar-and-anxiety-disorders-case-report-now-in-remission https://emmyvadnais.com/occupational-therapy-with-integrative-health-for-bipolar-and-anxiety-disorders-case-report-now-in-remission#respond Mon, 20 Jan 2020 19:17:29 +0000 https://emmyvadnais.com/?p=3176 By Emmy Vadnais, OTR/L and Carisa Hillman, OTS This case report was created by Emmy Vadnais, OTR/L and fieldwork student, Carisa Hillman, OTS, while providing occupational therapy with integrative health for their client “Mary” in 2016. It was submitted to an OT and mental health journal, and after two years of revisions, including thorough assistance […]

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By Emmy Vadnais, OTR/L and Carisa Hillman, OTS

This case report was created by Emmy Vadnais, OTR/L and fieldwork student, Carisa Hillman, OTS, while providing occupational therapy with integrative health for their client “Mary” in 2016. It was submitted to an OT and mental health journal, and after two years of revisions, including thorough assistance from an OT professor, it was not accepted. We were not told clearly how we could improve it for acceptance. We chose to not submit it to any other journals as we believe it will likely get more exposure and readership here. During this time Mary’s Bipolar Disorder diagnosis was reported to be in remission with a primary diagnosis of an Anxiety Disorder that she was managing well. Special thank you to Michelle Bradshaw, DC, OTR/L for her assistance with this case report.

ABSTRACT

Occupational therapy with integrative health approaches in a community setting improved occupations for a woman with Bipolar and Anxiety Disorders. A 40-year-old woman with a history of Bipolar Type I and II and an Anxiety Disorder received occupational therapy sessions for six weeks to improve her occupations. Client reported decreased stress and anxiety levels, increased participation in activities of daily living, increased physical activity and exercise, and overall improved sleep quality. Occupational therapy with integrative health approaches may improve the ability for individuals with mental health conditions to increase participation and satisfaction in meaningful occupations.

KEYWORDS Mental health, bipolar, anxiety, integrative health, meditation

Introduction

This paper describes the effectiveness of occupational therapy (OT) with integrative health approaches in a community setting for a woman with Bipolar and Anxiety Disorders.

Mental health

Occupational therapy has its roots in mental health. Mental illness can significantly affect an individual’s ability to engage in meaningful activities of daily living and productive daily routines (AOTA, 2016). Mental disorders are among the most common causes of disability. In 2014, an estimated 18.1% (43.6 million) of U.S. adults ages 18 years or older have suffered from any mental illness and 4.1% (9.8 million) suffered from a seriously debilitating mental illness (Hedden, S. L., Copello, E. A. P., Kennet, J., Kroutil, L. A., Lipari, R., Medley, G., Tice, P., 2015).However, since 2009, the number of research articles on occupational therapy in the practice area of mental health published in the American Journal of Occupational Therapy (AJOT) is less than the number of research articles in all other practice areas except work and industry, and health and wellness (Gutman, S.A. & Raphael-Greenfield, E., 2014), suggesting the intervention focus for OT has shifted back to an earlier emphasis on prevention and wellness, using daily activities within a natural context in order to provide a holistic perspective for intervention (Burroughs, T., Mathieson, K., Belden, C.V., Gross, M., 2016).

There is a growing body of psychoneuroimmunological research linking physical health to emotional well-being (Lattie, E. G., Antoni, M. H., Fletcher, M. A., Penedo, F., Czaja, S., Lopez, C., … Klimas, N., 2012). The state of a person’s mental health can play a major role in their ability to maintain good physical health. Mental illnesses can affect people’s ability to participate in health-promoting behaviors. Challenges with physical health, such as chronic diseases, can have a serious influence on mental health and lower a person’s ability to participate in treatment and recovery (Lando, J., Marshall Williams, S., Sturgis, S., & Williams, B., 2006). Occupational therapy provides care for people with both physical and mental illness.

