You are on page 1of 5



Psychiatria Danubina, 2023; Vol. 35, Suppl. 3, pp 102-106 Conference paper


© Medicinska naklada - Zagreb, Croatia Case report

2&&83$7,21$/7+(5$3<$7,67,78726(5$),&2
7+(5$3<%<³'2,1*´
6DQGUD&LFXWWLQ
Serafico Institute, Assisi, Perugia, Italy

    

2&&83$7,21$/7+(5$3<± NQRZQDQGUHVSHFWHGUHKDELOLWDWLRQVSHFLDOW\EH\RQGWKH
'(),1,7,21$1'6&23( ERUGHU LQ DOO PHPEHU FRXQWULHV RI WKH (XURSHDQ 8QLRQ
DQG RYHUVHDV $PHULFD DQG $VLD  7KH ELUWK RI WKH
2)35$&7,&(
SURIHVVLRQ GDWHV EDFN WR  LQ WKH 8QLWHG 6WDWHV
2FFXSDWLRQDO WKHUDS\ LV GHILQHG DV D ³FOLHQWFHQ ZKLOHLQ,WDO\WKHEHJLQQLQJVRI27FDQEHWUDFHGEDFN
WHUHG´ KHDOWK SURIHVVLRQ FRQFHUQHG ZLWK SURPRWLQJ WR WKH VV ZLWK DUULYDO RI WKH ILUVW ³UHKDELOL
KHDOWKDQGZHOOEHLQJWKURXJKRFFXSDWLRQ :)27  WDWLRQ WKHUDSLVWV´ D SURIHVVLRQDO ILJXUH LQFRUSRUDWLQJ
³2FFXSDWLRQV´DUHGHILQHGDVWKRVHDFWLYLWLHVWKDWSHRSOH VSHHFK WKHUDSLVWV SK\VLRWKHUDSLVWV DQG RFFXSDWLRQDO
HQJDJHLQHYHU\GD\WRJLYHWKHLUOLIHPHDQLQJDQGSXU WKHUDSLVWV7KHVHVSHFLDOW\ DUHDVZHUHQRW\HWGLIIHUHQ
SRVH +RZ LQGLYLGXDOV HQJDJH LQ RFFXSDWLRQV LV LQIOX WLDWHG DW WKH WLPH DQG WKHUH ZHUH QR LQGLYLGXDOL]HG
HQFHGE\FRPSRQHQWVDQGVNLOOVRISHUIRUPDQFHUDQJLQJ FRXUVHV RI HGXFDWLRQDO SUHSDUDWLRQ DQG WUDLQLQJ 3URLD
IURP PRWRU VHQVRU\ SHUFHSWXDO FRJQLWLYH VRFLDO DQG  
SV\FKRORJLFDO 2FFXSDWLRQDO WKHUDS\ LQWHUYHQWLRQV LQ 7KHSURIHVVLRQRIRFFXSDWLRQDOWKHUDS\LQ,WDO\ ZDV
FRUSRUDWH RFFXSDWLRQV WR HQKDQFH DFWLYH SDUWLFLSDWLRQ RQO\ OHJDOO\ VDQFWLRQHG IROORZLQJ SXEOLFDWLRQ RI /HJLV
DQG HQJDJHPHQW DQG WR IXUWKHU WKH GHYHORSPHQW RI ODWLYH'HFUHHQRGDWHG-DQXDU\
SHUIRUPDQFHVNLOOVDQGSHUIRUPDQFHSDWWHUQV7KHEURDG The occupational therapist is the healthcare profes-
UDQJH RI RFFXSDWLRQV LV GLIIHUHQWLDWHG LQ WKH 2FFXSD sional who, in possession of a qualifying university
WLRQDO 7KHUDS\ 3UDFWLFH )UDPHZRUN 273)  DV DFWL degree, is employed in the field of prevention, treat-
YLWLHV RI GDLO\ OLYLQJ $'/V  LQVWUXPHQWDO DFWLYLWLHV RI ment and rehabilitation of individuals suffering from
GDLO\ OLYLQJ ,$'/V  KHDOWK PDQDJHPHQW UHVW DQG physical and mental illnesses and disorders resulting
