Shannon Joyce

15 March 2018

Level I Fieldwork: Mental Health

Journal #2

After spending almost thirty hours at Kettering Behavioral Medicine Center, I have been
exposed to a wide variety of diagnoses and patients. I have quickly learned that even with similar
diagnoses, presenting symptoms and behaviors can vary significantly across patients. Although
symptoms and behaviors were different across patients, it was evident that all were experiencing
psychosocial challenges. Many were experiencing irrational thoughts and/or hallucinations
which could severely alter one’s perspective of their environment and surrounding people. There
was also a trend of patients being consumed by cognitive distortions and crippling negative
thoughts. Other patients, because of their mental state, were very irritable and could not tolerate
any level of social interaction.

Functional cognition was also significantly impaired in many of the patients. The most
common cognitive impairments seen were in concentration, problem-solving, and memory.
Patients may struggle to report details about their life, manage their ADL tasks, or participate in
a game due to their current impairments. These impairments seem to stem from anxiety and
depression, which suppress the brain ability to focus and operate correctly. Most interesting was
that when a patient experiencing cognitive dysfunction was given a mindless activity to work on
(such as water-color painting), after about 20 minutes patients would express more clarity in
their thinking and decreased anxiety.

Occupational therapy is an integral part of treatment at KBMC and addresses both

cognitive and psychosocial challenges experienced by patients. Occupational therapists complete
the ACLS, MoCA, and KELS assessments with any patient suspected of having a cognitive
impairment. In the acute setting, a lot of the cognitive treatment sessions were centered around
leisure tasks and mindfulness, as its been shown that leisure and relaxation can promote
concentration and memory. The therapists also encourage journaling and documenting when
anxiety develops throughout the patient’s day in order to identify trends and ways to combat
anxiety. There is a large variety of treatment sessions designed around psychosocial challenges.
A few treatment topics seen at KBMC include: coping strategies, positive thinking, self-esteem,
conflict management, communication styles, and also mindfulness. Patients are assigned to these
sessions based on their specific problem areas in order to get the most out of therapy.