2. Socialization- defined in Occupational Therapy
Practice Framework as a skill and an occupation
•Social Interaction skill: is a performance skill observed during a
social exchange. Skills include: approach, eye-contact, regulate,
question, express emotion, disagree, transition, response time, takes turns,
acknowledge, heed, conclude, thank
•Social Participation: “the interweaving of occupations to support
desired engagement in community and family activities as well as those
involving peers and friends.”
3. Health Benefits of Socialization
1. Potentially reduced risk for cardiovascular problems, some
cancers, osteoporosis, and rheumatoid arthritis
2. Potentially reduced risk for Alzheimer’s Disease (AD)
3. Lower blood pressure
4. Reduced risk for mental health issues such as, depression
5. Protection against illness because it boosts the immune system
6. Those who are socially connected live longer
4. Psychosocial Benefits of Socialization
1. Gives sense of purpose and belonging
2. Improves quality of life
3. Strengthens existing relationships
4. Improves role competence
5. Increases self-esteem
6. Contributes to a positive mental outlook
5. Psychosocial Benefits of Socialization
7. Increases self- confidence
8. Enhances occupational performance
9. Increases engagement and participation
10. Maintains cognitive function
11. Promotes well-being
6. Preventing and Assessing Social Isolation
1. Evaluate patients ability to establish and maintain relationships
a. Informal conversation on socialization, relationships, self-
concept.
b. Formal assessment:
i. Independent Living Scales (ILS) – social adjustment
subscale.
ii. Lubben Social Network Scale (LSNS)
7. Goals of Therapeutic Socialization
1. Embed social interaction during activity/treatment to:
a. foster social connection
1. promote and reinforce appropriate social skills
2. decrease possible behavioral issues between peers
b. Identify deficits, teach specific skills and give the client the
opportunity to practice these skills in a supportive
environment.
c. Foster self-awareness during treatment
d. Provide a milieu to reflect on positive past experiences and
build new ones to improve self-esteem.
8. Promoting socialization in your practice
Purposeful socialization between resident and practitioner
1. Get to know the resident by asking a personal questions during each
session. Have purposeful social interaction: meaningful discussion,
shared activity, promote interaction with others, etc. Embed this in
your treatment, so that it becomes natural and expected by the
resident.
2. Foster self-awareness
a. What did you do well?
b. What did you like or didn't’ like?
c. What are your goals for treatment or for next time?
d. Build in an assessment question at the end of each session:
how did the resident feel before and after the session?
3. Encourage social interactions with others
9. Promote socialization in your treatment
Purposeful socialization between resident and practioner
3. Set a psychosocial goal- to promote social skills, self-esteem, self-
awareness, and increase quality of life.
4. Reflect on your own deficits in the area of socialization: How can I do
better in interacting with my resident? What can I do to promote
socialization in my practice?
10. Promoting socialization in your practice
Purposeful socialization among residents
1. Identify deficits: What are the barriers to this person’s social
interaction? What can you do to address that barrier?
2. Promote peer interaction
a. One on one treatment- after session, encourage social
interaction with another resident or promote participation in
a therapeutic group.
b. In a therapeutic group- design groups that promote peer
sharing and interaction.
11. Therapeutic Group socialization
1. Have two residents complete a project together, play a game, or
complete a word search/crossword together.
2. Design groups that promote common interest between veterans
3. Have veterans work in teams to complete a project together
4. Encourage veterans to read questions out loud to the group/teach the
group.
5. Take an extra step to promote interactions on the units
13. Coat of Arms- Purpose of Group
1. Self reflection and awareness- What personality traits doe I have?
Who’s important to me? What am I good at? What do I enjoy?
2. Social interaction skills- taking turns, listening, responding
3. Build self-esteem- feels good to share about yourself
4. Find commonalities between the veterans
5. Foster friendships between veterans
15. Purpose of Group- Spring Art
1. Reminiscence- what does spring remind you of?
2. Social skills- giving a compliment to your peer
3. Self-awareness
4. Build relationships
5. Increase self-esteem
17. Purpose of Group- Travelling
1. Reminiscence- places I have visited, who I was with, what did I
see?
2. Social skills- listening, taking turns, responding to others, eye
contact, acknowledge, conclude
3. Commonalities: “We were born in the same state”
4. Build friendships- learn about each other
19. Purpose of Group- hats worn
1. Reminiscence
2. Social skills- listening, responding, etc.
3. Self-awareness- what am I good at?
4. Build friendships
5. Increase self-esteem-
20. Reflection and Personal Goal
Own self-awareness- How can I do better in interacting
with my resident? What can I do to promote socialization
in my practice?
Share with a peer
21. References
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and
process (3rd ed.). American Journal of Occupational Therapy, 68 (Suppl. 1), S1-S48.
Bermis, E. (2013). The importance of socialization at senior living communities. Aging and Caregiving. Retreived
from: http://www.umh.org/assisted-independent-living-blog/bid/271766/The-Importance-of-Socialization-at-
Senior-Living-Communities.
Diament, M. (2008). Friends make you smart: Boosting social interaction is key to your mental health. AARP
Bulletin, Nov. 21. Retrieved from: http://www.aarp.org/health/brain-health/info-11-2008/friends-are- good- for-
your-brain.html.
Freeborn, Donna. (20160. Older Adults and the importance of social interaction. Health Encyclopedia. University of
Rochester Medical Center. Retrieved from: https://www.urmc. rochester .edu/encyclopedia/ content. Aspx?
ContentTypeID=1&ContentID=4513.
