The criteria for submission of this assignment are as follows:
• Case study answers must be typed in 12-point font, double spaced
• Each answer must be written below the corresponding question and question number
o This assignment is a word document and will be forwarded to each student via e- mail. Answers can be typed directly into the document.
o Note: If an editing block presents on the case study document when you open it, please copy and paste the questions into a separate word document for your use.
• Ideas must be expressed in a clear, concise, organized manner
• Part 1 must be handed in at the beginning of class on Day 5
• Part 2 must be handed in at the beginning of class on Day 10
o A hard copy of the case study answers in Part 1 and Part 2 must be submitted for grading, unless otherwise specified by the instructor
• Hand written submissions will not be graded This assignment is worth 15% of the final grade.
DAY 4: Therapeutic Use of Self; Responding to Symptoms (31 marks)
1. Design an Alliance with Mark, assuming you are his OTA
a) Outline a minimum of 3 of your expectations for Mark during his occupational therapy
. (3 marks)
b) What do you think Mark’s expectations would be of you
Provide 3 examples. (3 Marks)
2. You are Mark’s OTA. During your last 2 sessions with Mark, you notice that he is becoming over dependent on you, relying on you to do things that he can do himself. He has commented on how you remind him of his friend in elementary school. He explains that you are kind and caring and he would like to do something special for you to show his appreciation. He adds that he and his friend always did nice things for each other.
The next day you arrive at work to find a bouquet of flowers on your desk from Mark. You thank him in the next session, tell him how nice it is that he appreciates the work that you are doing together, and ask him if he would like to go for coffee after work to talk about the importance of friendship.
Refer to your PPTs and readings from Day 4 on therapeutic issues to answer the following questions:
a. What type of dependence is Mark developing
(1 mark). Briefly describe one way that you can address this issue
(2 marks).
b. What issues in the therapeutic relationship, which usually begin at an unconscious level, might be unfolding
(2 marks). Briefly describe one way you can address this issues
(2 marks).
c. Are there personal feelings outside of friendship that Mark could be developing for you
If so, what are they
(1 mark). Briefly describe one way you can address the issue
(s) (2 marks).
d. In addition to the answers you have provided above, identify a professional boundary that you must be aware of as an OTA
. (1 mark)
3. You have been working with Mark for 2 months now, and it has become clear that Mark is developing strong feelings for you that go beyond a therapeutic relationship. You and your supervising OT have decided that it is best that another OTA be assigned to Mark’s file. Mark is aware of this and is about to have his last session with you.
Provide 3 examples of what you would say/do to therapeutically end your working relationship with Mark.
(3 marks)
4. Mark tells you his is thinking of hurting himself. What are 2 pertinent questions to ask
(2 marks)
5. Prior to attending the Day Program Mark had been hospitalized due to an acute psychotic episode. Once Mark’s psychotic symptoms were beginning to be controlled in hospital with medication, he was referred to occupational therapy. During an activity, however, Mark told the OTA that he can hear the aliens talking to him and that he is the chosen one and has powers.
Using pp. 322-327 from Chapter 10 in your text as a guide, answer the following:
a. What is the difference between a hallucination and a delusion
(2 marks)
b. Is Mark experiencing a hallucination or a delusion, or both
(1 mark)
c. What kind of activity is appropriate for Mark
(2 marks)
d. How might the OTA demonstrate therapeutic use of self
Provide 2 examples. (2 marks)
e. What are 2 considerations for the OTA in modifying the treatment environment for Mark
(2 marks)
CASE STUDY QUESTION – PART 2
Day 6: Assessments (12 marks)
6. Locate online THE ROLE CHECK LIST by Frances Oakley OTR
a. The role checklist is divided into 2 parts. What does each part assess
(2 marks)
b. Name 3 roles that the checklist assesses
(3 marks)
c. Do you think that this would be a useful tool to use with Mark
Why or why not
(2 marks)
7. One of the tools that was used in Mark’s assessment is the Routine Task Inventory – Expanded (RTI-E).
a. Name the 4 scales of this assessment. (1 mark)
b. For each scale you named, identify one challenge that the OT/OTA could address that would help Mark attain his long term goals. (4 marks)
DAY 7: ADLs and IADLs (4 marks)
8. In reading Mark’s results on the RTI-E Community Scale (IADL), what can you do as an OTA to help Mark manage his allowance
Describe 2 strategies. Keep in mind the
results from Mark’s RTI-E Communication Scale when providing your answers. (4 marks)
DAY 8: Education and Work; Leisure and Social Participation (34 marks)
9. For questions a & b, do not list the same group more than once
a) Of the groups available in the Day Program that Mark is attending, list 2 groups that would help in addressing his goal of improved work related skills
(2 marks). For each group you list, briefly explain how that group is related to Mark’s work skills goal
. (4 marks)
b) Of the groups available in the Day Program, list 2 groups that would help in addressing his goal of improved social participation (2 marks). For each group you list, briefly
explain how that group is related to Mark’s social participation goal.
(4 marks)
c) Based on Mark’s identified school interests in his occupational roles interview, list 2
groups that he is likely to find interesting
. (2 marks)
d) Mark attends the Day Program daily from Monday to Friday. There is the possibility of attending two 60 minute groups every morning and two 60 minute groups every
afternoon. The OT has asked you to make Mark’s schedule for his first week in the program. How/when would you schedule each group you have listed above for Mark’s first week
(6 marks)
Keep grading in mind as you answer this question, and justify your answers (below the chart). You need to consider several factors in making your schedule (e.g. medication side effects, new routine for Mark).
Weekly Schedule (for question 26-d)
Mon. Tues. Wed. Thurs. Fri.
A.M.
Time
P.M.
Time
Justification (6 marks):
10. a) Mark wants to make friends but has difficulty introducing himself. Write a brief social script that will help Mark introduce himself to others
. (4 marks)
b) Review the assessment findings for Mark under the RTI-E Communication Scale. Based on these findings, briefly describe 2 ways that you can teach Mark the social script for introducing himself. (4 marks)
See DAY 5: Documentation (6 marks)
11. The following occurred during a recent session with Mark.
Mark appeared disheveled when arriving to the day program cooking group. His face, hands and clothes were dirty, and his hair uncombed. Mark told you that he had not bathed in 2 weeks. Mark’s mother had called you earlier that day and explained that Mark had not taken his medication for at least the past 3 days. Mark tells you that one of the staff members threatened to kill him, and he began hiding the cutlery in cooking group stating that “now he can’t find it to hurt me”. You immediately ended the cooking session with Mark and asked him to accompany you to the OTs office, which he did. During the visit with the OT, Mark explained that he does not want to take his medication because of the side effects. The OT requested an emergency psychiatric consult.
When charting the session using a SOAP note, what would you write under the ‘S’ and ‘O’ of the note
Write a minimum of 3 entries under “each” the S and the O