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Fostering Self-Identity in Adolescents Who Experience Spinal Cord Injuries Lauren Schneibel University of North Dakota

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Fostering Self-Identity in Adolescents Who Experience Spinal Cord Injuries Lauren Schneibel University of North Dakota University of North Dakota UND Scholarly Commons Occupational Therapy Capstones Department of Occupational Therapy 2014 Fostering Self-Identity in Adolescents Who Experience Spinal Cord Injuries Lauren Schneibel University of North Dakota Terese Boeder University of North Dakota Follow this and additional works at: https://commons.und.edu/ot-grad Part of the Occupational Therapy Commons Recommended Citation Schneibel, Lauren and Boeder, Terese, "Fostering Self-Identity in Adolescents Who Experience Spinal Cord Injuries" (2014). Occupational Therapy Capstones. 324. https://commons.und.edu/ot-grad/324 This Scholarly Project is brought to you for free and open access by the Department of Occupational Therapy at UND Scholarly Commons. It has been accepted for inclusion in Occupational Therapy Capstones by an authorized administrator of UND Scholarly Commons. For more information, please contact [email protected]. FOSTERING SELF-IDENTITY IN ADOLESCENTS WHO EXPERIENCE SPINAL CORD INJURIES by Lauren Schneibel, MOTS & Terese Boeder, MOTS Advisor: Sonia Zimmerman, PhD, OTR/L, FAOTA A Scholarly Project Submitted to the Occupational Therapy Department of the University of North Dakota In partial fulfillment of the requirements for the degree of Master’s of Occupational Therapy Grand Forks, North Dakota May 17, 2014 This Scholarly Project Paper, submitted by Lauren Schneibel and Terese Boeder in partial fulfillment of the requirement for the Degree of Master’s of Occupational Therapy from the University of North Dakota, has been read by the Faculty Advisor under whom the work has been completed and is hereby approved. ________________________________ Faculty Advisor ________________________________ Date ii PERMISSION Title Fostering Self-Identity in Adolescents Who Experience Spinal Cord Injuries Department Occupational Therapy Degree Master’s of Occupational Therapy In presenting this Scholarly Project in partial fulfillment of the requirements for a graduate degree from the University of North Dakota, we agree that the Department of Occupational Therapy shall make it freely available for inspection. We further agree that permission for extensive copying for scholarly purposes may be granted by the professor who supervised our work or, in her absence, by the Chairperson of the Department. It is understood that any copying or publication or other use of this Scholarly Project or part thereof for financial gain shall not be allowed without our written permission. It is also understood that due recognition shall be given to us and the University of North Dakota in any scholarly use which may be made of any material in our Scholarly Project. Signature__________________________________ Date____________ Signature__________________________________ Date____________ iii TABLE OF CONTENTS ACKNOWLEDGEMENTS…………………………………………………vi ABSTRACT………………………………………………….……………...vii CHAPTER I. INTRODUCTION………………………………………………….1 II. REVIEW OF LITERATURE..........................................................4 Typical Adolescent Development………………………...….4 Identity…….............................................................................7 Spinal Cord Injury....................................................................10 Adolescent with Spinal Cord Injury.........................................13 Role of Occupational Therapy.................................................14 Summary..................................................................................15 Problem Statement...................................................................16 Purpose.....................................................................................17 III. METHODOLOGY.........................................................................18 IV. PRODUCT.....................................................................................20 Introduction..............................................................................22 Model of Human Occupation (MOHO)...................................25 iv Assessments................................................................................27 Self-Assessments.............................................................28 Interview Assessments....................................................38 Observation Assessments................................................41 Interventions...............................................................................44 Self-Esteem.....................................................................45 Values.............................................................................53 Social Participation.........................................................62 References...................................................................................68 V. SUMMARY.......................................................................................74 Limitations..................................................................................75 Recommendations......................................................................76 Conclusions................................................................................76 REFERENCES.......................................................................................78 APPENDIX.............................................................................................85 v ACKNOWLEDGEMENTS Lauren Schneibel I would like to thank Dr. Sonia Zimmerman, our advisor, for her advice and encouragement throughout the process, as well as the effort and dedication put forth for this project. The wisdom of occupational therapy and of life we have gained from you is priceless. I would like to thank my family, friends, and classmates for their continued support and encouragement throughout the occupational therapy program. I would like to thank Terese Boeder, my scholarly project partner for her support, dedication and the countless hours spent on completing our scholarly project. We “did work” and met our goal (graduation)! Thank you! Terese Boeder I would like to express my sincere gratitude to Dr. Sonia Zimmerman, my advisor, for her guidance, time, and encouragement. Her expertise in the field of occupational therapy and education has not only assisted me in seeing my full potential, but also inspired me to reach it. The completion of this project could not have been accomplished without the intellect, patience, and humor of my scholarly project partner, Lauren. I have enjoyed being her classmate, scholarly project partner, and most of all her friend. We did it! Thank you to my classmates, friends, and family for the continued support and love throughout the occupational therapy program. I truly would not be where I am without you. vi ABSTRACT The purpose of this scholarly project is to identify a need and to guide occupational therapists during the treatment of adolescents who have acquired a spinal cord injury. During the adolescence stage, an individual begins to develop a sense of self and sense of direction, as well as formulate values which all contribute to personal identity formation (Erickson, 1968). The manual will guide the occupational therapist to address identity formation through use of the chosen assessments and interventions. It is believed that focusing on aspects of identity formation as experienced in the midst of a traumatic spinal cord injury will foster successful adolescent identity development and a resultant higher quality of life. A literature review was conducted utilizing the search items “typical adolescent development, identity formation, spinal cord injury, and occupational therapy” in multiple online databases including: CINAHL, PubMed, PsychInfo, Academic Search Premier, OT Search, and Google Scholar. Textbooks and government-based websites were also utilized to obtain additional information. A manual was developed to guide occupational therapists treating adolescents with spinal cord injuries to foster a positive self-identity. The assessments and interventions chosen are guided by the Model of Human Occupation (MOHO), with the goal of building a strengthened identity, increasing self-esteem, and promoting a higher vii quality of life. The manual is appropriate for practicing occupational therapists in the inpatient neuro-rehabilitation setting. Prior to full implementation, it is suggested that research be conducted in order to test the clinical significance of the manual. Addressing identity as a part of the treatment for an adolescent with a spinal cord injury is an important aspect of occupational therapy services. viii CHAPTER I INTRODUCTION Adolescence is a time of life that presents many changes and challenges (Peterson, Leffert, & Graham, 1995). Specifically, adolescence is a time when the individual is in the process of determining who he/she is, distinguishing values, as well as developing a sense of direction (Erikson, 1968). Adolescent development and identity formation can be greatly influenced by a life-long spinal cord injury. According to the National Spinal Cord Injury Statistical Center (NSCISC) (2012), approximately 12,000 new spinal cord injuries are reported each year. In 2012, the NSCISC reported 6,456 spinal cord injuries occurred to individuals between the ages of 10-20 years old, with the most common age of injury at 19 years of age (NSCISC, 2012). Current literature does not specifically address the population of adolescents with a spinal cord injury, even though the statistical incidence of injury is evident. The majority of the current literature
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