Beverlea Tallant

“It Would Be a Shame to Lose Them”: A Critical Historical, Scoping, and Expert Review on the Use of Projective Assessments in Occupational Therapy, Part II

Projective assessments have a long history in occupational therapy, yet their relevance may be questioned. Part I of this article provided a critical history of their development and a scoping review of the evidence. This second article outlines an interview-based qualitative study of the clinical and academic perspectives of nine experts. Through this comprehensive two-part article, conceptual and methodological issues are articulated in order to suggest educational and clinical guidelines, and future research avenues. The place of projective assessments in occupational therapy is demonstrated as a salient specialty area of practice in the current evolving landscape of mental health.

Adjustment to community residential settings over time among older adults with serious mental illnesses.

This exploratory cross-sectional study examined adjustment over time of three groups of seniors with serious mental illnesses (N=33), who were transferred from a psychiatric hospital to a community residential facility from 1995-1998. The study participants had lived in the community for 6-41 months. Outcomes included measures of global, social, cognitive and ADL functioning, quality of life and rehospitalizations. Analyses revealed no significant deterioration in symptomatology, cognitive and ADL functioning between groups and a significant change in social functioning. Five participants were readmitted for short hospitalizations. Participants in all groups expressed a positive quality of life in their current community residence.

The Projective Use of Drawings as a Treatment Technique with the Depressed Unemployed Male

In this paper, a treatment plan, integrating brief psychotherapy and projective drawings, is proposed for the depressed unemployed male. The components of the crisis following the loss of employment are described in the context of the meaning of work in our society. Sequelae in health, self-perception, role-fulfillment and behaviour are presented within the framework of the classical mourning reaction. A proposed treatment plan is described with emphasis given to the selection of themes for the drawings and the therapists interaction with the client. Illustrations included support the combined use of verbal and graphic modes in treatment.

The Phenomenology of Early Psychosis Elicited in an Occupational Therapy Expressive Evaluation

ABSTRACT Expressive assessments facilitate sharing, and the therapeutic understanding of youth. The experiences of nine young adults seeking help for psychosis were explored with an arts-based, occupational therapy expressive evaluation. The study used participant-observation methods. Data analysis drew on hermeneutic phenomenology. The findings illustrate the challenges these participants have in feeling connected to a shared world of doing, and in locating themselves within the temporal flow of time. Of significance was the potential to read the unfolding of creation in clay media as an acted narrative to tap into “constellations of meaning.” Implications for clinical practice and professional reasoning are highlighted.

P03-198 - Functional performance in activities of daily living of individuals with a dual-diagnosis of schizophrenia and substance-use disorder

Introduction Research on functional performance of individuals with schizophrenia and substance use is limited, focusing primarily on cognitive impairments. Research findings are conflicting, making it difficult to understand how these individuals function despite their cognitive impairments. There is a need to use performance-based assessments to understand how individuals with a dual-diagnosis accomplish their daily living activities. Aims To describe the functional performance of individuals with a dual-diagnosis in two activities of daily living, using a performance-based assessment. Objectives To compare the functional performance of individuals with a dual-diagnosis, in grocery shopping and budgeting. Methods This descriptive cross-sectional study included ten participants with a dual-diagnosis of schizophrenia and substance-use disorder, aged 21 to 35, living independently in the community. They were evaluated on two tasks, budgeting and grocery shopping, using the Perceive-Recall-Plan-Perform (PRPP) system of task analysis (Chapparo & Ranka, 2005). The PRPP is a standardized criterion-referenced task-based assessment, and is valuable in describing individuals’ community functioning with regards to information-processing difficulties. Substance use was evaluated with the Addiction Severity Index (McLellan et al., 1989). Results Preliminary results indicate lower scores on both tasks, in the planning quadrant of the PRPP, particularly the evaluating sub-quadrant, which involves cognitive monitoring and appraisal processes. This trend occurs despite the participants prior familiarity with tasks. Conclusions: This study is a first step in describing the functional performance of individuals with a dual diagnosis of schizophrenia and substance use in activities of daily living. This information will lead to improved rehabilitation for these clients.