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.

References:

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

sojourner_auditorium_virtual_ability_001_edited-1

See schedule of entire event at:

http://blog.virtualability.org/2015/04/mental-health-symposium-may-2-2015.html

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.

Health Literacy in Health Care Education and Evaluating Virtual World Exhibits

Since our last update, the project team has focused on the importance of integrating health literacy principles into health care education and on developing a checklist for evaluating the fit of virtual world exhibits with principles of health literacy.  We presented Exploring the depths of health literacy: Are we teaching this and why does it matter? at the Gerontological Society of America annual scientific meeting in November 2012. Then, in April 2013 we presented Promoting health literacy through leading edge occupational therapy education at the American Occupational Therapy Association. Most recently, we presented our ongoing work on health literacy in virtual worlds at the annual faculty development conference at Jefferson, Evaluating the fit of virtual world exhibits with health literacy principles:

Health Literacy at POTA

By: Alyssa (Alzimarie) and Annalisa (ALiesel)

On September 29, 2012, Annalisa and I had the opportunity to present at the Pennsylvania Occupational Therapy Association (POTA) state conference about health literacy in Lancaster, Pennsylvania.  This was a phenomenal opportunity to learn new skills, present to a larger audience, and empower others in our profession to work towards a more health literate society.

We spent many hours preparing for this opportunity; debating what information was most important to convey, and how to present it in a meaningful, empowering manner so that occupational therapy practitioners could immediately begin to apply health literacy principles in practice.  We discussed what health literacy is, why it matters to occupational therapists, how we can apply it to our place of work, and how we’ve begun to apply these principles at Thomas Jefferson University.  We also encouraged attendees to participate in Health Literacy Month which occurs throughout October.

About 25 occupational therapy practitioners attended our presentation and the discussion was thrilling!  It was so exciting to see people consider how health literacy was already impacting their practice and share what they were doing to promote health literacy.  We discussed that there are three levels at which we can impact change: the patient level, the provider level, and the systems level.  Change at any of these three levels can have a positive impact on health outcomes.  We learned so much from the experienced OTs in the room as they shared their ideas for change on these levels.

Practitioners shared how challenging it can be to communicate with their clients in a health literate way and also discussed some techniques they use to overcome this difficulty.  They talked about the importance of checking client’s understanding by asking them to demonstrate a new skill.  One practitioner shared that she often involves the patient’s family members in conversations as a way to promote plain language. She explained that some patients find it easier to understand directions when they hear them from a family member who uses familiar words and communication patterns. Another practitioner shared that she uses health literacy principles when providing durable medical equipment. She pointed out that this equipment can be confusing for patients to use unless they have very clear directions. One OT who works in a hand clinic said that she uses the “teach back method” with her patients’ home exercise programs. Before she finishes her treatment sessions, she asks her patients to show her how they will do their exercises at home. She said this helps her see whether or not her instructions were clear. Another OT talked about how she chooses words carefully when talking with patients. She gave the example of the word “flexion.” She explained that even though this word might not seem like jargon, it might not make sense to a patient.

This was a phenomenal learning experience for Annalisa and me.  We learned so much about what goes into applying to present at a conference, preparing a presentation, and giving a presentation in a way that facilitates discussion.  These were new skills that will help us as we move forward in our careers.  I came away exhausted from an intense weekend and weeks of preparation, but am so excited about our next opportunity to present at the American Occupational Therapy Association’s national conference in San Diego, California in April 2013.

We are so grateful to Dr. Susan Toth-Cohen for her support and help walking us through each step of this process.  Her insights and ideas were invaluable.   Thanks also to each participant who came to our presentation and shared your own ideas.  Thank you for your feedback and investment into us as future practitioners who want to provide the best possible care for our patients/clients.