Integrative health, wellness and prevention

Health and Wellness is one of the six key OT practice areas, and possible outcomes from OT intervention (AOTA, 2014). The mainstream health care system in the United States has functioned primarily in the acute care or “sick care” biomedical model that addresses disease after a person has become ill and may be improved by providing a prevention model that focuses on health that forestalls disease development (Fani & Stafford, 2012). There is a call by Wendy Hildebrand, MPH, OTR/L, FAOTA and Amy Jo Lamb, OTD, OTR/L, FAOTA, president of the American Occupational Therapy Association, for occupational therapists to address health, wellness, and prevention (“Occupational Therapy in Prevention & Wellness”, 2013).

Integrative health care often combines conventional and complementary approaches together in a coordinated way. A holistic, patient-focused approach to health care and wellness is emphasized. It treats the whole person including the mental, emotional, functional, spiritual, social, and community aspects. When a non-mainstream practice is used together with conventional medicine, it’s considered “complementary.” When a non-mainstream practice is used in place of conventional medicine, it’s considered “alternative” (National Center for Complementary and Integrative Health, 2016). 

According to the National Center for Complementary and Integrative Health (NCCIH), the use of an integrative approach for health and wellness has grown within care settings across the United States, including hospitals, hospices, and military health facilities since its inception 16 years ago (National Center for Complementary and Integrative Health, 2016).

The OT scope of practice may be supported by integrative health, when appropriate. OT has a similar holistic approach as integrative health. OT with integrative health may be used to improve clinical outcomes (AOTA, 2011).

Clinical case

Mary, a pseudonym, is a 40-year old educated Caucasian woman who lives with her husband and pets and has been sober from alcohol for 20 years. At age 30 she was diagnosed with Bipolar I after a psychotic episode and hospitalization. After two more hospitalizations, Mary’s diagnosis changed to Bipolar II at age 36. Additionally, Mary was diagnosed with an Anxiety Disorder and her symptoms of anxiety temporarily improved following a support group. Despite her use of clonazepam, as needed, for her symptoms of anxiety, Mary recognized that she was not fully engaging in her meaningful occupations and sought OT services.

Mary was seen by a mental health practitioner weekly and followed by a psychiatrist.  She expressed interest in attending support groups, such as Alcoholics Anonymous or an anxiety group, that she has attended in the past, but reported feeling anxious about the required public speaking components of the groups. Mary denied any feelings of depression, but did express experiencing anxiety that can interfere with her ability to participate in meaningful occupations.

Occupational therapy assessments and findings

This case report was part of a Level 2 Fieldwork experience where the occupational therapy student (OTS) administered the initial OT assessments/evaluations under the supervision of the occupational therapist (OTR/L). Subsequent intervention sessions were co-led by the OTR/L and OTS to ensure proper administration of treatment methods. Mary was first seen for an initial evaluation that lasted 90 minutes followed by six visits averaging 90 minutes each.

Initial assessments

The Canadian Occupational Performance Measure (COPM) and the Kawa model were administered to Mary to determine her self-perception of overall occupational performance. The COPM is an outcome measure designed to be client-centered for occupational therapists to assess client outcomes in the areas of self-care, productivity and leisure (Law, Baptiste, McColl, Opzoomer, Polatajko, and Pollock, 1990). The Kawa model attempts to clarify the application of OT within the client’s particular social and cultural context. Kawa means river in Japanese and may have a symbolic meaning that provides a metaphor of a river being a person’s life where OT may help with a person’s life flow (Iwama, Thomson & Macdonald, 2009).

Based on the COPM’s semi-structured interview, Mary identified her top areas of occupational performance problem areas to be: Sleep, Relaxation, Budgeting, Verbally Reporting, and Managing Responsibilities. Anxiety seemed to be her primary client factor the impacted her successful participation in occupations (Table 1).

Kawa model was administered through an aerial view with paper and colored pencil and a cross section view on an iPhone app (Iwama, 2009 & Georgia Regents University, 2014). In the aerial view, Mary drew a river that appeared to be flowing well. However, when she completed the cross-section, Mary identified her obstacles and support were more spread out and that anxiety was her main obstacle. Her supports were work, friends, family, art and animals. She expressed that she would like her supports to be more connected and to surround her obstacles.

After completing the initial COPM (Table 1) and the Kawa Model Mary identified her top three occupational performance areas to address: sleep hygiene, stress management, and the ability to verbally report in a group.

