Occupational therapy must be more spread among child psychiatrists

A terapia ocupacional necessita de mais divulgação entre psiquiatras da infância

CARTA AOS EDITORES

Occupational therapy must be more spread among child psychiatrists

A terapia ocupacional necessita de mais divulgação entre psiquiatras da infância

Dear Editor,

The Brazilian Psychiatric Association (ABP) has recently published its Guidelines to a Model for Integral Assistance in Mental Health in Brazil.¹ In this prestigious document, ABP highlights the importance of Occupational Therapy (OT) in the treatment of psychiatric patients, specially children and adolescents.

A chart review was carried out by the OT Ambulatory of the Centro Psíquico da Adolescência e da Infância (Adolescence and Childhood Psychical Center) – CePAI/FHEMIG with the objective of characterizing its service. CePAI/FHEMIG is the main secondary and tertiary public unit of childhood and adolescence psychiatry in the state of Minas Gerais.

The data refer to the period from January 2006 to April 2007. During this time, a total of forty-three outpatients were evaluated and treated in the Ambulatory by its single OT. The age ranged between 3 and 15 years old (mean 8.8 y.o.; SD ± 3.4). Most of them were male (74.4%). These children and adolescents had the following psychiatric disorders: mental retardation (39.5%), pervasive developmental disorders (14.0%), conduct disorder (11.6%), mixed specific developmental disorders and specific developmental disorders of coordination (11.6%), ADHD (9.3%), psychosis (7%) and mood disorders (7%).

Psychologists were the professional who most frequently referred to OT (32.6%), followed by neurologists (18.6%), psychiatrists (16.3%) and speech therapists (14.0%). Curiously, when we analyzed the professionals who were most commonly conducting their treatment alongside with the OT, psychiatrists were the majority (67.4%), followed by the speech therapists (48.8%). In other words, despite psychiatrists being the professionals who most frequently worked with occupational therapists treating these patients, they were one of those who least referred their patients to OT. Of these patients in treatment with psychiatry, 38% and 41.3% were referred to OT by psychologists and other professional, respectively.

It must be reiterated that adherence to OT seems to be extremely high. Of the children attended in our service, 60.5% continue on treatment, 18.5% were transferred to other services closer to their home and 14% were discharged. Only 7% abandoned their treatment.

Occupational Therapy aims to construct a way to examine, evoke, and reconstruct healthy behaviors and abilities. The care offered to the patient happens in a dynamic process which is built by the relationship between therapist, patient and activity. While executing the therapeutic activities, the patient is encouraged to explore many of his/her motor, sensorial, cognitive and perceptual skills aiming to develop or regain proficiency. The Occupational Therapist works to achieve the functioning independence and autonomy of his/her patients, taking into consideration their needs, wishes, lifestyles, by promoting their capacities to react and adapt to their surroundings. The improvement of occupational performance of the children is promoted through specific approaches and models.

The data presented here suggest that despite the favorable results and adherence to the OT treatment, there is still a great need of its promotion and awareness among psychiatrists. If the treatment of psychiatric disorders ought to be multidisciplinary, particularly with children and adolescents, as stated by the ABP Guidelines, the role of Occupational Therapy cannot and should not be disregarded.

Estefânia Harsányi

Adolescence and Childhood Psychical Center (CePAI),

Belo Horizonte (MG), Brazil

Hospital Foundation of the State of Minas Gerais (FHEMIG),

Belo Horizonte (MG), Brazil

^Disclosures

• ¹
  Associação Brasileira de Psiquiatria, Associação Médica Brasileira, Conselho Federal de Medicina, Federação Nacional dos Médicos. Diretrizes para um modelo de assistência integral em saúde mental no Brasil. Citado 20 Nov 2007. Disponível em: http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_assit_integral_final.pdf

Publication Dates

• Publication in this collection
  25 Sept 2008
• Date of issue
  Sept 2008