Manojigyasa Episode 43

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This is the podcast of the radio program Manojigyasa which was originally broadcasted from Ujjyalo 90 Network. Manojigyasa is a program based on Psychology and Mental Health. This was originally broadcasted on September 17, 2016.

In this expert episode, we had senior psychiatrist Dr. Kapil Upadhyay talking about his work and experience in Mental Health and its various aspects.

‘Occupational Therapy and Mental Health’

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World Occupational Therapy day is celebrated on the 27th October every year. In honour of World Occupational Therapy 2016 we provide a summary about Occupational Therapy (OT). This will be a refresher for those we had the pleasure of meeting last year and an introduction to all those who are unfamiliar with Occupational Therapy.

 

What is occupational therapy?

Occupational therapy (OT) is a person centred health profession which aims to promote health and wellbeing through occupation.  OT takes a whole person approach to mental and physical health and wellbeing.  The primary goals of OT are to enable a person to participate in activities of everyday life and to enable people to achieve their full potential. Occupational Therapists (OT’s) are valued health care professionals in many countries, but OT is not yet a familiar profession within Nepal.

Occupation refers to the everyday activities that a person does as an individual, with their family or as part of a community in order to occupy their time.  It includes what people need to, want to or are expected to do and brings meaning and purpose to their lives.  Everyday activities allow a person to live independently and have a sense of identity and include tasks such as self-care, leisure and work.  Lack of access or restricted access to everyday activities may negatively impact on an individual’s health and quality of life.  The use of everyday activities to improve health and quality of life is at the heart of occupational therapy.

(Here is the Audio Interview regarding Occupational Therapy with the writer herself. Click Here.)

What does an occupational therapist do?

At a basic level OT’s use and prescribe activities as a “medicine” and a form of treatment to promote recovery and/or prevention.

OT’s will consider the person, their environment and their occupations.  An OT considers the roles, routines and habits of a person and will determine how to recover, develop and maintain the skills a person needs in order to do what they want or need to do as independently as possible.  OT provides practical support to facilitate recovery and overcome barriers.  Although an OT will consider a diagnosis, symptoms and behaviours, these are not the most important factors.  A person’s ability to participate in an activity is more important.  An OT will look at how a person is able to function and participate in an activity and will adapt an activity or the environment accordingly.  It is important that the person is not set up to fail.

Occupational Therapy and Mental Health

The World Health Organisation (1946) defined health as a state:

“…of complete physical, mental and social well being and not merely the absence of disease or infirmity”

and well being as a state:

“…in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.” World Health Organisation (1999).

These definitions highlight the interaction of mind, body, spirit and social context and as such OT’s are well placed to act as health agents. OT’s take a whole person approach to mental and physical health and wellbeing.

(Here is the link on Interaction on Occupational therapy Psychbigyaan Kurakani on OT from 2016)

 Occupational Therapy at the Organizaton

Since the first volunteer OT visitors in 2015 we have focused on staff training in the concepts of OT in mental health, introducing therapeutic groups, enhancing occupational opportunities within the hospital and in the community, developing in-house activity resources and supporting patients in achieving meaningful roles and routines that are goal focused and person-centred.

Our most recent volunteer Occupational Therapist, amongst other initiatives, has introduced a walking group to Amrita. Patients spend the majority of their time confined to the building and garden compound within Amrita. The walking group is a valuable and supportive opportunity to gradually transition patients back into the community.

We have displayed the protocol below for this group to demonstrate an OT’s approach to mental health and wellbeing and therapy. We have highlighted key concepts.

(Amrita Foundation Nepal, is a Nepalese mental health rehabilitation hospital based in Boudha, Kathmandu. Amrita Foundation Nepal is a non-governmental organisation that provides residential rehabilitation and treatment for adults with mental health needs and learning disabilities. From time to time UK qualified occupational therapists offer volunteer support either in person or remotely.)

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Evidence

Exercise can contribute to improvements in mood, alertness, concentration, sleep patterns and psychotic symptoms.  Walking has been shown to decrease anxiety and depression and improve psychological wellbeing as well as physical fitness.  It helps not only to improve social skills but also assists with integration into the community.  It has a key role to play as a preventative and therapeutic intervention.  It is one of the easiest and most inexpensive forms of physical exercise.  It can be done almost anywhere and by almost anyone; it can easily be incorporated into a daily routine.

