TOG : Revista de Terapia Ocupacional de la APGTO (Dec 2004)
Occupational Therapy in mental health: the occupation as an entity, agent and means of treatment
Abstract
I hope you excuse me for starting my exposition telling you a little story. My purpose is not being witty, because maybe most of you do not see anything funny at all in it; at best, quite the reverse: I want to give the best example, which is not always easy, of the reality of our profession. A reality we keep facing despite the passage of time.A few months ago, I was visiting a relative with my wife and my son in a rest home belonging to one of the most famous names of geriatric services today. In the lobby, decorated like a hotel, we were received by the girl at the desk, who was very kind and wore the unavoidable white coat. That was the moment my son took up to shake off my hand and our vigilance. He had found a room which had strongly caught his attention; of course, he ran to it. Once on the inside, he started to manipulate the familiar objects filling that big room. On the table, there was a dominoes of animals (of a famous toys brand) which was by chance like the one he had been given as a present; a puzzle with images from the latest Disney film; plastic cubes and little balls of very vivid colours, blue, red, yellow, green, and a very strange sphere whith a metallic net and containing small spheres with numbers inscribed. The big sphere rotated and ejected the small ones when pressing a button. Excited, he pointed on the wall the sheets to be coloured. Some of them were about butterflies, little ducks, fish, flowers, Bamby, Donald, the duck and the chubby face of an Indian baby with a feather. He also put his attention into a corner full of mats, balls, rings, ropes and coloured rolling-pins.I guess Diego was amazed, maybe surprised by the fact of having been driven by us to such an amusing place without previous notice (as usual). So that, he needed to express his discovery: “Look mummy, it's a school!”.Then, his comment made me laugh ironically, with a bitter face, hardly raising my lip. I remembered the picture of the new costume of the Emperor.Diego, who is not easily cheated by words—in this case, because he could not read the explanatory labels: T.O.R (on the puzzles and the dominoes), gerontogymnastics (near the rings and the balls), and especially a label over the entry door reading: Occupational Therapy. As I said, the child could not read nor perceive more than the bare reality: a kind of school.At that moment I better understood why the relative we were visiting repeatedly refused to go to Occupational Therapy; why he did not listen to my reccomendations, and why he liked better chatting with his friends at the garden, drinking a coffee or, when the pain and the sick feeling permitting, playing dominoes or going to the nearest park to play pétanque.I am afraid the story I am telling you is not an isolated fact in the practise of our profession. Furthermore, I would dare to say, without concrete data and relying on my experience (limited as everyone's), that it is more a standard than an exception.If what I suppose is true—and I hope it isn't so!—I think It is necessary to wonder: would you like to go to a similar place when being elder?; how would you feel colouring sheets with little ducks or throwing a red ball while repeating your name?; what can mean seeing yourself doing these things? and what about being watched by the rest of the people meanwhile?; Does a label give more sense to it?; what's its use?We can also wonder some other questions, these ones for experienced therapists. For instance: what kind of occupation is done there?; which is their personal, cultural or social meaning?; does stringing counting balls or mounting plastic cubes have any purpose?; Wouldn't be better playing dominoes or chess, even simplifying the game instead of playing with a children game to recover we don't know which capacities that the passage of time or the age tends to damage irremediably?. And what is more: Does the fact of improving coordination, attention or memory necessarily implies looking after the person?; Does occupying in any way mean making Occupational Therapy?; Could the prescription of children's activities be a counter-indication for health?; Does making something therapeutic necessarily imply making Occupational Therapy?Definitely, I think at this point we must keep wondering about what we do as Occupational Therapists, which is our scope of study, what do we pursue with our intervention...in short , what do we call Occupational Therapy?
