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Introduction

Life skills are aptitudes that help people to cope effectively with the demands and challenges of their everyday life (Srikala & Kishore, 2010). Life skills training help individuals to develop the abilities needed to change behaviors and their environments in order to have a healthy life (Unicef for every children, 2003). It has proven to be effective for individuals with a variety of chronic mental illnesses (Tungpunkom, Maayan, & Soares-Weiser, 2012).

Theory

Social learning theory is based on the idea that individuals learn from one another through observation, imitation, and modeling (Albert bandura’s social learning theory, 2008). Occupational therapists are skillfully trained in incorporating this theory into a life skills training for patients with eating disorders.

Evidence

Life Skills Training programs have been found to be a positive and effective program for populations such as adolescents facing substance abuse. These programs help teach such skills that are intended to enhance both personal and social competence. An article published by Botvin and Griffin (2004) states how several studies, large and small, have been shown to demonstrate positive effects on behaviors and in addition, prevention of relapse that extended to the end of their high school years (Botvin & Griffin, 2004). Anorexia, just like substance abuse, is life threatening and requires a great deal of care. Not only do individuals with eating disorders require acute or long term care, they also require preventative and life skills training to protect their future wellness across the continuum of care.

Case Study

Helen is 18 years old and was diagnosed with anorexia nervosa. She lives with a roommate and feels she is a burden to her. Helen has fainted a couple of times in the last two months because of malnutrition/ dehydration. Her roommate has had to come home from work to take care of her. Helen feels she is overweight, however she has a BMI of 15. She lacks cooking skills and her only source of nutrition is frozen foods, in which she approximately intakes about 25%. Helen has a few friends whom she feels she is inferior to because all of her friends have started college and she has not been able to get her G.E.D. In addition, Helen has not been able to attain a driver’s license because she doesn’t think she is smart enough to do so. Helen’s eating disorder perpetuates when she feels her life is out of control. Helen is ready to make a change in her eating habits.

Intervention Plan

Problem Statement

Due to lack of knowledge on healthy eating habits, client is unable to prepare healthy meals.

Long Term Goals:

1. Helen will demonstrate 3 healthy eating habits to improve health management skills by discharge.
2. Helen will prepare a meal that includes 1 portion of protein, 1 portion of vegetables and 1 portion of carbohydrates to demonstrate meal prep skills by discharge.

Short Term Goals:

1. Helen will follow 2 healthy recipes to improve her health management by 2 weeks.
2. Helen will list 10 healthy food options to improve health management skills by 2 weeks.

Intervention Format

Individual

Setting

Helen will meet with the occupational therapist individually in the home setting for 60 minutes 2x a week.

Supplies

None

Agenda

• Discuss previous session and assigned homework (5 mins)

• Didactic nutrition training including nutrition facts and meal proportions (12 mins)

• Create a list of healthy food options with appropriate portions (8 mins)

• Prepare a practice meal following a simple macaroni and cheese recipe (15 mins)

• Final demonstration of a more complex meal prep (20 mins)

Documentation

S: “I feel ready to put together a meal. I feel confident that I am able to handle the stressors in which preparing a meal can bring upon.”

O: Client selected a meal she wanted to prepare given 3 choices. Client was able to collect food materials from the kitchen environment. Client chose 4 oz. of chicken, 1 cup of mixed vegetables, and ½ a cup of rice. Client was able to safely work appliances and cook food items so that they may be safely consumed. Client demonstrates comfortable behavior while working with food. Client consumed all the food she cooked and expressed being satisfied with the amount of food consumed.

A:  By including protein, vegetables and whole grains, the client demonstrated awareness of various healthy food options. Client has demonstrated an increase in self-efficacy as evidenced by preparing an entire meal individually with appropriate portions. Client is demonstrating an improvement in coping skills as evidenced by a development of a positive relationship with food prepared by her.

P: Client will continue therapy 2x a week for 60 minutes. Next session, will consists of preparing a meal for herself and her roomate.

References

Albert bandura’s social learning theory. (2008). Retrieved from

https://search-proquest-com.ezproxy.fiu.edu/docview/1943819380

Botvin, G.J. & Griffin, K.W. The Journal of Primary Prevention (2004) 25: 211.

https://doi.org/10.1023/B:JOPP.0000042391.58573.5b

Definition of Terms. (2003, June 13). Retrieved January 29, 2018, from

https://www.unicef.org/lifeskills/index_7308.html

Srikala, B., & Kishore, K. K. (2010). Empowering adolescents with life skills education in

schools–School mental health program: Does it work?. Indian Journal of Psychiatry, 52(4), 344.

Tungpunkom, P., Maayan, N., & Soares-Weiser, K. (2012). Life skills programmes for

chronic mental illnesses. The Cochrane Database of Systematic Reviews, 1,

CD000381. Retrieved from http://www-ncbi-nlm-nih-gov.ezproxy.fiu.edu/pubmed/22258941