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COMIC 1
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  • Liz
  • Awesome warm up everyone!  On to our main activity for our hygiene group, something familiar we take part in everyday.  I want everyone to think about one area of self care or hygiene that you would like to improve- one area that you might need some help in.  This can be with any area we mentioned in our warm up.  We will then work on how we might be able to modify these behaviors.
  • Tim
  • Ari
  • Ritchie
  • Well you are an OT right because I have a lot of areas I want help in because my sister says I don't shower enough and I live with her and she says that she smells me and I know I need some help with cleaning myself and making sure I do it everyday because I don't want my sister to be upset with me
  • Tim
  • Liz
  • Thank you so much for sharing, Tim.  It sounds like you are aware that there is an issue and are ready to work to become healthier!  We can talk about some suggestions to help you establish a schedule so that showering can become a part of your everyday routine, and the results you can achieve from those changes in behavior. Does anyone have any suggestions? 
  • Tim
  • Ari
  • Ritchie
  • The group is now ready to start the main activity of their group, facilitated by occupational therapy student Liz.  The goal is to utilize the Transtheoretical Model (TTM) which looks at stages of change to modify and manage behaviors through a self management lens.  Today the group is discussing hygiene awareness and needs, and areas the clients feel they need assistance in, how to promote change in these areas, and what other areas of life these changes can have affect in. 
  • Well, when I first got my job I was homeless and didn't have any money for deodorant- or a place to shower.  And it wasn't unless someone I trusted let me know that I smelled a little funky that I began to change my habits.  You're already aware of it!  So, I saved some money for deodorant, and now it's a been a part of my routine for almost a year. 
  • Ari
  • Tim has diagnosed ADHD and generalized anxiety disorder.  He self discloses that he has trouble with showering and sticking to a hygiene schedule, and this is effecting his relationship with his sister.  Tim recognizes an issue, and appears to be in the preparation stage of TTM, determined to make a change. 
  • Liz
  • Thank you for sharing, Ari.  It sounds like you were able to self manage that situation with the help of your friend, and I am happy you are sticking with it!  Sometimes coming up with an area of need is the hardest part.  Tim, you already know which behaviors need to be modified.  The next step is finding how to best do this.  Can you take me through how you take a shower, if you are comfortable? 
  • Liz thanks Tim for sharing and reaffirms that his choice to change his hygiene habits is one that will be beneficial to leading a healthy lifestyle, characteristic of this stage of TTM.  Together, they will build on these skills and maintain them to work towards self management. The rest of the group is asked to build on this statement however they may be able to. 
  • Well I shower probably twice a week since I am so tired after playing video games that I don't want to shower and I get in and then I use a bar of soap and rub it in my hands and then rub my hands over my body to clean it and rub my hair under the water to rinse it and ummm then I dry off and put on a clothes
  • Tim
  • Ari has a mild intellectual disability and social anxiety.  Holding this change for over six months and not having intention on going back indicates that Ari is in the maintenance stage of TTM.  He relates to Tim's situation by sharing an example of how he self managed his hygiene.  Further, he was able to identify behaviors to change, has maintained this change, and recognizes how this affects other areas- all aspects of self management.      
  • Liz thanks Ari for sharing, and praises him for his progress in this area thus far.  She also  offers some insight into identification of an issue as a difficult part of TTM.  To best suit Tim's needs, Liz asks him to take her through a shower so that a task analysis may be performed.  In this way, key points can be managed and modified to better Tim's hygiene, and further his success in self-managing his hygiene care. 
  • Tim
  • Ari
  • Ritchie
  • Tim is noticeably anxious during his description, but is candid and honest with this schedule.  By breaking down each component of the shower, he may be able to recognize where he can fit in different skills.  An important step in self management is being able to recognize an issue on your own, as well as areas of needed change.  And so, Liz facilitates this process. 
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