VOHHSHGXFDWLRQ ZRUNSOD\ OHLVXUHDQGVRFLDOSDUWLFL in both temporary and permanent disabilities, using
SDWLRQ $27$  expressive and manual activities – representative/
$W WKH FRUH RI SURIHVVLRQDO SUDFWLFH WRGD\ DUH GH playful, of everyday life. (Art.1)
https://www.gazzettaufficiale.it/eli/id/1997/05/24/097G0168/sg
FDGHVRIUHVHDUFKDQGVWXGLHVRQRFFXSDWLRQDOVFLHQFH
EDVHG RQ WKH LPSRUWDQFH RI RFFXSDWLRQ LQ KXPDQ ,W LV RQO\ LQ  WKDW WKH ILUVW XQLYHUVLW\ GHJUHH
WKURXJKRXW DOO GHYHORSPHQWDO VWDJHV RI WKH LQGLYLGXDO¶V FRXUVHV LQ WKH YDULRXV DOOLHG KHDOWK SURIHVVLRQV ZHUH
OLIHVSDQ $,72  GHYHORSHG IROORZLQJ WKH SDVVDJH RI PLQLVWHULDO GHJUHH
:KDW GLVWLQJXLVKHV RFFXSDWLRQDO WKHUDS\ IURP WKH '0
PRUH ZHOONQRZQ DQG UHVSHFWHG SURIHVVLRQ RI SK\VLR (https://www.fnopi.it/archivio_news/leggi/172/DM020401c
WKHUDS\" %RWK DOOLHG KHDOWKFDUH SURIHVVLRQV DLP WR lassi.pdf)
LPSURYH WKH OHYHO RI LQGHSHQGHQFH DQG DFWLYH SDUWLFL 7KHILUVW\HDUOHYHO,XQLYHUVLW\SURJUDPVLQRFFX
SDWLRQLQWKHUHKDELOLWDWLRQSURFHVV,ZRXOGVD\WKDWWKH SDWLRQDO WKHUDS\ ZHUH RIIHUHG ZLWKLQ WKH IDFXOW\ RI
J\P IRU WKH RFFXSDWLRQDO WKHUDSLVW LV WKH LQGLYLGXDO V PHGLFLQHDQGVXUJHU\
GDLO\OLIHLQFOXGLQJWKHLQGLYLGXDO¶VOLIHFRQWH[WVZKLOH 
WKH WKHUDSHXWLF PRGDOLW\RUH[HUFLVHLVHVVHQWLDOO\WKH 7+(2&&83$7,21$/7+(5$3<
DFWLYLW\LWVHOIWKHRFFXSDWLRQDSSURSULDWHO\FDOLEUDWHG '(3$570(172),67,78726(5$),&2
WR IDFLOLWDWH WKH LQGLYLGXDO¶V DFWLYH SDUWLFLSDWLRQ DQG
DGGUHVVWUHDWPHQWREMHFWLYHV DOO ZKLOHFRQVLGHULQJDJH 2FFXSDWLRQDO WKHUDS\ VHUYLFHV KDYH EHHQ RIIHUHG
SDWKRORJ\IXQFWLRQDOSURJQRVLVDQGVRFLDOFRQWH[WRIWKH ZLWKLQ WKH FOLQLFDO UHKDELOLWDWLRQ GHSDUWPHQW DW ,VWLWXWR
LQGLYLGXDO 6HUDILFR VLQFH  7KH GHSDUWPHQW LV FRPSULVHG RI
 YDULRXVUHKDELOLWDWLRQVSHFLDOLVWVLQFOXGLQJSK\VLFDOWKHUD
7+(+,6725<2)2&&83$7,21$/ SLVWV VSHHFK WKHUDSLVWV QHXURSV\FKRPRWRU WKHUDSLVWV D
7+(5$3<,1,7$/< PXVLF WKHUDSLVW VSHFLDOLVWV LQ VZDOORZLQJ DQG IHHGLQJ
GLVRUGHUVDQGDGDSWHGSK\VLFDOWKHUDS\DVZHOODVDTXDWLF
2FFXSDWLRQDOWKHUDS\UHPDLQVRQHRIWKHOHDVWNQRZQ SK\VLFDOWKHUDS\ RWKHUZLVHNQRZQDVK\GURWKHUDS\ 7KH
UHKDELOLWDWLRQGLVFLSOLQHVLQ,WDO\GHVSLWHLWEHLQJDZHOO GHSDUWPHQW SURYLGHV VSHFLDOL]HG DQG SHUVRQDOL]HG PXOWL

