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Reclaiming Her PowHER (Women & MHA): Kate Ehrlich

We chatted to occupational therapist Kate Erhlich about the ins-and-outs of the profession and occupational therapy as a treatment for mental illness.

the OCCUPATIONal therapist


I am an occupational therapist to the core. I believe in the untapped potential and capacity of every person I am privileged to meet. With a particular focus on mental health, I am driven to enable people to recognise and reach this potential regardless of their challenges.


I have a Bachelor of Science in Occupational Therapy from the University of the Witwatersrand - BSc (OT) WITS. I graduated in 2013. I am currently completing a MSc OT by dissertation at Wits University titled OT Practice Models, Frames of Reference and Postnatal Depression: An Integrative Literature Review.


I always knew that I wanted to help people, but I knew I couldn’t do anything that required me to come into contact with blood and guts! With some encouragement from my parents, I was led down the path of rehabilitation.


What I love so much about occupational therapy is that it does not patronise the client. One of our biggest principles is to recognise and celebrate the client’s prior knowledge – this allows the therapeutic relationship to be one of mutual respect, reciprocity and shared investment. It’s a partnership.


I work at an in-patient psychiatric hospital in Johannesburg. I manage the adolescent unit, and I facilitate group therapy on all the units, namely the adolescent, general adult and dual diagnosis units. I also see individual clients on an in-patient and out-patient basis to assess and treat mental health and psychiatric concerns affecting their functioning.


I enjoy the versatility of my job – OT is anything but boring! Each and every client is different, and there is no recipe book you can revert back to – it’s all about working with your client to adapt, build skills and learn together what works.


A person’s occupations are fundamental to his/her identity and sense of competency, and therefore they have particular meaning and value to that person. At times it can be challenging to find the right activity that honours the client but also provides the “just right challenge”. A good rapport, and honest feedback from your client, is key.


'JUST RIGHT CHALLENGE'


Occupational therapy is all about function. The primary goal of any OT session is to help our clients do what matters most to them. Sometimes this means changes need to be made to the client’s environment, an activity requires adaptation or therapy is focussed on the client’s psychological, psychosocial or physical difficulties or skills. Often it’s a combination of all three that is required.


We are trained to find the “just right challenge” for each client. What that means is adapting an activity, task or occupation to meet a client at their current level, then adjusting it in order to challenge the person just enough to keep it exciting and stimulating.


In this way, occupational therapy is very client-centred. Activities are chosen together, which allow the client to find a sense of enjoyment, choice and control. The “just right challenge” allows clients to leave the therapy sessions feeling empowered and proud of their accomplishments. Often the biggest lesson is in learning that challenges are okay! There’s power in discovering that one’s struggles don’t have to be frustrating.


beyond MENTAL ILLNESS


OT is a very person-centred approach. We have different tools in our toolbox, and several theories from which we draw – ultimately we try to assess and treat the person, not the label.


Many people face stigma, isolation, and as a result, confidence issues. Depending on where the occupational difficulties and participation limitations are, we base our therapy to address issues to empower our clients and build resiliency. This may include stress and anxiety management, burnout prevention techniques, communication skills and conflict resolution skills to name a few.


NAVIGATING THE big wide world


How someone participates in an activity that is meaningful to them can be limited due to psychological or physical difficulties, such as unhelpful thought patterns, poor self-esteem, limited coping skills, or limited mobility.


Occupational therapy could, therefore, include cognitive restructuring with regards to the unhelpful thought processes, constructive coping skills, improving self-esteem by achieving mastery of skills, and improving or maintaining physical function by addressing their physical condition.


With regards to one’s occupations, our daily activities can be divided into four broad categories namely self-care, productivity, social participation and leisure. Occupational therapists can assist clients should they struggle with a specific task/activity within any of these occupational areas.


For example, a client battling with depression may struggle with poor sleeping patterns, and he/she may find it difficult to get up in the morning. This ultimately leads to the client choosing to skip the morning shower in order to get to work on time.


In this simple example, an OT could work with the client to find sleep hygiene strategies that would suit the person’s lifestyle and living arrangement. Another simple suggestion may be to bath at night, which would aid sleep as well as solve the morning rush dilemma.


Another approach taken in occupational therapy is to assess how one’s environment is impacting a person’s ability to function. OTs are trained to make practical and reasonable adaptations to the home, school and work environments in order to facilitate one’s participation in daily activities.


Occupational therapy can improve social skills in an individual or group therapy setting with young adults by working on communication skills, boundary setting, assertiveness, self-esteem building, conflict resolution and resiliency training. Occupational therapy can also strengthen or build essential cognitive skills such as problem-solving, planning, organisation, insight or memory skills.


Occupational therapy takes a holistic approach - we believe in working with the person, the occupation and the environment simultaneously.


COVID-19 SELF-CARE


What we’ve found is that people are either repressing/ignoring their needs or displacing their needs. For example, a very social person who’s struggling with not seeing their friends during lockdown may find themselves drinking more alcohol, and thus find themselves seeking destructive outlets.


Due to the restrictions put in place, the activities that we can do often feel like “half measures”, and therefore lose meaning. Being mindful of our thoughts and feelings during this time can help us identify what needs of ours are feeling unmet so that we can take committed action towards caring for ourselves, even when we know that action won’t be perfect.


Stacking activities can increase our experiences, and therefore increase the likelihood of enjoyment and satisfaction. For example, listening to music while you cook. This multisensory approach enriches the experience.


WORD OF ADVICE


There’s no shame in reaching out for help. Needing help isn’t a character flaw. Every person, even when we’ve tried our very best, can (and does!) need help. Recognising that we need help shows wisdom and humility.


RECOMMENDATIONS


I am such a fan of animated films! While “Inside Out” may appear to be a kid’s movie, it’s actually quite clever. It explains how our thoughts and feelings impact our actions, and just how complicated and complex that process can get. If you google Paul Ekman’s “Atlas of Emotions”, you’ll see it’s the same concept – the movie’s director worked very closely with this American psychologist. The “Atlas of Emotions” is a great interactive website, and helps explain several concepts.


get in touch


People are welcome to email me to request an appointment, and I will see how I can best serve them. My email address is k8.ehrlich@gmail.com

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