individuals. The occupational therapist must be able to differentiate between constructive
expression, release, and the use of the activity to reinforce the pathological pattern
(Doniger, 1953). A patient who works his/her hostility out towards the therapist instead
of working it through at the scheduled time are ultimately working at their own
disadvantage. An example is a patient who uses creative painting to withdrawal into a
fantasy world, when really the patient should be drawn out and expressing his/her
emotions within the group. The occupational therapy group provides support,
opportunities for growth, and to assess one’s limitations. Occupational therapy, in some
circumstances, can help patients through vocational exploration even though some may
avoid contacts with working situations because of emotional difficulties (Doniger, 1953).
The following activities facilitate the individual in many ways. Classical treatment
activities include:
Evaluation where a self-image collage, combined with an interview and goal-setting
session, serves as the foundation of the occupational therapy program.
Therapeutic use of crafts is used to indicate underlying resistance to the entire
program, and can surface when patients are asked to perform specific tasks. During
the task, the patient is asked to focus on dealing with behaviors and attitudes which
are related reasons for why they are in treatment.
Recreational programs provide extra opportunity for socialization, development of
interpersonal skills, group interaction, and to decrease social isolation.
Group process involves task-oriented groups where patients meet with the occupational
therapist to discuss issues or problems related to alcoholism. The emphasis is on learning
alternative ways of dealing with problems and issues relating to the recovery process.
Some innovative ideas for treatment concerning this particular patient population
include:
Having the individual video taped during the behavior, then later have them watch to
see how it makes them feel, what it makes them look like, and how they think others
perceive them.
Viewing movie clips that make a point on how destructive their drinking behavior is
and has become. This part of the treatment plan would focus on extinguishing the idea
of “that would never happen to me.”
Having a party for the treatment group that simulates a bar-type atmosphere, however,
only non-alcoholic beverages would be served and they would be aware of the fact.
The purpose of this exercise is to facilitate social interaction, and to learn suitable
behaviors so they can realize alcohol does not need to be at hand in the presence of
others.
In conclusion, occupational therapists are always learning and trying news ways
to approach therapy. If one activity does not work, then we know of one way not to
approach the problem. Every evening that a patient spends at a therapy social event is one
less night spent in a bar. These are the experiences that can provide opportunities to
rediscover interests and rebuild values.
.
Bibliography
References
Doniger, J., (1953). An activity program with alcoholics. American journal of
occupational therapy, VII, #3. (May-June) (pp. 110-112, 135).
Kaplan, H., & Sadock, B., (1998). Synopsis of psychiatry (8th ed.) (pp. 404-406).
Baltimore, MA: Williams & Wilkins publishers.
Neistadt, M., & Crepeau, E., (1998). Willard & spackman’s occupational therapy
(9th ed.) (pp. 724-728). Philadelphia, PA: Lippincott.
Reed, K., (1991). Quick reference to occupational therapy (pp. 497-501).
Gaithersburg, MA: Aspen publishers.
Riley, K., Ramsey, R., & Cara, E., (1998). Substance abuse and occupational
therapy. In E. Cara, & A. MacRae (eds.), Psychosocial occupational therapy: a clinical
practice (pp. 227-260). Albany, NY: Delmar publishers
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