 Aim

To support social inclusion and community integration

To increase confidence in use of transport

To increase self-esteem and confidence when out in the community

To provide stimulation and engage patients in physical activity

To improve mood and reduce symptoms of illness

 Target group

Inclusion:          Individuals who are working towards discharge

Exclusion:         Individuals who are at an active risk of harming themselves or others

                             Individuals who are at an active risk of aggressive or threatening behaviour

                             Individuals who are at an active risk of absconding

 Assessment

Referral from psychologist and staff

Risk assessment for individuals to be completed on the day by staff

 Structure of group

When:                                         Tuesday afternoon         1500-1600         ladies

                                                     Wednesday afternoon    1500-1600         men

Where:                                        To be decided in advance by group leader

Duration:                                   60 minutes (can be longer if using transport)

Number of patients:                Maximum 3:1 member of staff

Number of sessions:                Ongoing

Closed or open group:            Open

Resources required:                None although money for fares will be needed if using transport

 

Initially, walk to and around the Stupa (as many times as the patients agree on) and then back.  Allow patients to adjust to being outside of Amrita.  The Stupa allows for patients to walk along and also to cross a busy road and then provides a more peaceful environment on arrival.  It also allows for patients who are religious to pray.

 As the group progresses, provide choice to patients where possible on where they would like to go.  Gradually build up confidence in being outside and work towards using transport to go to places further afield.

 Review and Evaluation Process

Patients who attend are to debrief with psychologist after every session

Attendance to be monitored

Engagement in the group and individuals’ motivation will indicate group success

Group to be discussed and reviewed by Multi Disciplinary Team (MDT)

Our challenge to you

We urge you on World Occupational Therapy day and beyond to:

1: challenge the ongoing stigma surrounding mental health

2: spread the word about the power of activity as a therapeutic tool in the recovery process and prevention of mental health both for your own mental health and well being and,  for those of you who work or study in the field of mental health, that of your patients.

References:

Alexandratos K, Barnett F, Thomas Y (2012) The impact of exercise on the mental health and quality of life of people with severe mental illness: a critical review. British Journal of Occupational Therapy, 75(2), 48-60.

Richardson CR, Faulkner G, McDevitt J, Skrinar GS, Hutchinson DS, Piette JD (2005) Integrating physical activity into mental health services for persons with serious mental illness. Psychiatric Services, 56(3), 324-31.

Wilbur J, Zenk S, Wang E, Oh A, McDevitt J, Block D, McNeil S, Ju S (2009) Neighbourhood characteristics, adherence to walking, and depressive symptoms in midlife African American women. Journal of Women’s Health, 18(8), 1201-10.

For additional information please visit:

www.amritafoundationnepal.org

http://www.wfot.org

or contact the writers on on:

info@theablespace.com

 

 

Manojigyasa Episode 36

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This is the episode published on July 30 2016.
We have special episode where we celebrated Psychbigyaan Network Nepal’s first anniversary through radio program talking about the organization and various other aspects related to us.

Manojigyasa Episdoe 37

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This is the episode published on August 6 2016.

We are talking about ‘International Research Conference which was organized in Nepal’ in the first part, ‘Air Pollution and its psychological perspective’ in second and the ‘psychbigyaan tip’ in third.
Feedback would be appreciated …


The youtube link is here : Manojigyaasa Episode 37

‘Uncertainty हटाउने- एक निर्णय !’

 

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आज भोलि नेपालीमा लेख्न औधी मन पर्छ | सायद उज्यालोमा कार्यक्रम चलाएको नतिजा होला | जे भएपनि अंग्रेजीमा फाट्ट फुट्ट साथी संग बोल्ने गरेको बानि छाडेर पुरै नेपाली मा बोल्नु को छुटै मज्जा छ कार्यक्रममा | तर अनौठो पनि लाग्छ है प्रस्तोता हुन | आफ्नै रेडियो सहकर्मीबाट खिल्ली नउडेको पक्कै होइन |  एउटा रमाइलो उदाहरण हो मेरो ‘निर्णय’ को उचारण | धेरै पटक निर्णय लाइ ‘निंनए’ भनेर कार्यक्रम सकिएपछि हाँसोको पात्र भएको याद गरेर आफै हाँस्छु कहिले काहिँ  |

फेरी आजको यो लेख मेरो नेपालीमा खिल्ली उडेको बारेमा चाहिं  पक्कै होइन, आज को लेख अलिकति जटिल छ | आज ‘uncertainty’ को बारे लेख्न मन लागिराछ | यसो लेख्न बसेकी थिएँ , फेरी आफै ‘uncertain’ भए के लेख्ने भनेर | के लेख्न त बरु लेखुला, जे भएनी लेख्न रुचाउने मान्छे परे | अर्को ‘uncertainty’ भयो नेपाली कि अंग्रेजी मा लेख्ने ‘मेरो निनए’ गर्न | अचम्म, कति हो ‘जिन्दगीको uncertainty’ ; लेख के मा लेख्ने देखि, के बन्ने सम्म, कुन भाषामा लेख्ने देखी, १० वर्ष मा आफुलाई कहाँ देख्छु सम्म |

