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Quality Assurance in Psychiatric Occupational Therapy by Treatment Manuals: Patients’ Perceptions of Resistance- and Regeneration-specific Occupational Therapy


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Figure 1

Sum scores of the BTCC subscales for regeneration and resistance-oriented ratings in the TAU, RG and RS groups, indicating the amount of respective interventions per treatment group.
Sum scores of the BTCC subscales for regeneration and resistance-oriented ratings in the TAU, RG and RS groups, indicating the amount of respective interventions per treatment group.

Patient ratings on the therapy competency checklist (TAU: routine occupational therapy only, RG: regeneration group, RS: resistance group, scale:1 = not, 7 = completely)

All(N = 259)TAU(N = 119)RG(N = 67)RS(N = 73)ANOVA TAU vs. RG vs. RST-Test TAU vs. RG & RSRG vs. RS
mean (SD)mean (SD)mean (SD)mean (SD)
Regeneration
1 We talked about pleasant and compensatory activities5.05(1.50)4.99(1.42)5.73(1.04)4.51(1.75)F(2,256) = 12.85, p < 0.001TAU vs. RG (p = 0.003), TAU vs. RS (p = 0.07)RG vs. RS (p <0.001)
2 We looked at the difference between former and current pleasant activities3.74(1.74)3.74(1.73)4.10(1.65)3.41(1.79)F(2,255) = 2.82 p = 0.06TAU vs. RG (p = 0.50), TAU vs. RS (p = 0.62)RG vs. RS (p <0.001)
3 We planned pleasant activities for the time after discharge from the hospital3.61(1.93)3.68(1.95)4.13(1.80)3.04(1.88)F(2,254) = 6.03, p = 0.003TAU vs. RG (p = 0.36), TAU vs. RS (p = 0.07)RG vs. RS (p = 0.002)
4 I was able to experience moments of indulgence4.56(1.85)4.33(1.83)5.40(1.46)4.16(1.97)F(2,259) = 10.31, p < 0.001TAU vs. RG (p < 0.001), TAU vs. RS (p = 1.00)RG vs. RS (p <0.001)
5 We focussed on eating as a part of pleasure3.59(2.20)3.59(1.94)5.16(1.44)2.18(1.82)F(2,259) = 49.06, p < 0.001TAU vs. RG (p < 0.001), TAU vs. RS (p < 0.001)RG vs. RS (p <0.001)
6 I had nice and relaxing conversations with the other patients5.57(1.45)5.47(1.48)6.01(1.20)5.32(1.54)F(2,257) = 4.63, p = 0.01TAU vs. RG (p = 0.04), TAU vs. RS (p = 1.00)RG vs. RS (p = 0.01)
7 I was able to test creative techniques in relation to my personal well-being5.25(4.13)4.72(1.77)5.24(1.39)5.30(1.60)F(2,256) = 0.01, p = 0.99TAU vs. RG (p = 1.00), TAU vs. RS (p = 1.00)RG vs. RS (p = 1.00)
8 We spoke about my first impression in social situations3.13(2.19)2.83(2.07)4.81(1.92)2.05(1.66)F(2,253) = 38.32, p < 0.001TAU vs. RG (p < 0.001), TAU vs. RS (p = 0.02)RG vs. RS (p <0.001)
9 I got tips on how to improve my first impression2.93(2.06)2.86(2.05)4.34(1.89)1.78(1.36)F(2,253) = 33.57, p < 0.001TAU vs. RG (p < 0.001), TAU vs. RS (p < 0.001)RG vs. RS (p <0.001)
10 I was animated to talk to others5.02(1.74)4.68(1.79)5.75(1.21)4.87(1.90)F(2,208) = 7.34, p = 0.001TAU vs. RG (p = 0.001), TAU vs. RS (p = 1.00)RG vs. RS (p = 0.02)
RG scale (sum score)4.21(1.24)4.09(1.20)5.05(1.00)3.63(1.09)F(2,259) = 25.17, p < 0.001TAU vs. RG (p < 0.001), TAU vs. RS (p = 0.01)RG vs. RS (p <0.001)
Resistance
1 I learned to improve my frustration tolerance3.81(1.75)3.52(1.77)3.92(1.55)4.19(1.82)F(2,256) = 3.58, p = 0.03TAU vs. RG (p = 0.39), TAU vs. RS (p = 0.03)RG vs. RS (p = 1.00)
2 I learned to improve my level of detachment when I get frustrated4.10(1.74)3.95(1.72)4.03(1.69)4.41(1.79)F(2,255) = 1.68, p = 0.19TAU vs. RG (p = 1.00), TAU vs. RS (p = 0.23)RG vs. RS (p = 0.58)
3 I was trained to enhance my level of stamina in dealing with tasks4.01(1.77)3.87(1.82)3.81(1.64)4.42(1.77)F(2,256) = 2.82, p = 0.06TAU vs. RG (p = 1.00), TAU vs. RS (p = 0.11)RG vs. RS (p = 1.00)
4 I learned that preservation is important while dealing with strains4.58(1.80)4.37(1.91)4.50(1.58)4.97(1.78)F(2,252) = 2.61, p = 0.08TAU vs. RG (p = 1.00), TAU vs. RS (p = 0.08)RG vs. RS (p = 0.37)
5 I trained my adherence to instructions4.07(1.90)3.70(1.92)3.89(1.70)4.81(1.88)F(2,251) = 8.46, p < 0.001TAU vs. RG (p = 1.00), TAU vs. RS (p < 0.001)RG vs. RS (p = 0.01)
6 I trained my accuracy in task processing3.75(1.95)3.50(1.94)3.41(1.82)4.43(1.94)F(2,252) = 6.73, p = 0.001TAU vs. RG (p = 1.00), TAU vs. RS (p < 0.001)RG vs. RS (p = 0.01)
7 I trained my discomfort tolerance3.38(1.94)3.03(1.94)3.24(1.79)4.10(1.91)F(2,255) = 7.46. p=0.001TAU vs. SP (p = 1.00), TAU vs. RS (p = 0.02)RG vs. RS (p = 0.02)
8 I have increased my readiness to overcome personal deficits3.52(1.81)3.13(1.68)3.55(1.85)4.12(1.82)F(2,251) = 7.06, p = 0.001TAU vs. RG (p = 0.39), TAU vs. RS (p < 0.001)RG vs. RS (p = 0.17)
9 I learned to endure unpleasant tasks3.85(1.92)3.17(1.82)3.70(1.79)5.04(1.63)F(2,254) = 25.74, p <0.001TAU vs. RG (p = 0.15), TAU vs. RS (p < 0.001)RG vs. RS (p <0.001)
10 I was able to improve my flexibility4.33(1.79)3.89(1.78)4.30(1.64)5.05(1.71)F(2,255) = 10.37, p <0.001TAU vs. RG (p = 0.37), TAU vs. RS (p < 0.001)RG vs. RS (p = 0.03)
RS scale (sum score)3.93(1.36)3.60(1.26)3.82(1.29)4.55(1.40)F(2,257) = 12.26, p < 0.001TAU vs. RG (p = 0.82), TAU vs. RS (p < 0.001)RG vs. RS (p = 0.003)
I was asked in all sessions to refer to the topic of the day4.23(2.17)-4.28(2.17)4.20(2.25)F(2,253) = 0.01, p = 0.99-RG vs. RS (p=0.99)