Therapy goals:

The results of the assessments were discussed with Mary and long-term goals were established. By the fifth visit Mary had met her long-term goals 1 and 2 and the goals were reviewed. We updated her long-term goal 3 and created a new long-term goal 4 to reflect the changing needs of Mary.

Long term goal 1: By 6 weeks, client will be independent in sleep hygiene program as evidenced by report of staying asleep throughout the night.

Long term goal 2: Client will identify and implement three relaxation and coping strategies that will decrease reported anxiety to an average of 3/10 or less during activities of daily living (ADLs).

Long term goal 3: Client will be able to report verbally in a group at a decreased anxiety level of 5/10 or less.

New long term goal 3:  By the 7th visit, client will be independent in diet and healthy meal planning.

New long term goal 4: By the 7th visit, client will participate in home exercise program at least 5 times per week to manage stress and anxiety, aid in weight management and prevent further illness and disease.

Strategies, interventions and outcomes

Multiple OT and integrative health strategies and interventions were used. Below are a summary of Mary’s sessions and illustrate her response to OT and integrative health services.

Visit 2: 

Mary reported feeling stressed at 6/10 as she felt pressure to complete several errands prior to her OT session. An interventions strategy consisted of her creating a priority-based to-do list to help organize her days/week to reduce her feelings of stress with completing tasks. Anxiety and low self-esteem may be correlated (Mruk, 2013). Therefore, she completed the Sorenson Self-Esteem Test. She scored a 16/30 indicating moderately low self-esteem. We guided her in abdominal breathing, progressive relaxation, and a special imagery. We recommended that Mary meditate by practicing these techniques for five minutes, three times in the next week, as research has found that participating a relaxation techniques or activities and meditation can reduce stress and anxiety levels (Benson, H. & Proctor, W., 2010). We then educated her on sleep hygiene tips from the American Sleep Association, and recommended she try completing a reflection journal nightly to aid with falling asleep, as she had mentioned this was something she had done years ago and has improved her ability to fall asleep (The American Sleep Association, 2016). Her reported stress level decreased to a 2/10 at the end of the session.

Visit 3:

Mary rated her stress level at a 3/10. She stated, “The meditation I did today before coming in put me in a great mood. I am much more calm.” She reported that the relaxation techniques were “going great” for her. She identified a relaxation activity of making art. She also read a book, participated in a dance event, went for a walk, and a bike ride that were all relaxing for her. She did not complete the sleep journal as it was too cumbersome. Her cats were disturbing her ability to sleep as they would scratch her bedroom door and took up too much space in her bed. We recommended she look in to a cat scratching post or cat house to give them another space to go during the night. When discussing nightly routines, Mary identified that she used to reflect on her day every night before going to bed, and it would help her fall asleep. However, she hadn’t participated in reflection for a number of years stating, “I can’t remember why I stopped.” We recommended that she try to reflect before bed nightly for one week.

Mary reported her consumption of sugary drinks was more than she would like to admit, and she recognized that this might have been interfering with her energy, mood, and stress and anxiety levels. She identified Kombucha as a substitute she would like to use. Mary reported practicing eight minutes of meditation three times per week and found a few online meditations she really liked. We recommended that she increase her meditations to 10 minutes three times for the upcoming week. At the end of session Mary rated her stress at a 3/10 as well.

Visit 4

Mary stated “I am feeling good today.” Her stress was a 3/10. She reported that her priority-based to-do lists assisted her to complete more of her daily tasks. She also reported success with reading for leisure, reflection before bed, and weekly meditations.

However, she noted difficulty with substituting sugary drinks as after three days without drinking any, she drank seven in one day. On one day, she felt highly stressed and took four Seroquel and three Klonopin. The rest of the week she had less stress. She reported meditations were reducing her anxiety. The reading and meditations were starting to become more routine and that the reflection before bed had been helping her sleep. She had not woken up during the night. We educated Mary on reading food labels, healthy portion sizes, and pairing of healthy foods that supported her weight loss goals. We provided her with resources such as the “Australian Guide for Healthy Eating” and the Centers for Disease Control and Prevention (CDC), “Healthy Eating for healthy weight” (The Australian Guide to Healthy Eating, 2016, The Centers for Disease Control, 2016).

