Everyday language in depression and anxiety – OT student presentation

On Saturday, May 2nd, Amanda and I, both entry level Masters students in Occupational Therapy at Thomas Jefferson University in Philadelphia, had the opportunity to present at the Virtual Ability Mental Health Symposium in Sojourner Auditorium, Second Life.  Our presentation was titled “Everyday Language and Clinical Diagnosis in Depression and Anxiety” and focused on comparing everyday language used to describe the mental health conditions of major depression and generalized anxiety disorder with definitions of the clinical diagnoses. We were very excited to present on this topic because we both are very interested in mental health.  We chose to focus on the language associated with depression and anxiety as well as the stigma that can surround these conditions because we both feel that these are very important topics that generally do not get much attention.

Jenna and Amanda presenting in Sojourner Auditorium

Jenna and Amanda presenting in Sojourner Auditorium.

We began our presentation by discussing the importance that language plays on our everyday interactions.  We explained the importance in understanding that medical terms can be quite different from the words we use every day to describe health conditions – including mental health. The first mental health condition that we focused on was clinical depression.  We gave examples about the way that the term depression is used in everyday language and contrasted them to the actual diagnoses of clinical depression.  Clinical depression is a mood disorder that is diagnosed by a doctor.  In order to be diagnosed with major depressive disorder, an individual must meet 5 out of 9 criteria established by the DSM-V , which is a diagnostic tool for mental health conditions.  In addition to defining clinical depression, we detailed the difference between the feeling of sadness and clinical depression.

The next mental health diagnosis that we described was generalized anxiety disorder.  Generalized anxiety disorder is a clinical diagnosis that goes beyond the common feeling of anxiousness. To be diagnosed with generalized anxiety disorder, a person must have at least three out of the six criteria listed in the DSM-V.

In addition to defining these mental health diagnoses, we also discussed myths and facts about depression and anxiety disorders.  For example, it is a common myth that people can control their depression and “snap out of it” if they want to. But in fact, people with depression cannot just “snap out of it.” Most people with depression benefit from treatment including medications and counseling.  A common myth about anxiety disorders is that they are not very common, when in fact about 18 percent of American adults experience some type of anxiety disorder in any given year.  It was interesting to hear from the audience about their take on these different myths.  One audience member said that she was surprised to hear that some people actually thought that anxiety disorders were uncommon, while others shared that they were surprised to hear just how common they are.

Presenting in Second Life was an incredibly unique experience.  As this was our first presentation in Second Life, Amanda and I were both rather nervous to begin.  Once we started, however, we both became much more comfortable with presenting and came to really enjoy the process.  Something that made the presentation very unique was the lively discussion with the audience.  Being able to engage with the audience and hear about their real life experiences with the topics we were presenting on was fascinating.  One audience member recounted her previous experience with having difficulty naming and explaining her emotions to her doctor.  This led us deeper into discussion about complications associated with “invisible” conditions, such as the mental health disorders we were focusing on.   In addition to this, we also talked with the audience about their reactions to the fact that depression is the leading cause of disability in the United States.  One audience member remarked that she only thought that depression was caused by disability, and had never realized that it could also go in the other direction.  Being able to spread information like this was very rewarding, and we are glad that the audience was able to learn from our presentation.  Having the opportunity to hear firsthand from individuals in the Second Life community about their experiences with these topics and their interactions with healthcare providers was extremely valuable to both Amanda and me.  We later discussed how hearing these experiences and learning from them will help us to become better healthcare providers.  We had a wonderful time presenting and are looking forward to presenting again in the future.


Generalized Anxiety Disorder. (2013). In Diagnostic and statistical manual of mental disorders (5th ed.). doi: 10.1176/appi.books.9780890425596.dsm05

Major Depressive Disorder. (2013). In Diagnostic and statistical manual of mental disorders (5th ed.). doi: 10.1176/appi.books.9780890425596.dsm04

Jefferson OT students to present at Virtual Ability’s Mental Health Symposium on 5-2-15

Mental Health Symposium – May 2, 2015 – Losing It: On Disability, Diagnosis, and Depression


See schedule of entire event at:


Looks like a great conference!
OT Students Jenna Hannan and Amanda Gilroy will present on “Everyday Language
and Clinical Diagnosis in Depression and Anxiety.”

Virtual Worlds, Best Practices in Education Conference (VWBPE) 2015

On Saturday, March 21 at 10 am EDT (7 am SLT), I will present  7 Years of Adaptation and Renewal in Second Life at VWBPE 2015.

Please see the full description of this and other presentations at: http://vwbpe.org/conference/vwbpe-2015-calendar

Hope to see you there!

Graduate Student Reports on the International Disability Rights Conference

OT Graduate Student Nicole Matyas, from Thomas Jefferson University, discusses the International Disability Rights Affirmation Conference held at Virtual Ability on October 3-4, 2014.

What is OT? Promoting our profession in a virtual world

presentation, What is OT?

Presentation at Virtual Ability: What is OT?

