Introduction
With increased number of accidents, more and more people are joining the disabled bracket. Spinal cord injury (SCI) is one of the most devastating possible outcomes of an accident as it results into disability (Wilder, 2006). The loss of sensation that comes with SCIs impacts severely on the social role of an individual. Occupational therapy, as a profession, has been instrumental in ensuring that disabled people lead a meaningful and purposeful life (Turner, 2003). This paper analyses a case in which an individual which was involved in a car accident, thereby sustaining an injury to the spinal cord, seeks for a suitable work. The paper is written from an employment consultant’s viewpoint and supposed to provide a plan on how the victim (Philip) can be assisted to develop and achieve a vocationally-relevant goal. Philip has already gone through a comprehensive rehabilitation program and, therefore, feels that it is appropriate for him to reintegrate into the community.
Situation brief
Philip, aged 37, went through a terrible past that was a car accident that severed his spine at T2. He has been through rehabilitation and now feels re-energized and wants to get his life back. Philip has maintained the upper body strength he had before the accident. He manages all the personal activities and even prefers to use the manual wheelchair for shorter distances. He wants to get a job and live like everyone else. The problem is that his current state cannot allow him to go back to his previous job as a roof tiler. There are some points to take into account: before the accident, Philip was a very social person with many friends. He considers himself to be an achiever and therefore, he is not satisfied with the disconnected life he is currently leading. According to Philip, an ideal job for him will be the one that allows him to stay in contact with others, that is not too repetitive, and involves music, if possible. He is willing to take a course that will help him get a job.
Nature of Philip’sdisability
As per the case brief, Philip’s spinal cord was severed at the thoracic level two (T2). Medical data indicates that thoracic injuries from T1 to T8 result in paraplegia. The paraplegia causes a complete loss of sensation in the lower limbs, and poor trunk control that occurs due to the loss of abdominal muscle control (Alpert & Wisnia, 2008). In most cases, persons with this class of spinal injuries have full control of their upper limbs. Additionally, affected individuals may develop impotence, urinary and faecal incontinence. Though, medical literature states that this people may require all round assistance, this is not true in Philip’s case. The case brief provided shows that Philip is able to accomplish most of his daily tasks on his own (Andrew & Contento, 2010). He only receives assistance ones a week. This implies that he has full control of his upper limbs and the trunk to some extent. This will be confirmed before identifying a suitable vocational program for him. Nevertheless, a suitable occupation for Philip will be one that makes effective use of his hands with slight trunk movement. Therefore, it is important that the selected employment role or educational be appropriate for his physical condition.
Evaluating the appropriate career/course for Philip to undertake
Philip’s situationthe model of human occupation
Based on the situation brief given above, Philip wants to be in an active career that will make use of his upper body abilities. The work must allow him to socialize with other people and should not be repetitive(Flinn& Radomski, 2008). There are several occupational therapy models that can be used to address Philip’s situation, depending on how and individual looks at it. However, as per the pertinent details provided in the brief the most suitable occupation therapy model that applies to Philip’s case is the “model of human occupation” (Berkowitz, 1998, pp. 34).
The basic elements of the model focuses on an “individual’s occupation, motivation, routines and lifestyle, the nature of the skilled performance and the environmental influence” (Berkowitz, 1998, p. 37). The model takes into account that a human being is a system in itself and therefore describes him/her using system theories. One of the theories utilized is the “dynamic systems theory” which stipulates that interaction between human beings and the environment gives way to occupational behaviour (Thew & Edwards, 2011, p. 3).
The fundamental concepts outlined in the “model of human occupation” include the understanding that human occupation is complex in nature; each person is made up of diverse components; and realization that performance is under environmental influence (Rigby & Lowe, 2008).
Indeed, the basic assumptions of this model can be used to understand Philip’s situation. If one looks at Philip as a dynamic system, he/she will understand that he needs an occupation that will form the essence of his organization. The ideal occupational opportunity must reflect the nature of his disability and personal desires. However, it is important to note that occupations result “from motivation, patterns, performance ability factors and environmental influence” (Lasher, 2008, p.34). Unless there is occupation that specifically meets Philip’s requirements, then he will be offered a therapy process that helps him to reshape his occupational identity and therefore motivate him to become more adaptive (Latham, 2008a).