म आफुलाई सुल्झेको मान्छे ठान्छु, कहिले काहिँ अत्तालिने  बाहेक | सोच्छु ओह्हो ममा त ‘Clear Cut Vision’ पनि छ | एकदमै मन लागेर सुरु गरेको मनोविज्ञान पढाउने जागिर छ, राम्रै पढाई छ आफ्नै, मन परेको विषय  मनोविज्ञान मा काम पनि गरिराखेकी छु, सपना देखेको संस्था  ‘Psychbigyaan’ पनि खोलेको १ वर्ष हुन लाग्यो, संस्थाले  पनि राम्रै काम गरिराखेकोछ, uncertainty चाहिं  किन हो कुन्नि !!

सायद हो, आज को एकजना साथीसंग को कुराले |

कुरा गर्दै थियौं , ठ्याकै ‘Personal Mission Statement ‘ के हो भन्ने कुरा आयो, मैले भन्न सकिनँ  ; र अहिले यो लेखी रहँदा  पनि भन्न सकिराको छैन | म clear cut vision छ भनेर सोच्ने लाइ जिन्दगीको mission statement नै पो थाहा रैनछ , भयो त अब? यो त, लेख्न मन छ, के लेख्ने थाहा छैन जस्तो कुरा भएन र ?

अनि फेरी मनोविज्ञान मा आफै कतै पढेकी थिए  ‘How we can cope with uncertainty determines how our life is going to be?’ तेसैले uncertain भैरहन मन लागेन, बरु यसलाई मनन गरेर अगाडी बढ्ने फेरी पनि ‘मेरो निनए’ गरे | यहाँ फेरी सोचे, म जस्तै कहिँ कतै कोहि uncertain त हुनु भाछैन, त्यो बेलामा के गर्ने होला ? र निर्णय गरे एउटा लेख लेख्न, यो पालि आफ्नो सोच मा ‘certainty’ ल्याएर :

पहिलो : यदि कहिले uncertain भयौं भने, सबै भन्दा पहिला गर्नु पर्ने तेस्लाई ‘मनन’ | जब सम्म हामीलाई ‘केहि थाहा छैन है‘ भनेर थाहा हुँदैन , परिबर्तन पक्कै आउँदैन | कति रमाइलो होला थाहा नभाको सिक्ने उत्साहा राख्नु, नभए त सब थाहा छ, जिन्दगीमा uncertain केहि छैन भन्ने मा त के नै चाख होला र ?

दोस्रो: फेरी आशा मात्र राखेर त के नै होला र? त्यसमा  काम गर्नुको पनि छुटै मज्जा छ, होइन? आशा र सपनाले पनि धेरै कुरामा uncertainty ल्याउँछ  | सोच्नुस त, तपाई आशा मात्र राख्नुहुन्छ जिन्दगीबाट, तर के गर्ने थाहा छैन भने आशा को पोल्टो भरिंदा पनि केहि काम हुंदैन  र नैराश्यता बढ्छ, अनि त uncertainty त चुलिने नै भयो| त्यसैले काम थाल्यो भने, uncertainty को पोल्टो खुकुलो हुन्छ र सजिलो हुन्छ, मलाई जस्तै ‘Personal statement बनाउनका लागि’ |

अर्को: जिन्दगि लाइ जटिल त बनाइँराखेका त छैनौं हामीले? आफ्नो मातहतमा नभएको, आफुले control गर्न नसकिने कुरा सोचेर uncertain त भएको छैनौ? सोचौ है ? धेरै पल्ट रोक्न नसकिने समय र छुटाउन नसकिने परिबन्ध ले हामीलाई निराशाको खाडलमा लागिराखेको हुन्छ | सोच्नुस त, तपाइको हातमा नभएको कुराले कहिँ कतै जिन्दगीमा uncertainty त ल्याईराखेको छैन ?

