Cognitive Therapy of Depression

Children for a variety of reasons often are reluctant to talk about their feelings and concerns in therapy whether individual, group, or family therapy. Therapists sometimes need to be resourceful to help children who are anxious to participate in a meaningful way in the therapy process. It is important for children to feel included in the process. Some children may not feel they can express themselves because they may be too young, others may be silent due to anxiety, anger, fear, resentment, and a few may not be able to talk due to trauma events.

Therapists need to have various strategies that do not rely on language such as symbolic play either directive or non-directive, drawing, storytelling, or therapeutic work with symbols. Many therapists, irrespective of the therapeutic modality (e.g. CBT, Interpersonal, Psychodynamic), have integrated play techniques in their work with children.

Most children do not choose to come to therapy, rather they are “brought” or “sent” by parents, teachers or other professionals who in turn are sometimes pressured to do so by extended family, social services, or courts.  The child’s experience upon arrival at the therapist’s office is often like being punished and sent to the principal’s office.

Creative methods of engagement are dictated by necessity because good therapy doesn’t usually take place in a context of fear and punishment. The therapist must think out-of-the box for ways to transform the experience for the child and make the context a safe, comfortable, and playful context that gradually allows for trust to build and for the child to be able to use the therapeutic space in a helpful way.

for more information go to: http://cognitivetherapyforchildren.net

Both NLP ( Neuro Linguistic Programming ) and CBT ( Cognitive Behaviour Therapy ) are effective techniques for treating people who are suffering from panic attacks. At my practice in Hertfordshire I have treated many clients for panic attacks. Panic attacks can be more serious then people imagine. Some severe cases can cause the person to experience physical pain to such an extent they feel they are having a heart attack. Also in some severe cases people go on to develop Agoraphobia which can affect their daily life. I use both NLP and CBT techniques at my practice in Hertfordshire to treat clients suffering from panic disorder. I use both techniques as it really depends on the client. Some clients respond better to NLP and others respond better to CBT.

 Cognitive Behaviour Therapy works by looking at the relationship between what people think, do and feel. It is based upon the principle that what you are thinking will affect what you feel and what you do, and what you are doing will have an effect on what you are thinking. Within CBT Herts, people learn to change the way they are thinking and feeling. Part of the CBT therapy I offer in Hertfordshire involves helping clients overcome their fear of panic attacks by going through whatever gives them a panic attack, for example a train ride or being in a lift. CBT, Herts, encourages you to challenge your fears, however, this does not mean forcing the person to go into that situation. This will come at a later date and really will depend on the individual. It is about working with the client and asking them questions so that they can devise their own programme to overcome panic attacks.

Nuero Linguistic Programming Herts is different from CBT as it looks at the language people use in their own mind. NLP Herts is about finding out what’s going on in a person’s head to allow panic attacks and then teaching them new ways of conquering panic attacks. An NLP Practitioner will ask clients to describe what happens before a panic attack comes on. This would involve asking a client if they see, feel, hear anything just before the attack takes over. The practitioner can put the client in a deep state of relaxation by using hypnotic techniques to try to combat the fear. At my practice in Hertfordshire I find it helpful to teach clients ways of calming their mind by teaching them relaxation techniques such as breathing techniques.

Ultimately the test will be asking the client to go back into the situation that causes them to experience panic attacks such as getting in a lift, being in a large crowd of people etc……….

At my practice in Hertfordshire I would assess a client to see which therapy NLP or CBT would be most effective for them. Sometimes it is good to use a mixture of both therapies in order to create the desired solution.

As Fibromyalgia (FM) sufferers we are often made to feel like our pain is “all in your head”, but research has consistently proven that Fibromyalgia is not a form of depression or hypochondria. IT IS REAL!  However, there is a connection between FM and other chronic pain conditions to depression and anxiety.  Treatment is important because both can make FM worse and interfere with symptom management.

There is some debate by medical and mental professionals about what causes what.  The “What came first?  The chicken or the egg” debate translates into “What came first?  The chronic pain or the depression?”  TRUE Fibromyalgia experts, researchers and others know that the chronic pain of FM & overlapping conditions leads to depression and anxiety. 