Course/ job selection vs. nature of disability and personal desires
From the sections explored above, it is evident that Philip wants a job or a vocational training program that has the following characteristics: the program should take into account the fact that he is only able to actively use his hands in all undertakings of the job; the selected training program should not lead to a job that is repetitive in nature or if a job is directly selected then it should not be repetitive in nature; the activities of the job should allow him to actively socializewith other people; finally, the job can preferably have some kind of music. There are some job categories that can work best for Philip. First, there are several computer based jobs that are accomplished by people in the same situation. Secondly, he can work as a cashier for a sales store. Other jobs will require a departure from some of the issues raised in the criteria. Therefore, a good employment consultant who understands Philip’s situation will recommend a vocational training that will impart the necessary skills required performing a computer based job.
Following the identification of the possible role/work that matches Philip’s requirements, an employment consultant should invite him for a collaborative approach to identify the “best match” between his skills, interests, abilities (and taking into account the barriers) and the broad ranges of possible employment or educational options that will help him achieve the desired vocational goals (Latham, 2008b).
Job selection and requirements vs. Philip’s skills, desires and capacity to work
Philip, a former roof tiler, stated that he could not work as a cashier because the job was not enough intuitive for him. If an employment consultant talks to him about the opportunities in the IT sector, he will respond, perhaps, saying that he has the basic knowledge on computer systems and is not sure that it is enough to get him a computer related job. One can learn that Philip basically uses computers to chat with friends online, or just send and retrieve email messages (Manyibe, 2007). Then he/she can decide to suggest Philip expressing his opinion regarding the opportunities available in the wide information technology sector. The systems administrator’s job will definitely be rejected taking into account that it requires a considerable level of technical skills and knowledge, and in some instances, quick decisions and constant move might be needed. Online jobs, such as freelance writing and data entry, will not be suitable for Philip as well due to the following reasons. First, he might say that he does not have the skill and passion required to accomplish different forms of writing. Second, such jobs require a quite secluded environment that is not desired by Philip. At this point, they can proceed on with several other options, and at the end, they may settle for film and video editing.
Evaluation of whether or not Philip had the capacity and desire to work as a film and video editor
Before considering this option, it is important to note that film and video editor’s job description includes the following: creating; compiling; inserting computer generated effects, editing films and videos to ensure that they are of the desired quality (Cole, 2004). These tasks are mostly accomplished through teamwork due to the need to evaluate and consider the views of different people. The video material to be edited can be posted and received via the internet and, therefore, does not require one to constantly move (Goldstone, 2002). The job is not repetitive as the nature and requirements for every editing task vary considerably depending on the specifications needed. Therefore, the job matched with the physical capacity and desires of Philip well. However, the main challenge is that his basic computer skills might not be sufficient for him to work as a film and video editor for any organization. We may then decide to check if there are any flexible vocational training opportunities for Philip.
Selection of vocational training courseand application
A search can be conducted online, and it may identify more than 20 institutions that offer courses related to video editing within Australia. Some of them include:Polytechnic West, Regent College, Canberra Institute of Technology (CIT), Victoria University, The University of Sydney, Western Sydney Institute and the Centre for Adult Education (CAE) in Melbourne (Reed & Sanderson, 1999).
After much consideration regarding the training model and other requirements, such as location, fees and duration, Philip may decide to settle on Polytechnic West. The institution is favourably located in Western Australia and offers vocational training through the VET system. The film and video editing skill is provided as part of Certificate III in Media course at the College. The course is offered on a full time basis and can be completed in one semester or in a variable time depending on the needs of the student. An affordable fee of 5,250 Australian dollars is charged for the entire course. The certificate course is specifically designed for the media industry and provides benefits for those interested in film and video editing and sound mixing. The two programs which the course offers are provided by the Thornlie campus. There are some entry requirements which students need to fulfil before they can be considered for the course. The requirements are basically centred on the ability of the student to read and understand the English language well enough to be able to go through the course and comprehend the material.
In line with the recent advocacy for inclusion of disabled people in the mainstream education, the Institute does not offer special classes for the disabled. The design of most general use infrastructures has been modified to take into account the needs of disabled people. The college provides several ways through which people with special needs can seek for assistance. This includes a guide to learning support which communicates how the college assesses and helps the disabled students to meet their needs. There are some special accommodation arrangements for people with disability.
