Latest in Lifestyle Redesign®
July 2024

LR IRL — Lifestyle Redesign in Real Life

Sculpting a New Narrative

In the days following her diagnosis, Susie couldn’t help but reflect on her nearly 40 years of life and mentally scroll through all of the subtle signs that had been overlooked ever since she was a child; up until now, Susie felt she was “doing too well to have ADHD.” Recent life events, including opening a second business and moving to a new home, had begun to feel unmanageable and Susie’s optimism faded behind a looming functional paralysis. Susie was a sculptor by trade yet was struggling to muster any creative energy, in part due to her non-existent sleep routines; she was finding herself in a “shame spiral” most evenings, which inevitably led to short spurts of productivity followed by staying up late to “numb out” once the heightened feelings had subsided. She, resiliently, sought support for this inexplicable shift and a few weeks later she was diagnosed with attention deficit hyperactivity disorder (ADHD). Susie scoured the internet for support and stumbled upon a friendly, purple-haired headshot on the Spectrum Psych Los Angeles website. Susie immediately thought “we would definitely get along;” within a week she met her OT, Dr. Samantha Valasek.

In their first session together, Susie bluntly shared that she was experiencing a total collapse of her sense of routine and her ability to manage her responsibilities. Given that Susie’s diagnosis was so new, Samantha began their treatment sessions with ADHD psychoeducation in an effort to empower Susie to identify her symptoms and explore compensatory strategies to mitigate their functional impact. As Susie learned more about ADHD and how it presented for her, Samantha wove in self-compassion and mindfulness activities to support Susie in learning to accept her diagnosis and create a new narrative for herself. As Susie grew to understand and accept her symptoms, sessions began to focus more on her sleep and energy management. Samantha provided education about sleep rhythms, activity pacing for cognitively demanding tasks, and the relationship between sleep and physical activity. Together, the duo strategized ways in which Susie could begin to integrate this information to build sustainable sleep and exercise routines. In the process of tackling activity pacing for energy-draining tasks, Susie confided in Samantha that she felt she was expending a lot of emotional energy into her intimate relationship. In response, Samantha encouraged Susie to advocate for herself in her relationship and express how she was being affected by her partner’s own mental health challenges. Ultimately, Susie felt that the effort to find a healthy balance was one-sided and decided that she needed to prioritize her own health, soon thereafter ending the relationship; a bittersweet byproduct of Susie’s self-acceptance.

As Susie’s personal life began to feel more manageable, she had greater capacity for creativity and was prepared to address her work responsibilities; Susie was to organize her first solo sculpture exhibit and only had a few months to pull it all together. Collaboratively, Susie and Samantha tackled higher level executive functioning needs, including independent problem solving and addressing the financial/administrative side of Susie’s work. They focused on budgeting, breaking down big tasks into smaller ones, and managing time in a way that felt authentic and realistic for Susie. In this process, Susie began to recognize that she did have the capacity to execute these less-enjoyable tasks and what she really needed was emotional regulation strategies to combat the sense of dread and intimidation that would get in her way. As Samantha would put it, Susie benefitted from “self-regulation in order to access higher level cognition”. She was able to apply the strategies learned in her OT sessions and Susie’s exhibit came together better than she could have imagined! Concurrently, their sessions touched on the concepts of eustress and principles of positive psychology, which set the stage for even further lifestyle changes in Susie’s life. The most significant change came when Susie brought home a new puppy, and, unknowingly at the time, a new sense of motivation, structure, and joy.

Within one year’s time and 24 sessions later, Susie was ready to continue on this new life path on her own, despite enjoying the safety net and accountability her OT sessions gave her. “I have an amazing routine now,” Susie shared, reflecting on how, what started as small changes in her daily life, expanded to rediscovering her creativity and achieving professional milestones. Susie now had a toolkit she could rely on when she encountered challenges again, “like a guidebook for how to get through it on her own,” Samantha would add.

When asked what she would like others to know about working with people with ADHD, Samantha shared:

“It’s so critical to start with building a shared vocabulary and a non-judgmental space where the person can really lean into self-compassion and build habits in a way that actually fits the ‘shape’ of their brain. A lot of habit formation advice is too rigid for our neurodivergent folks and we really need to adapt [our approaches] to better suit them.”

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Research Spotlight

Autistic Adult Perspectives on Occupational Therapy for Autistic Children and Youth

Historically, much of autism research has focused on behavioral interventions for Autistic children, relying on the parents’ perspectives about their child’s preferences and progress. The Autistic community has placed greater value on neurodiversity-positive approaches over behavioral interventions and occupational therapy (OT) practice is gradually shifting to better align with such approaches. In an effort to understand the perspectives of Autistic adults on OT for Autistic children, a group of researchers conducted a thematic analysis that shed light on how occupational therapy practice can evolve to align with the Autistic community’s values.

