Contents

Question ..................................................................................................... 2
Introduction ............................................................................................... 2
METHOD .................................................................................................. 3
RESULT .................................................................................................... 3
DISCUSSION............................................................................................ 7
CONCLUSION ......................................................................................... 8
References ................................................................................................. 8

Question
Effectiveness of Occupational Therapy Intervention in Borderline Personality Disorder and PostTraumatic Stress Disorder

Introduction
A lot more composed of significant daily actions or even jobs for example strolling your dog,
horticulture, planning meals, artwork, carrying it out washing as well as doing offers.
Occupations tend to be portion of living; these people explain who else we have been and just
how all of us experience you. Occupations assist provide which means alive (Townsend &
Polatajko, 2007). Whenever we cannot take part in every day Occupations, because of injuries,
sickness, and afflictions or even interpersonal as well as environment conditions, Occupational
Therapist give you an idea about methods to tackle the actual significant daily actions associated
with living. Work-related treatment will also help avoid impairment or even sicknesses as well as
improves the method all of us take part in our own interests as well as life. Occupational Therapy
assists all of us participate in the actual profession associated with residing (Schell & Cervero,
1993).
Post-Traumatic Stress Disorder (PTSD) is a complex condition caused by traumatic events such
as accidents, crimes, natural disasters, war, or other threats to life. Nightmares, flashbacks, or
thoughts of the event can interfere with normal life for months.For some people, alcohol or drugs
is the only way they found to cope with PTSD (Excellence, 2005).
Borderline Personality disorder is considered the most typical personality disorder within
medical configurations, which is found in civilizations all over the world. Still this particular
problem is usually improperly identified or even underdiagnosed within medical exercise.
Borderline Personality disorder leads to noticeable stress as well as disability within
interpersonal, work-related, as well as part working, which is related to higher prices associated
with self-destructive conduct (e.g., committing suicide attempts) as well as finished committing
suicide. The fundamental function associated with Borderline Personality disorder is really a
predominant design associated with lack of stability associated with social human relationships,

impacts, as well as self-image, along with noticeable impulsivity. These types of features start by
earlier adult life and they are found in a number of situations (Association & Disorder, 2001).

METHOD

PubMed as key database was searched using MeSH terms ("Borderline Personality
disorder"[Mesh] AND "Occupational Therapy"[Mesh]), ("Post Traumatic Stress disorder
[Mesh] AND "Occupational Therapy"[Mesh]),. Initially no limit was put on search and it
resulted in 88 hits. In another search, using key words Occupational Therapy AND Borderline
Personality disorder 8 articles articles were shown. To limit the search, boxes against Full text,
Human and English were checked. Eventually the search was ended up with 5 articles. 15
articles were selected after initial screening; those were seemed to be related to the key words,
orderline Personality disorder, Occupational Therapy, Post Traumatic Stress disorder. Articles
those did not directly study association between marital status and obesity and published before
1990 were excluded. Finally, 7 articles have been included and it has also been double checked
to ensure all related articles have been selected. Apart from this, Google, OTseeker, Google
Scholar were also been used. As there were lack of research available on the internet this
literature review used some gray literature too.

RESULT

The key article selected for this literature review was conducted in USA. This was study took
place in a private mental health facility in Ontario. Initial interviews and assessments were
conducted by an interdisciplinary treatment team. Clients were followed for six months
following their planned return to work date. By gaining a trust relationship with the therapists,
the subjects more easily shared experiences throughout this narrative study. The study highlights
the fact that occupational therapists, by profession, addresses the person, occupation, and
environment which makes them effective in working with this particular population.
The outcomes exposed the effect from the hidden injuries associated with battle such as
emotional as well as intellectual injuries. The very best five difficulties recognized had been:

trouble along with interpersonal human relationships outside the army which frequently led to
solitude; issues with college for example focusing as well as relearning abilities; reduced actual
physical wellness for example exercising healthful dietary routines demonstrated hard with an
increase of spare time, insufficient framework, as well as improved entry to meals; problems
along with sleep=-psychological as well as actual physical modifications impacted capability to
rest as well as rest; as well as problems with traveling because of emotions associated with pain
as well as worry within a car impacted their own capability to land on the street. This article says
that it must be essential which experienced look for assist to determine as well as deal with the
actual hurdles now they encounter whilst trying to achieve the actual objectives as well as
motives these people really feel most significant for them individually. The final outcome says
which OT is actually distinctively placed in order to provide experienced in most mature
exercise settings that help all of them accomplish work-related independence. Individuals
within this research recognized a number of work-related treatment surgery which are useful for
this recognized procedure for modify as well as effective go back to function. Dealing techniques
which were accepted integrated conversation abilities as well as learning how to produce
security. A number of resources for example inhaling and exhaling as well as grounding had
been recognized as important through individuals for his or her recuperation because they carried
on to make use of this tool to keep a sense security on time for function. This particular
discovering is actually in line with suggestions through Froehlich who else stressed the value of
utilizing grounding processes to maintain individuals within the present. Throughout the
followup stage of the research most of the individuals had been crystal clear of their enhanced
capability to carry out their own work via intentionally doing dealing techniques as well as via
their own dedication to perform points in a different way. The ones that dropped back to aged
designs carried on in order to battle (Cowls & Galloway, 2009).
The second study was a case report published by American Occupational Therapy Association.
This case study involved a male who worked as an industrial inspector. He was injured on the
job experiencing a fall through a scaffolding?. He was initially just treated for his physical
injuries, denying any PTSD symptoms. During a session with OT in work-simulation the OT was
able to identify PTSD symptoms and reported them to the team.
The occupational therapy treatment strategy integrated organized work-simulation actions
(sedentary, nonsedentary). Inactive duties integrated finishing workplace duties, for example