Fibromyalgia is a common condition in which a person suffers from chronic musculoskeletal pain. There are points called tender points, sometimes all over the body, and these tender and painful points are used as part of the diagnosis of FM. Individuals with FM may also be more susceptible to pain in general. Whenever the tender points are simply touched, they can send sharp pain impulses. Many Fibromyalgia sufferers experience pain all over and some experience pain only in specific regions. It can involve the muscles and the joints. Sometimes, there is so much pain that it is hard to pinpoint exactly where the pain originates.  Fibromyalgia is often accompanied by other overlapping conditions such as chronic myofascial pain (CMP), chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), restless legs syndrome (RLS), migraine & tension headaches, interstitial cystitis (IC), mitral valve prolapse (MVP), cognitive dysfunction, depression, anxiety and more.  The symptoms of Fibromyalgia, alone, are wide-ranging and debilitating.  Do they really think that depression and anxiety is the CAUSE for ALL of the above?

Depression is a mental illness characterized by feelings of profound sadness and lack of interest in enjoyable activities. It is a constant low mood that interferes with the ability to function and appreciate things in life. It may cause a wide range of symptoms, both physical and emotional. It can last for weeks, months, or years. People with depression rarely recover without treatment and if you have Fibromyalgia, you may have to fight it for the rest of your life.

Anxiety is a normal state of apprehension, tension, and uneasiness in response to a real or perceived threat.  Although anxiety is considered a normal response to temporary periods of stress or uncertain situations, prolonged, intense, periods of anxiety may indicate an anxiety disorder. Other indicators of an anxiety disorder are anxiety that occurs without an external threat and anxiety that impairs daily functioning.

What can cause depression & anxiety?  Stressful life events, chronic stress, low self-esteem, imbalances in brain chemicals and hormones, lack of control over circumstances (helplessness and hopelessness), negative thought patterns and beliefs, chronic pain, chronic physical or mental illness, including thyroid disease & headaches can ALL cause both.  Little or no social  and familial support can be a main factor in depression for FM patients. Family history of depression & anxiety can also be a factor.

Lack of quality sleep is also believed to have an influence on depression.  Since FM & Chronic Fatigue Syndrome patients tend to have insomnia and/or other sleep disorders, it stands to reason that poor sleep can lead to depression.

There is a wide variety of medications, vitamins, minerals, herbs and therapies that can help ease the impact of pain, anxiety and depression.  With so many out there, you and your doctor may have to go through the process of trial and error to find what works best for you!

Exercise is not only good for FM, it is also highly beneficial for depression and anxiety.  Recent studies suggest exercise can change your brain chemistry. Exercising can boost your level of serotonin, a brain chemical that is effects mood and pain perception. It can also stimulate the production of endorphins, natural painkillers that can give you an overall feeling of well-being.

Exercise is a great for stress, too. It relieves muscle tension and it gets the heart rate up. The combination makes us more relaxed and alert, which helps us deal with our problems in a calmer and more controlled way.

There are several other methods you can use to combat stress, including: meditation, deep breathing exercises, progressive muscle relaxation, mental imagery relaxation, relaxation to music, biofeedback, counseling – to help you recognize and release stress. 

You can learn more about this topic, medications, supplements, alternative therapies and more at my website AND I will be writing more articles – so check back here!

Get Paid to Submit Article like “Can Psychotherapy Really Help?”Therapy in this case means behaviour change or at least behaviour modification, which can be achieved in a number of ways. Psychotherapy all started with Freudian psychoanalysis, but protracted therapy sessions with an analysis slowly grew less popular as people looked for quicker ways to solve their problems.

