Impact of vision boards for meaningful occupations
In 1967, members of the Winston-Salem community opened the Rescue Mission to relieve the burden of men who struggle with substance abuse, addiction, and homelessness. The Winston-Salem Rescue Mission (WSRM, 2020) carefully established a vision and mission considering the needs of those who felt hopelessness, and spiritually, emotionally, and mentally wounded. Offering support and a judgment-free space, the WSRM uses a client-centered and holistic approach to transform the lives of individuals of the community. Being a service to the community, WSRM stands firm in the belief that we are, “not to be served, but to serve.” The philosophy, or model of care, is focused on meeting three basic levels: physical, emotional, and spiritual needs. Physical needs are met through short- and long-term interventions, which include providing clothing, housing, employment assistance, education opportunities, and medical assistance. Emotional needs are met through a high-quality substance abuse recovery program, life skills training, and anger management courses to focus on growth and development. Spiritual needs are met by encouraging individuals to connect with a higher power, providing meaning and significance to one’s life as well as self-worth (Collins et al., 2002; Oakley et al., 2010).
Today, more than 55 years later, the WSRM continues to serve this population, as well as other individuals in the community who may have physical, emotional, and spiritual needs. The WSRM receives funding through donations and fundraising to maintain their programs and operations.
Although the mission serves the community, its focal point has maintained that of assisting men, as they are more likely to have substance abuse disorders (Winston-Salem/Forsyth County Community of Care, 2022), and make up the highest proportion of the homeless population (Winston-Salem, n.d.). Factors such as poverty, exposure to trauma, and social endorsements of substances, as well as dual diagnoses with mental illness contribute to homelessness (Moyer, 2019). The U.S. Census Bureau’s data reveals that poverty may be a driving factor in the growing need for the WSRM’s services, as Winston-Salem has a poverty rate of 19%, which is significantly higher than the state average of 13.4% (2023, July 1). Substance abuse, mental illness, and homelessness all disrupt one’s ability to perform occupations that promote health and well-being, such as rest and sleep, work, education, leisure, and social participation. The most common disruptions occur within role fulfillment, personal and family routines, social relationships, coping skills, employment, home and self-care, and leisure engagement (Moyer, 2019).
One of the many programs at WSRM is the Life-Builders’ Program, which is designed to help men overcome their addictions and gain tools required to become productive members of society. Through work therapy and courses in anger management, financial management, life skills, and more, residents are taught recovery principles as well as the skills needed to make positive changes in their lives.
Another important WSRM program is the Transformers Program, which is a 1-year recovery program where residents are guided through a process of total life transformation involving physical, social, cognitive, emotional, and spiritual growth. This program is designed to assist residents in changing their thought patterns, which in turn changes behaviors and overall approaches to life. This program includes courses such as computer skills, adult education, financial management, healthy living, leadership skills, and career development. Upon completing the Transformers Program, residents are assisted with gaining permanent employment and housing as they transition back into society.
During the fall and spring semester, Winston-Salem State University first year occupational therapy students complete an 8-week Level I fieldwork placement at WSRM under the supervision of a WSSU OT faculty member, providing group and individual interventions to a group of 8 to 10 men. Students are exposed to community mental health, while understanding the various mental health diagnoses, an individual’s experience living with a mental health diagnosis, and additional community services and resources provided to support individuals in Winston-Salem. Students address issues such as healthy eating, medication management, writing a resume, using a computer, mock job interviewing, positive leisure pursuits, and more. Using a client-centered approach, students begin to partner with residents at WSRM to identify the primary issues and barriers that impede occupation. When the data is collected, the students design meaningful therapeutic interventions to maximize performance in occupations to return to society. Interventions are tailored to address ways to enhance health and wellness for clients through balancing areas of occupation related to ADLs and IADLs, such as education, work, rest, sleep, leisure, and social participation.
During the spring 2023 semester, five students were assigned to the Winston-Salem Rescue Mission. Each student partnered with one resident. Every week, students were responsible for designing and implementing a group and an individual intervention to assist the residents with achieving their goals. JaLonta Brogdon, a second year occupational therapy student was inspired to lead a group intervention involving a vision board. JaLonta gained inspiration when she conducted an individual intervention session. She stated that her client wanted to create something tangible to keep him motivated to achieve his goals. The following week, as a group activity, students brought magazines to cut out pictures and create a vision board. The purpose of the vision board was to identify and establish goals to create a path to ignite reintegration into the community. Occupational therapy interventions move “beyond the individual treatment of a client working with systems that affect the ability of an individual or group to achieve work, leisure, and social goals” (Brownson, 1998, p. 61). Each resident was receptive to the intervention. After completion of their vision board, each resident and student discussed the significance, meaning, and strategies on how they were going to achieve the items listed on the vison board.
The first year occupational therapy students returned to WSRM during the fall 2023 semester to partner with a new group of residents in the Transformers Program. On the first day of arrival, Richard Combs, former resident of WSRM Transformers Program informed the current students that the vison board that he had completed with the previous group was an integral part of his life. Richard stated that using the vision board taught him how to live from start to finish. In Richard’s words, the vision board allowed him “to take an ugly mess and make a beautiful picture.” As a previous turner for a world championship drag racing team, Richard had earned all the money that he could ask for working behind the scenes in the entertainment industry. However, drugs and associating with the wrong crowd led to the loss of his family, and eventually, circumstances led him to homelessness. Through the programs at the Winston-Salem Rescue Mission and support from Winston-Salem State University occupational therapy students, he was able to seek new employment.