j.gp-2018-0010.tab.037.w2aab3b7c10b1b6b1ab2b3ad109Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck the list of participants, welcome new participants
5’-15’Presentation of the motto of today “goal orientation and acceptance of undesired tasks“Personal motto on „ “goal orientation and acceptance of undesired tasks”support find their participants own motto to on acceptance of undesired tasks
15-30’Introduction to wood carvingIllustrative materialExplain how wood to work with
30’-70’Work on wood with sandpaperWooden blocks, sandpaper for each participantencourage Pay attention participants to time, to go on
70’-80Presentation of results in the group by each participant, what were the difficulties, feedback on performance, suggestions for improvementMCD sheetAsk participants specifically about compensatory strategies, reinforce effort independent of result
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn step by step to improve your coping skills with stress” Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.038.w2aab3b7c10b1b6b1ab2b3ad112Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-15’Presentation of the motto of the day: “goal orientation and acceptance of undesired tasks”, repetition of earlier experiencesIndividual motto of the day regarding “goal orientation and acceptance of undesired tasks “Reiterate the results from past session
15’-25‘Work on Rubick cube and brain teaserRubick cube for each participantExplain the Rubick cube task, motivate to go on at the beginning and then step back
25’-30’Discussion limits? on Collection current of task, ideas Where on solutions are my ownMCD sheetSpecify compensation strategies
30’-80’Continue work on complex wood structures with sandpaperWooden blocks. Sandpaper for each participantPay attention to time, encourage participants to go on
80’ – 90’Summary of session and explanation of step treatment to improve topic: your „Here coping you can skills learn with step stress” by Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.010.w2aab3b7c10b1b6b1ab2b3ac25Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 15’Repeat hedonic ruleworksheet with hedonic rulesEncourage repetition
15’ - 65’Set up small groups, preparation of different spreadsworksheet with recipes, ingredients for spreadsEncourage patients to communicate and have small talk, appreciate small progresses
65’ - 85’Jointly eating of prepared foods, eat slowly, concentrate on taste and concomitant emotionsCutlery and plates, nice background musicJoin the conversation of participants, discriminate differences in tastes, focus on pleasant experiences
85’ – 90’Summary of session and explanation of treatment take care topic: of yourself „Here when you can stressed”. learn to Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.018.w2aab3b7c10b1b6b1ab2b3ac49Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 20’Information about importance of body care and hairstyle, refer to prominent personsPictures of prominent persons, ideally with different hair stylesGive information about first impression
20’ - 80’All participants should get individual feedback on their hairstyle and suggestions for improvement, everybody should try something new (hairstyle, cosmetics)MED rating, cosmetic preparations for hair and body, digital cameraencourage change and experiments with hair and cosmetics
80’ – 90’Summary of session and explanation of care treatment of yourself topic: when „Here stressed”. you can learn Termination to take of sessionList of participantsGive a summary

