Ms. Little is a 21-year-old black woman who sought treatment after the Departmen

Question

Ms. Little is a 21-year-old black woman who sought treatment after the Department of Social Services threatened to take her two children, a boy aged 6 and a girl aged 2. Client stated that her neighbor reported her for leaving her children alone. Client is unemployed and on welfare. She said she can’t make enough money working to pay bills and child care. Client has drunk alcohol and abused drugs since age 15. She is currently still drinking and abusing diazepam (Valium).

Ms. Little stated she has used cocaine for the past 9 months and denies any other drugs since then. She also reports drinking at least 3-4 alcoholic beverages a day which don’t affect her at all. Client admitted to using her welfare check for drugs and selling her food stamps to obtain money. She was never married and does not receive financial support from the father of her children. Client, who is slightly overweight, was observed purging food in the bathroom of the detoxification unit and admitted to episodic purging to control weight.

Ms. Little described herself as a good student in high school until her drug use became more important than studying. She has a high school diploma but did not attempt college, as she felt she could not afford it. Client’s parents both drank and were physically abusive to one another. Ms. Little denies physical or sexual abuse of self or siblings by parents. Client reported she cooks, cleans, and takes care of all household chores independently. She stated she has been “out of control”, “snorting” approximately $200 worth of cocaine 1 to 2 days per week at friends’ homes or on the street. She admitted to leaving the children alone twice over the last month and was appalled to having slept with drug dealers to obtain drugs. Client stated that she knows she has to get clean or she will lose her children. She has never obtained a driver’s license but does have a car of her mother’s that she drives. She has no friends except other users, and other than drug use her only leisure activity is renting a movie for the children. Ms. Little stated that she feels depressed much of the time and has no energy.

OT goals identified:

Client will obtain a driver’s license

Client will complete 1 job interview.

Client will identify leisure activities to pursue with children at home and in the community

Client will improve energy level through exercise and explore healthier methods of losing weight, as well as maintain healthy and balanced nutrition for her and her children.

QUESTIONS

1. Identify any liability issues related to the OT treatment and any precautions ans safety needs

2. Describe the role of the OT, OTA in treating this patient and list 2 other professionals that Ms. Little would be seeing based on her issues, and describe briefly their role in the healing process or what they will be helping her with more specifically.

Explanation / Answer

Poor or improper technique

Injury from manipulation

Burns or other heat injuries from the use of hot packs

Stretching or exercise injuries

2. Occupational therapy practitioners are well trained to help clients look critically at everyday routines and examine how they affect their state of health and their ability to carry out what is important to them. “Occupational therapy can help people recognize how their substance use affects those roles that are most meaningful; it helps people explore and make those links, and move toward the occupational roles and patterns they want to achieve,” says Stoffel. For example, if the role of parent is most important to a client, then he or she might learn how to re-parent in a way that boosts his or her parenting skills and simultaneously improves the skills needed to deal with the stresses of parenting without drinking.

Occupational therapists can teach other strategies to those trying to recover from substance abuse, as well, including:

•   Stress management techniques such as mindfulness meditation, guided imagery, and progressive muscle relaxation;
•   Sleep hygiene, which involves promoting the habits and practices necessary to ensure good sleep quality and full daytime alertness;
•   Reframing a problem so it is not seen as a crisis;
•   Activity pacing and alternative approaches, which teach patients how to avoid additional injuries when they’re already suffering from pain or an existing injury

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