2024-01-31 14:19:51

The aim of this research carried out by Margalith Benayoun with a view to obtaining a state diploma in occupational therapy is to understand how occupational therapists use games to promote the therapeutic alliance with adult patients under the constraint of psychological care. We thank Margalith for sharing this work with our readers.

Forging the therapeutic alliance is a delicate and essential step in occupational therapy care in adult psychiatry. It is even more complex when the patient is forced to provide care. Game mediation can sometimes promote the establishment of this alliancece. Indeed, the use of games in adult psychiatry is a very common practice. This method is studied here with regard to its usefulness in occupational therapy and particularly in the establishment of a therapeutic alliance between the occupational therapist and his patient, a delicate and essential step in treatment. Thus, the study begins with an inventory of the work of the occupational therapist in psychiatry, imbued with the psychodynamic current and/or the cognitive-behavioral current. Then the conditions necessary for the establishment of the therapeutic alliance are considered, requiring among other things a request for care from the sick person, which questions care when it is administered under constraint. The games are then defined and explored from different angles with regard to their contribution to psychological care. We note that the modalities of use of the games might influence the establishment of the alliance with a patient in the refusal of care. Thus, the aim of the proposed research is to understand how occupational therapists use games to promote the therapeutic alliance with adult patients under the constraint of psychological care. The application of the playful model, which promotes free and spontaneous play, might be one possible answer.

“Although the playful model is little known, it is considered potentially useful for promoting the therapeutic alliance with patients treated under constraint. It would promote pleasure and freedom of choice.”

As part of a qualitative study, six semi-structured interviews were carried out with occupational therapists working in adult psychiatry departments and caring for patients under care constraints. The results of the survey show that, although the playful model is little known, it is considered potentially useful for promoting the therapeutic alliance with patients treated under constraint. It would promote pleasure and freedom of choice. However, this study also highlighted certain reservations on the part of occupational therapists. In particular, the fact that the playful model is initially intended for child patients would require specific adaptation to the particularities of adult psychiatry. This adaptation might be inspired by the model of the playful attitude in adulthood (Guitard, Ferland, & Dutill, 2006), which has until now not been sufficiently developed to be put into practice.

• “The contribution of games to the therapeutic alliance in adult psychiatry. Application to patients under care constraints. Qualitative study”, dissertation by Margalith Benayoun with a view to obtaining her State diploma in Occupational Therapy, June 2023. (PDF)

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