Here it is, my care plan, the plan I made with Mark my OT, for managing and overcoming anxiety around starting school. Feedback is appreciated.
Management Strategies Identified
- Anticipation and Preparation
- Breathing techniques
- Body Scans
- Think about 3 things near to me. Sounds in the room. Sometimes require prompting.
- Use quiet room
- Time out and collect thoughts. Perhaps toilet break. If triggered can use water.
What am I looking forward to:
Learning new things
Building computer skills
Getting into the workforce
Having a satisfying routine
Structure to the day
Something to get up for in the morning
What do I see as obstacles to course engagement:
- Instructors not knowing about jaws or equipment
- Equipment breaking down
- Lack of awareness about dog
- Not familiar with spreadsheets etc and difficulty with such
- Concerns about becoming unwell and unstable
- Work Placement and finding the right placement Will companies want to take me on
- Mobilising around the building
- Exams and exam process (Will I get to do the exams on same day)
What Strategies can I use to overcome obstacles?
- Ring Brain Manning form NCB and he can give training on Jaws as it is specialised equipment. I can help out re commands etc. On email support lists and I can get answers from this around technology supports.
- They have tech support and also Brian Manning can help with such.
- Have had Natalie (trainer) in and if needed she could come in again. Perhaps get leaflets about guide dogs if needed. Like the Basement, people get used to the dog and more familiar. Confidence will be developed being around the dog.
- There will be individual support when needed and I will have an opportunity to confirm items and question if I have not processed information or grasped concepts.
- Use weekly appointments to discuss about impacting items from past aswell as current stressors. Prioritise what needs to be talked about. Do things in personal life to maintain wellness i.e. relationships. Basement resource centre. Fill up evenings and use distraction techniques. Talk to link worker on the course so they are aware.
- When go to do work placement anticipation and preparation will be key and using resources in NLN and outside of this to get the best opportunities available.
- I have done route familiarisation and I know much of the building. The first two weeks of induction will give me time to adjust fully. Confidence has developed already and staff have been so friendly and will be helpful if required.
- The exams are every 6 weeks approximately. It is continuous assessment as opposed to one exam at the end of the year. This takes stress off. I have initiated availing of extra time and supports for exam to maximise likelihood of best outcomes. I will link in with my key support worker in NLN leading up to exams and discuss any concerns as they arise. Link with Mark (OT) leading up to exams as an aspect of exam preparation.
What preparation do I feel I need prior to commencing NLN on Sept 7th:
- Adjust sleep pattern: Starting Monday 31st August getting up at 7am and going to bed before 12. I will adjust body clock as when I commence NLN I will be getting up at 6am. This preparation will give me confidence to start the course.
- Ring Brian Manning as I need guidance on a scanning ap on the phone. This will be necessary to scan printed material on the course.
- I feel ready for the course.
I met with our OT Mark today. We had met two weeks ago and started a plan for going back to college. Basically we did a kinda care plan and a plan of action around my anxietys. Its called anticipation and preparation. Today we were just finishing it off. I almost didnt make it this morning, as I went to bed quite late and so when it came time to get up I was being lazy. But eventually I got out the door and I’m so glad I did. Mark has written everything out in a kinda bullet point format. He’s going to email it to me as soon as he gets a chance. Then it will be up to me what I do with it. I plan on giving a copy to my key worker in college, and I told Mark to put a copy in my file for Dr Barry to read. I also plan on sharing it here and with some other friends. Mark suggested that once I start college that instead of me going to meet him once a month at the day hospital, he could come to me instead. This I thought was a great idea. It will also save me some money on taxi costs. The school are ok with him coming to see me there too. They know him as he’s attended meetings on my behalf with the manager of the college and the college psychologist. It actually makes sense for him to come to me otherwise I’d be trying to get to our appointment for 8:15 AM and then on to college and I’d be about an hour late as the classes start at 9 AM. Mark told me that between now and my start date if I need anything to feel free to call him and he even said that next week if anything comes up for me and I needed to see him he would be able to slot me in. I doubt I’ll need to see him though before I start. I will probably call him after my first day though just to let him know how it all went.
This morning I had an appointment with Mark our OT. We usually meet once a month but over the past couple of weeks we’ve met twice a month. Today we were doing a session on coping with the anxiety I am feeling surrounding going back to college in a couple of weeks. Mark uses a technique called anticipation and preparation. Basically that means you talk about the reasons why you are anxious, you ancipiate the obstacles and then you prepare for them. So he started off by asking me first of all what I was looking forward to about starting college. Surprisingly I came up with a lot of things, including having a structure to my day, having something to get up for each morning, making new friends, socialising, learning new things, enhancing my computer skills, and further down the road going out to work and get a job eventually. So yep, a long list of things to look forward to which is nice. Mark wrote as I talked and he’s going to send me a copy of what he wrote out so I will have it and can look at it when I am feeling overwhelmed about the course, or like what am I doing this for, why am I putting myself through this etc etc. After talking about the things I’m looking forward to we went on to discuss obstacles I think I might come up against. Again there were quite a few things I came up with when I started to think about things. Things like accessibility issues, not grasping things when I’m told, for example if the instructor tells me to do something or shows me how to do something and I am dissociated and dont hear it or take it in, issues around the dog and telling people not to pat him or distract him, issues about my mental illness and diagnosis, what if the equipment breaks down during my course, exam worries, etc etc. After we wrote everything down we discussed strategies and solutions to the obstacles, hence the preparation part of the anticipation and preparation. We didnt get to finish it because our time was up but in two weeks time we’ll have another appointment and we will finish strategising and then after doing all that we’re going to do up a list of coping and distraction techniques that I can use when I am distressed dissociative or overwhelmed. We started that list today and I included things like I will check in with my body, breath deeply, go to the bathroom and collect myself and my thoughts, go to the quiet room which yes they do have in the school, notice whats in the room around me, notice sounds around me, splash water on my face etc. I plan when Mark sends me the whole finished plan to give it to my link worker at the school and say here you go, this is my plan of action. So then they will be aware of the things I was anxious about, what I plan to do about my anxiety, my distraction techniques and coping skills, and hopefully they will see me as someone who is really focused on the task at hand which is learning and doing the course, and that I am also focused on my recovery and an active participant in that. Overall it was a really productive appointment and Mark said he thinks I am really ready to do this. He kept saying how resourceful I am and how I always have answers and even though I am very anxious and nervous about starting, somehow it will all work out because I have the answers, the keys and all I have to do is look within myself to find the answers. We also talked a little bit about the meeting he attended on Tuesday, and there will be a follow up meeting at the end of September which I will also attend with Mark and the manager of the school and the school psychologist. Hopefully by then I’ll be settled in and well on my way and that meeting will be a huge success.