He shared, “I had all of the finer things, but eventually, no matter what I did, I was miserable.” Recently, Richard graduated from the Transformers Program at WSRM. He will be attending Man Camp in Royston, GA, to strengthen his spirituality journey and continue to discover and follow through with his future endeavors. Man Camp is a 5-day catalyst experience to help men identify who they are and discover who they can become. The purpose of Man Camp is to develop a healthy man in body, soul, and spirit. Richard stated that prior to attending the Transformers Program, he “put money before his spirituality,” but this time, he is “putting his spirituality before the money.” Richard achieved all his goals on his vision board except finding a beautiful queen. He states that he is waiting and trusting in a higher power to make that happen.
Conclusion
The WSRM and WSSU occupational therapy program has been a gratifying partnership that bridges the gap in the community.
The experience with the vision boards was so powerful, that the next semester when I saw a few of the men, including Richard, they shared how influential the vison boards were. They stated that the boards provide daily motivation to meet their goals. Several of the men stated that their vision board keeps them on track to prevent relapse.
In addition, residents often testify to the miraculous power of their belief and the significant change in their lives because of the Rescue Mission. By participating in daily devotions, spirituality services, and one-on-one and group counseling, residents are equipped with strategies on how to live a successful life and continue to be connected to their spirituality.
Communities provide a unique setting for occupational therapy practice (Fidler, 2001). Through this experience, students can identify and understand the needs of the residents in the community while facilitating skills and strategies to reintegrate residents back into the community. Through the partnership at WSRM, students are gaining insight on meaning and occupation in a community and non-traditional settings. According to Mattila (2019), students in community settings improve their clinical and communication adaptability and professional competence. The community connects students and residents through occupational engagement and a collaborative sense of meaning.
References
Brownson, C. A. (1998). Finding community practice: Stage 1. American Journal of Occupational Therapy, 52, 60–64. https://doi.org/10.5014/ajot.52.1.60
Collins, J. S., Paul, S., & West-Frasier, J. (2002) The utilization of spirituality in occupational therapy: Beliefs, practices, and perceived barriers. Occupational Therapy in Health Care, 14(3–4), 73–92. https://doi.org/10.1080/J003v14n03_05
Fidler, G. S. (2001) Community practice: It’s more than geography. Occupational Therapy in Healthcare, 13(3–4), 7–9. https://doi.org/10.1080/J003v13n03_02
Mattila, A. (2019). Role-emerging fieldwork at community agencies: An exploration of self-efficacy, personal transformation, and professional growth. American Journal of Occupational Therapy, 73(4_Suppl. 1), 7311500057p1. https://doi.org/10.5014/ajot.2019.73S1-PO8024
Moyer, P. (2019). Co-occurring disorders. In C. Brown, V. C. Stoffel, & J. P. Muñoz (Eds.), Occupational therapy in mental health: A vision for participation (2nd ed., pp. 211–224). F. A. Davis.
Oakley, E. T., Katz, G., Sauer, K., Dent, B., & Millar, L. A. (2010). Physical therapists’ perception of spirituality and patient care: Beliefs, practices, and perceived barriers. Journal of Physical Therapy Education 24(2), 45–52. https://journals.lww.com/jopte/fulltext/2010/01000/physical_therapists__perception_of_spirituality.6.aspx
U.S. Census Bureau (2023, July 1). QuickFacts: North Carolina. https://www.census.gov/quickfacts/fact/table/NC/PST045221
Winston-Salem/Forsyth County Community of Care. (2022). Winston-Salem/Forsyth County CoC (NC500) plan to serve the unsheltered homeless population. https://www.cityofws.org/DocumentCenter/View/26156/Final--Unsheltered-Plan-PDF?bidId= Winston-Salem. (n.d.). Homelessness. https://www.cityofws.org/2453/Homelessness
Winston-Salem Rescue Mission (2020, December 14). History. https://wsrescue.org/history/
Jeffery Lucas, PhD, OTR/L, CDP, CKTP, CAPS, is an Assistant Professor in the Department of Occupational Therapy at Winston-Salem State University in North Carolina.
JaLonta Brogdon, OTS, received a bachelor's degree in Kinesiology with a minor in Human Development and Family Studies from the University of North Carolina at Greensboro. JaLonta has a desire to work in the school system and acute care.
Breanna Daley, OTS, received a Bachelor of Science in Recreational Therapy at East Carolina University. She has a strong desire to work in inpatient rehabilitation setting with the brain injury population.
Karon Jeter, OTS, earned his Bachelor of Science degree in Exercise Science from Winston-Salem State University. He would like to do work in acute care and skilled nursing.
Ashley Loyd, OTS, is a graduate of Winston-Salem State University State University with a Bachelor of Science in Rehabilitation Studies. Her preferred practice setting is acute care or an outpatient adult clinic.
Andre Ross Jr, OTS, graduated from Winston-Salem State University State University with a Bachelor of Science in Exercise Physiology. He plans to practice in SNF/LTC or inpatient rehabilitation.