Multi team intervention

Multidisciplinary team assessment

When an individual with complex medical needs is assessed and supported by therapists of multiple disciplines, it is called an MDT Assessment. MDTs include doctors, therapists, dieticians and other support workers.

MDT assessment is vital when an individual has difficulties in more than one system or function. For example, speech problem and mobility difficulties. Some genetic and neurological conditions usually manifest with difficulties in multiple body functions. For example, children with Down’s syndrome or cerebral palsy; Elderly with Alzheimer’s disease or Parkinson’s disease.

Each practitioner in the MDT assessment plays a key role in improving symptom-free quality of life. A model of MDT looks like this:

Speech and language therapist

Speech and language therapists [SLT] are specialist professionals who are trained in the assessment and support of communication and swallowing skills.

Speech and language therapists have a diverse set of specialist skills that they use to identify the communication and swallowing problems, assess the severity, make their recommendations, deliver support and monitor the patient’s improvement.

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Communication skills include verbal communication (articulating in words, expressive language, speech, etc.) and non-verbal communication (Gestures, Facial expression, Emotion, Eye contact, Eye to eye gaze – pointing with eyes, Smiling, Greeting others.)

They also support improving attention and focus, play skills, and social skills.

Speech and language difficulties may pose negative impacts on children and adults, for example, this can affect self-esteem, and engagement with friends and family members at home and in school settings.

Speech and Language Therapists support people in all age groups, including newborn babies, children, adults, and the elderly [age 70+].

Speech and Language Therapists support diverse problems:

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Components of expressive language/speech:

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Speech skill level depends on various key components:

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Tips to improve speech in children with a speech delay:

Swallowing

Swallowing effectively involves the coordination of chewing and swallowing food without the issue to pass it to the stomach. Speech Therapists treat people of any age, from babies to the elderly, to assess whether they are swallowing effectively or not. Ineffective swallowing can lead to hazards such as choking or gagging, posing a considerable risk of food travelling into the windpipe and lungs. People with certain health conditions can be at a higher risk for swallowing complications such as people with severe brain damage and/or altered consciousness. Assessment is imperative to assure swallowing safety. A specialised test called the video fluoroscopy test is needed in some cases as a part of swallowing assessment.

Physiotherapy

Physiotherapists are specialist therapists who provide support with body posture, body movement and improving the strength of muscles to achieve optimum independence in bodily functions.

Physiotherapists offer assessment and support across all age groups, from babies to the elderly. Babies born with club feet (talipes equinovarus – which means babies born with the foot turned inward and downward) require early physiotherapy to relax muscles and restore normal foot position.

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Physiotherapists play a vital role in improving the independence of elderly people by helping with exercise, body movements and physical activity.

Mobility is a vital skill for independent life, which could be affected in the early years due to problems in the brain or spine or muscles or mechanical problems in the joints.  Self-dependent mobility or assisted mobility body movements and pain-free movements are essential to do activities of daily living [ADL].

Physiotherapists offer support, not only improving muscle strength when it is weak but also optimising muscle relaxation by targeted exercise / stretching muscles.

It is not uncommon for people to develop body pain after unusual physical exertion such as gardening or strenuous sports activity.

When do you need Physiotherapist support?

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Physiotherapists use various techniques to assess and support joint and muscle function. Many of the therapies are manual for example muscle relaxation, muscle stretching exercise and massage etc. Equally, they use various equipment to provide specific interventions.  One of the common instruments used by physiotherapists is a TENS machine. TENS stands for transcutaneous electrical nerve stimulation.  TENS machines are widely used for relieving body pain and joint pain and muscle spasms. It is recommended to use this kind of instrument with the guidance of your specialists.

There are a few examples of techniques used by physiotherapist given here:

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Occupational Therapist [OT]

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Occupational Therapists [OTs] are specialists who improve independence in performing everyday activities.  

Their work not only involves the assessment of difficulties but also provides appropriate interventions and strategies to enhance functional skills such as daily life skills, self-care skills, work-related support and sensory integration.

OTs use various tools to measure the individual’s difficulties and grade their ability so that they may deliver individual-specific support. For example, OTs use the ‘Barthel Index of Activities of Daily Living’ to measure a person’s ability to live independently, and the ‘Hand Grip Ability’ scale is used to assess hand grip skills.

Some of the areas where an Occupational Therapist [OT] will help:

OT use specific assessment methods. An ergonomic assessment is vital in a certain type of occupation that can pose an increased risk for musculoskeletal problems due to posture and movement with the ultimate objective of preventing injury.

For example, working at a desktop computer in the workplace and school for long hours can cause issues with the position of the neck and back, sitting posture and hand position can cause pain and discomfort.  There are many ways we could achieve ergonomic compliance, for example, by using an adjustable chair, back support and keeping your hand at a neutral position if you use a computer mouse.

Creative therapy / Art therapy

What is art therapy?

Art therapy is the usage of artistic methods and techniques for treating psychological issues and nourishing mental health.

Art therapy became an official course of treatment in the 1940s but art itself has been used by people for centuries as a tool for self-expression, as a communication source, and to heal themselves.

Some psychologists have noted that many people suffering from mental health problems find their escape in artistic practices. Art Therapy has become an effective treatment tool for many therapists treating patients with mental health issues and has caused more people to seek out this form of therapy.

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Types of art therapy:

There are several types of Art therapy being used by therapists to treat their client’s mental health. , a few of them are explained here.