More recently CBT or Cognitive Behaviour Therapy which has evolved from behaviour Modification Therapy has become increasingly more popular. It is now in common usage as a treatment option and is widely accepted as an empirically based and cost effective treatment alternative by the medical establishment. Thus it is used to address many disorders and psychological problems. If for instance somebody is suffering from an anxiety state such as the fear of flying the person will set up a number of protective behaviours that will guard them from the belief that flying is inherently dangerous. Overall they will probably avoid flying in an aeroplane at all. If forced some people will travel by air but in great discomfort and under a lot of stress. In some cases anti-anxiety drugs may alleviate this. However, if the individual avoids flying altogether they will find that the behaviour inhibits them in many avenues of life. For instance it will be difficult to travel on overseas holidays which might result in family pressures. More likely the real crunch will come when the person is required to travel abroad for work reasons. A refusal or inability to fly could have huge repercussions on work prospects and could lead to the loss of a job. However, we all have feelings about flying which can range on one hand to an exhilarating adventure and to the other to something that is dreaded, I think all will agree it would be nice to have a choice in the matter. CBT is able to help in situations like this by getting the subject to examine the beliefs that came into being that designated flying as something dangerous. Frequently the cause events go back to childhood. However, CBT is unable to deal with a problem like fear of flying quickly. It will take several months to come to a place where the subject is able to take a plane and travel to a destination with acceptably reduced stress levels. Unfortunately people in need of this treatment to offset the fear of flying usually do not have the luxury of this elongated time frame. Very often business executives are notified of overseas business trips just a few short weeks before departure date. Moreover treatment requires severall therapy sessions and this can work out costly. However, it must be said that treatment techniques like CBT are considerably better than those that preceded them, so it seems we are on a gradually improving learning curve.

However, when we go outside the empirically proven techniques that fit within the belief structures of the scientific principals favoured by the medical profession we do come to therapies that are quick and effective, Hypnosis or more precisely hypnotherapy has gained favour over the years because it can be effective and it can be quick. Some people are afraid because there are so many misconceptions about hypnosis. Many people think that a cloaked Svengali figure will take possession of their minds whilst waving a pocket watch in front of their eyes. This is nonsensical but stereotyped images like this get in the way of the true effectiveness of hypnosis.More recently the Meridian Energy Therapies have gained some popularity. The best known of these therapies is EFT or Emotional Freedom Technique. There is no hypnosis involved merely the tapping of the end points of the acupuncture meridians in a form of acupressure. EFT has had some amazing results from ridding people of life long phobias in a matter of minutes to curing Dengue Fever! It can be effective and is worth checking out because psychotherapy in the expert hands of a capable practitioner can result in truly amazing long-term benefits.

Are you struggling to deal with anxiety and panic attacks in your life? No matter how overwhelming your problem may seem, there are effective treatments for it. Medication can provide some relief from your symptoms, but some people are reluctant to take drugs or would prefer to limit the duration. Another option that is often recommended for panic attack sufferers is cognitive-behavioral therapy.Cognitive-behavioral therapy (CBT) focuses on changing your thoughts and behaviours. It deals primarily with solving problems in the here and now. Unlike some types of therapy, you don’t have to analyze every little event from your childhood or spend many hours in the psychologist’s office. People who have a great deal of anxiety usually think and behave in ways that are counterproductive. In therapy, you will learn ways to change your thoughts and actions so that you feel better and are less prone to anxiety and panic.People may not realize how deeply their thoughts influence their emotions. Those with high levels of anxiety often suffer from “wrong” thinking. While some individuals take an optimistic view of life, anxious people may interpret events in the worst possible light. They distort and exaggerate events in their mind to make them seem more catastrophic than they truly are. They may fret about problems that don’t really exist or aren’t important. Negative and unrealistic thoughts like these contribute unnecessarily to anxiety, panic, and depression. The therapist can gently steer you away from unproductive thoughts, put things into perspective, and teach you more helpful and realistic ways to think.Using cognitive-behavioral therapy, you can learn how to stop a panic attack before it develops. For example, there is a cycle you may get caught up in. It goes like this. You feel a little anxious. You become hypersensitive to the internal bodily sensations you associate with a panic attack. You start worrying that a panic episode is imminent, which adds another level of anxiety. Thinking and worrying can escalate those mildly anxious feelings into a full-blown panic attack. However, if you can interrupt this cycle, you can prevent an attack from occurring.One CBT technique that can give you relief from panic attack symptoms is proper breathing. Breathing patterns can affect how you feel and how much anxiety you experience. If you tend to hyperventilate (breathe rapidly and shallowly), you will increase your anxiety. Instead, you want to learn how to breathe deeply and slowly. Practice is essential, so that it becomes second nature even when you’re feeling panicky. Your therapist can also teach you other ways to reduce anxiety, such as relaxation exercises or biofeedback.Cognitive-behavioral therapy can produce very good results for panic attack sufferers. It will teach you more constructive and rational ways to think about situations and events, reducing your anxiety and worry. Instead of being held hostage by panic, you become empowered and capable of changing how you feel.

