Client Centered Care, Psychosis, and OT

The research we discuss on the OT Potential Podcast has a recurring theme: therapy goals should always support what is meaningful to the client.

But, lurking behind this best practice is an important question: what do we do when a patient is not of sound mind?

We’ll explore an article that hits the question head on, looking at client-centered care for patients with psychosis. It’s an especially helpful read for mental health OTs—but we can all learn something from it, since every clinician sees clients whose decision making could be perceived as impaired.

The takeaway from this article is that we can always find ways to be client-centered. And, it’s worth making the effort to do so, since it always seems to improve patient engagement and outcomes.

To help us unpack this article, it is our privilege to welcome Lauren Jones, MS, OTR/L.  Lauren currently works on an interdisciplinary team as a Senior Occupational Therapist, providing services to youth, adults, and older adults in an inpatient psychiatry setting. Together, we will discuss practical strategies for keeping your interventions client-centered, regardless of your treatment setting(s).

1. You will be able to recall which symptoms patients with schizophrenia felt were most important to address in treatment.

2. You will be able to identify assessments OTs can utilize to ensure their treatment remains client-centered.

• Intro

• Breakdown and analysis of journal article

  • Quick refresher on schizophrenia and its symptoms

  • The treatment disconnect regarding what’s important to patients versus providers

  • What was the goal of this paper?

  • What were the authors’ methods?

  • What were the results?

  • Discussion: negative symptoms ranked as most important to target for treatment

  • Conclusion

  • Takeaways for OT practitioners

• Discussion on practical implications for OTs (with guest Lauren Jones)

  1. Can you tell us the story of how you found occupational therapy in mental health?

  2. What were your initial impressions of the journal article?

  3. Do you see this discrepancy between what is important to the treatment team versus the patient playing out in your setting?

  4. What are strategies you currently use to stay client centered in your occupational therapy evaluation and treatment?

  5. Do you have specific examples of times when taking patient preference into account was difficult?

  6. Occupational therapy was not ranked by patients as one of the most effective treatments. What do you think needs to change in OT delivery to increase our efficacy in the eyes of patients?

  7. For OTs who do not work in mental health, what lessons have you learned in your current work about being client centered that have a broader application?

  8. How would you like to see occupational therapy delivery in mental health change in the next 5-10 years to be more client centered and more effective?

Primary Article Explored

• The customer is always right? subjective target symptoms and treatment preferences in patients with psychosis

Additional

• Occupational therapy interventions in mental health: A literature review in search of evidence

• The development of an occupational therapy intervention for adults with a diagnosed psychotic disorder following discharge from hospital

• Shared decision making and associated factors among patients with psychotic disorders: a cross-sectional study

• Occupational Therapy in the Treatment of Early Psychosis: a Scoping Review

• Increasing person-centeredness in psychosis inpatient care: staff experiences from the Person-Centered Psychosis Care (PCPC) project

Assessments

• The Medi-Cog

• The Occupational Self Assessment (OSA)

• The Personal Recovery Outcome Measure (PROM)

• Pediatric Specific Quality of Life Questionnaire (PedsQL)

It is the policy of OT Potential to disclose any financial and non-financial interest the provider or instructor may have in a product or service mentioned during an activity. This is to ensure that the audience is made aware of any bias of the speaker.

OT Potential pays guest speakers an honorarium for their participation, either directly or to an institution of the speaker's choosing at their request. We invite guests whose expertise often comes from practices, programs, or building products in their field. Where a speaker has a financial interest in the subject of a course, we disclose it below so you can weigh it for yourself.

OT Potential's interest in this topic: We have no financial stake in this topic.

Speaker interests: Lauren Jones has no financial interest in this topic to disclose.