accounting as well as inputting in a pc, whilst changing seated as well as position. Nonsedentary
duties integrated rising the step ladder, jogging raised supports, as well as managing on the
rocker panel (to replicate strolling as well as located on unequal surfaces). Some other workrelated treatment objectives had been enhancing posrure as well as entire body technicians as
well as enhancing overall performance within house servicing, community, as well as raising
child duties. The customer had been likewise known as driver's treatment, something supplied by
a good work-related counselor along with a traveling instructor, to judge their safery and also to
reduce their serious mid back pain whilst traveling.
Occupational therapy intervention was designed to be comprehensive, including complex ADL
training, work simulation, craft activities, endurance [raining, and education in posture and body
mechanics. Responed here are those aspects of treatment directly related to addressing workrelated trauma in work-simulation activities. Overall, the c1iem received 18 individual or group
sessions of occupational therapy during his 4-week treatment program (Phillips, Bruehl, &
Harden, 1997).
During the 3rd week of Treatment, the occupational therapist began To address work activities,
including ladder climbing and walking on elevated and uneven surfaces. Substantial anxiety and
autonomic arousal (i.e., sweating, tachycardia, flushed face) were noted when the client walked a
6-in. high balance beam and climbed a ladder. The client also responded severely increased low
back pain while attempting to balance on an uneven surface (i.e., the rocker board).
Throughout the very first program, the actual c1iem wandered on the stability ray which was 4in. broad as well as 6-in. over a floor. Emotions associated with instability because this
individual wandered the actual ray supplied proprioceptive tips which brought on imense
distressing thoughts related to improved anxiety as well as lack of stability. First associated with
treatment, having been not able to navigate the actual 6-h lengthy ray without having dropping.
The actual work-related counselor supplied support to conserve the dient's stability as the psycho
therapist well guided your pet via publicity treatment. Due to the client's difficulty within
executing this, none other actions had been tried throughout the very first program.
An additional program had been integrated bodyweight changing within the rocker panel within
a position place without having upper-extremity assistance. The help of the actual work-related
counselor with regard to stability as well as bodyweight changing slowly reduced. The actual
rocker panel after that had been positioned alongside the actual 10th-story windowpane to supply

extra elevation tips for your publicity. Stimuli just like the seams from the incident (e.g.,
lightweight aluminum "clanking") were additional. At first, contact with these types of extra
physical tips motivated improved trauma thoughts as well as anxiousness, needing much more
support with regard to stability (Phillips et al., 1997).
The third one an informative article describing PTSD, the role of OT with persons with PTSD,
and where these OT services are provided. The article states that OT practitioners are uniquely
skilled to provide treatment for persons with PTSD. Several examples of OT interventions are
learning coping strategies, training in adaptive self-care, planning daily routines, home
modifications, and relapse prevention. OT services are provided in a variety of settings such as
hospitals, rehab centers, outpatient clinics, day programs, homes, skilled nursing facilities, and
military bases. Services are provided in group settings or one-on-one settings. Another way OT
provides services is by consulting organizations, community groups, other professionals or
colleagues. OT practitioners are a vital member of the multidisciplinary team that treats patients
with PTSD (Champagne, 2010).

An article describes Dialectical behavior therapy as an important intervention provided by

occupational therapist for the management of borderline personality disorder (Innovation, 2015).
Four sets of skills are taught in a group setting: core mindfulness, or attention to experience;
interpersonal effectiveness, predominantly assertiveness; emotional regulation, or the capacity to
experience and modulate emotions; and distress tolerance, or the capacity to tolerate painful
emotions without impulsivity. Each day patients record target behaviors, such as suicidal
ideation, urges to self-harm, and incidents of parasuicide, on a preprinted diary card. The
therapist reviews the card at the beginning of the session to set the agenda. In randomized
clinical trials, dialectical behavior therapy was more effective than usual treatment in reducing
suicidal and self-injurious behaviors, dropout from treatment, hospitalization, and self-reports of
anger and anxious rumination (Simpson et al., 1998).
Another article described some intervention techniques like Life skills teaching, Guided imagery:
it is utilized in many methods. Every client offers his or her personal inner globe wherever
changes reside, take part in actions, and steer clear of fact. Utilizing well guided images we are
able to set or even team changes to maintain each other. A grownup change may be trained how
you can enjoyment foster a fresh change. Changes who else think they may be unclean or even

nude could be in house washed upward as well as dressed up. It really is more suitable with
regard to changes to get this done on their own, following greatest would be to possess some
other changes assist. We may request, "who may comfort and ease Sally that help the girl obtain
washed up". Well guided images may also be used within a conventional way with regard to
tension decrease, Projective methods: they are essential resources with regard to customers.
Artworks, fine sand perform, sketching, clay-based as well as perform treatment permit changes
in order to connect non-verbally (Oke & Kanigsberg, 1991).