फेरी अर्को जानीराख्न पर्ने कुरो: uncertainty ले पक्कै पनि निराशा र तनाब बढाउँछ, मनोविज्ञानको विधार्थी हो, यो चाही certain  भएर भन्न सक्छु | सोच्नुस त अन्तिम पटक तपाइँ तनाब मा किन हुनुहुन्थ्यो? रक्तचाप, शरीर गरुङ्गो कहिलेभएको थियो ? के गरौँ कसो गरौँ कहिले भएको थियो ? सायद uncertain भएर कुनै निर्णय लिन नसकेर त होइन? तेसैले एस्तो येही समस्या परेमा, तनाव घटाउने केहि उपाए अपनाउनु होला | साथीसंग मनको कुरा साट्ने, एक्लै बसेर मनन गर्ने, खेल्ने, दिमाग ताजा गराउने देखि म जस्तै तनावको बेलामा लेख्न मनपराउने भयो भने पनि धेरै फाइदा हुन सक्छ |

र अन्तिम : जुन कुरा भएकै छैन त्यो विषयमा  नसोची वर्तमानमा  रम्न सकेपनि uncertainty पक्कै कम हुनेछ | १० वर्ष पछि के होला ? जिन्दगीमा के होला ? काममा के होला? भोलि के होला? हामीले अहिले भन्न सक्छौं  र? त्यसैले  वर्तमानमा रहने गरे पनि uncertainty नामक डर बाट बच्न सकिन्छ | Psychology मा ‘Mindfulness: Being at present’ भनेर एकदमै चर्चित एउटा उपाय छ, जुन uncertainty को अवस्थामा काम लाग्छ  |

त्यसैले साथी यदि जिन्दगी | ‘certain’ छ भनेर कहिले सोच्नु भएको  भने, त्यो भ्रम हो भनेर बुझ्दा  सायद गल्ति नहोला | बर्खाको बेलामा पनि भोली पानी पर्ला कि नपर्ला भन्न नसक्ने हामी, पछी के होला भनेर जिन्दगीको uncertainty संग डराउनु कत्ति को उचित होला, विचार गर्नुहोस त ?

यी थिए म uncertain भएको बेलामा मैले अपनाउने उपाय जस्तै आज | अहिलेसम्म नेपालीमा कि अंग्रेजीमा, कुन विषयमा भनेर uncertain भएको भए, लेखेर पाना पनि भरिन्थिएन होला | यो लेखी रहँदा  सम्म मेरो ‘Personal Mission Statement’ अझै पनि uncertain नै छ, तर अन्तिमसम्म आउँदा ‘एउटा निनए’ के गरे भने ‘किन छैन भनेर अनौठो मान्नु भन्दा अब चाहिं के हुन सक्छ भनेर सोच्ने छु’ |

अन्त्यमा, ‘uncertainty’ र ‘निनए’ शब्दको छुट्टै  महत्तो छ मेरो जिन्दगीमा, त्यसैले ‘अनिश्चितता’ र धेरै ठाउमा निर्णय भन्न रुचाइंन है |
~~~ धन्यबाद ~~~

One day Training Workshop on Motivational Interviewing

2 July 2016

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Psychbigyaan Network Nepal (PNN) conducted one day workshop on the theme of “Motivational Interviewing” on 2nd of July 2016 with venue support from Global Peace Youth Corp (GPYC) Nepal. The workshop was facilitated by Ms. Priti Pun, Masters in Mental Health Sciences with Cognitive Behavioral Therapy (CBT) specialization from Flinders University Australia.

 


Motivational Interviewing (MI) was developed by William R. Miller and Stephen Rollnick and is described as a style of patient centred collaborative counselling which facilitates the change in health related behaviours. MI is a directive approach, not in a confrontational or ‘pushy’ way, but in a quiet eliciting style which allows the person to move towards change rather than it being externally imposed. Originally developed for use with people who had problems with alcohol and drugs, it has now been applied to a wide range of problem areas such as public health, mental health, medical school and even corporate systems as it is helpful in settings where there is resistance to change. The principles are simple yet less easy to apply in practice; the workshop will highlight the importance of MI and its application. The workshop was targeted towards counselors, therapists, social workers or allied health professionals, and anyone who are involved in change or motivational talk with their client or patients.

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29 enthusiastic participants from different field like nursing, teaching, psycho social support, rehabilitation of trafficked women and students of psychology participated the workshop.

 

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The workshop was started at 11:00 sharp after registration which was started from 10:00 in the morning. 6 hour-long workshop included 45 mins lunch break and 5 min tea-break in between. The workshop was conducted on the module of theoretical and practical activities conducted by Facilitator and helped by PNN members. The program ended with the Thank you Note from PNN to all the participants and facilitator Ms. Pun.


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Overall, the workshop on “Motivational Interviewing” was successful as clear by the positive feedback of the participants. However, one of the common feedback was that the workshop should be extended and make it a 2 or 3 days workshop as the contents were really useful and it would help to go through them in even more detail with even more role-plays and practices.

Psychbigyaan Network Nepal (PNN) would like to thank Ms. Priti Pun for facilitating the workshop, GPYC Nepal for the venue and all the participants for making the workshop a success. PNN is encouraged and committed to conduct even more fruitful and large-scale workshops in the near future.

For more photos of activities of the event. Click  Here: Photos of One day MI workshop.