Painting:

Painting is the practice of applying paint, pigment, colour or another medium to a surface. The medium is commonly applied to the base with a brush but other implements, such as knives, sponges, and airbrushes, can be used. In art, the term painting describes both the act and the result of the action.

Painting is a fluid art form that takes precision and control to master so, if a patient is experiencing issues with these areas, painting could be a very effective form of therapy for them.

Drawing:

Drawing is the practice of making art by creating marking using items such as pens, pencils, pastels, crayons, or charcoal, typically on a piece of paper.

Art Therapists can direct their patients to explore a variety of emotions through their drawings. Many people are already familiar with the concept of using drawing to express their emotions which means that they can do it with a little guidance

Sculpture:

The sculpture is three-dimensional art, often made using paper clay, clay, carving tools, decorative items, and Paper Mache.

The benefit of therapy through sculpturing is that it gives the client a multi-dimensional view. It is a kind of tactile art which provides the client with an opportunity to construct their environment. It gives the client hope that their situation is multi-dimensional and that they can approach its solution from different perspectives.

Collage:

Collage is the art of collecting pictures and text from magazines, newspapers, substrates, stamps, brayer, patterned papers, and stickers but pens, pencils, and paints can also be added to help patients translate their thoughts and emotions more precisely.

Collage can be a more accessible type of Art Therapy to some clients as they are working with images and text that have already been created. It can especially help therapists treat patients facing difficulties with starting tasks and issues related to decision making.

Writing:

While it is not considered a creative visual outlet, writing can be a very useful tool for art therapy.

In this course of therapy, patients will write their thoughts in a journal or create a comic to let go of their hard thoughts and emotions. Writing can help the client with arranging and solidifying their thoughts and feelings about a particular problem they are facing.

What are art therapists?

Art therapists are top-level clinicians and experts who deal with clients of all ages and have broad experience related to the field. They are especially guided by ethical standards. Their education prepares them to work with a variety of diverse people and in various situations. They work to keep an individual’s cultural values and beliefs in consideration.  They treat those facing mental health, or any other health issues, in life. Their purpose also includes coaxing out emotions and creativeness hidden in people, which they are afraid to show and helping people to grow spiritually.

Techniques applied in art therapy:

Art therapy is used to expose all the problems inside of a person in visual form so that they might work through them, leaving the healed person behind. The goal of this is to explore emotions hidden inside the person, allowing them to develop self-awareness, helping them to deal with issues, giving insight into people’s thoughts, and develop exciting new skills in them.

It works by engaging the person with their body, mind, and spirit in many distinctive ways using visual or written articulation only. Engaging the senses and creating tactile manifestations of thoughts and feelings can bring out those things from inside of the person which can’t be done by simple communication only. When a person feels too uncomfortable to speak, symbolic and visual communication give those emotions a voice with which to shout their heart out. It empowers the person to face the harsh side of society and fight those issues building up inside them.

When an art therapy client creates a piece of art, they analyse their art and realise how this piece of art is a reflection of their emotions, thoughts and behaviours and how can they positively rearrange their mind.

Types of mental health art therapy support with:

Art Therapy is considered one of the main treatments to deal with traditional mental health problems. It aims to manage and arrange the feelings, behaviours, and emotions, reduce stress and anxiety, and increase the self-esteem of the client. Some mental health problems with can be dealt with through art therapy are discussed here:

Self discovery:

By creating art, you can get the awareness of those feelings hidden inside you. You get familiar with a new side and beautiful side of you, which is never in view with others and even of yourself.

Self-esteem:

With the process of art therapy, you get the motivation for self-accomplishment. By getting the motivation of self-accomplishment you can work on your confidence, self-development, and self-appreciation, and can gain a better understanding of your thoughts too.

Emotional release:

Unfortunately, a lack of methods for the healthy emotional release can lead many people with mental health issues to suicide. Sometimes we can express our fears, feelings, and harsh emotions causing sadness through our words, this is where art helps you to release your disturbing emotions through visual representations.  One of the benefits of art therapy is developing a healthy lifestyle by expressing your feelings and getting rid of those things which are disturbing you mentally.

Stress relief:

Fighting your anxiety, stress, depression and emotional traumas is a very difficult thing, especially when you try to express your insecurities and people start making fun of you, consider you weak, and take advantage of these insecurities. But keeping them inside you can hurt you both mentally and physically. If you are experiencing one or more of these issues, art therapy could work wonders for you. You can take out these harmful, stressful emotions through your art without the fear of becoming a joke or getting mistreated.

Many children and adults feel the negative impact of their mental health issues on their studies and work respectively. Art therapy gives relief to their stress by taking out their frustration through art creation.

Benefits of art therapy:

Besides these mental health problems, there are also many physical health issues with which art therapy appears beneficial. Some of them are discussed here:

Addictions:

Art therapy helps treat those people who are addicted to substances such as drugs and alcohol. It gives them the escape from their struggles with addiction by taking their mental frustration out in the form of art.

Dementia:

Dementia is a disease which causes you to lose your cognitive functioning i.e. sense of thinking, remembering and reasoning. It changes a person’s behaviour and personality as well as causes issues with emotional control. Using art therapy, they can arrange their thoughts, calm down and properly memorize things by looking at the art created them.

Cancer:

Individuals with active cancer experience pain while going through the disease and subsequent treatment. Mental health support is vital for these situations. Art Therapy and Creative Therapy play an important role in non-medicinal support

In conclusion, Art Therapy is a gentle but beneficial treatment for your mental health and many other diseases, which allows you to improve your issues while having fun and enjoyment at the same time.