I wrote this article when I was studing Occupational Therapy at University in 2003.

I am a second year occupational therapy student from Sheffield Hallam University, currently reaching the end of a ten-week placement with the assertive outreach service at Loversall Hospital, Doncaster. I am also a registered tai chi instructor with the Tal Chi Union of Great Britain.

Tai chi is a very gentle form of movement exercise, which aids concentration and focus for the practitioner. Additional recognised benefits arc reduced stress, better mobility and wel l­ being (Tsung Hwa J 1997). During my placement it occurred to me that perhaps tai chi could be a useful activity in the mental healthcare setting. Literature searches using MEDLlNE, SWETSWlSE and CINAHL revealed that most of the recorded documentation on the effects of tat chi is related to physical disabilities and the older adult. There has been little previous research into the effects of rai chi within the mental health domain. I facilitated a four-week taster course of tai chi for a client group comprising mental health patients from the community and the hospital day unit. The main aim was to identify to what extent, if any, tal chi could be a useful and beneficial activity, specifically with clients suffering from schizophrenia.

Some benefits for the clients that I anticipated were increased body awareness, reaching a stale of relaxation and increased social interaction. The method of measurement was by observation and verbal feedback.

My first step in setting up the course was to present my proposal to the multidisciplinary team. by setting up an introductory session of tal chi which they could attend and then presenting them with a document outlining my aims, session content, potential benefits for the clients, material requirements, risk assessment, etc.

The next step was to find a suitable venue for the course to take place (I was able. to use the seminar room in the hospital) and for the team to inform those clients that they thought would benefit the most.

In the first session the group was very small. This had been anticipated as we had envisaged that low motivation levels, lack of interest, little trust of the subject/facilitator and lack of appropriate time management/planning would be the predominant features expressed by the assertive outreach clients. By the last two weeks of the course more clients wanted to be involved. This may have been due to the client-centred approach that was used, whereby clients were free to join in only when they fell they were ready to do so. I had also built a rapport with them by this time, as the potential clients were part of my caseload.

An important consideration was the extent to which clients would initially be able to maintain the attention and application needed to do the exercises that in turn would increase their concentration and focus further. On evaluation, observation and feedback from the clients suggested that focus and concentration were a problem for one or two of them, but that the majority managed to maintain concentration throughout the hour sessions.

Some mentioned thai their muscles ached afterwards and so were given the opportunity to participate sitting down in future sessions, which they did when tired. Most felt that they had gained benefits from the sessions.

I feel that tai chi, given the availability of qualified instructors with an awareness of any possible risk factors that may need to be considered, should be encouraged in the mental health field. 1 would welcome any information about any groups actually doing tal chi or qi gong within the mental health field.

References:

  • Kwau-Sang Yau (2002) Older people and Tai Ch.i Occupational Therapy News, 10(10), 21.
  • Sandlund E, Norlander T (2002) The Effects of Tai Chi Chuan Relaxation and Exercise on Stress Responses and Well-Being: An Overview of Research. International Journal of Stress Management, Vol. 7(2), 139-149
  • Tsung Hwa J (1997) The Tao of Tai-Chi Chuan. USA, Tai Chi Foundation.
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