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First Encounter at NCMH

    When I was assigned to conduct fieldwork at the National Center for Mental Health, it was truly a mixture of feelings. I was very excited because that was the first time that I’ll be sent to a psychiatric setting. My previous fieldworks were mostly of adult patients with physical dysfunction and adolescents with mild psychosocial problems, and it was my first time ever to really work with mentally ill patients. On the other hand, I was nervous also. Not just me, but as well as most of us assigned at NCMH because it was our first time to be there. It was also my first time to be in a mental hospital with patients whom I could call really insane. I mean, the typical schizophrenics you would see on the streets – most of which are really chronic in condition.
    The first question that I had in mind then was “how am I suppose to deal with these people?” Really, what kind of help do mentally ill patients need? It is really complicated and difficult to imagine how to deal with severely cognitively impaired individuals. Will the goal for treatment would be to get them back to the original level of functioning, or at least near normal?
    The patient I observed was having difficulty in organizing thoughts and in social participation. The therapist in charge was using the cognitive disability FOR to teach skills that focus on improving the client’s concentration, frustration tolerance and attention span which were problematic. To achieve client’s goals, the therapist used a stitching activity, which she incorporated in a group session. The intervention technique generally used was restoration in an attempt to target specific client deficits in performance areas, and gradations and adaptations were provided like simpler instructions, designs and materials used. Since the patients in the group were high functional already and are to be discharged in a few weeks time, the approach used was generally top-down so that the skills learned by the clients could be readily applied outside after discharge. Some clients seem to respond very well while some clients seem to challenge the therapist. I guess, you really have to be strong and you must establish authority at the very start of the therapy session especially when you’re working in a psychiatric setting to gain client’s cooperation for a more effective treatment.    



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