j.gp-2018-0010.tab.034.w2aab3b7c10b1b6b1ab2b3ad100Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-15’Repetition of past learned lessons, what has beenMCD sheetCollect group responses
15’-25‘Instruction to weaving of a wicket basketMaterials for each basket patient weaving forPay attention participants to time, to go encourage on
25’-80’Basket problems weaving in reference and focusing to MCD on personal sheetMCD sheetSpecify compensatory strategies
80’ – 90’Summary of session and explanation of step treatment to improve topic: your „Here coping you can skills learn with step stress” by Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.027.w2aab3b7c10b1b6b1ab2b3ac78Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-15’Presentation of the task („today we are going to fold a real difficult figure “)Written instruction, Origami paper for each participant, individual motto on the topic of „frustration tolerance“Explain the exercise
15’-80‘Give a demanding time frameMCD-sheet to remind the patient of stress coping skills to be learned; Origami materialsMake patients fold origamis, Support the patient to go on; discuss the topic in reference to different areas in life
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn step by step to improve your coping skills with stress” Termination of sessionList of participantsGive a summary

Therapeutic interventions in the regeneration and the resistance group

Resistance groupRegeneration group
Frustration training (origami)Recreational activities (collection and planning of hobbies and activities)
Endurance training (soap stone)Ability to relish and hedonic rules (eating, tea ceremony, mindfulness cooking)
Accuracy training (silhouette cuttings, basketry)Self-care and relaxation (wax bath, relaxation and imagination exercises, mindfulness walks)
Goal orientation and acceptance of undesired tasks (working with hard wood)First impression formation (clothing, hairstyle, situational adjustment)
Acceptance of stress and criticism (enkaustik, aquarelle painting, soap stone with swapping with the neighbour during working on the task)Interaction and small talk (parlour games, small talk)

j.gp-2018-0010.tab.024.w2aab3b7c10b1b6b1ab2b3ac70Aa

When it matters, I do not let myself be impressed by adverse conditions
The ascent is especially worth it, if it takes a rocky way
Life ´s not a bowl of cherries
One has to accept the reality: eaten bread is soon forgotten
_________________________________________________