6

Sandra Cicuttin: OCCUPATIONAL THERAPY AT ISTITUTO SERAFICO: THERAPY BY “DOING”
Psychiatria Danubina, 2023; Vol. 35, Suppl. 3, pp 102-106


GLVFLSOLQDU\ LQWHUYHQWLRQV IRU D YDULHW\ RI QHXURPRWRU &$6(6
FRJQLWLYH VHQVRULDO DQG EHKDYLRUDO LVVXHV LQ UHVLGHQWLDO
VHPLUHVLGHQWLDO GD\KRVSLWDO DQGRXWSDWLHQWVHWWLQJV &DVHVWXG\
$V DQ RFFXSDWLRQDO WKHUDSLVW WKH JRDO RI P\ LQWHU &DVHVWXG\LQYROYHVD\HDUROGPDOHUHVLGHQWRI
YHQWLRQLVQRWWRFXUHEXWWRLGHQWLI\DQGDSSO\WKRVH ,VWLWXWR 6HUDILFR ZLWK D GLDJQRVLV RI SHULQDWDO HQFH
VWUDWHJLHVWRPDNHGRLQJSRVVLEOHGHVSLWHWKHGHILFLWV SKDOLF GLVWUHVV GHULYHG K\GURFHSKDOXV DQG 523 VHFRQ
DQG YDULRXV OLPLWDWLRQV RI WKH LQGLYLGXDOV ZKR DUH GDU\WRSUHPDWXULW\)URPDPRWRUVWDQGSRLQWKHSUHVHQWV
UHIHUUHG WR WKH VHUYLFH )ROORZLQJ WKH NH\ SULQFLSOHV RI ZLWK TXDGULSDUHVLV PRVW SUHYDOHQW LQ WKH ORZHU H[WUH
WKHSURIHVVLRQ,XVHRFFXSDWLRQVDQGDFWLYLWLHVRIGDLO\ PLWLHV JHQHUDOL]HG HSLOHSV\ DQG VHYHUH YLVXDO LPSDLU
OLYLQJ WR IRUPXODWH LQWHUYHQWLRQV IRFXVHG RQ WKH ZKROH PHQW ZLWK LQWHOOHFWXDO GHILFLW 7KH \RXQJ PDQ GHPRQ
SHUVRQ ZLWK WKH DLP RI KHOSLQJ WKHLU SK\VLFDO VWUDWHVPRWRULQLWLDWLYHLQDOODUHDVEXWOLPLWDWLRQVLQWKH
SV\FKRORJLFDODQGRUVRFLDODGDSWDWLRQWRLPSURYHWKHLU IOXLGLW\ RI PRYHPHQW SDWWHUQV SHUVLVW GXH WR DEQRUPDO
RYHUDOOTXDOLW\RIOLIHGHVSLWHWKHLUGLVDELOLW\ SDWWHUQVRIPXVFOHWRQHKHDOVRSUHVHQWVZLWKSRRUKHDG
7KH FRUH RI 27 LQWHUYHQWLRQ LV DGDSWDWLRQ ,Q RUGHU FRQWURODQGSRRUH\HKDQGFRRUGLQDWLRQ7KHULJKWXSSHU
WR SURPRWH IDFLOLWDWH DFWLYH SDUWLFLSDWLRQ HYHU\WKLQJ H[WUHPLW\LVGRPLQDQWEHFDXVHLWLVWKHPRVWIXQFWLRQDO
UHYROYLQJ DURXQG WKH LQGLYLGXDO PXVW EH DGDSWHG WR $FWLYH XVH RI WKH OHIW XSSHU H[WUHPLW\ UHPDLQV OLPLWHG
KLVKHU SRWHQWLDO LW LV 127 WKH LQGLYLGXDO ZKR PXVW WKRXJK LPSURYHV ZLWK YHUEDO JXLGLQJ VXJJHVWLQJ D
PXVWDGDSWWRKLVKHUVXUURXQGLQJV PRWRUSDWWHUQRIlearned non-use (OLDVVRQ *RUGRQ
0\ UROH DV DQ RFFXSDWLRQDO WKHUDSLVW DW WKH ,VWLWXWR   0XVFXODU LPEDODQFHV SHUVLVW LQ YDULRXV MRLQW
6HUDILFRSUHVHQWVPDQ\FKDOOHQJHVLQWU\LQJWRPDNHWKLV GLVWULFWVRIWKHOHIWXSSHUH[WUHPLW\UHPLQLVFHQWRIFODZ
GRLQJ SRVVLEOH FRQVLGHULQJ WKH FRPSOH[LW\ RI WKH KDQG SDWWHUQLQJ HJ WHQGHQF\ WR K\SHUH[WHQG DW WKH
GLVDELOLWLHV DQG OLPLWDWLRQV RI RXU SRSXODWLRQ ,W LV QRW OHYHORIWKH0&RQWKHOHIWKDQGGXHWRK\SHUWRQLFLW\RI
DOZD\V HDV\ WR LGHQWLI\ VROXWLRQV WKDW FDQ WUXO\ PDNH D WKH H[WULQVLF IOH[RUV RI WKH ILQJHUV K\SHUH[WHQVLRQ RI