Writing has always been a type of ‘therapy’ in that it allows us to put into words our deepest secrets and feelings – things that we might be afraid or unwilling to share with anyone. People are often encouraged to keep diaries of their innermost thoughts as a way of removing the burden of problems from our every waking moment. We All Feel Sad Sometimes Few of us could say that we have never felt ‘down’ or ‘despondent’ at some time in our lives. These feelings are natural and are a part of what makes us human. Such feelings can be triggered by a great sadness in our lives, or be stress-related. Whatever the causes, most of us will get over them, and move on with our lives. Clinical Depression Sadly however, some people are unable to do so, and become what is known as ‘clinically depressed’. If diagnosed, they are often referred to psychologists who attempt to find the root cause of the depression and devise methods for coping with it. If this doesn’t work drugs, which may become a lifelong crutch, are prescribed. A stigma is often attached to people who take anti-depressant medication, and such prejudices can lead to furthering the sufferer’s low self-esteem. Alternative Treatments There are however a lot of alternative treatments for depression which are showing sensational results. Cognitive behavioral therapy encourages patients to try to see their problems from different perspectives. Acupuncture and hypnotherapy also work for some. Such therapies need to be ongoing to have maximum benefit to the sufferer, and this puts them out of reach of the many of us who cannot afford private health care. While self-help groups, families and friends can provide a sympathetic ear, they are not qualified to provide the long term help that is needed by sufferers of depression. After a while their sympathy can turn to frustration as they cannot understand why you just can’t “snap out of it”. Can Writing Help? Writing has been proven to be therapeutic for sufferers of many types of illnesses, from cancer to menopause. Not that it cures any of these – I make that very clear. But it helps the sufferers ‘cope’ with their illness. The same can be said for sufferers of depression. Writing down and describing their high and lows, what the triggers are to mood swings and so on, can help them and their therapists understand the warning signs. If these documented triggers can be identified, ways of coping with them can be devised. Other suffers may also benefit by reading about how others share and deal with similar experiences. Often when a person is told they have clinical depression, they feel isolated. If they are able to read about the journey of fellow sufferers, their burden is shared. Want To Be Published? The best way of getting such writing published is via the internet. By having your own website, you are able to self-publish your writing to thousands, even millions of people – many of whom may relate to your experiences. Creating a blog is a neat way of documenting your progress, and getting feedback via a forum is also worthwhile. Building a website is not the highly technical thing it used to be. If you buy user friendly software, one that takes you step by step through the process, you will be published in no time, and updating it is even simpler. The top website building software for writers’ sites even has ready to go templates – so simple that you just need to ‘fill in the gaps’.

How to find the right way to go about publishing your writing on the internet is to get loads of information on the top website building software for writers.  XSitepro provides an excellent tutorial for first-timers and a huge array of tools for when you are more experienced. More writing information is available at http://www.writers-xsited.com