Hermann, H., Saxena, S., Moodie, R. (2005). Promoting mental health: Concepts, emerging evidence, practice,
World Health Organization, A Report of the World Health Organization and Department of Mental Health and
Substance Abuse in Collaboration with the Victorian Health Promotion Foundation and the University of
Melbourne. Retrieved from: http://www.who.int/mental_health/evidence/MH_Promotion_Book.pdf.
22. References
Lubben, J., Blozik, E., Gillmann, G., Iliffe, S., von Renteln Kruse, W., Beck, J.C., Stuck, A.E.(2006). Performance
of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older
adult populations. Gerontologist. Aug, 46(4) 503-13.
Lubben, J., Gironda, M. (2004). Measuring social networks and assessing their benefits. In Social Networks and
Social Exclusion: Sociological and Policy Perspectives. Eds. Phillipson, C., Allan, G., Morgan, D.Ashgate.
Tinglin, C. (2016). Therapeutic socialization offers support. Today’s Geriatric Medicine, 7, 3, 28. Retrieved from:
http://www.todaysgeriatricmedicine.com/archive/052714p28.shtml
Umberson. D, and Montez, J. K. (2010) Social Relationships and Health: A Flashpoint for Health Policy. Journal of
Health and Social Behavior, 51(Suppl): S54–S66. doi: 10.1177/0022146510383501
Editor's Notes
After 4 weeks in building 360, I observed the veterans with psychiatric and dementia conditions and thought that this topic would be interesting to focus on increasing socialization in the OT therapeutic groups and one on one.
Performance skills include: Motor skills, process skills, and social interaction skills
8 Occupations: ADL’s, IADL’s, Rest and Sleep, education, work, play, leisure, social participation. Social Participation: Community- neighborhood, organization, workplace, school, spiritual group. Family- fulfilling family roles; Peer, friend- all different levels of interaction and intimacy
Berkman and Syme (1979) showed that the risk of death among men and women with the fewest social ties was more than twice as high as the risk for adults with the most social ties. Brummett and colleagues (2001) found that, among adults with coronary artery disease, the socially isolated had a risk of subsequent cardiac death 2.4 times greater than their more socially connected peers. compelling evidence linking a low quantity or quality of social ties with a host of conditions, including development and progression of cardiovascular disease, recurrent myocardial infarction, atherosclerosis, autonomic dysregulation, high blood pressure, cancer and delayed cancer recovery, and slower wound healing (Ertel, Glymour, and Berkman 2009; Everson-Rose and Lewis 2005; Robles and Kiecolt-Glaser 2003; Uchino 2006). Social ties can instill a sense of responsibility and concern for others that then lead individuals to engage in behaviors that protect the health of others, as well as their own health. In another study at Rush, researchers followed about 800 people, all about age 80, for four years. The participants had no signs of dementia at the beginning of the study, but some described themselves as lonely and tested positive on a “loneliness scale.” During the study, 76 people developed Alzheimer’s-like dementia. People with the highest scores on the loneliness scale had more than twice the risk of developing dementia as those with more social connections who had scored lower
The World Health Organization identifies mental health as an essential dimension of overall health status (World Health Organization 2007). The World Health Organization (WHO) embraces a definition of health as “physical, mental, and social well-being”.
Role competence- When a person has a mental illness there is a disruption of their roles. They no longer have a job or do the activites that they used to. They no longer married or their family roles have changed dramatically. So, their identity changes greatly especially moving into our CLC. How can we help them continue to build role competence? Focusing on building friendships with their peers and even staff. Help them to focus on role development and competence in other areas. Promoting awareness of who they ar today and what they CAN DO.
Cognition- Whenever we have even the most basic exchange, we have to think about how to respond, and that stimulates the brain. There are people who are outliers, who have two very close relationships and are fine cognitively. But people who have three or more relationships tend to do better.” When the brain is stimulate by social inteaction, then person is more engaged and better able to participate in their occupations.
Promotes well being: I just had played the game “Uno” with one of the residents and he won 3 games. This is a quote, “ I never win anything, that felt good”.
LSNS: Used in many settings (nursing homes), 12 scale measure of person’s social network. Identifies persons at increased risk for social isolation who might benefit from in-depth assessment and targeted interventions. If the assessment indicates that the patient may also be at risk of depression, providers should perform further investigations in this area, employing the Patient Health Questionnaire-9 depression screening tool.
The ILS has a social adjustment piece that we can use to assess resident’s social interactions.
Milieu- reminiscence, positive social interactions, reflection on different activities that resident participated in.
Teach skills- model the skill in your interaction, embed it in your treatment session or therapeutic group.
At end of treatment, connect a resident with another and give a topic of conversation or pull out a deck of cards for them to play.
Converstion starters, bring in leisure activities to spur conversation during treatment (i.e. cards, word search, magazine, etc.)
Social skills could include any of the listed skills from our OTPF. Focus on one and imbed in your treatment.
Reflection builds on your own self-awareness, making you better at your job as an OT.
Barriers: When preparing for the purpose, consider the barriers of each of the veterans.
Provide a list of personality traits (show list to group, samples), so that they will have assistance in thinking of words to add to their coat of arms.
1. Social skills- giving a compliment. Why is it important to give a compliment? Encouraging, builds up your morality, helps you get to know others, show an appreciation. Working on listening, responding appropriately, eye contact, taking turns
2. Self awareness- - “I like getting compliments and giving them” Reflection on how the activity felt.
3. When you are appreciated, you feel good about yourself- builds self –esteem/confidence.
4. Giving compliments can build friendships
Share sample of handout for activity. Each veteran picked a question and read it out loud and we all answered the question.
