Participation in Context; Occupational Therapy

This essay discusses the story of a person suffering from schizophrenia and the various social, cultural, economical and personal factors that influence the participation of a person in human occupation. It also analyzes the role of identified elements in creating barriers and enablers to participation and their effect on the health and well-being of the character.

Running head: PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
Name of the student:
Name of the University:
Author note:

1PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
Introduction:
Occupational therapy is a process of treatment that helps a person to participate in the
human occupation that they want to do by using daily activities (Taylor 2017). It is the duty of an
occupational therapist to assist people in order to recover injury to regain skills, disability to
perform in social activities and other cognitive challenges. Through a psychotherapy or
individual evaluation the occupational therapist tries to determine the goal of the person (Upton
et al. 2014). They provide effective interventions to help the person in order to achieve the goal.
The focus of the essay is to understand the story of a person suffering from schizophrenia and
discuss various social, cultural, economical and personal factors that influence the participation
of a person in human occupation. The patient in this case has suffered from schizophrenia since
the college time. The main problem is, she heard a voice of a lady that narrated the daily
activities of the patient, for example, if she was going to attend a lecture the voice narrated it like
she is going to a lecture, but when she tried to find the lady she could not find anyone. Such
things made her afraid and with increasing illness she started to ignore communicating with
friends and society. Then she decided to take help of a psychiatrist and gather knowledge to
counter the issue. The paper will provide a brief idea about the relevant social, cultural,
economical and personal factors that has created barriers or enablers for the person in order to
participate in human occupation and the effect of the illness on the health and well-being of the
person.

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Discussion:
Identification of the elements those are relevant to the story regarding socio-cultural
values:
The critical thinking tool regarding the contexts of participation provides relevant factors
that have effect on the person related to participation in human occupation (Thomas and Law
2013). According to the story of schizophrenia, most of the elements of the wheel are relevant to
the case considering the socio-cultural value. Daily living activity is one of the important factors
in case of schizophrenia. The daily activities like going to college, attending lectures,
conversation with the friends and social activities could influence the patient’s condition.
Another important element is the local environment. In order to stay in a society it is important to
adapt the local environment, otherwise it could affect the living condition of a person and create
stress within the person that could trigger the sign of schizophrenia (Wilkinson and Marmot
2003). Economic status of a person is important to consider in the case of schizophrenia, as it is
one of the major factor that create pressure and lead to mental distress ((Warner 2013).
Education is another factor which is very important for managing the case of schizophrenia, as it
provides knowledge about the illness which helps the patient to understand the signs of the
illness and motivate them to counter the issue (Bentall 2013). Support network like social
support, medical support and family support play an important role in addressing or influencing
the issue. The importance of health and social care is the most important part as it provides
effective service in order to treat such illness and without the support of such care service it is
impossible to address the issue related to schizophrenia (Tandon et al. 2013). The additional
element is media in the case of schizophrenia it could help to disseminate the important
information about schizophrenia so that people could understand the issue related to the illness

3PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
and avail effective treatment or support a person that is suffering from the illness. Such factors
play important role in order to create barriers or enablers for the patient. The positive influence
of the element could help the patient to counter the issue in an effective manner, whereas, the
negative influence could increase the risk of psychotic symptoms like delusion and hallucination
or thought disorder (Frith 2014).
Analysis of the occupations of the character:
The consequence of schizophrenia has destructed the patient to an extent, and then the
patient decided to fight with her fear and took move in order to counter the issue. Due to the
circumstances she was feeling helpless then she decided to take help f a psychiatrist in order to
cure the illness. After suffering from lots of difficulties, discrimination, humiliation and
disappointment, she got the help of an experienced psychiatrist, who has helped the patient to
resolve the issues related to schizophrenia (Stefansson et al. 2014). The nursing team has helped
her to increase her ability to heal. The patient has learned how to turn the violent voice to a
positive message. Such turning point in her life has brought positive changes. The nursing
professionals have helped her to connect with UK Hearing Voice Network. Such interventions in
her life have helped her to cope up with the illness. After that the patient started to collect more
articles and books in order to gain knowledge about the illness to create awareness within the
community. She has participated in the TED talk in order to share her experience regarding the
situation she had faced due to schizophrenia. Such step is difficult to take but it has helped the
patient to disseminate the information about the risk factors and consequence if schizophrenia.
She has written TED book on her experience that has helped others to understand the
consequence of schizophrenia. The patient then again started to attend her college and finally she
graduated from British Psychological Society and got the undergraduate award with first class

4PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
degree. She completed MSc in health Psychology as well. She used to work in the NHS for Early
Interventions in psychosis service. In addition she completed PhD, freelance teaching, training,
public speaking in order to provide information to the people and help them to address their
cognitive problems. Such activities of the patient are valuable in order to cope up with the illness
and motivate others to fight with such thought disorders.
Role of the identified elements in creating barriers to participation:
The elements of critical thinking tool regarding contexts of participation are correlated to
each other in order to create barriers to the participation of the patient in human occupation. As
mentioned before that adaptation to local environment is important in order to settle in the
society, in this regard, social support is important for the person to connect with the society.
Social inequality and humiliation due to the illness create stress within the patient, thus the
patient become unfocused and lack the ability to perform daily activities (Swain et al. 2013). The
consequence of lacking ability to perform daily activities such as physical activities,
disorganization in work, attending college, connecting with people lead to the pressure of
unemployment and financial crisis, which in return trigger the sign of the illness thus, the patient
lack motivation, feel helpless and fails to participate in the human occupation (Vancampfort et
al. 2015). Education is also correlated to the social support and family support that are important
in order to encourage the patient to participate in an effective manner. Due to lack of knowledge
regarding schizophrenia, people fail to understand the problem of the patient, thus, the patient
has to face humiliation and abuse in the society. It affects the thought of the patient and the
patient prevent herself to connect with the external environment, thus, become domesticated that
increase the risk of psychotic symptoms such as delusion, hallucination and other thought
disorders (Cooke 2017). In this way the factors provide negative influence to the participation of

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the patient and such barriers created by the elements need to be resolved in order to cure the
mental distress of the patient in an effective manner.
Role of the elements in creating enablers to participation:
In order to provide effective care to the patient and help a patient to participate in the
human occupation the interaction between the elements of critical thinking tool is important. The
most important element regarding this is the service provided by the health care and social care
organizations. They are the main source that provides knowledge about the illness in order to
create awareness and provide adequate information to the society so that they could provide
support to the patient and encourage the patient to participate in the human occupation. Such
social and family support enables the patient to interact with the external environment and it
could help the patient to reduce the stress (Chien and Chan 2013). Health care service provides
effective therapy to help the patient in order to overcome the mental distress and participate
effectively in the human occupation. Such help provide improvement to the condition of the
patient, thus, enable the patient to carry out daily activities that reduce the pressure of
unemployment and financial crisis (Hasan et al. 2013). In addition the involvement of media in
the case provides information regarding the illness and effective interventions to counter the
issue. Such coordination of the elements enables the patient to participate effectively and achieve
the goal.
Assumption about the main character:
The main character of the story is interesting. She was suffering from schizophrenia since
her college time. The main problem with her is that she used to hear a voice that narrated her
daily activities. Such fearful condition started to increase gradually and she started to hear the
voice even during sleep. Such thought disorder has affected her personal and social life as well.

6PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
She has lacked the ability to connect with the people and conduct daily activities. She has started
to recognize her as socially isolated. Such condition had severe impact on the patient. The patient
became accustomed to the appearance of such voice narrating the daily activities of the patient in
the third person as it was unthreatening. The patient always tried to find the voice in order to
reassure the presence of the voice. After that the patient started to create emotional connection
with the voice and achieved some positive results. She visited to a psychiatrist and admitted in
hospital, but the situation become more horrible. She became confused, unhappy and frightened
to an extent. The condition became uncontrollable. She started to have some antipsychotic drugs
and the side effects of the drugs have increased the level of depression. After such disastrous
moment the patient got the help of an experienced psychiatrist and the turning point has brought
tremendous changes in her life. The positive step taken by the patient is appreciable. She started
to cope up with her illness and join some organization in order to help other people that are
suffering from such illness. It provides a positive impact about the character. The patient started
to gather knowledge about the illness from various journal and books. Such initiative taken by
the patient helps to assume her ability to fight with such severe condition. Her positive thinking
and eager to help others has helped her to complete graduation in health psychology. Such shade
of the character is encouraging and it provides effective way to manage weakness and turn it into
strength.
Effect on the health and well-being of the character:
The consequence of schizophrenia has affected the physical and mental health of the
patient to an extent. Due to the illness the patient became unable to attend her college that affects
her study and career. The continuous disturbance of the voice made the patient disturbed and
anxious. She became moody and started to neglect communication with family and friends

7PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
group. She started to display negative beliefs in the form of delusion of persecution or grandeur
(Boyle 2014). She started to feel controlled by the voice and suffered from mental distress. She
started to jump from one content to another during any conversation without any reason that
made her erratic to follow. Such thought disorder known as suspicions or paranoia affected her
physical health as well. She lacked the ability to perform daily activities. She became
disorganised in her work, her eating habit got affected and she was suffering from sleeplessness
or insomnia. Lack of physical activities resulted in muscle immobility (Lepage, Bodnar and
Bowie 2014). Other mental disorder includes poor expression of emotion like she stopped
responding in sad or happy moment. Such catatonic behaviour has resulted in psychotic
symptoms like hallucination due to which she was suffering from a fear that somebody want to
harm her thus prevented herself to participate in the social activities and became isolated and
domesticated. She also suffered from some cognitive difficulties like facing problem in
remembering something and communication difficulties. Due to such problem she was taken to
a psychiatrist by her friend and admitted in the hospital that made her situation more disastrous.
She started to become addicted towards drug thus refused to take medicine provided by the
health professionals. The side effects of the drug made her situation more severe. Due to such
horrible condition she suffered from mental distress for a long period. Such situation affects the
health and well-being of the patient and she started to feel helpless and hopeless as well (Frith
2014).
Effect of the barriers and enablers on the participation of the character and effect
on health and well-being:
There are many barriers in the society that increased the risk of the patient and trigger the
signs of the illness within the patient. The socio-cultural barriers such as, the humiliation and

8PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
insult that she had faced in the society had increase her level of stress and she started to neglect
connecting with people in the society and prevent herself to participate in the social activities
(Cameron 2013). Some childhood trauma was responsible for her condition and other factors that
influence the severe condition was her tension regarding study, future, responsibility and
relationship. Due to such stress she failed to attend her college that affected her study and career.
The barrier related to lack of education or proper information about schizophrenia affected the
support network. Due to lack of information the patient failed to recognize he illness and started
to ignore it, thus, the illness affects her physical and mental health to an extent. The people of the
society started to humiliate her for the illness and her behaviour. Thus, she became domesticated.
Such circumstances have played an important role in order to demotivate the patient. Thus she
prevented herself from sharing anything with the friends and family and did not express her
emotion. Thus, such barriers made the condition more difficult. After suffering from such
psychotic disorder and a period of helplessness she decided to fight against such barriers to
resolve her issue. The support of her mother and friends that have helped to encourage her to
take step in order to treat the illness even after suffering from hospitalization. She has availed the
help of health care and the efficient health professionals that has helped her to increase her
ability to heal. The knowledge she has gained from her experience and other journals or books
has inspired her to study about the illness. The help of media like TED talk programme has
helped her to share her experience with others to provide them information regarding
schizophrenia and help them to understand the consequence. Through such process she has
countered the barriers of social discrimination and provided a message regarding how the
enablers have helped her to convert her weakness into strength.

9PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
Strategy to give depth and validity to the ideas and literature need to consult
regarding this:
According to the research, only 1% population is suffered from schizophrenia, thus the
consequence and factors that could influence the situation of schizophrenia is unknown to most
of the people (Bland 2015). Thus it is important to provide value to the ideas of the patient in
order to create awareness regarding schizophrenia. In order to understand the condition in depth
it is important to done some research about the illness (Jauhar et al. 2014). The research literature
would provide details about the factors that are responsible for the occurrence of schizophrenia
within a person. It would provide effective interventions in order to cope up with the condition of
mental distress (Weiner 2013). The health care and social care service providers need to
contribute effectively in order to provide efficient care service to the people with need (French
and Swain 2011). It is important to disseminate the importance of occupational therapy in order
to cure the illness in an effective manner. Information about proper therapy need to be provided
to the individual so that people could avail the treatment process and address the issue of
schizophrenia in an effective manner ((Kronenberg 2013). In case of schizophrenia, the patients
fail to communicate with friends or family. In order to counter the issue Psychopathology and
mood detection therapy is another effective intervention that could help the patients to share their
problem with the health professionals. In this way the health professionals could understand the
central problem and requirements of the patients and could provide effective treatment in order
to cure the illness. The patient could be motivated through such process (Vancampfort et al.
2013). Creating awareness is important in order to control the socio-cultural factors that could
trigger the condition of the patient and increase the risk factors. In this regard, media could play
an important role in order to provide information to the individual. Involvement of social media

10PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
could make the process faster (Mitchell, Hollingshead and Coppersmith 2015). In addition, to
gather knowledge regarding the illness relevant journals and books could be read. Journal of
occupational therapy could help to understand the process of such therapy in resolving the issue
of schizophrenia. Books and journal related to schizophrenia could help to understand the issue
related to the illness in depth. These are the positive steps that could be taken in order to
understand the problems and treatment related to schizophrenia and could help to provide better
intervention to counter the issue in an effective manner (Ran et al. 2015).
Conclusion:
From the above analysis it can e concluded that, occupational therapist play an important
role in order to provide effective care in order to treat the patient with injury, disability and
cognitive challenges through participation in the daily activities. The patient in the story was
suffering from schizophrenia thus lacked the ability to perform daily activities. The voice she
used to hear started to haunt her and due such hallucination she failed to connect with the
external environment and became domesticated. There are many factors that influence the
condition of the patient. They have both the ability to create barriers and enablers. Such
condition has affected the health and well-being of the patient to an extent. The condition has
reduced the ability of the patient to participate in the human occupation. However, through
effective occupational therapy, social and family support and education related to the illness
could help the patient to address the issue. Journal and books related to the illness could help the
occupational therapist to introduce innovation in the therapy that could help them to provide
service in an effective manner.

11PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
Reflection:
Critical reflection is a process to create meaning of an experience. The process of critical
reflection helps the students to recognize their mistakes, introduce effective solutions and
improve their skill (Rymes 2015). The responsibility of an occupational therapist is to provide
treatment to the disabled patients through effective therapeutic utilization of regular activities
(Scaffa and Reitz 2013). Thus, it is important for an occupational therapist to reflect on their
experience regarding their practice to improve their skill and provide effective care service to the
patients. As an occupational therapist I will reflect on one of my experience regarding
schizophrenia and provide the contribution of the experience in developing my skill in the
following paper. The experience is about the circumstances of a schizophrenia patient. The
patient got the illness during college days. The problem with the patient is that she heard a voice
of a lady narrating the activities she had been doing like when the patient was going to attend a
lecture, she could hear a voice narrating it like she is going to a lecture. The situation became
regular to her life and started to haunt her even during sleep, which made her anxious and
frighten. She started to avoid meeting with friends, fail to communicate with the society and
became domesticated. The patient had shared that she had faced humiliation that forced her to
feel lonely and demotivated. Then the patient had decided to take help of a psychiatrist in order
to understand her situation. The psychiatrist had informed her about the consequence of
schizophrenia and provided concern that had helped her to understand that due to some stress
and childhood traumas she is suffering from such mental distress and ensured that through some
occupational therapy she could resolve such issues. After that the patient started to gather
knowledge about schizophrenia through articles, books and other medical support in order to

12PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
counter her issue. The story has encouraged me to an extent and the effort of the patient is
inspiring in order to learn the way of managing mental distress like schizophrenia. The
experience with the patient has helped me a lot to understand the signs of such illness and factors
like stress, past trauma and social deprivation that could trigger the signs within a patient
(Lepage, Bodnar and Bowie 2014). The experience had helped me to understand that it is
important to provide adequate information to the patient about their illness in order to motivate
them to cure such illness (Vohs and Lysaker 2014). The experience has helped me to understand
effective way of counselling such patients. At first I was quite surprise after encounter the story
as I feel it would happen in movies or stories, thus I failed to understand the situation of the
patient. In order to connect with the story I have done some research on schizophrenia to
understand the signs and effect of the illness. I have read some journals like British journal of
occupational therapy to understand the contribution of such treatment to schizophrenia. Books on
disability studies have helped me to recognize the circumstances of schizophrenia. Such research
has helped me to develop the paper. In future I would like to encounter some interviews with
other patients that are suffering from same illness, as it would help me to understand the
consequence of schizophrenia with different perception. Thus, as an occupational therapist, I
have decided to include such strategies in my practice in order to improve my skill and establish
myself as a successful occupational therapist in future.

13PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
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14PARTICIPATION IN CONTEXT; OCCUPATIONAL THERAPY
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