We also instructed her on how to perform mindfulness meditation to aid in identifying triggers associated with stressful situations and observe thoughts and feelings with less judgement and more compassion during her daily occupations.

Visit 5:

Mary reported completing errands prior to the session. She stated, “I probably shouldn’t have done so much.” Her stress level was at a 4/10. Mary completed a food intake journal. We encouraged her to identify foods she could include to make her meals more balanced and nutritious while using information from the CDC and Australian healthy meal planning guide.

Mary reported having met her long-term goals 1 and 2 related to sleep hygiene and relaxation. She expressed that her long-term goal of verbally reporting was not an area of priority for her at the time. Therefore, we changed short term goal 3 to address healthy meal planning, diet and exercise to new long-term goal 4. 

Visit 6:

 Client reported, “I’ve been doing a lot better with relaxing and sleeping since I started working with you.” We re-evaluated the COPM for sleep and relaxation. She was receptive to the meal planning and a home workout for beginner’s handouts were provided.

Visit 7:

Mary completed her exercises, but felt they were an effort to do. She reported walking three times in the past week, completed two 20-minute workout videos, including yoga. She also completed her home exercise hand-out three days during the week and stretched daily. She reported walking outside was too cold due to winter. We recommended walking at the mall, stores, taking stairs, and parking further away from stores. We suggested that she could combine meditation and stretching. She identified that moving was the best way to keep her active. We suggested that she find exercise and movement activities that she might enjoy, because then she will be more likely to engage in these activities. She had identified that she enjoyed dancing. We re-evaluated the COPM for occupational performance for healthy meal planning and physical activity.

We assessed how likely Mary thought she would continue with the approaches she received during the visits. Mary reported an 8/10 likelihood that she would continue with physical activity. She had removed all unhealthy snacks from her home and was using the suggested snack ideas from the healthy meal planning handouts. She stated that the likelihood for her to continue with healthy meal planning was a 10/10.

Mary reported being grateful for her experience with occupational therapy with integrative health. “I now feel like things I used to worry about don’t seem so bad. I worry less and I’m suppressing less. The meditations can make things that seem like a big deal not so bad and reflection helps keep me calm. Mindfulness helps me be less judgmental of things that have happened during the day and in the past. I have a greater appreciation for the things around me and my support system.”

Mary noted that her spirituality has increased over the seven sessions stating that it had become an unexpected improved area of occupation in her life. “Spirituality feels like a whole new world. The meditation is really great – you can feel peace about everything. I don’t have to worry so much. I feel so confident when I meditate. The reflection reminds me of my old self. I would be afraid to close my eyes. The thoughts… I would just want to be knocked out and go to sleep. It feels like I’m not judging myself and I’m better able to participate in the activities I enjoy.”

At the end of our visits, we recommended that Mary continue with occupational therapy to address verbally reporting in a group and/or to address this with her mental health practitioner.

Re-evaluation

We re-evaluated with the COPM (Table 2) at the sixth and seventh visits. Mary’s occupational performance average increased from 5.2/10 to 6.8/10 and her satisfaction increased from 4.3/10 to 6.7/10. Her occupational performance for sleep increased from 7/10 to 8/10 and her satisfaction increased from 4/10 to 8/10 from the initial evaluation. Her occupational performance for relaxation increased from 7/10 to 9/10 and her satisfaction increased from 5/10 to 9/10. Her occupational performance for healthy meal planning and physical activity increased from 2/10 to 9/10 and her satisfaction increased from 2/10 to 8/10 (Tables 1 and 2).

The KAWA Model was re-evaluated at the sixth session. Mary identified her obstacles and supports felt closer together which she explained as symbolizing unity and a sense of connection with each other that felt better to her. At the initial evaluation she identified that her obstacles and support were more spread out and expressed that she would like her supports to be more connected and to surround her obstacles at the initial evaluation.

She completed the Sorensen Self Esteem Test and scored indicating an improvement to mild self-esteem 7/30 from moderately low self-esteem 16/30.