With such information, the employment consultant will review a number of challenges that might be associated with the course. In this case, Philip is going to attend classes with the students having some disabilities. The ordinary students might not understand the needs of the disabled. Others may give negative disheartening comments that might abuse or injure the feelings of a disabled person. Some other challenges which may appear touch such issues as friendships outside the classroom setting. After reviewing all the possible challenges, Philip will be encouraged to feel that he should go ahead with the application process. He might not see that as a challenge as he is able to do most things on his own. Just like many disabled people around the world, it is assumed that Philip supports the principle of inclusion. He might cite the various social benefits that will be achieved through constant interaction at the college. He is positive regarding the situation as he considers that training would be the best for his long term objectives (Radomski, 2008).
Luckily enough, the application for this course can be conducted online in a four step process that includes choosing a course, applying to take it, receiving an offer and accepting it. The college website is very informative, and Philip can get all the required information. As a consultant, one can provide Philip with a computer to see if he can complete the application. Philip did applications before and, therefore, he might just make a perfect one. The application will be mailed through the college e-mail address that can be found on the website. According to the information provided, it can take a maximum of four weeks for the response to come through.
Support for preparation to enrol and undertake the course
Assuming that nothing goes wrong with the application, Philip should then be able to receive an e-mail in which the college accepts him to take the course. The course begins in two or three months after acceptance. A quick assessment of Philip’s needs in relation to his physical disability, basic requirements and his desires should be carried out. The assessment should be based on three components as described by the model of human occupation (McColl, 2003).
This will not be difficult because one will be working with Philip for some time and will have a complete picture of his performance capacity and environmental needs.
The first thing to consider is whether he is going to commute or relocate because the college may be located far from his home. In such a case, a transport arrangement should be considered. Philip does not own a car at the moment, and therefore, it would be better if he rent a small house near the college for four months he is to study. Philip will be required to relocate for the four months of training.
Therefore, home visit will be conducted to identify his current lifestyle so as to assist him to set up a similar arrangement when he enters college. Some of the important factors include the need for retraining on wheelchair use since the college may offer a different experience. This will also include how to effectively transfer his the “hour a week home care” that he currently receives (Foster, 2003).
The overall cost of taking the course will include accommodation arrangement and the tuition fees. Philip may state that he is in a position to meet the accommodation charges for the three months as his family members might agree to provide some funds. Therefore, ways of how to raise the remaining funds should be considered. Some of the available options will include welfare and private sponsors (Forsyth & Kielhofner, 2008).
On-going support plan for Philip
This support plan is based on Philip’s situation, the course and the environmental implications of the educational setting. The plan aims at improving the timing and quality of any assistance that might be required. It is important to note that the college has an existing framework that evaluates the needs of disabled people and provides some level of assistance. Research indicates that college staff is usually very understanding and ready to help such a student to ease his study experience as much as possible. The only problem is that they may not be in a position to understand the needs of all the disabled people in the college.
Therefore, the on-going support plan will seek to deal with the foreseen challenges and those that might arise during the study. An appropriate person who will directly monitor and report on Philip on a weekly basis should be identified. If a need arises, then the regular visits to address any challenges that might arise are required. Philip should be encouraged to befriend his tutors and classmates who can provide assistance in regard to the course material. The overall objective will be to ensure that Philip gets enough motivation to take the course and form a strong basis for a long term career.
Reflection
The model of human occupation is selected to provide the desired assistance for Philip. The model is best suited to identify Philip’s needs based on his performance capacity and desires. After using the model to analyse Philip’s situation, it is important to identify a job/course that will provide him with a long term satisfaction. In other words, this is a holistic approach intended to ensure that Philip’s needs are taken care of on a long-term basis. The various components of the model human occupation ,such as volition, habituation, and environment and performance capacity, are all considered in this paper. In the end, the study and analysis of Philip’s case reflects and tries to identify what should be done in a real life scenario.
Conclusion
This paper seeks to use a situation (Philip’s case) to show how an occupational therapy model can be used to identify an appropriate work role/course for a disabled person. The paper uses the provided brief on Philip as an example, thus his situation is fully addressed using the model of human occupation. This model is selected on the basis to take into account all the basic needs of individuals by looking at human beings as systems. The paper is appropriately developed to show how occupational therapy models can be used in practice. The model of human occupation is particularly operative because it cares of the needs of everyone. This model can be used effectively by practising occupational therapists to address the needs of their clients. Additionally, it can be used by employment agencies to help identify the best job options that are available for the disabled members of the society.