Women with Disabilities

Women and girls with disabilities was not a topic I had previously considered.  Although it seemed interesting, I really didn’t think we would be able to find much information about the topic.  When we started researching we found that this was not true at all.  There was so much information about the struggles that women with disabilities experience.  Many articles talked about how these individuals experience may experience discrimination on two accounts, because they are women and because they have a visible disability.  These women may experience discrimination when looking for a job, when looking for a place to live and even in their medical care.  We found that many doctors will not discuss these women’s sexual health because they assume they cannot be intimate.  I thought this was very interesting and must really impact the patients.

Our presentation of this material went very well.  We did two presentations on the 15th.  We had a fairly large turnout and our audience was very diverse.  We had visitors from all over the world, including Brazil, Germany, Australia, The United Kingdom, and America.  Many of our visitors also shared that they had disabilities.  The women with disabilities who were in the audience shared their own personal experiences, which was very interesting.  The women all seemed to agree with the information we were presenting.  Many of them said that they had experienced discrimination in the areas that we had discussed.  They were very open with their own struggles of depression and feeling isolated.  The women said that sometimes they felt like they were standing in their own way but could not pull themselves out of the depression.  There was one young woman who said she had just finished her first semester at college. She said that she was so exhausted from proving to herself and others that she could do everything that any able bodied person could do.  Her partner was also in the audience and said that after her accident she was very depressed and it took her a long time to get over the depression.  Another topic that the women were very vocal about was their sexual health needs being ignored by doctors.  They said that many times they felt like doctors seemed to think of them as being asexual.  The one thing that seemed to surprise the audience was that women with disabilities are more at risk for violence.  Our research showed that this population was more at risk for physical, verbal and sexual abuse.  None of the women spoke of any personal experience with this, however they all seemed very concerned at the possibility.

I think our audience added such a great component to our presentation. We learned so much from their discussion and it seemed like they really enjoyed speaking with each other.  They explained that they often feel alone with the issues that go along with having a disability, and it was great to see them interacting with other people who face the same issues.  Overall I think the sessions went very well and our very diverse audience added so much to the discussion.

Carpal Tunnel Syndrome Presentation

On October 16th we held a presentation focusing on carpal tunnel syndrome. To prepare for this presentation a lot of research was done on general carpal tunnel syndrome information such as the signs, symptoms, treatment approaches, and how to decrease your risk for developing this condition. The research used for this presentation was the most up to date information available and evidence based to ensure that the most accurate information was being presented. Most of the information was found in occupational therapy journals and on hospital based websites. After the research was complete a power point and script were created along with several interactive aspects such as hand splint, carpal tunnel wrist animation,  and a 3D image demonstrating proper seated positioning at a desk.

                     This picture shows the wrist animation

The audience was very interested in this topic and most of them have had some experience with carpal tunnel syndrome. One attendee was diagnosed with carpal tunnel syndrome and was very interested in gaining more information about it. The audience members asked a lot of interesting questions and shared their personal experiences with carpal tunnel.

Some of the questions that surprised me were about how you can develop carpal tunnel syndrome. One question that was particularly interesting was about if yoga could cause carpal tunnel of make the symptoms worse. We had not conducted any research specifically on yoga and had not thought about how something like yoga could affect the wrists. Any excessive bending or stretching of the wrist can cause increased pressure on the median nerve (which is the cause of carpal tunnel) so yoga could cause the symptoms if it is done for a long period of time or very frequently. Many of our guests were coming up with other ideas and activities that could potentially cause carpal tunnel of make the symptoms worse.

The audience was very interested in the section our presentation on proper positioning and how to decrease your risk of developing carpal tunnel. Many of the audience members participate in activities, such as typing a lot, that can increase the risk of developing this condition so they were anxious to hear about how to decrease this risk and protect themselves and their bodies while continuing to do the activities they like (such as being on second life!).

Overall, this presentation went very well. The audience was interested and had good questions and discussions. I was surprised by how many of them had heard about carpal tunnel syndrome and new a fair amount of information on the topic. This presentation gave them extra information about carpal tunnel and also provided them with ways to avoid developing this disease.