Occupational Therapy

Head of Service: Ms. Liora Barkai.
E-mail: [email protected]
 
Occupational therapy is a therapeutic, rehabilitative, educational profession, one of the health professions that draws its knowledge from the occupational, medical, and social and behavioral sciences.
 

The aim of this profession is provide a person with tools and skills that will enable him to cope with the demands of life. Therefore, occupational therapists consider it their main role to assist the individual to get involved in occupations which have purpose and meaning for him, and which will allow him to once again become a productive person both at home and in the community.
 
The ultimate goal of any intervention of occupational therapists is:
To increase independence and participation daily activities, to develop adaptive skills, to prevent dysfunction and to maintain health.
 
The occupational therapist's work with mental patients at a hospital setting and in the community, takes into account all the various types of activity and occupations patients participate at.

 
In recent years there a change occurred in the perception of psychiatric hospitalization. Hospitalization duration was shortened, and recovery was transferred to certain facilities within the community. If in the past a process of rehabilitation through occupational therapy was initiated within the hospital setting, nowadays, the short hospitalization duration dictates a different form of treatment and approach in terms of occupational therapy.

 
Treatment focuses on creating an initial therapeutic relationship, evaluation and diagnosis of capability and performance, and only then, advancing to meaningful occupations, as per the patient's capabilities and choice.
 
The therapeutic intervention is done individually and/or in a group.
The objective of the occupations and activities is to provide a positive experience of success and competence, to restore and maintain any affected abilities and to work on functional everyday activities. However, consideration is also given to the reality to which the patient returns in the community, at work and in his leisure activities.
 
The occupational therapy team is part of the multidisciplinary team present in each ward, takes part in team meetings and in the design of the treatment program. The multidisciplinary team's work enables transferring information on a daily regular basis regarding the progress of the patient or any changes in his condition.
 
The occupational therapy team consists of an occupational therapist, employment counselors and movement therapists. The occupational therapists have a college degree in occupational therapy and are professionally licensed, the guides have a background in various fields such as art, crafts, teaching and so on. The other therapists are academically qualified to practice in their field.
 
Diagnosis, evaluation and the design of a treatment program, are all made by an occupational therapist, whereas the activation of patients within a vocational setting is conducted by guides under the supervision and monitoring of an occupational therapist.
 
Every ward employs an occupational therapist and a guide, except for the long-term and geriatric wards, where the activity is guided by guides.
 
Occupational therapy intervention starts at the more acute stages of the disease, even when the patient is hospitalized in the closed wing. A preliminary evaluation of the patients' suitability and capability to take part in the activities is carried out in cooperation with the ward's staff.  The activity proposed for this stage mainly includes short-term works, expressive tasks using different materials, and all without involving tools or materials that could pose a risk. This is the first encounter with occupational therapy, in which the initial contact is made.
 
Occupational therapy activity offers the patients a positive experience of working in a pleasant and supportive atmosphere, which also allows forming social bonds. All that at the same time with a process of creation and various expressive tasks.

 
The activity promotes the initiation of a process of inner organization, which is followed by evaluation and diagnosis within the open settings of occupational therapy.

 
When the patient is hospitalized in the open wing, the occupational therapist conducts a structured introduction interview and an initial diagnosis. The treatment program is designed according to the findings of the evaluation, professional impression, and the patient's needs and abilities.

 
Among the groups operated within the ward's occupational therapy activities we should specify the support group where treatment includes using therapy cards, the emotional expression group that utilizes different means and the cooking group.
 
With the improvement in the patient's mental state, where a significant change in his functional, cognitive and behavioral competence can also be detected, the patient is assigned to one of the workshops.
 
Workshops:
There are a number of workshops offering various occupations in the field of different handicrafts, woodwork and crafts such as jewelry, ceramics and stained glass. The patient, at his discretion and as per his treatment program, will be assigned to one of the workshops, where he will work under the guidance of the guides, as shall be directed by the occupational therapist of the ward to which he belongs.
 

The work at the workshops entitles patients to a financial compensation, according to a rate index referring to the type of work, number of hours and a bonus of up to 20% of the hourly salary awarded in cases of excellence at work.
 
Patients that exhibit high efficacy level and motivation, are assigned to services groups within the center's servicing system, such as: Laundry room, dining room, storage room and the cafeteria. This work also entitles the patient to financial compensation.
  
Instruction for students
Bachelor's degree studies in occupational therapy at Haifa University, Tel Aviv University, the Hebrew University of Jerusalem and Ono Academic College, include four clinical practices as per the standards of the World Organization of occupational therapists (WFOT). The duration of each practice is extended according to the study year, while the last training is the longest and most profound one.  During the first year training is consisted of a few days of observation, during the second year training lasts 8 weeks, during the third year 9 weeks and during the fourth year training last 13 weeks.  Students in practical training must spend 30 hours a week at the institution. The aim of the various training periods is to enable gaining exposure and familiarity with the wide range of institutions, groups, individuals and therapies. Maale Hacarmel Mental Health Center employs a team of occupational therapists who are trained instructors, and who are assigned with students from Haifa University, Hebrew University and Tel Aviv University.

During the training period the students take part in all the professional activities that the staff members participate in, such as: Staff meetings, seminars, access to the professional library and to patients' records, in coordination with and under the supervision of the guide at the practical training site. The students are obliged to abide by the code of ethics of occupational therapists and the professional ethics rules and procedures practiced at the site.

The students undergo individual training and periodic evaluations as part of a formal process that links between the training process and the university. Students' requirements include submitting a written assignment at each one of the practical training periods. During the last practical training period a project is conducted, which forms a part of the study requirements at this stage, in addition to the stated assignment. The project is conducted in coordination with the guide according to the needs of the institute and in consideration of the patients, and it is kept as a contribution to the treatment framework of occupational therapy. Fourth year students are expected to exhibit higher level of integration of theoretical knowledge with therapeutic activity. The long duration of the training process allows for greater and deeper clinical experience.

In conclusion, the students are an important and significant contribution to the daily work with the patients. This experience provides them with a learning experience and contributes to their molding as future professionals.