j.gp-2018-0010.tab.036.w2aab3b7c10b1b6b1ab2b3ad107Aa

If you want success, go on even if you feel bad
Do not allow distress to distract you from your responsibilities
What must be done has to be done
If you can not change it, accept it
There is no choice, then make the best out of it
Business over pleasure
_________________________________________________________

j.gp-2018-0010.tab.031.w2aab3b7c10b1b6b1ab2b3ac90Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-15’Repetition of the experiences of the last session, link to general framework of session (topic:„endurance “), remind of individual mottosIndividual materials on the topic of „endurance“Prepare transfer into real life
15’-80‘Set time frame to work on a severe soap stone figure, give on written instructions (building on past experiences)Template with pictures, soap stone, MCD work sheetSupport the patient to go on; discuss the topic in reference to different areas in life
80’ – 90’Summary of session and explanation of step treatment to improve topic: your „Here coping you can skills learn with step stress” byList of participantsGive a summary

j.gp-2018-0010.tab.015.w2aab3b7c10b1b6b1ab2b3ac40Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 15’Introduce manual activities as method of relaxation. Refer to session 4Discuss with patient their prior experiences
15‘ – 65‘Stimulate work on creative activities, painting, nitting, handycraft, etcMaterials for craft activitiy, RADL list of participantEncourage patients to engage in an interesting activity, give help if needed, encourage interaction between patients
65‘ – 80‘Exchange about relaxation by activityFree discussion, aspects focus on positive
80’–90’Summary of session and explanation of treatment take care topic: of yourself „Here when you can stressed”. learn to Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.012.w2aab3b7c10b1b6b1ab2b3ac32Aa

Recover energy by pampering yourself
To avoid decay means to maintain
I spoil myself, because I am worth it
Before you can help others, you must help yours
feel the power you gain from calmness
________________________________________________

j.gp-2018-0010.tab.041.w2aab3b7c10b1b6b1ab2b3ad121Aa

Time (Min)ContentMaterialTasks of Therapist
0–5’Welcoming of participantsList of participantsCheck the list of participants, welcome new participants
5’-15’Repetition of the mottos on the topic of „Acceptance of stress and criticism “, preparation of transfer ⌷ Where could I use it?individual mottos for each participantCompile the results, motivate participants, refer to individual mottos
15’-35‘Block of tasks I: Solving of simple brain teasers under time pressure and competitive pressurepackage with brain teaser for each participantPay attention to time regulation
35’-45’Evaluation of the first block of tasks, „What was easy?“, „What was difficult?“, „What was stressful?“, „Does the stress remind me of other situations?“MCD work sheetSpecify compensatory strategies, focus on transfer perspective
45’-65’Block of tasks II: Solving of difficult brain teasers under time pressure and competitve pressure, evaluation of results in the grouppackage with brain teaser for each participantCompile the results, motivate participants, refer to individual mottos
65’-80’Evaluation of the second block of tasks, „What was easy?“, „What was difficult?“, „What was stressful?“, „Does the stress remind me of other situations?“, comparison with first taskMCD work sheetSpecify compensatory strategies, apply topic across different areas in life
80’–90’Summary of session and explanation of step treatment to improve topic: your „Here coping you can skills learn with step stress” by Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.040.w2aab3b7c10b1b6b1ab2b3ad119Aa

Do not allow everything to touch you
If I am mad on me, it is myself who is mad on me
This is life: sometimes you win, sometimes you loose
Take it as it is
Be happy don’t worry
___________________________________________

j.gp-2018-0010.tab.008.w2aab3b7c10b1b6b1ab2b3ac20Aa

Meals are a wonderful opportunity to make me happy
Eating is more than just taking in food
If you feel bad, spoil yourself
Feeling, tasting and smelling can all cheer you up
______________________________________________

j.gp-2018-0010.tab.003.w2aab3b7c10b1b6b1ab2b3ab4Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck the list of participants, welcome new participants
5’-30’Presentation of the RADL list (Recreational Activities of Daily Living), What is it about? Explanation of the general framework (activities despite impairment, What comes to my mind when filling in the list?completion of RADL list by each participantCollect ideas by of participants, support the exchange of personal experiences
30’-40’Focus of collection on recreational activities in the past (each participant writes down at least 3 activities)Pencil and paper for each participantSupport the exchange of experiences and give examples
40’ – 85’Specify individual goals („Which pleasant things do I want to do again?“)Pencil and paper for each participantMake sure that discussion is focused on exchange, without evaluation, reinforce small progresses and ideas
85’ – 90’Summary of session and explanation of treatment topic: „Here you can learn to take care of yourself when stressed”. Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.005.w2aab3b7c10b1b6b1ab2b3ac10Aa

