Sorry for taking so long to reply. This is actually a subject I take a
lot of interest in, and I have also introduced my colleagues to the
"plissit" model. Good thing about it is that it presents a way to deal
with the fact that not everyone is equally comfortable dealing with the
subject, so you can have different staff members working on different
levels - only sharing the permission level, which will involve e.g.
having informational pamphlets openly available. Also everyone
should be able to identify a need for help - estimate which level
of help is needed - and be informed which staff member or other
professional can provide this help. This is important as it often
takes a lot of courage from the patient/client (or partner) to come
out and start talking about sexual needs and worries. He/she
most likely will choose a person he feels confident with, and
then being ordered around several professionals with this
private issue might be very discouraging - guess you can all
imagine.....
In Denmark the OT is a central person re: sexual issues in
rehabilitation, care etc. A few specializes in this area and and can be
contacted about e.g. adapted sexual aids and equipment. But every one of
us must be prepared to use our skills to assist with finding solutions -
could be about positioning, bowel and bladder considerations, safety,
pain mangement, trying out equipment (for gratification of self and/or
partner) - and then teaching patient, partner, carers how hopefully to
continue independantly from that point.
Also, the topic of sexuality should not be limited to that which you
have with a partner. Masturbation is a biiig issue - be it the
inapropriate choice of time and place (staff and family complaining) -
the "I can't do it myself anymore" ("can someone help?") - education of
care workers about the need to provide clients with private time and
opportunity ("Yikes! Everytime I open his diaper, his hands will go
there"). I could go on.....
Also education of care workers about human sexual responses might be
needed. I've had (female) workers complaining about male patients
getting an erection while being washed or cathed - they actually felt
insultet and intimidated.......
Hmmmm - guess I better stop before I write a book here. Looking forward
to some more input though, and questions are also welcomed!
susanne, denmark
----- Original Message -----
From: "T Fitzpatrick" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, May 08, 2002 4:26 AM
Subject: Re: OT practice and sexuality
> Hello,
> I am a recent OT grad. We touched briefly on this topic and were
introduced
> to the PLISSIT model. The PLISSIT model refers to:
>
> Permission: (lowest level) You give the individual permission to ask
> questions setting a safe non-judgemental environment.
>
> Limited Information: You are able to give general facts in regards to
> general physiological factors. Therapist is able to provide basic
> information.
>
> Specific Suggestions: You are able to give solutions to problems i.e.
> environmental suggestions or stimulation suggestions.
>
> Intensive Therapy: (highest level) A sex therapist is referred to
assist
> the individual and partner.
>
> If faced with this situation, we as OT's have the resposibilty to
assist the
> individual. If not directly, we must help indirectly by referring the
> individual to someone who can. Afterall, sexual expression does fall
under
> ADLs according to our Uniform Terminology.
.........................................
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