Goal Management Training (GMT) is a cognitive rehabilitation program developed to help people with executive functions. Executive functions are a set of skills that allows people to manage daily life. Examples of skills include working memory, impulse control, flexible thinking and planning and prioritizing. GMT benefits people with a variety of conditions associated with executive function impairments. These conditions include stroke, brain injury, multiple sclerosis, age-related cognitive decline, and many others. People with executive function challenges struggle with planning, problem-solving and managing daily activities. For example, they may have issues organizing or keeping track of their items, regulating emotions, managing time, and trouble recalling or following multistep instructions. The original nine-session GMT program can be administered individually or in groups. A modified six-session GMT program is also available. GMT is based on the theory of sustained attention (autopilot mode), which states that a malfunctioning sustained attention system can negatively impact a person's ability to achieve their goals. Being unable to track and complete goals is a common complaint for people with cognitive impairments. The primary objective of GMT is typically a multistep process: Train individuals to periodically "STOP" what they are doing and bring their mind to the present moment. Attend to their goals and break down those goals into smaller steps. Monitor their progress and check for outcomes. The overall purpose of "STOP" is to turn off the autopilot mode and bring attention back to achieving a goal. Training and regular practice of these steps can improve a person's ability to achieve their goals and withstand interference from distractions. Reference: Stamenova, V., & Levine, B. (2018). Effectiveness of goal management training® in improving executive functions: A meta-analysis. Neuropsychological rehabilitation.
After eating a meal, the digestive system metabolizes food into small molecules. Carbohydrates break down into small sugar molecules called glucose which travels throughout the bloodstream to all body regions. Cells absorb glucose and use it for energy. Insulin is a hormone produced by the pancreas and helps regulate glucose levels in the blood. If glucose levels get too high, insulin signals your body to store excess glucose in the liver to use later. Diabetes is a metabolic disease that typically arises when the body does not produce enough insulin or does not respond appropriately to insulin. Excess glucose in the bloodstream can damage blood vessels and increase the risk of stroke, heart disease, kidney disease, nerve and vision problems. For people with high glucose levels, insulin injections into the bloodstream help reduce and control glucose levels. Occupational therapists (OTs) have many roles when working with people at risk or currently have diabetes. For example, OTs may help modify a person's routines and habits to promote a healthier lifestyle. The Association of Diabetes Care and Education Specialists have seven self-care behaviours that OTs can use with clients. These behaviours include: Healthy Coping: develop strategies to physically and emotionally cope. Healthy Eating: help manage the intake of food that affects blood sugar levels. Being Active: physical activity helps to stabilize blood sugar levels. Monitoring: check your blood sugar levels regularly. Medication: educate on different types of available medications and reduce complications. Problem Solving: help develop plans for the future. Reducing Risks: lowers the chance of developing diabetes-related complications. Reference: AADE7 Self-Care Behaviors for Managing Diabetes Effectively. https://www.diabeteseducator.org/living-with-diabetes/aade7-self-care-behaviors. Accessed 4 Mar. 2021.
Occupational therapists (OTs) commit to being competent, accountable and ethical when offering healthcare services to the public. A therapist's scope of practice describes what OTs can and cannot do when working with clients. Only authorized healthcare professionals can perform certain procedures or activities because they may pose a public health risk. In Ontario, procedures that OTs generally cannot perform are called Controlled Acts. In British Columbia or Alberta, they are called Restricted Activities. Provinces or territories may use different terminology, and OTs must follow the guidelines provided by their provincial College of Occupational Therapists. Let's briefly look at a summary of the 14 Controlled Acts for OTs in Ontario provided by the College of Occupational Therapists of Ontario. Communicating to an individual or others a diagnosis identifying a disease or disorder. Performing a procedure below the dermis. Setting a fractured bone or dislocated joint. Moving joints of the spine beyond a person's normal range of motion. Administering a substance by inhalation or injection Inserting an instrument, hand or finger into an opening of the body such as the ear, nasal passages, etc. Applying a form of energy such as ultrasound. Prescribing, dispensing, selling or compounding a drug. Prescribing or dispensing devices for vision or eye problems. Prescribing devices for a person hard of hearing. Fitting or dispensing a dental prosthesis to protect the teeth. Managing or performing the delivery of a baby. Performing allergy testing that results in a significant allergic response. Treating by means of psychotherapy. There may be specific incidences that allow the transfer of legal authority for OTs to perform a controlled act called Delegation. For more information regarding the Delegation Process, refer to your provincial College website. Reference: Guide to Controlled Acts and Delegation. https://www.coto.org/docs/default-source/guides-guidelines/guide_to_controlled_acts_2020.pdf?sfvrsn=676b5d59_46