Panic and anxiety attacks affect around 5% of the population at some point in their life – usually young people up to the age of 35. Standard medical treatment includes a variety of medication to help ease the affects of the attacks and help gain control at an emotional level.
However if you are not into medication or natural remedies to treat panic attacks, then you may want to try the Three Minute Therapy: a cognitive approach to dealing with panic attacks.
This may be the most logical method of overcoming panic attacks compared to seeing a psychologist or physician. This therapy assists the mental processes that a person goes through when experiencing a panic attack. There are two stages to this: first, identifying the “must do” activities that are driving the panic attack, and secondly disputing these “must do” activities until you overcome the pressure.
Anxiety prone people are more prone to dwell and magnify things that they “must do”. For instance, a mother of small children might think that she “must know” exactly why she feels panicky. She tells herself that she “must” never lose control. She “must” not do something to look stupid. She tells herself that she “must” have a guarantee that she’s not going to make herself panic.
These “must do” activities become an unrealistic obsession, and this develops into feelings of fright, panic, becoming hysterical and ultimately depression. People with these feelings of panic might also want to avoid uncomfortable situations so as to avoid further loss of control.
Using Three Minute Therapy, the panic attack sufferer needs to identify the “must do” activities in their life. Though it is “nice” to avoid discomfort or unwanted situations, it is not entirely a “must have” situation. Being uncomfortable is a perfectly normal human feeling, every once in a while. So you will need to realise that this is part of everyday existence and get on with life.
The second step in Three Minute Therapy is to convince yourself that these “must do” activities are not really that important after all. This will be a real mental battle for some people, as it goes directly against the grain of their thinking. As a sufferer you will need to be persistent and confront these thoughts when they arrive and dispute these “must do” activities until you feel it is natural to let go with the situation.
One method of overcoming panic attacks is to practise doing things that you would otherwise be afraid of doing. This stretches your boundaries and you will be able to demonstrate that discomfort isn’t life threatening, and will tend to diminish in its ability to cause panic the more you face it.
By using Three Minute Therapy you may be able to overcome panic and anxiety attacks without the use of drugs or medication.

Depression is all too real and results in relationship conflicts, family dysfunction and lost work productivity. The National Institute of Mental Health estimates that 17 million adults suffer from depression in the U.S. alone during any 1-year period. Yet, it is highly treatable using counseling techniques.
Is Depression Really Different from Occasional Sadness?
We all feel sad or “blue” from time to time. After all, it is normal to grieve over upsetting experiences, such as a death in the family, a life-threatening illness, job loss, or a divorce. But when these feelings are normal the grief and sadness lessen gradually with the passage of time.
However, if your feelings of sadness last longer than 2 weeks, and they interfere with the quality of your daily life, you may be experiencing a medical affliction known as clinical depression.
Depressed individuals often feel helpless and are saturated with feelings of futility. Not only that, but they often blame themselves for their listlessness and negativity. They also frequently become overwhelmed, spent and stop participating in routine activities. They may withdraw from others and may even have thoughts of suicide.
What is its Cause? Why does it Happen?
There are various answers and speculation on this question. Changes in the body’s chemistry can effect mood and thought processes that result in an overwhelming pessimism. Also, depression can be the outcome of certain emotional aspects of your life that are out of whack because of the feelings of futility generated by certain situations. For example, the death of a spouse or child can bring about a depressive episode.
Can It Be Successfully Treated?
Absolutely. Your depression is highly treatable by receiving competent diagnosis and care. If you suspect that you, a friend or family member may be experiencing depression it is crucial that you encourage or seek treatment from a licensed mental health professional.
If you suffer from depression but do not seek help you end up suffering needlessly. Unexpressed worries which are accompanied by feelings of isolation often worsen depressive symptoms; therefore, its crucial to get professional help immediately.
How Does Psychotherapy or Counseling Help?
Several counseling approaches, including thought-management, relationship re-structuring and psychoanalytic can help you and others who are depressed recover and get their life back. Counseling provides the opportunity for you to identify factors that contribute to your symptoms and to deal effectively with them.
Skilled therapists will help you to:
Pinpoint the issues or situations that contribute to your symptoms and help you understand which aspects you may be able to improve.
A professional psychologist or counselor can help you identify options for your future. You will be assisted in setting realistic goals that will enable you to enhance the quality of your emotional well-being and to identify how you have successfully coped with similar feelings in the past.
Identify pessimistic or distorted thoughts that contribute to your feelings of depression. For example, those suffering from depression overgeneralize, that is, think of life in terms of “always” or “never.” They also take events too personally. A psychological therapist can help the depressed patient modify and reduce these behaviors which worsen the symptoms.
Explore other learned thoughts and attitudes that contribute and worsen depression.
For example, psychologists can help you understand and improve any patterns of interacting with others that you may have which contribute to your depression.
Regain a sense of control and pleasure in your life.
Psychological counseling can help you see options and help you to gradually incorporate satisfying and rewarding activities back into your life.
Remember that experiencing an episode of depression once increases your risk of having another episode. However, ongoing psychotherapy or counseling may reduce the chance or seriousness of future episodes.
In What Other Ways Can Psychologists Help?
The support and involvement of your family and friends can be crucial. Individuals in your support system can help by encouraging you to stick with your treatment and practice the coping techniques you are learning through psychotherapy.
Living with a depressed person can be very difficult. The pain of watching a loved one suffer often generates feelings of helplessness and futility. Family or marital therapy may help in bringing together everyone affected by your depression and help them to learn effective ways to cope.
This type of therapy can also help those who have never experienced depression personally, to learn more about it and identify constructive ways of supporting a loved one who is experiencing it.
Are Medications Useful or are they just a Cover-Up?
Medications can be very helpful for reducing depressive symptoms in some people, particularly if you are suffering from a moderate to severe case. Recent studies demonstrate that often a combination of psychotherapy and medication is the most effective treatment.
Some depressed individuals prefer psychotherapy or counseling to the use of medications. After a thorough assessment, a licensed counseling professional can make recommendations about the most effective course of treatment for you.

