If you follow us on our social media, you recently read about some of the Occupational Therapists here at Trilogy. You might be wondering what an occupational therapist does, or how they fit into our mission of supporting individuals with mental illness. Since April 2017 marks not only the national observance of Occupational Therapy (OT) Month, but also the centennial of the profession, we thought it an appropriate occasion to highlight the nature of OT at Trilogy.
In 2012, when Trilogy was designated a Williams Class Member service provider by the State of Illinois, we were one of the first community-based mental health organizations to assist individuals transitioning out of nursing homes and into the community. It became apparent early-on that many of the Williams’ clients needed individualized support to learn or relearn skills necessary for a successful transition into independent living. Trilogy firmly believed these daily living skills were also essential to the client’s mental health recovery, and hired and Occupational Therapist. Additionally, the organization leased an apartment where clients could practice independent living skills in preparation for their move out of the nursing home. (1)
Helping clients develop the skills for independent living has been so successful, Trilogy now employs five OTs, and hosts several interns from universities like Rush, UIC, and Midwestern. Though OT was primarily used in mental health institutions 100 years ago, today, most occupational therapists in the U.S. are employed in hospitals, nursing homes, schools, home-health services, or offices dedicated to OT. (2) Trilogy is currently one of only a few community-based mental health organizations that offer OT services, and the only one in Illinois with placements for OT interns.
Occupational Therapists help clients with any activities revolving around daily occupations or routines. Jamie Rotter, one of the first OTs at Trilogy, explains how she commonly works with clients on activities such as grocery shopping, doing laundry, budgeting and money management, cooking, cleaning, managing medications, and personal hygiene. She said, “While these activities seem mundane and second nature to many individuals, the clients being transitioned out of nursing homes may have been living in a setting where, possibly for decades, these tasks had been done for them.”
When an eligible client is first referred to Trilogy, an OT meets with them for an initial assessment. The assessment takes place at a ‘practice apartment’ leased by Trilogy, where the client is asked to complete tasks they are likely to undertake in their own daily living. This initial assessment allows the OT to observe strengths or difficulties the client may encounter in a real-life setting. Clients often do not understand the purpose of these activities initially, but after starting, they realize they have not performed such tasks for extended periods of time, and need the initial support before they can do so with confidence. Rotter says, “Clients are able to see the value in the support they are given and it can inspire them with a new sense of independence and self-determination.”
There are many OTs who work out of medical institutions since their support is particularly applicable following traumatic brain injury or physically traumatic accidents and injuries. Rotter believes that OTs are equally important in mental health organizations like Trilogy, since the profession requires training on how to help individuals who are not only affected by their mental illness, but also those who are further impacted by a physical impairment brought on by something such as a stroke. Rotter says “helping individuals restore their habits and routines is incredibly important, because if they are not able to fully participate in their own lives it can have a serious negative impact on their mental health.”
The OTs at Trilogy currently see clients across the whole organization, which serves not only our Chicago sites in South Shore, Lawndale, Uptown, and Rogers Park, but also beyond the borders of Chicago including Evanston and Skokie. In any given week, there may be up to 15 referrals for the OT team, leading to some diverse needs arising. Rotter made mention of a client who had transitioned out of a nursing home, and was living in a community setting. The individual could not read or write, and had never lived on his own, so even making a grocery list to plan for his homemade meals required a creative approach. Since the client had diabetes, a healthy diet and skills in preparing meals at home were vital to improving his health outcomes. Rotter was able to work with the client’s nurse to come up with a client-centered solution, which was a visual list for grocery shopping so that he could be more independent in managing his diabetes. In another situation, the same client was struggling to understand where all his money was going, since he was unable to reference written documentation. Rotter and the team came up with a creative solution to help him understand his budget. They made a visual chart, for which the individual could select images that represented different expenditures he had such as utilities, food, rent, etc. These images paired with numbers and symbols helped the client better understand his monthly budgeting.
Rotter’s account illustrates how providing mental health care also requires ancillary supports. That is why Trilogy provides services related to employment, housing, and primary care to help individuals discover and reclaim their capabilities, life direction, and wellbeing. It is exciting to think about what the future holds for OT. Early last year, the American Occupational Therapy Association (AOTA) reached out to Trilogy as they prepared for the AOTA 2017 Conference. Because of Trilogy’s integrated approach in helping so many populations a team came out to gather footage for a video on the history of OT.