A team led by Dr. Julia Sterman thematically analyzed Autistic adults’ data from an Autistic-led Facebook group, as well as transcripts from Autistic guests on an OT-led podcast focused on amplifying Autistic voices. Researchers especially sought to include data from Black, Indigenous, and other People of Color (BIPOC) voices. Several themes arose that have the potential to shift OT’s approach to pediatric interventions, most saliently, (1) accepting Autistic identities rather than trying to “fix” children; (2) changing environments or tasks rather than using behavioral strategies; (3) creating goals that address self-advocacy and autonomy. The authors challenge pediatric OTPs to seek out more Autistic adult perspectives to inform their practice and assert the importance of amplifying Autistic voices in OT research to facilitate a shift in the way autism is viewed, not as “deficit among neurotypes”, but as diversity.

When asked about this publication, author Dr. Julia Sterman shared:

“One thing I would want to highlight is that the authors for the paper included Autistic adults, as well as the data coming from the perspective of Autistic adults. There is a need to shift practice to valuing the perspectives of Autistic people and how they would shape the priorities of treatment for themselves and other Autistic people. I was following these conversations and wanting to capture them in a rigorous way to help build the academic literature base in this area, to support community informed practice, and knowledge translation.”

 

Occupational Therapy Is a Vital Member of the Interprofessional Team-Based Approach for the Management of Rheumatoid Arthritis: Applying the 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis

Rheumatoid arthritis (RA) and its fluctuating symptoms, including pain, fatigue, and functional limitations, impact all aspects of life for those living with this chronic autoimmune condition. While pharmacological treatments continue to advance, there continue to be gaps in interdisciplinary and holistic care, resulting in the need for reemphasizing the value of non-pharmacological interventions for people with RA. This position paper expands upon the 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis to explicitly outline occupational therapy’s (OT) role as a valuable member to an interdisciplinary team for this population.

The authors synthesized and contextualized OT techniques in an effort to provide guidance for OT’s role in supporting people with RA. OT techniques highlighted include adapting daily activities, education on self-management, exercise programs and/or prescription of orthotics and participation in work activities. Within these techniques, the authors expand further, emphasizing OT’s unique capacity to address topics such as environmental adaptations, adaptive or assistive devices, joint protection training, and energy conservation training, to name a few. The overarching technique that solidifies the foundation for all other techniques is that of comprehensive OT; the authors argue that, in general, people with RA should receive referrals for comprehensive OT rather than for a singular service. Comprehensive OT refers to a truly holistic approach to assessment and goal setting that is unique among other care partners a person with RA may encounter.

In reflecting on this publication, the authors shared:

“When we talked with people with RA we learned that they found OT to be an essential service in helping them to continue to have meaningful and productive lives that included RA. Many commented that they found it useful to see OTPs at different stages of their lives as their occupational needs changed with age, experience and disease fluctuations.”

 

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Upcoming Opportunities

Late-Diagnosed ADHD and Autism: Supporting Adults Through A Period Of Discovery
Webinar | Thursday, August 22, 2024

Join this webinar to learn about supporting late-diagnosed ADHD and autistic adults through the health and well-being challenges they commonly encounter. Understand the critical role occupational therapy can play in guiding clients as they come to a greater understanding of themselves, their needs, and their strengths. Explore the impact of lifestyle considerations and activity adaptations on occupational engagement, the benefits of interprofessional care, and the evidence-based intervention approaches you can bring into your sessions today. Consider how the insights from case studies from the interprofessional team at Spectrum Psych Los Angeles could apply to your practice.

Date: Thursday, August 22, 2024
Time: 10am PDT
Location: Zoom
Cost: This webinar is offered at no cost. Registration is required to join the webinar.
CEUs: 1 contact hour (0.1 CEU)

About the Speaker: Samantha Valasek, OTD, OTR/L, CTTS, ADHD-RSP

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Certification Section

LRC Info Sessions

We are wrapping up the Summer with one more Lifestyle Redesign Certification information session on Monday, August 5, 2024 @ 9am PDT!

Info sessions will be live, online events, hosted via Zoom:

• Topic: Lifestyle Redesign® Certification Information Sessions
• usc.zoom.us/j/94343068918
• Meeting ID: 943 4306 8918

For full Zoom meeting details and future info session dates/times, check out our calendar by visiting the Upcoming Events page.

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Course Series Corner

Core Course 1 Starts September 9th!

Register for the first course in the Foundations of Lifestyle Redesign Course Series! Core Course 1 is the prerequisite to all subsequent Course Series courses and will be offered annually in the Fall.

This is an online, paced asynchronous course, meaning you can access it from anywhere in the world and can expect a structured format to help you keep up with the course. Other supports include:

• Optional synchronous discussion sessions provide the opportunity for participants to ask questions, seek clarification regarding course concepts and terminology, analyze case studies, and engage in problem solving.
• Course instructors available to respond to questions via email throughout the duration of the course.

Course Start: Monday, September 9, 2024
Course End: Friday, October 25, 2024
Format: online, paced asynchronous
CEUs: 12 contact hours (1.2 CEU)
Deadline to register: September 9, 2024¹

Cost
Regular: $400
AOTA Members: $360
USC Chan Alumni: $360

¹Note that if registering between 09/04/24 - 09/09/24, please allow 4-6 business days to activate course access following registration.