RATIONALE
After experiencing an acute psychotic episode, an individual may not be ready to return to school, work, or his/her daily activities right away. RAP provides simple low-stress activities that enhance daily functioning and work towards personal goals. It is a transitional group, monitoring individuals in their early stages of recovery, often providing the link between the inpatient unit and the community.
INTRODUCTION
RAP is a client-centered, activity-based group conducted twice a week in the out-patient setting. The activities are chosen by the group members and are graded to meet their current needs and accomplish the goals of the members at that time. Activities may include, for example, cooking, games, sports, guest speakers or community field trips. The occupational therapist and two case managers facilitate RAP.
GOALS
- To aid in the assessment of daily functioning
- To gain skills essential for role functioning
- To increase structure during the week
- To provide ongoing support and encouragement
- To increase social interaction
- To increase activity tolerance
- To encourage personal responsibility for recovery (attendance in groups and work towards personal goals)
CRITERIA
All individuals in RAP must be members of (admitted to) PEPP, who have experienced a recent psychotic episode with or without hospitalization. Typically, they have an impaired level of functioning secondary to the psychosis. Those who show gross behavioural disturbance or who are actively suicidal or aggressive requiring treatment in a secure room will not be able to participate in the group activities.
GROUP ENTRY
Group entry is facilitated by the occupational therapist and the patient's case manager once the client has been allocated to a case manager for PEPP. Inpatients are encouraged to attend the group prior to discharge and continue to attend as an outpatient.
PARTICIPATION IN THE GROUP
Throughout the duration of the group, attendance and progress of members is recorded on a weekly basis. Progress sheets are kept in the RAP binder, along with occupational therapy initial assessment, until the patient has completed the group.
GROUP EXIT
The member's goals and group discharge plans are re-reviewuated with the case manager on an ongoing basis. Their readiness for exiting the group is discussed and depending on their goals and rate of recovery, alternative means of productivity or community involvement is explored. Optimally, all members exit the group in eight to twelve weeks. However, occasionally circumstances such as lack of response to medication and continued psychotic symptoms may inhibit their ability to move to other interventions at the end of 12 weeks. Clients are encouraged to move on to attendance at the Youth Education and Support group (see section 2).