Drums are one of the few, perhaps the only, musical instruments to earn a very unique distinction in human culture. Not only are they utilized for the traditional purpose of music, but they have been put to other uses as well. One of the most interesting of these alternative uses is that of music therapy. Music therapy is an approach that uses music to address the physical, emotional, cognitive and social needs of individuals. The American Music Therapy Association defines this type of therapy as “the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship.” There are claims that music therapy can promote wellness, manage stress, alleviate pain, express feelings, enhance memory, improve communication and promote physical rehabilitation.
Although many might assume that drum therapy is a fairly recent advent, this is not necessarily the case. Some proponents advocate that drum therapy is an ancient technique and evidence of its history may be found in both Asia and Africa, where some of the world’s oldest civilizations reside. While it may be true that drum therapy has been around for thousands of years, it is also true that in the 20th and 21st centuries, science has been used in an attempt to verify the therapeutic effects of drum therapy and its rhythm techniques. Much to the delight of drummers everywhere, some studies indeed show that drumming accelerates physical healing, boosts the immune system, produces feelings of wellbeing and even has a calming effect on people suffering from Autism, Alzheimer’s and various traumatic experiences.
Drums, especially those played with the bare hand, are often used in music therapy for two reasons. One, they are exceptionally tactile in nature and two, they are easy to use. This combination makes them ideal for therapeutic situations. The act of drumming is believed to help people express and address emotional issues that may be otherwise difficult to face. It allows the drummer to create an external and almost physical manifestation of whatever frustration they may feel inside.
Drum circles are a popular form of music therapy. In such a situation, each person is able to express themselves through their individual instrument while simultaneously participating as part of a larger whole. Such groups can range from just a few people to literally thousands of individuals. Drum circles have no beginning or end, no top or bottom. Such a construction places every participant on equal footing, another important component in a therapeutic situation. Drum circles may be facilitated, meaning that they are, to some degree, guided by a facilitator who encourages the participants. The circles may also be anarchic, possessing no formal leadership or moderation.
Drum circles may also have a spiritual focus, which for some is an important component of therapy. The practices most commonly associated with drum circles are Neo-Paganism, sometimes referred to as Wicca, and those of the Native American people. The drum circles of Neo-Pagans can also involve changing, singing, poetry and spoken artistry and are generally anarchic. Those of the Native Americans are usually facilitated by a shaman who uses the music of the circle to enter a trance or go on a spiritual journey.