With every new presentation we hold in Second Life we learn a little more about the virtual community and a lot more about ourselves as future occupational therapists.  Our most recent discussion, “What is OT?” was held at the Sojourner Auditorium in Virtual Ability. The discussion was an exciting one for us; we continually learn throughout our courses about the importance of advocacy for our future profession, meaning we need to act as educators and proponents for OT and all that it entails.  Widespread understanding of our skill set is important because only through increased awareness will we be able assist all potential clients and communities that may benefit from our services.  Professionals and clients alike need to comprehend the impact we could possibly have on various situations so that the necessary requests and referrals can be made to begin therapy.  Without an accurate understanding of our scope of skills, accommodations and interventions may be withheld, thereby withholding progress from people.  Therefore, we were especially motivated for this presentation because it gave us a way to get the word out about OT and act as advocates for the profession to which we have devoted our lives!

The prior knowledge we gained through our courses at Thomas Jefferson University, Jefferson School of Health Professions this year definitely shaped the structure and content of our discussion.  We began by asking our audience what OT means to them to try to gain an idea of the experiences people have had with OT.  As we anticipated, there was some confusion about what OT encompasses, though some attendees did report prior OT interactions.  We used this opportunity to outline occupational therapy, including the populations served, the environments addressed, and the interventions used.

According to The American Occupational Therapy Association (AOTA), occupational therapy “helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations).”  Our audience was extremely forthcoming in their responses and shared many activities that they do every day that hold meaning for them beyond just the activity itself.  Responses reflected a desire for mastery and independence in daily functioning; for instance, putting on a woman’s undergarment meant much more to one attendee than just getting dressed; it meant she could take care of herself.  OTs play a key role in helping people to attain goals such as this one.

We also discussed why OTs use meaningful occupations in therapy specific to each client.  The audience members recognized that OT works this way in order to utilize people’s own intrinsic motivation to progress.  One attendee shared an experience her mother had in a session that was not meaningful or stimulating for her because it did not include activities that were personally meaningful for her, so her motivation to progress was absent.  Though we never like to learn about negative experiences, stories such as this one help us OT students realize the importance of staying client-centered in therapy.  We are excited that our graduate experience is preparing us to work with our clients in this way.

Nicki and Kristina discuss OT

Nicki and Kristina discuss OT

Our discussion then progressed to cover some of the specifics of OT, including the environments in which we work (schools, clinics, hospitals, industries, senior centers, and many more), the populations we work with (across the lifespan and all diagnoses), and the practices we use and believe in.  One of the practices that sparked a lot of conversation was Universal Design.  Universal Design has 7 principles: equitable use, flexibility, simple and intuitive nature, perceptible information, tolerance for error, low physical effort, and adequate size/space.  These principles are meant to guide the construction of spaces so that everyone can participate and engage equally within the space, regardless of size, shape, ability, and needs.  Our audience thought of many ways this idea could be applied, and we hope to see more UD in the future since all people have the right to a comfortable, safe environment that meets all needs.

This discussion was one of our favorites because OT is our passion.  We were fortunate to have such an interactive audience, filled with participants of many backgrounds with a wide range of experiences and knowledge about OT.  We hope we shed light on our profession, its goals, and its services.  We plan to continue to act as advocates for OT and for our clients throughout the future.

Note: You can see our slideshare presentation here

Relationships in Second Life

As graduate students new to Second Life, we continue to learn about the similarities and differences between “real life” and the virtual world. For example, we know that in both, technology adds a new layer to the ways we define and experience relationships. But, while we are very familiar with how people communicate through texting, email, and various social media outlets in real life (RL), we wanted to understand the relationship experience in Second Life (SL). Do people build and maintain relationships differently than in “RL”? How are relationships structured in SL? Do SL and RL relationships overlap?

relationships_002Our preparations for this event differed from our past events, which were largely scripted, beginning with an informative presentation and leading into open discussions. Since we are SL newcomers, we felt that our points of view on this topic did not hold much value. We went in with quotes from users found on community forums, a few relevant statistics on SL relationships, and some formulated questions to guide the discussion. From there, the attendees took the reins.

The attendees expressed a sort of translation between SL and RL social behaviors and relationships of any kind—friendship, companionship, or romantic: there are boundaries, norms, and expectations. With that said, some individuals indicated that SL is a place where they can compensate for challenges in RL, such as disabilities, relationship troubles of their own, or self-esteem issues. As explained in Leshed & McLeod’s (2012) article and shown throughout the discussion, people in SL reveal their “layers” in different arrangements than in RL: “…individuals share experiences, emotions, and who they are from the inside while holding back information such as material life name, contact details, occupation, and age.”

This goes hand-in-hand with “alt-avis,” a theme discussed in depth. People use these to adopt identities for different purposes—education, social interactions, etc. The majority of attendees expressed their choices to keep their identities separate. There seemed to be no overlap between these avis; lives were organized and structured on SL accordingly. Dr. Boellstorfff’s talk delves deeper into the structure of the SL community and how individuals with disabilities fit into these communities.