Time(Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 30’Refer to RADL list, now we do the transfer into real life Presentation of the weekly activity schedule, Every participant fills in a plan for the next week. Quantity is less important than performanceFor each patient a template of a weekly activity schedule, pencilsCollect ideas by interviewing the participants, support exchange of ideas
30’ - 50’fill in the activity scheduleHelp participants to fill in the schedule, reinforce creativity and little progresses
50’ – 65’Evaluation of weekly schedule for each category of the RADLSummarize main categories, reinforce own ideas and progress
65’ - 80’Set up groups participants according to favorite activities (Are there persons, who do things together? (go to cinema, go out for a mea). Arrangement of appointmentsWrite appointments on flipchartStimulate openness, record appointments, praise ideas and progresses
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn to take care of yourself when stressed”. Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.021.w2aab3b7c10b1b6b1ab2b3ac58Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 20’Introduction of the topic social interaction as method to reduce stressGive information and encourage discussion
20‘ – 80‘Play parlour games and encourage small talkDifferent parlour gamesEncourage ion participants small talk to engage
80’ – 90’Summary of session and explanation of treatment care of yourself topic: when „Here stressed”. you can learn Termination to take of sessionList of participantsGive a summary

j.gp-2018-0010.tab.025.w2aab3b7c10b1b6b1ab2b3ac72Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-10’Introduction in the topic „frustration tolerance“, ask for individual mottosWorksheet for each participant, pencilsProvide assistance if participants do not understand the task, discuss the topic in reference to different areas in life
10’- 15‘Introduction of „Origami“, „What does frustration tolerance have to do with it?“Origami + templateClarify transfer to life burdens
15’ – 70’Explanation and implementation of technique by therapists, Tutorial to fold a figure/templateTemplate for each patient, Origami-PaperExplain the, motivate the patient to go on
70’ - 80’Feedback: „What have I learned or practiced regarding my frustration tolerance” or stress coping skills?Worksheet for personal selection-optimization- compensation (SOC) strategiesEach participant should have the opportunity to participate in the discussion
80’ – 90’Summary of session and explanation of treatment by step to topic: improve „Here your you coping can learn skills step with stress” Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.030.w2aab3b7c10b1b6b1ab2b3ac87Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck the list new of participants, participants welcome
5’-15’Repetition of the experiences of the last session, link to general framework of session (topic:„endurance “) and repetition of individual mottosIndividual materials on the topic of „endurance“Prepare transfer into real life
15’-80‘Set a time frame for making a moderately severe soap stone figureTemplate with pictures, soap stone, MCD work sheetSupport the patient to go on; discuss the topic in reference to different areas in life
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn step by step to improve your coping skills with stress” Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.032.w2aab3b7c10b1b6b1ab2b3ac94Aa

If you do the work properly from the beginning, you save time
Doing something correctly is better than doing it sloppy
Sloppiness is not a virtue
_________________________________________________________
_________________________________________________________

j.gp-2018-0010.tab.007.w2aab3b7c10b1b6b1ab2b3ac16Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 70’Present creative activities, painting, nitting, handycraft, etc., refer to RADL list, what have I done in former times ? Motivate patients to try out new techniquesMaterials for craft activity, RADL list of participantEncourage patient to freely try out, give instructions if needed, also encourage to interact
70‘ – 80‘Presentation of results, exchange in the groupGuide open also discussion, minor details appreciate
80’ – 90’Summary of session and explanation of treatment care of yourself topic: when „Here stressed”. you can learn Termination to take of sessionList of participantsGive a summary