Discussion

This case report attempts to demonstrate the effectiveness of OT with integrative health approaches in a community setting for a woman with Bipolar and Anxiety Disorders to engage in meaningful activities of daily living and productive daily routines.

Occupational performance and satisfaction increased in all identified areas of occupational performance for Mary. Overall, we were encouraged with the level of reported improvements Mary had with her daily occupational performance and decrease in anxiety symptoms within six sessions. We found the COPM and Kawa model can assist well with identifying occupational performance areas and assist with health, wellness, and prevention.

One of the limitations identified within this case study was the time frame in which therapy was provided. Mary was provided OT interventions for six visits. However, with a longer treatment period, we could have further supported her movement and fitness goals for greater adherence. The occupational performance goal of verbally reporting could have also been addressed as it was earlier identified as a priority for Mary.

Further research is needed to determine the optimal time frame in which therapies could be provided to clients to develop long term carryover.

Conclusion

This case study begins to highlight how occupational therapy with evidence-based integrative health approaches may improve the ability for clients with mental health diagnoses to engage in meaningful occupations.

Informed consent

The patient read this case report to confirm its content and gave verbal consent to publish.

References

American Occupational Therapy Association (AOTA). Giese, T. (2011). Complementary and

Alternative Medicine Position Paper. American Journal of Occupational Therapy, 65(Supplement_6), doi:10.5014/ajot.2011.65S26

American Occupational Therapy Association. (2014). Occupational Therapy Practice framework: Domain and process(3rd Ed.). American Journal of Occupational Therapy, 68(139). doi:10.5014/ajot.2014.682005

The American Occupational Therapy Association (2016). Occupational Therapy’s Role in Community Mental Health. Retrieved December 16, 2016, from htt://www.aota.org/about-occupational-therapy/professionals/mh/community-mental-health.aspx

The American Sleep Association (2016). Sleep Hygiene. Retrieved December 16, 2016, from American Sleep Association

Eatforhealth.gov.au. (2016). The Australian Guide to Healthy Eating. Retrieved December 16, 2016, from https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating

Benson, H. & Proctor, W. (2010). Relaxation Revolution: Enhancing Your Personal Health Through the Science and Genetics of Mind Body Healing. New York, NY: Simon and Schuster, Inc.

Burroughs, T., Mathieson, K., Belden, C.V., Gross, M. (2016). A Qualitative Study of the Role of Occupational Therapy in Mental Health Community-Based Settings. American Journal of Occupational Therapy, 70, 7011505136p1. doi:10.5014/ajot.2016.70S1-PO4031

Centers for Disease Control and Prevention. (2016). Health Eating for Healthy Weight. Retrieved December 16, 2016, from https://www.cdc.gov/healthyweight/healthy_eating/

Fani Marvasti, F., & Stafford, R. S. (2012). From sick care to health care–reengineering prevention into the U.S. system. The New England journal of medicine367(10), 889–891. doi:10.1056/NEJMp1206230

Georgia Regents University. (2014). Kawa (82.9 MB). [Mobile application software]. Retrieved December 16, 2016, from https://itunes.apple.com/us/app/kawa/id882899927?mt=8.

Gutman, S.A. & Raphael-Greenfield, E. (2014). Five Years of Mental Health Research in the American Journal of Occupational Therapy, 2009–2013. American Journal of Occupational Therapy, 68, e21-e36. doi:10.5014/ajot.2014.010249

Hedden, S. L., Copello, E. A. P., Kennet, J., Kroutil, L. A., Lipari, R., Medley, G., Tice, P., Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved December 16, 2016, from http://www.samhsa.gov/data/

Hildenbrand. W. & Lamb, A. (2013). Occupational Therapy in Prevention & Wellness: Retaining Relevance in a New Health Care World. American Journal of Occupational Therapy, 67, 266-271. doi: http://ajot.aota.org/Article.aspx?articleid=1851676

Iwama, M. K., Thomson, N. A., & Macdonald, R. M. (2009). The Kawa model: The power of culturally responsive occupational therapy. Disability and Rehabilitation, 31, 1125-1135.