Just home from an appointment with Dr Barry. It was a good appointment as always.
We mostly discussed stuff around college, especially my anxiety around that. I told her that I was afraid I would become unstable again when I start, that the stress of doing the course would cause me to decompress. I know when I start the course we will have teething problems, mostly due to my blindness, and the fact that I am the first blind person to do this particular course. They’ve had parcially sighted people before but not someone whose totally blind. So I do know there will be problems. I told Dr barry that I did not want my mental illness to be the focus point, but that I’m afraid when I start it will take a dive and I will become unstable again. Dr Barry said that she can understand why I am worried, but she said she thinks I’ll be ok, that I’ve spent the last 12 months stabilising and doing lots of hard work in therapy, and that she doesnt think that I will undo it. She’s hopeful I wont. She said to take things slowly and I should be ok. Mostly our appointment today focused on the college stuff, it was a shorter than usual appointment, I was done in 30 minutes when usually I am with her for an hour or more.
Yesterday Mark our OT went to a meeting with the school psychologist and the manager of the college and himself about me and about what supports I’ll need in order that I can deal with my mental illness effectively. He rang me when he was finished and he said it all went off ok. Apparently they wanted to know what they should tell the other trainees on the course, whether they should mention our did to them or not. Mark told them to consult me about it, but that he thought I wouldnt want them to mention it, as I dont usually tell just anyone, that I prefer to only tell those who I think will have an understanding of the disorder. He told the school that if there was a problem with my mental health or if I was in crisis that I’d contact either my psychiatrist dr Barry or my therapist Eileen, he said to leave it up to me to do that which the school agreed to do. He told them that I prefered to keep my mental illnesses separate from the academic side of things, that I am there to learn about IT stuff, and not to focus on my mental illness. They seemed to be ok with that which I am glad about. I am meeting Mark tomorrow to discuss the anxiety and ptsd stuff so I will probably talk omore to him then about stuff. Yesterdays call was just to touch base after the meeting.
I told Dr Barry today that we’re going away for the weekend, me, my mom, my sister and her kids. I’m so looking forward to it too. It will be nice to get away for a couple of nights and I know we’ll have a good time.
So this morning I met Mark our OT. We had a long discussion on a number of different topics. First off, we discussed the upcoming meeting that he is attending about us going back to college. The manager rang him and set up a meeting between him and the college psychologist. Basically they want to know if we have enough supports in place outside of the school supports, if we’re able to manage our mental health, and what they should do if a crisis arises and we need extra support. Mark said that he’s going to reassure them that if we need extra support we will initiate it by contacting either our therapist or psychiatrist. He’s also going to let them know that we’d like to keep our mental health issues separate from our schooling and issures arising from that. They will be meeting on August 11th, and Mark said when he’s finished with the psychologist and on his way home he’ll buzz me to let me know how it went. We decided to meet again on the 13th of August…and when we meet we are doing a session around my anxiety going back to college. He said he’d be using a strategy called anticipation and preparation. basically, you anticipate what issues will arise for you, then you prepare for those issues. Sounds simple but it probably isnt. Still I’m looking forward to that session. Putting things into perspective will set my mind at ease. We also talked about me doing voluntary work and I said for now I’d rather wait a while. I want to start college and see how that goes, what the work load is like, if I’ll be tired in the evenings etc before I commit myself to doing extra voluntary hours on top of that. Mark had looked into me volunteering for friendly call, which is a service where vulnerable people or older people can request a daily check in, and someone from the friendly call service will ring them and chat to them for a while, checking in with them to see how things are going for them. I would love to volunteer my time there. They expect their volunteers to commit for a year, and work I think a four hour shift a week. I think if I still want to do it after xmas then I will. The other thing mark had been looking at for me is singing lessons. We looked into me going back to the stage school I attended as a child. Its pretty expensive though for private tuition. There is an adult choir which I could go to but even doing that you have to pay by the simester. I’m going to think about it. Again I can always wait until after xmas to join. Since I am also thinking of joining spinning classes in september I’ll need to set time aside for that. And two evenings a week I’ll be seeing eileen and Dr Barry. So my evenings are already pretty full on. It was a good appointment though and Mark said if I get anxious during the two weeks I can phone him and we can meet sooner than two weeks. He also said once I go back to college that he would still meet me just maybe not as often. I am lucky to have him because he is not dr barrys OT he works in the locked secure unit as their OT but some years back he was my old psychiatrists OT and that s how I got refered to him was through her. Then he kept me on as a client once I switched over to Dr Barrys team. He’s a really good OT though…very thorough.