OT weekly notes
26/01/2023
To become more aware of sensory strategies that can help me
To continue to think about & use what I find helpful that alerts or calms me and to avoid what can trigger me
Goal for next week:
To take the following with me on Monday; blanket,
fidget toys, ear defenders to help with anxiety (to keep in bag so that I can feel them discreetly if needed)
To practice a body mindfulness exercise by lying down on a flat surface and concentrate on breathing, feeling the sensation of the breath and focusing on my body, letting go of thoughts in my mind. Lavender oil may be good to use before & after
To include movement in my everyday routine
Goal for next week: to use my stepper for 10 mins in the morning and 10 mins in the afternoon. To think about other ways to receive proprioceptive feedback – the ‘proprioceptive’ sense is the one that helps us to feel grounded
02/02-2023
Daily routine
To begin completing a weekly timetable online to look at activities during day to include times to engage with sensory/grounding techniques
XX to email RO a timetable
XX to contact possible community services
RO reports at time not feeling connected to this world and wants to learn more about ways to ground herself.
Engagement with interests
RO spoke enthusiastically about her enjoyment of finding waterfalls, visiting the theatre for musicals and dance productions. Also brought up mixed feelings about turning 50 but then could identify that she is in a much better place than she was on past milestone birthdays, this acceptance can help her to move forward.
Sensory Integration
RO was supported to engage with a brief mind/body breathing exercise. RO was observed to engage with the activity whilst sitting down and she reported liking the brief time when she felt the rise and fall of her chest. RO was encouraged to practice and advised of the benefits or repeated practice.
23.02.23
Hi Rachel,
As promised, I’m sending you a summary of our conversation today;
– xxx gave recommendations on different strategies to try to manage this. Strategies include using different body postures such as rolling body up with head to chest (foetal position), walking and using large arm movements. Xxx to send other proprioceptive exercises
Rachel to use restorative techniques when returning home to help with the adjustment
XXX to send information on introception
Thank you & Kind regards,
xxx
Occupational Therapist
01/03/2023
Main points discussed:
Can feel overwhelmed when leaving the flat, discussed strategies to help manage such as sitting down to practice deep breathing, use of sensory hand item and looking at a picture of a waterfall and saying out loud ‘I can create a positive change’.
Discussed assessment findings and explored sensory items, particularly those that offer proprioceptive feedback
................................
Stand up and put your feet firmly on the ground
Move about: stretch, stamp your feet, jump up and down, dance, run on the spot, rub your arms and legs, clap your hands, walk, remind yourself where you are right now.
Try to think about different things, almost like playing mental games, for example: count backwards in 7s from 100, think of 10 different animals, 10 blue things, one animal or country for each letter of the alphabet, say the alphabet slowly, say the alphabet backwards etc.
Carry a grounding object with you. Some people carry a stone or other small object, perhaps which has personal meaning, to comfort and touch when you need to
Ask yourself questions in order to bring yourself into the present. Write down your own questions, for example:
- Where am I, right now?
- What day is it?
- What year is it?
- How old am I?
- Where do I live?
.....................................
SENSORY WORK BELOW….
Problem areas to work on first:
Proprioception/vestibular/tactile & auditory problems
Gravitational insecurity
What can help?
Proprioceptive input is an active movement of muscles. Tendons and joints activate the proprioception system. The jaw house a high proportion of proprioceptive receptors, so many sucking and chewing motions provide calming effects.
Proprioceptive input can be calming, energising, and organizing.
Other ideas include sucking thick smoothie through a straw
What do the different sensory activities do?
Hand weights, you can use these whilst sitting and also in the exercise below;
Stand upright holding the weights above your head, slowly bend forward as far as you can with straining and then slowly raise the hands up and then lower to rest by your sides
Squidgy poppet & other handheld items
Blowing bubbles uses proprioception - Other ideas include sucking thick smoothie through a straw
Shutting eyes and practicing standing on either leg with eye closed – this helps with gravitational insecurity which is connected to your balance
Try completing these exercises in the morning to help achieve a grounding, calming effect. If you feel that you need them later in the day, do them again!
At times when you become overwhelmed with thoughts
practice using the foetal position and gently rocking. Also use the LED lights if you think that will help to distract from the thoughts and help to provide a calming environment whereby you can practice the positive mantra of
‘I can create positive change’.
Important points: Slow, linear and rhythmical movements are calming, and fast, rotary and erratic movements are excitatory
I am excited to hear about your experiences of using the sensory strategies. As you practice more we can explore when in the day you may need them more and what type of sensory input you need and then your sensory diet can be tailored to you.
XXX
Occupational Therapist
10/03/2023
Hi Rachel,
It was good to see you today, here is a summary of what we discussed, I have written it in the first person, is that helpful?:
- I want to look after myself and keep physically well
- I will use sensory strategies to help calm me when I start to feel overwhelmed
- I will use postcards to write positive self-statements so that I can visualize the words when I need to use them
- I will practice saying these out loud when the negative thoughts that say ‘give up’ become loud
- Liz will make a referral to IMAGINE day services as this could offer opportunity to engage with support in the community and meet others
23/03/2023
Hi Rachel,
Please find a summary of what we discussed & forward plan this week:
. We explored again different ways to manage stress.
- Rachel said that she has been practicing different sensory strategies to help when feeling anxious and found these helpful.
- She said that she finds it difficult to remember what to do when she needs it, a visual diagram may help to prompt memory
Rachel expressed worry about upcoming family celebrations at her sisters this Saturday. She said that her parents do not understand her ED and she is fearful of what they may do.
Discussed coping mechanisms with what to do if she starts to feel overwhelmed.:
To go to a bedroom upstairs and use deep breathing, rocking and body tapping as ways to calm, to try this every hour may be helpful.
To further explore:
- sensory diet with more specific times of when to practice certain activities
Plan: OT to send summary of discussions.
To email chart showing hyperarousal/hypoarousal to help map sensory activities to changing states - sensory diet
Next h/v booked for Thursday 30th at 10am
Kind regards,
XXX
Occupational Therapist
03/04/2023
Hi Rachel,
Please find below a summary of what we discussed last week;
Discussed the use of a sensory diet and thinking about timings of different activities. Rachel said that she would like to purchase herself a rocking chair and has begun to look online at the options. Rachel is also open to considering walking as an option of a grounding/calming strategy. This was discussed within the boundaries of walking to nearby park.
Rachel had visited Blenheim Castle last week and showed OT pictures she had taken on the day. Engagement in interests which are healthy was strongly encouraged.
Plan:
OT to send summary of discussions
Next appointment booked for Thursday 20th April at 10am
Xxx