j.gp-2018-0010.tab.014.w2aab3b7c10b1b6b1ab2b3ac37Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 45’Introduction music in the to background, tea ceremony, different calm and kinds relaxing of teaTea kettle, cups, supplies music (candy, player, honey), lemon cutlery, juice, evaporated milklet the group have a chat
45’ - 60’Debriefing of tea ceremony, what was pleasant? Reference to hedonic rulesIndividual materials on hedonic rulesFocus on pleasant experiences
60’-80’General information about tea, cultural characteristics (far eastern countries), exchange of experiences/knowledge in patient group, on the basis of journeys, readingGive information about tea and simultaneously include ideas of the patients
80’–90’Summary of session and explanation of treatment topic: „Here you can learn to take care of yourself when stressed”. Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.004.w2aab3b7c10b1b6b1ab2b3ab8Aa

Under stress you need recreation
Always keep a balance between work and leisure
There is a time for everything, work and relaxation
Creativity is pleasure, which pretends to be work
________________________________________________

j.gp-2018-0010.tab.016.w2aab3b7c10b1b6b1ab2b3ac44Aa

Your outer appearances decides about how others see you
Look the way you want to be seen
If one feels bad, one should at least not look bad
If the world is grey, put glitter on it
_____________________________________________________

j.gp-2018-0010.tab.028.w2aab3b7c10b1b6b1ab2b3ac82Aa

Never throw in the towel too early
Only those who keep a stiff upper lip will succeed
Giving in is not an option
If something is difficult, just try harder
If you want to play the piano, you have to practice
Rome was not build in a day
__________________________________________

j.gp-2018-0010.tab.006.w2aab3b7c10b1b6b1ab2b3ac13Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 20’Summary of current state of knowledge. Why are pleasant activities important? What did I already learn?Individual materials on the topic of „spontaneous and recreational activities“Collect ideas by interviewing the participants, support the exchange of ideas
20’ - 40’Work on an individual weekly schedule for the time after treatment, completion of RADL, How to put the ideas in practiceEmpty weekly schedule. RADL list for the time after the end of therapy, pencilsHelp participants if needed, reinforce creativity and small progresses
40’ – 50’Presentation of the concept of a „hedonistic niche“. How could a respective room look like?Pictures of different rooms from furniture cataloguesGuide open discussion, appreciate also minor details (e.g. flowers, candles etc.)
50’ - 85’How can I establish a hedonistic niche in my room? Set up small groups of patients to discuss solutionsWorksheets for documentation of events and own ideasSpecify solutions, reinforce even small steps, focus only on positive aspects
80’ – 90’Summary of session and explanation of treatment care of yourself topic: when „Here stressed”. you can learn Termination to take of sessionList of participantsGive a summary

j.gp-2018-0010.tab.022.w2aab3b7c10b1b6b1ab2b3ac61Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 20’Repeat experience of last session, What is difficult, what easy in regard to small talk
20‘ – 60‘Play parlour games and encourage mutual supportive communicationDifferent parlour gamesEncourage participants to encourage, console and support each other, especially when somebody is loosing or making mistakes
60‘ – 80‘Feedback on experience with communicationEncourage discussion, focus on positive aspects
80’–90’Summary of session and explanation of treatment take care topic: of yourself „Here when you can stressed”. learn to Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.009.w2aab3b7c10b1b6b1ab2b3ac22Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 25’Eating as What a source does of eating well-being, mean? clarify the difference to nutrition counsellingGuide a brainstorming of patients, reinforce good ideas
20’ - 25’Set up small groups of patients. What does eating mean for me? Discuss regional differences, exchange of information on special meals and methods of preparation, personal rituals: Which meal is the most important for me?Map of the country/world, indicate the origin of participants, worksheet to collect individual eating ritualsReinforce interest in unknown meals
35’ - 45’What was special Evaluation in each of group group? work What was new, what did I learn?Summarize results, create a calm and relaxing atmosphere
45’ - 80’Exercise with scents, refer to hedonic rules, what was pleasant and why?„sample of aromas“, worksheet with hedonic rulesFocus on pleasant experiences, transfer into real life, what does this smell remind me of?
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn to take care of yourself when stressed”. Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.035.w2aab3b7c10b1b6b1ab2b3ad103Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-15’Repetition of what has been learnedMCD worksheetSummarize results
15’-80’Continuation of basket weaving, focus on difficulties and compensatory strategiesMaterials for basket weaving for each patientSpecify compensatory strategies, support transfer into real life
80’ – 90’Summary of session and explanation of step treatment to improve topic: your „Here coping you can skills learn with step stress” by Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.039.w2aab3b7c10b1b6b1ab2b3ad115Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck the list of participants, welcome new participants
5’-15’Presentation of today´s contents: Presentation of the motto of the day “goal orientation and acceptance of undesired tasks“Personal motto on “goal orientation and acceptance of undesired tasks“support participants to find their own motto
10’-30‘Moderately severe brain teaserPackage of brain teasers for each participantencourage Pay attention participants to time, to gon on
30’-40’Discussion of task, Where are my own limits?Motto on flexibilitySpecify compensatory strategies
50’-80’Work on wood with sandpaperWooden blocks, sandpaper for each participantencourage Pay attention participants to time, to go on
70’-80Presentation of results in the group by each participant, what were the difficulties, feedback on performance, suggestions for improvementMCD sheetAsk participants specifically about compensatory strategies, reinforce effort independent of result
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn step by step to improve your coping skills with stress” Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.013.w2aab3b7c10b1b6b1ab2b3ac34Aa

