Siskin Vocational Rehab Clients Learn Money Management

Tuesday, April 10, 2018

The job of rehabilitating clients at Siskin Hospital just got easier with a new teaching module developed by a student intern, according to officials.

"For most of us, basic money management is a skill we take for granted. For the disabled, however, it’s one of a host of skills that have to be either re-learned or improved after a devastating illness or injury leaves them unable to work," officials said.

Fidela Mendiola, a UTC occupational therapy student, created “Money & Me,” a nine-week teaching plan complete with activities and handouts to help increase clients’ competency in personal finance. The program is the culmination of her 16-week experiential internship with Siskin Hospital, and can be utilized by Siskin Hospital staff in its ongoing service offerings.

“It’s a tough area to master,” says Ms. Fidela, who will graduate in May with an occupational therapy doctorate, “especially when you’re working with clients who have varying degrees of executive function deficits.”

Clients met in a group setting twice weekly with four follow-up sessions. Ms. Fidela says the group setting let clients know they were not alone; they could hear input and suggestions from others. 

“I structured the program on basic money management skills, and then built on skills acquirement,” says Ms. Fidela. Gradually, clients began to develop their own personal financial goals. 

“They started to keep up with their expenses and saved their receipts,” says Ms. Fidela. “They learned to differentiate between desires and needs. So small steps at first.”

One client later told her he had gone shopping and saw something he liked. Then, at that moment, he heard her “in his head” asking if it was something he needed or wanted. 

“As a student, you read the textbooks and case studies, but you’re not a part of it,” says Ms. Fidela. “But when you are taking this journey with your clients, it’s really rewarding.”

Ms. Fidela says she applied many of the principles she was learning in school to develop a program that was client-centered and occupation-based. While OTs regularly help their patients with activities of daily living (ADLs), money management may not readily come to mind as one of those activities. Ms. Fidela terms those “Instrumental ADLs.” Besides money management, this includes other cognitive strategies, such as communication skills and learning to construct a grocery list. 

“What I love the most from school is how holistic I learned OT is,” says Ms. Fidela. “To really help our clients/patients, we need to know their stories, and what’s important to them. I get excited about how I, as a future clinician, will construct interventions to meet those goals.”

This was the first time Siskin Hospital had a Vocational Services intern for a full semester, and Darlene Lentz, who directs the program, was thrilled with the opportunity to help educate a future OT in community re-entry programs. She acted as Ms. Fidela’s supervisor, but Ms. Fidela says she was more like a mentor.

“Even though the sessions are completed, our clients continue to use the money-management principles Fidela has taught them,” says Ms. Lentz. “OTs in these types of settings really get to know their patients.”

"Programs like Siskin Hospital’s Vocational Services are considered “alternative therapy” in the sense that they differ from the traditional occupational focus on ADLs. Alternative therapy can be utilized in public schools, mental health agencies, or community re-entry programs like Siskin Hospital’s," officials said.

Fidela says the internship gave her the opportunity to apply what she learned in school about the ‘therapeutic use of self.’ When she first heard about this concept in class, she wondered how she was supposed to mold herself to become an avenue of help to patients. What she learned was to just be herself.

“At first I wanted to be really directive – ‘this is what you should do, then you do this, and then this . . . .’ But that wasn’t working out,” says Ms. Fidela. “Then I took a step back and realized I needed to get to know them, and help them to learn to trust me. And that helped me to develop the program’s ‘just-right challenge’ – not too easy or too hard.”

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