References
Alpert, M. & Wisnia, S. ( 2008). Spinal cord injury and the family: A new guide. USA: Harvard University Press.
Andrew, P. & Contento, B. (2010). Barriers to employing persons with disabilities: Three common misconceptions. Web.
Berkowitz, P., O’Leary, P. Kruse, D., & Harvey, C. (1998). Spinal cord injury: An analysis of medical and social costs. New York: Demos Medical Publishing, Inc.
Cole, J. (2004). Still lives: Narratives of spinal cord injury. Massachusetts: Massachusetts Institute of Technology.
Disabled world towards tomorrow: Jobs for people with disabilities, 2009. Web.
Flinn, N. & Radomski, M. (2008). Learning. In M. Radomski & C. Latham (Eds.), Occupational therapy for physical dysfunction (sixth edition) (pp. 382-401). Philadelphia, Pennsylvania: Wolters Kluwer.
Forsyth, K., Kielhofner, G., Bowyer, P., Kramer, K., Ploszaj, A., Blondis, M…. Parkinson, S. (2008). Assessments combining methods of information gathering. In G. Kielhofner (Ed.), Models of human occupation: theory and application (pp. 288-312). Philadelphia, Pennsylvania: Lippincott Williams & Wilkins.
Foster, M. (2003). Skills for practice. In A. Turner, M. Foster, & S. Johnson (Eds.), Occupational therapy and physical dysfunction: Principles, skills and practice (pp. 85-106). UK: Elsevier Limited.
Goldstone, C. (2002). Barriers to employment for disabled people: A study carried out on behalf of the Department for Work and Pensions. Web.
Lasher, E. (2008). An investigation of quality of life, job satisfaction, and the return to work related experiences of women with spinal cord injury: A dissertation in counsellor education. Ann Arbor, Michigan: ProQuest LLC.
Latham, C. (2008a). Conceptual foundations for practice. In M. Radomski & C. Latham (Eds.), Occupational therapy for physical dysfunction (sixth edition) (pp. 1-20). Philadelphia, Pennsylvania: Wolters Kluwer.
Latham, C (2008b). Occupation: Philosophy and concepts. In M. Radomski & C. Latham (Eds.), Occupational therapy for physical dysfunction (sixth edition) (pp. 339-357). Philadelphia, Pennsylvania: Wolters Kluwer.
Manyibe, E. (2007). Outcomes of individuals with spinal cord injury served by state vocational rehabilitation services. Arizona: ProQuest.
McColl, M. (2003). Introduction: A basis for theory in occupational theory. In M. McColl et al. (Eds.), Theoretical basis of occupational therapy (pp. 1-4). Thorofare, New Jersey: Slack Incorporated.
Radomski, M. (2008). Assessing context: Personal, social and cultural. In M. Radomski & C. Latham (Eds.), Occupational therapy for physical dysfunction (sixth edition) (pp. 284-309). Philadelphia, Pennsylvania: Wolters Kluwer.
Reed, K. & Sanderson, S. (1999). Concepts of occupational therapy (fourth ed.). Philadelphia, Pennsylvania: Lippincott Williams & Wilkins.
Rigby, P., Lowe, M., Letts, L., & Stewart, D. (2008). Assessing environment: home, community, and workplace access. In M. Radomski & C. Latham (Eds.), Occupational therapy for physical dysfunction (sixth edition) (pp. 310-338). Philadelphia, Pennsylvania: Wolters Kluwer.
Thew, M., Edwards, M., Baptiste, S., & Molineux, M. (2011). Role emerging occupational therapy: Maximising occupation-focused practice. West Sussex, UK: Blackwell Publishing Ltd.
Turner, A. (2003). History and philosophy of occupational therapy. In A. Turner, M. Foster, & S. Johnson (Eds.), Occupational therapy and physical dysfunction: Principles, skills and practice (pp. 3-24). UK: Elsevier Limited.
Wilder, E. (2006). Wheeling and dealing: Living with spinal cord injury. United States of America: Vanderbilt University Press.