Time (MinContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 20’Presentation of hedonic rules, exchange of own ideasIndividual materials on the topic of: „ability to relish“Give information on hedonic rules
20’ - 25’Presentation of paraffin bath and focus on practicing an hedonic rulePencil for patients to tick off one hedonic ruleonly one aspect should be practised
25’ - 70’Paraffin bath with pleasant and relaxing musicParaffin disinfectant bath, glovesHelp participants to paraffin, concentrate create on results a calm and of relaxing atmosphere
70’ - 80’Which hedonic rule do I want to practice this week? (transfer in real life)A pencil and small index cards for every patient to write down the hedonic rule he wants to practice
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn to take care of yourself when stressed”. Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.042.w2aab3b7c10b1b6b1ab2b3ad124Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-15’Discussion of the topic „Acceptance of stress and criticism“Personal motto on acceptance of stress and criticismSupport participants to find their own specific motto of the day
15’-25‘Explain „Tangram“, hand out materials, give an easy task, set out time frameTangram-packages for each participantPay attention to time, encourage participants to go on
25’-35’Second Tangram task, moderately severe taskTangram-participant packages for eachencourage Pay attention participants to time, to go on
35’-45’Summary: What was the task, what were the difficulties, how did you manage to go on?MCD work sheetSummarize and transfer ideas of participants to real life
45’-65’difficult Tanagram taskTanagram-packages for each participantPay attention to time, encourage participants to go on
65’-80Summary: What was the task, what were the difficulties, how did you manage problems?MCD work sheetSummarize and transfer ideas of participants to real life
80’ – 90’Summary of session and explanation of step treatment to improve topic: your „Here coping you can skills learn with step stress” by Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.019.w2aab3b7c10b1b6b1ab2b3ac52Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 20’Information about importance of first impression formation in different situations, („How do I have to look, if..“, „Shall I go to a first date like this“?)Fill-in MED questionnaire, in regard to prominent personsEncourage discussion of participants
20’ - 80’Individual transfer: what are important situations in my life?, When and where should I change my attire and outlook? Set up small groups to give feedback per personFocus on goals in different situations; what do I want to achieve
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn to take care of yourself when stressed”. Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.033.w2aab3b7c10b1b6b1ab2b3ac97Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-15’Introduction into the topic accuracy, presentation of silhouette cutting, exchange of experiences of patients, link to general framework of sessionSheet for individual motto on the topic of „accuracy“, pencilsExplain the exercise and prepare the transfer into real life
15’-30‘Set a time frame for making a first silhouette, Explain the need of concentration and accuracyExamples, scissors, paperSupport the patient to go on; discuss the topic in reference to different areas in life
30 – 40Summary, what was easy, what diffficultGet response from patients
40 – 75Make another silhouettePaper, scissors, templateSupport the patient to go on; discuss the topic in reference to different areas in life
75 – 80Presentatin of results in the groupaccuracy, Focus on irrespective strategies to of reach results
80’ – 90’Summary of session and explanation of step treatment to improve topic: your „Here coping you can skills learn with step stress” by Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.017.w2aab3b7c10b1b6b1ab2b3ac46Aa