We left the discussion with the realization that Second Life relationships are not different from RL. In our lives, we take on different identities that we share…or don’t share…depending on the context. We often separate our professional life from our social life, and although we don’t call it an “alt-avis,” isn’t that what it really is? The only difference is that in RL, our external layers are the first to show. With the use of technology, however, this line is being blurred, and the ways in which we reveal our layers is jumbled. The discussion was an educational insight into the world virtual relationships, as well as a way to understand interactions in all dimensions.

Conveying information about spirituality without words

How we are using an occupational therapy model to design an interactive exhibit in a virtual world

Have you ever engaged in a discussion about spirituality only to find yourself stuck? What is spirituality? How does it differ from religion?  How do different people experience it? And, why does it matter?  Answering these questions can be challenging for anyone.  But, imagine not being able to use words to talk about it.

The team behind the Garden of Healthy Aging has been working hard to streamline the exhibits in Second Life and the linked wiki pages using the principles of Health Literacy.  In the past few months, we updated exhibits and wiki pages on topics such as diabetes, healthy hearts, caregiving, social supports, healthy activity, and brain health to make them more user-friendly.


Though we experienced hurdles with each of these topics, by far the most challenging exhibit to develop was the exhibit on spirituality and aging. We wanted to address the difference between spirituality and religion and focus specifically on spirituality and its effects on aging.  We found that while there was plenty of research on religion and aging, evidence on spirituality was more limited.  We wanted the exhibit to be inclusive of all beliefs and practices, as well as being concrete enough to convey the meaning of spirituality and how it can be cultivated to improve health outcomes for aging adults.

Because the possibilities for interaction in Second Life are bound only by one’s imagination and building skills, we did not want to limit ourselves to using words as the primary medium.  The most effective way to convey this information was to harness interactive capabilities such as animation, object/person interfacing, sound, and links to our wiki pages.  The question was how to make it feel intuitive.

The first order of business was to identify a model or theme to guide the design of the exhibit and to ensure consistency of the information presented within it.  In our theory class, we had studied the Kawa ‘River’ Model, designed by Japanese occupational therapist, Michael Iwama.  This model is used by occupational therapists to help clients map or draw out their lives in a visual way in an effort to help the client identify supports and obstacles in their particular life circumstances.

There are several key features of the Kawa Model.  The river itself represents the course of life, with a beginning and end.  The river walls and bottom represent an individual’s social and physical environment (family, friends, co-workers).  The water represents one’s energy or life flow.  Objects in the river, such as rocks or driftwood, change the flow of the water, both positively and negatively.  Rocks represent life circumstances (health conditions, injury, illness) and driftwood represents assets and liabilities (personality, values, skills, living situation).  The idea is that fewer or smaller  objects in the river promote a stronger flow, or better well-being.

The Kawa Model seems to suit the topic of spirituality and aging perfectly.  The metaphor of the river and its grounding in elements of nature is fitting for the discussion of spirituality.  The Kawa Model is open-ended, allowing for more client-centered exploration of spirituality, and individuals of any culture can relate to the image of the river.  The Kawa Model also allows for change across the lifespan, which is an extremely important consideration in a forum focused on aging.

We chose the Kawa Model for use in Second Life because we could effectively convey ideas about spirituality across the lifespan using an interactive river within the exhibit.  Visitors in the Garden of Healthy Aging will have the opportunity to obtain their own river models by clicking on a sign that gives them a kit comprising the river, rocks, and driftwood. They can then take the kit home with them and put together a personalized version by naming and positioning the rocks and driftwood as challenges, opportunities, life events, and so forth. For example, enrollment in OT school could be a “rock” that has moved the river in a particular direction. A piece of driftwood covering a portion of the river could represent a challenge or an opportunity presented to the student. In this way, visitors can examine their own lives by experimenting with their models, to show how these factors in their lives change or could change the course of their lives.

Below are screenshots of the spirituality exhibit within the Garden of Healthy Aging, including a close-up of the interactive model. The Kawa Model elements will be added to the Garden and the team will have a public event in which graduate students and faculty will explain the Kawa model as it applies to human adaptation. This event will take place later in September or in early October.

While the interactive model can be used as means of exploring spirituality, it does not necessarily have to serve that purpose and can be used however the visitor would like. Visitors can also give their models to Garden of Healthy Aging staff to be added to the river and become part of the exhibit.

The spirituality exhibit in Second Life is complemented by a corresponding wiki post which describes the Kawa Model, gives definitions and examples of spirituality, and provides evidence to support the cultivation of everyday spiritual experiences to promote health and well-being in older adults.  The wiki was intended to be used as a springboard to enhance understanding of the topic of spirituality before diving into the exhibit in Second Life.

Our hope is that purposeful interactions within the Spirituality & Aging exhibit will enhance visitors’ understanding of this complex topic so that they can identify the rocks and driftwood in their river. Reflecting on their own opportunities, challenges, and life events may then help them understand the “flow” of their lives and avoid the feeling of being stuck.


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