The following article care of CBC provides another shining example of the value of Occupational Therapy — helping to bring meaningful activities into the lives of our clients.
O-Tip of the Week: Make Time for “Me Time” Every Day
Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living.
For the month of February, our O-Tip of the week series will talk about Self-Esteem, which is defined as confidence or belief in one’s own worth or abilities. Self-esteem issues affect more than just teenagers and encompass more than physical insecurities. Follow along this February to learn more about self-esteem, its importance and some simple ways give yourself a boost!
Put yourself first by doing something kind for yourself every day. Practicing self-care is not selfish, it is a necessary activity that needs to happen in order to support both mental and physical health. Be sure to take time each to do something just for you (take a walk, have a warm bath, enjoy a special delicious treat). You deserve it!
The following care of Psychology Today discusses the importance of self-care and provides tips to get you started!
Psychology Today: Self-Care: 12 Ways to Take Better Care of Yourself
Weekly Mind Bender
Occupational Therapy Approaches for Substance Use in Clients with Brain Injuries
Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Co-written by Ashley Best, Student Occupational Therapist
In our previous blog post titled “Brain Injury and Substance Use”, we discussed how the cognitive and emotional changes associated with brain injury can overlap with substance use. But what wasn’t covered was the role of the Occupational Therapist when working with clients who have these challenges. While our role is complex in cases like these, we have tried to simplify how we use function and meaningful activity in combination with direct treatment to address some common themes as outlined below.
1. Harm Reduction
Arguably the most important strategy of any professional working with someone who uses substances is Harm Reduction. An Occupational Therapist can work with a client to better understand the process of using a substance with the same skill used for analyzing other daily activities. By breaking down what a client’s substance use looks like, from the trigger to being under the influence, the OT can identify areas of potential harm or danger. Some common concerns with substance use, and some OT intervention examples are:
It is important to recognize that the above strategies are not meant to encourage substance use but ensure the safety of the client when they are not willing or able to stop. Sometimes just reducing the harm is all we can offer until the harm can be eliminated.
Clinical Example: A man with previous regular alcohol use prior to an accident, now has seizures when he does not have alcohol in his system. Thus, it is actually more harmful to ask this client to not use alcohol. Instead, monitoring the amount he drinks and ensuring he has regular supports at home are two strategies that can reduce the harm that alcohol may cause.
2. Recognizing Substance Use as a Barrier to Goals
The financial, behavioural, and health effects of substance use often negatively impact a client’s ability to reach their goals. An occupational therapist can help a client to understand and hopefully address the gap between substance use and being able/unable to move forward in other areas of life. An OT may also strategize ways to achieve goals despite substance use by planning use around occupations and this, in turn, may help decrease use over time.
Clinical Example: An individual with a brain injury has a goal to return to work but does not have the insight to recognize how using narcotics would impact their success on the job. Thus, helping the client break down the requirements of a job, recognize poor fits, and then implementing strategies to change substance use behaviour so that it doesn’t impact work (in the case that abstaining from use is not an option) could be an intervention focus.
3. Using Activity to Avoid Triggers
Often, substance use is time-consuming between acquiring, using, and coming down from the influence. This becomes a major challenge when people stop using because there is a lot of free time that may lead to boredom and relapse. This is an important place for occupational therapists to intervene by helping the client identify meaningful activities to engage in when they are feeling an urge to use. This could involve interests and values, or just discussing past activities that the client would like to resume.
In the case of someone with a brain injury, more guidance may be required to identify triggers (if the client has low insight what is triggering). In addition, activities that the client can perform may be different following a brain injury, and thus they may need support in finding new meaningful activities to fill the time that was previously taken up with substance use.
What is the take-home message?
As the above indicates, implementing any of these strategies will require the client to exercise a high level of control over their addiction. Thus, an OT can help support and accommodate each client’s unique situation by providing remedial and compensatory strategies to help clients transition from the occupation of substance use, to other, ideally more meaningful and healthy alternatives.
Heading Away for Spring Break? Check Out our Accessible Travel Guide
While travel is a fun and rewarding leisure activity, it can also be extremely stressful. Traveling with a disability can be even more difficult, but with thorough planning, it can be a wonderful experience. Consult our Accessible Travel Planning Guide to help you have your best vacation yet!
O-Tip of the Week: Self-Improve by Showing Gratitude
Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living.
For the month of February, our O-Tip of the week series will talk about Self-Esteem, which is defined as confidence or belief in one’s own worth or abilities. Self-esteem issues affect more than just teenagers and encompass more than physical insecurities. Follow along this February to learn more about self-esteem, its importance and some simple ways give yourself a boost!