Time (Min)ContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 20’Introduction to the concept of first impression formation, give example of prominent personsMED (minimal emotional dysfunction) rating formGive information about first impression
20‘ – 40‘MED rating (minimal and observer emotional rating, dysfunction) comparison self of both ratings, focus on clothingMED rating form, pencilBe careful and helpful, point to positive aspects of positive and negative ratings
40’ - 80’Set up small groups, participants should provide and receive individual feedback, suggestions for improvementMED rating form, digital cameraPoint to aspects which can be improved, specify what can be changed
80’ – 90’Summary of session and explanation of treatment take care topic: of yourself „Here when you can stressed”. learn to Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.020.w2aab3b7c10b1b6b1ab2b3ac56Aa

Two heads know more than one
If you start a long journey, take a friend along
A problem shared is a problem halved
We all need friends and company
__________________________________________

j.gp-2018-0010.tab.011.w2aab3b7c10b1b6b1ab2b3ac28Aa

Time (MindContentsMaterialsTasks of Therapist
0 – 5’Welcoming of participants, Reiterate motto of the dayList of participantsCheck the list of participants, welcome new participants
5’ - 15’What is important for a good meal except the food: table decoration, how does my table at home look like?Show pictures of different tablesMotivate participants to exchange thoughts about „pleasant/unpleasant“ table decoration
15’ - 80’Preparation of a table decoration as group activity, seasonal differences? (Easter, spring, summer)Serviettes, fabric belts, other decoration materials, flowers etcSupport group activities, review feasibility, appreciate proposals, encourage casual exchange
80’ – 90’Summary of session and explanation of treatment care of yourself topic: when „Here stressed”. you can learn Termination to take of sessionList of participantsGive a summary

j.gp-2018-0010.tab.029.w2aab3b7c10b1b6b1ab2b3ac84Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-15’Introduction into the topic endurance, presentation of the material „soap stone“, exchange of experiences of patients, link to general framework of sessionSheet for individual motto on the topic of „endurance“, pencilsExplain the exercise and prepare the transfer into real life
15’- 80‘Set a time frame for making a simple soap stone figurestone Template figures, with soap pictures stone, of MCD sheet to remind patient of his personal goalsSupport the patient to go on; discuss the topic in reference to different areas in life
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn step by step to improve your coping skills with stress” Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.023.w2aab3b7c10b1b6b1ab2b3ac66Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-25’Introduction to the concept of minimal cerebral dysfunctions (MCD) and skills needed to cope with stressPictures and illustrative materialeducation about the MCD concept and stress coping skills
25’-40‘Completion of the MCD-scaleMCD scaleSupport participants questionnaire to fill in the
40’ – 75’Group discussion on „compensation strategies“ for personal problemsMarker pen and flipchartCollect ideas of participants, add your own suggestions
75’ - 80’Listing of individual goals ⌷ „This is what I want to practice“Small index cards for each patientHelp participants to specify their training goals
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn step by step to improve your coping skills with stress” Termination of sessionList of participantsGive a summary

j.gp-2018-0010.tab.026.w2aab3b7c10b1b6b1ab2b3ac75Aa

Time (Min)ContentMaterialTasks of Therapist
0 – 5’Welcoming of participantsList of participantsCheck welcome the list new of participants participants
5’-15’Presentation of the task („today we are going to fold a more difficult figure than last time“)Written instruction, Origami paper for each participant, individual motto on the topic of „frustration tolerance“Explain the exercise
15’-80‘Give a time frameMCD-sheet to remind the patient of stress coping skills to be learned; Origami materialsMake patients fold origamis, Support the patient to go on; discuss the topic in reference to different areas in life
80’ – 90’Summary of session and explanation of treatment topic: „Here you can learn step by step to improve your coping skills with stress” Termination of sessionList of participantsGive a summary