DISCUSSION

All studies showed the intervention techniques used by occupational therapist for treating
borderline personality disorder and post-traumatic personality disorder. PTSD is definitely an
panic attacks that may create according to contact with a considerable distressing occasion
within ones living. These types of occasions may include army fight, chaotic individual
approaches, terrorist assaults, organic unfortunate occurrences, or even severe mishaps. PTSD
signs and symptoms generally begin right after the actual distressing occasion, however they
might not occur till a few months or even many years later on. To become identified as having
PTSD, an individual should have 3 various kinds of signs and symptoms: re-experiencing signs
and symptoms (becoming annoyed whenever confronted by the distressing tip or even taking
into consideration the stress if you are attempting to take action else), prevention as well as
mind-numbing signs and symptoms (detachment through individuals as well as locations,
interpersonal isolation), as well as excitement levels signs and symptoms (sleeplessness, very
easily stunned, hyper-alertness in order to danger). The actual analysis requirements with regard
to PTSD views the actual length as well as regarding signs and symptoms. Extreme worry,
pessimism, decreased tension patience, as well as reduced stamina tend to be characteristics from
the illness and may impact almost all working facets of the persons life. It is extremely typical
with regard to some other circumstances to happen together with PTSD, for example depressive
disorders, anxiousness, or even drug abuse. These types of emotional and physical signs and
symptoms have an effect on the individual along with PTSDs capability to sustain their own
work-related functions, particularly work. It is necessary for your individual, by using

professionals, in order to focusing on how their own problem and also the character of the
function impact each other. Within the domain of personality disorders, Border Line personality
Disorder (BPD) offers drawn the best interest; the actual materials dedicated to it really is much
more large compared to which dedicated to some of the some other acknowledged character
problems. This particular interest and enormous materials offers much more related to the actual
difficult character from the problem and also the issues worker on dealing with this, in order to
the rate of recurrence. Actually the actual put occurrence with regard to BPD continues to be
approximated because one 16% within the common populace, that is under the actual rates for
your asocial, histrionic, obsessive-compulsive, as well as avoidant kinds. OT plays a huge role in
assisting the individual in order to establish/reestablish work-related abilities for example dealing
techniques, job-matching, work-hardening, as well as interpersonal discussion.

CONCLUSION

There are various intervention are used by occupational therapist for the treatment of PTSD and
BPD. But there were not adequate studies to support the effectiveness of occupational therapy
activity based interventions. Since all studies were narrative or qualitative it is not possible to
show effectiveness. Further studies should focus on randomized controlled trails and treatment
based.

References
1. Association, A. P., & Disorder, A. P. A. W. G. o. B. P. (2001). Practice guideline for the
treatment of patients with borderline personality disorder (Vol. 110): American
Psychiatric Pub.
2. Champagne, T. (2010). Occupational Therapy Role with Posttraumatic Stress Disorder,
2015,

from

http://www.aota.org/Consumers/Professionals/WhatIsOT/MH/Facts/PTSD.aspx,2010.

3. Cowls, J., & Galloway, E. (2009). Understanding how traumatic re-enactment impacts
the workplace: Assisting clients' successful return to work. Work: A Journal of
Prevention, Assessment and Rehabilitation, 33(4), 401-411.
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Clinical Excellence.
5. Innovation, O. (2015). Dialectical Behavior Therapy 2015, from http://www.otinnovations.com/content/view/40/46/
6. Oke, S., & Kanigsberg, E. (1991). Occupational therapy in the treatment of individuals
with multiple personality disorder. Canadian Journal of Occupational Therapy, 58(5),
234-240.
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disorder: Use of exposure therapy in work-simulation activities. American Journal of
Occupational Therapy, 51(8), 696-700.
8. Schell, B. A., & Cervero, R. M. (1993). Clinical reasoning in occupational therapy: An
integrative review. American Journal of Occupational Therapy, 47(7), 605-610.
9. Simpson, E. B., Pistorello, J., Begin, A., Costello, E., Levinson, J., Mulberry, S., . . .
Stevens, M. (1998). Focus on Women: Use of Dialectical Behavior Therapy in a Partial
Hospital Program for Women with Borderline Personality Disorder. Focus, 49(5).
10. Townsend, E. A., & Polatajko, H. J. (2007). Advancing an occupational therapy vision
for health, well-being, and justice through occupation. Ottawa, ON: CAOT Publications
ACE.Enabling Occupation II prsente une vue en coupe tranversale du MCRO-P pour
dfinir et dlimiter le domaine de proccupation des ergothrapeutes, cest-dire
loccupation humaine.