Another proven way to boost your self-esteem is by practicing gratefulness. Keep a daily (or weekly) gratitude journal where you take a few moments to reflect on 3 things you are thankful for. Learn more about how the practice of gratitude can boost self-esteem and more in the following care of Forbes.
Brain Injury and Substance Use
Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Co-written with Ashley Best, Student Occupational Therapist
As clinicians working in the community with clients who have a brain injury, we all too often see the challenges of recovery impacted by the use of illicit drugs and alcohol. And while we treat both the brain injury and substance use as they impact function and the ability to participate in life roles, we often wonder, which came first?
Statistics show that individuals with brain injuries have higher rates of substance use than the general population. However, statistics also show that individuals with brain injuries have higher pre-injury rates of substance use. While this does not explain a “causal relationship” or answer the “which came first” question, we know the interplay is complicated and that acquiring a brain injury can change the way the brain processes information which may influence substance use behaviours and patterns.
Here are some examples of how this can happen:
- Cognitive Changes: Having a brain injury can result in cognitive changes from mild to severe difficulties with memory and concentration, communication, processing speed, problem-solving, and more.
- Emotional and Personality Changes: A brain injury can also result in emotional and personality changes such as impulsivity, irritability, and lack of insight.
The changes and symptoms mentioned above occur as a result of injury to the brain’s frontal lobe. The frontal lobe is responsible for more complicated cognitive processes. It helps us to problem solve everyday challenges and consider the positive and negative impacts of our decisions. When a person hits their head or is jolted quickly, the frontal lobe will often impact against the skull – bruising, damaging, and disrupting the connections between the brain cells in this region.
So how does this relate to substance use?
Well, there are reward pathways in the brain which react and process substance use triggers and the associated emotional response. These pathways respond to the positive feelings associated with substance use and strengthen the more the substance is used, telling the brain to seek more. These pathways recognize triggers of substance use and respond by sending the “craving” to the frontal lobe. The frontal lobe determines whether or not the substance will be sought after, and if so, how the substance will be obtained and used.
When we think about individuals with brain injuries and associated cognitive and emotional challenges, we can see how if a person has difficulty with impulsivity, for example, then ignoring a craving may be more difficult than it would be pre-accident. In addition, when a person with a brain injury decides to engage in substance use, challenges such as poor planning and problem-solving may make the use even more unsafe.
Though we may not have evidence to connect brain injury to substance use directly, the cognitive changes in the brain are likely to make managing, using and even recovering from substance use much more difficult.
So now that we have talked about how substance use behaviours and patterns may change after acquiring a brain injury, the question remains, What can be done to help an individual who has both a brain injury and problems with substance use? This question will be answered in part 2 of our blog post: The Comorbidity of Substances and ABI – the Role of the OT…stay tuned!
References:
Bjork, J. M. & Grant, S. J. (2009). Does traumatic brain injury increase risk for substance abuse. Journal of Neurotrauma, 26, 1077 – 1082.
Ilie, G., Adlaf, E. M., Mann, R. E., Ialomiteanu, A., Hamilton, H., Rehm, J.,… Cusimano, M. D. (2015). Associations between a history of traumatic brain injuries and current cigarette smoking, substance use, and elevated psychological distress in a population sample of Canadian adults. Journal of Neurotrauma, 32, 1130 – 1134.
West, S. L. (2011). Substance use among persons with traumatic brain injury: A review. Neurorehabilitation, 29, 1 – 8.
WETA. (2017). Facts about concussion and brain injury. Retrieved from https://www.brainline.org/article/facts-about-concussion-and-brain-injury
Weekly Mind Bender
What are the next three letters in the following sequence?
J, F, M, A, M, J, J, A, __, __, __
S, O, N.
The sequence is the 1st letter of the months of the year. September, October, and November are the next in the sequence.
What is Hygge and How Can it Help You Survive Winter?
Hygge (pronounced hue-guh) defined as, a quality of coziness and comfortable conviviality that engenders a feeling of contentment or well-being (regarded as a defining characteristic of Danish culture), is becoming very popular. Its basic principles revolve around creating an environment that is comfortable, full of love, warm, and cozy – sounds like a great way to make it through a cold Canadian winter if you ask me! Learn more about Hygge and its benefits in the following care of HealthLine.
HealthLine: What the Heck Is Hygge and Why Do You Need Some This Winter?
O-Tip of the Week: Give Yourself a Pat on the Back
Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living.
For the month of February, our O-Tip of the week series will talk about Self-Esteem, which is defined as confidence or belief in one’s own worth or abilities. Self-esteem issues affect more than just teenagers and encompass more than physical insecurities. Follow along this February to learn more about self-esteem, its importance and some simple ways give yourself a boost!
This week we invite you to reflect on and record your accomplishments. Big or small, past or present, make a list of all the things you have achieved and refer to this when you are feeling down or need a boost.