Lando, J., Marshall Williams, S., Sturgis, S., & Williams, B. (2006). A Logic Model for the Integration of Mental Health into Chronic Disease Prevention and Health Promotion. Preventing Chronic Disease, 3(2), A61.

Lattie, E. G., Antoni, M. H., Fletcher, M. A., Penedo, F., Czaja, S., Lopez, C., … Klimas, N. (2012). Stress management skills, neuroimmune processes and fatigue levels in persons with chronic fatigue syndrome. Brain, Behavior, and Immunity, 26(6), 849–858. http://doi.org/10.1016/j.bbi.2012.02.008

Law, M., Baptiste, S., McColl, M., Opzoomer, A., Polatajko, H. and Pollock, N. (1990). The Canadian Occupational Performance Measure: An Outcome Measure for Occupational Therapy. Canadian Journal of Occupational Therapy, 57(2), pp.82-87.

Mruk, C. (2013). Self-Esteem and Positive Psychology, 4th Edition: Research, Theory, and Practice. New York, NY: Springer Publishing Company

National Center for Complementary and Integrative Health (2016). Complementary, Alternative, or Integrative Health: What’s in a Name? Retrieved December 16, 2016, from https://nccih.nih.gov/health/integrative-health

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Love Remains https://emmyvadnais.com/love-remains https://emmyvadnais.com/love-remains#respond Wed, 15 Jan 2020 20:14:24 +0000 https://emmyvadnais.com/?p=3170 Having recently lost a loved one, what is most important is that #LoveRemains🌷 Love Remains for Sally “After the first sprout, your days in the sunYour days in the rainOften lit by moonlight and your own magic when in the sky there was none,shining your love,shining your smile,your joy After you toiled, you made it look […]

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Having recently lost a loved one, what is most important is that #LoveRemains🌷

Love Remains for Sally

“After the first sprout, your days in the sun
Your days in the rain
Often lit by moonlight and your own magic
when in the sky there was none,
shining your love,
shining your smile,
your joy

After you toiled, you made it look effortless,
gradually transforming “the system”
greeting people into your heart, they couldn’t resist
into your home

After creating your family with all of the artists, poets, singers and filmmakers,
all the way to great grandchildren,
inspiring others to be their authentic self,
you’d say “Be original.”

After the words left your mouth and the presence grew stronger,
your eyes grew ever brighter,
your heart swelled, shining brighter,
there was no mistaking – Love remains.”

–– Emmy Vadnais

We all experience loss. It can be the physical loss of person, a pet, a place, a home, a relationship, a job – it can be anything.

It is important to honor the grief. What does this mean? To allow yourself to feel how you feel. At the same time, acknowledge what was gained. What did you learn? What did you receive? What did you give? What remains?

If you need help processing your feelings or support with a loss, grief or transition, let me know. I may be able to help you.

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Living in a Wild Country: Is a Community Based on Love Possible? https://emmyvadnais.com/living-in-a-wild-country-is-a-community-based-on-love-possible https://emmyvadnais.com/living-in-a-wild-country-is-a-community-based-on-love-possible#respond Mon, 02 Dec 2019 18:47:54 +0000 https://emmyvadnais.com/?p=3151 On the Healing Connections Podcast, Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness.  Emmy Vadnais, OTR/L interviews Niren, also known as Philip Toelkes about “Living in a Wild Country: Is a Community Based on Love Possible?” Niren has been a lawyer for over 40 years, […]

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On the Healing Connections Podcast, Emmy Vadnais, OTR/L interviews thought leaders and health care practitioners about integrative health, wellness, prevention, spirituality, and consciousness. 

Emmy Vadnais, OTR/L interviews Niren, also known as Philip Toelkes about “Living in a Wild Country: Is a Community Based on Love Possible?”

Niren has been a lawyer for over 40 years, a daily meditator for over 30 years, and a mediator and coach for over 20 years – from big firm lawyer, he has come to a very quiet life, in nature, meditating, writing and doing his work as a Consciousness Coach.

He may be best known for being Osho’s lawyer and was featured in the Emmy award winning documentary, “Wild, Wild Country” on Netflix. Visit NirenConsciousnessCoaching.com.

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