Occupational therapists believe that there is a relationship between occupation, health and well-being. Findings from studies over the years indicate that occupation has an important influence on health and well-being. Ranging from physiological to functional outcomes, it is clear that the performance in everyday occupations is an important part of everyday life. Withdrawal or changes in occupation for a person have a significant impact on a person’s self-perceived health and well-being. There are many definitions of occupational therapy: The World Federation of Occupational Therapists (1989) states that: Occupational therapy is the treatment of physical and psychiatric conditions through specific activities to help people to reach their maximum level of function and independence. Definitions of occupational therapy do not cover the scope of the profession. ‘Occupational therapy is concerned with the individual and the roles, occupations, activities and interactions within the individual’s personal environment. Occupational therapy enables and empowers the individual to be a competent and confident performer in his or her daily life, and enhances his or her well-being. Occupational therapy uses activities creatively and therapeutically to achieve goals which are meaningful to the individual and to reduce the effect of dysfunction. Occupational therapy requires the individual to engage actively in the process of therapy and to be a partner with the therapist in designing and directing this process’ (Hagedorn 1997). Professional goal The major goal of occupational therapy is to enable the client to achieve a satisfying and productive life through the development of skills that will allow him to function at a level satisfactory to himself and others. Occupational therapy is focused upon enabling the individual to achieve what is important to him rather than aiming for normality, conformity or desired professional opinions. * Assess the patients needs in terms of the occupations which are important to him * Identify the skills needed to support those occupations * Remove or minimise barriers to successful occupational performance * Assist the client to develop, relearn or maintain skills to a level of competence that will allow him to perform occupations to his own satisfaction * Help the patient to achieve a satisfactory balance of activities in his daily life, i.e., self-care, productivity and leisure. The focus of intervention is always the patient and his goals, rather than the problem or the method of intervention (Creek 1997). The following six elements reflect a consensus in the profession: 1. Occupational performance — occupational therapists are centrally concerned with how individuals function in their work, leisure and domestic/personal self-care. A person’s occupational performance may well become disrupted or impaired when he becomes unwell, either physically or psychologically. We work with these individuals who experience some difficulty in their daily life functioning 2. Importance of being active — through being active it is believed that we learn about ourselves, develop skills and maintain out physical/mental health 3. Therapeutic use of activities — occupational therapy is premised on the idea that purposeful activity can be therapeutic and can be used to improve individual’s functioning. We apply activities in the treatment process valuing the activities inherent properties, the experience of ‘doing’ the activity and the end-product. Occupational therapists employ two main types of activities, activities of daily living (cooking) and specifically orientated therapy activities (such as groupwork). Treatment involves grading and adapting the activity to enable the patient to achieve an optimum level of performance and satisfaction. 4. Problem-solving process — the occupational therapy process (assessment – treatment plan — implementation of treatment — evaluation) is primarily a problem-solving process. 5. Holistic gaze — occupational therapists aim to view and treat individuals as complex, whole beings, whereby attending to emotional, cognitive, social and physical aspects of the person 6. Unique individuals — all individuals are seen as unique and the implication this carries for occupational therapy is that each person requires his or her own individualised treatment programme, containing aims, objectives and goals. Occupational therapists central concern with occupation and activity provides us with a unique focus and role. Core skills * The use of purposeful activity and meaningful occupation as therapeutic tools * The ability to enable patients to explore, achieve and maintain balance in daily living tasks and roles * The ability to assess the effects of, and then to manipulate, physical and psychosocial environments to maximise function and social integration * The ability to analyse, select and apply occupations as specific therapeutic media Legitimate tools * Purposeful activity — the activity is both purposeful and meaningful to the patient to enable the patient to reach their goal * The environment — the goal of intervention maybe to help the patient to adapt to his environment, or to adapt the environment to suit the patients needs and abilities, e.g., equipment prescription and provision (perching stool, grab rails, bath board, kettle tipper). * The therapeutic use of self — this is the therapists ability to relate effectively to patient, which will determine the success of the relationship between the therapist and the patient, e.g., empathy, flexibility, self-awareness.