GLIIHUHQFHDQGWKDWDUHFRQVLGHUHGLPSRUWDQWWRDSSO\LQ WKH0&RIWKHOHIWWKXPE 6LJQLILFDQWOLPLWDWLRQRISDV
WKHFRQWH[WRIGDLO\OLYLQJ7KLVLVDQRQJRLQJFKDOOHQJH VLYH520DWWKHHOERZDQGIRUHDUPOHYHOLVREVHUYDEOH
2FFXSDWLRQDO WKHUDS\ FDQ EH FRQFHLYHG RI DV SUREOHP GXH WR IOXFWXDWLRQV LQ WRQH ZKLFK LV GLIILFXOW IRU WKH
VROYLQJ SURFHVV LQYROYLQJ D EOHQG RI VFLHQFH WKHRU\ LQGLYLGXDO WR DFWLYDWH :KHQ UHDFKLQJ DQG JUDVSLQJ
DQG FUHDWLYLW\ DOO LQ D FRQWH[W RI D FRQVROLGDWHG REMHFWVZLWKWKHOHIWXSSHUH[WUHPLW\WKHSDWWHUQGHVFUL
UHODWLRQVKLS RI WUXVW EHWZHHQ WKH WKHUDSLVW DQG WKH EHGLVFRQVWDQWO\REVHUYHGWKHUHLVDQRWDEOHDFWLYDWLRQ
LQGLYLGXDO DQG KLVKHU IDPLO\ DQG FDUHWDNHU V\VWHP RIWKHHOERZIOH[RUVDQGSURQDWRUV ZKLFKOLPLWVDFWLYD
%OHVHGHOO&UHSHDX %R\W6FKHOO  WLRQLQVXSLQDWLRQ
 :LWKUHJDUGVWRIXQFWLRQDOOLPLWDWLRQVWKHPRWRUDQG
2&&83$7,21$/7+(5$3<$1''2,1* YLVXDO SUREOHPV GHVFULEHG OLPLW LQGHSHQGHQFH LQ DFWL
$7,67,78726(5$),&2 YLWLHV RI GDLO\ OLYLQJ $'/V  &RQVLVWHQW VXSSRUW LV
UHTXLUHG WR DVVXUH DFWLYH LQYROYHPHQW LQ RUGHU IRU WKH
0DNLQJ '2,1* SRVVLEOH DW ,VWLWXWR 6HUDILFR \RXQJPDQWRFRPSOHWHWKHYDULRXVVHTXHQFHRIDFWLRQV
LQYROYHVDWKRURXJKHYDOXDWLRQRIWKHLQGLYLGXDOWDNLQJ LQYROYHG LQ EDWKLQJ K\JLHQH DQG GUHVVLQJ DFWLYLWLHV
LQWR DFFRXQW LQGLYLGXDO VWUHQJWKV DQG OLPLWDWLRQV OHYHO 'HVSLWH WKHVH GLIILFXOWLHV WKH HYDOXDWLRQ SURFHVV LQ 27
RI PRWLYDWLRQDQGDZDUHQHVV0DNLQJ '2,1* SRVVLEOH OHG WR WKH LGHQWLILFDWLRQ RI VSHFLILF VWUDWHJLHV DLPHG DW
PHDQV LGHQWLI\LQJ DQG SURSRVLQJ VROXWLRQV RI YDULRXV LPSURYLQJDFWLYHSDUWLFLSDWLRQLQVHOIFDUHUHJDUGLQJWKH
NLQGV IURP WKH VLPSOHVW WR WKH PRUH FRPSOH[ IURP DFWLYLW\WKDWZDVREVHUYHGWREHPRVWGLIILFXOWGRQQLQJ
ORZWHFKWR³KLJKWHFK´ZKLFKDUHPHDQLQJIXOZLWKLQ VRFNV7RRYHUFRPHWKHPRWRUGLIILFXOW\GHPRQVWUDWHGLQ
WKH FRQWH[W RI WKH SHUVRQ¶V GDLO\ OLIH ZLWK WKH XOWLPDWH SLQFKLQJWKHVRFNDQGWKHGLIILFXOWLHVZLWKFRRUGLQDWLQJ
JRDO RI IDFLOLWDWLQJ DQGRU HQKDQFLQJ WKH IXQFWLRQDO WKH VHTXHQFH RI GRQQLQJ RQ WKH IRRW D VLPSOH VRFN
FDSDELOLWLHVRIWKHLQGLYLGXDO DLGDVVLVW´ ZDVFUHDWHGRXWRIWKHUPRSODVWLF PDWHULDO$
7KH SRWHQWLDO DQG VWUHQJWK RI WKH RFFXSDWLRQDO SHULRG RI WUDLQLQJ LQ LWV XVH ZDV FDUULHG RXW LQ WKH 27
WKHUDS\ DSSURDFK LQ WKLV XQLTXH VHWWLQJ FDQ EH EHWWHU GHSDUWPHQW$W WKLVWLPH27WUHDWPHQWFRQVLVWVRI ZRU
XQGHUVWRRG E\ SUHVHQWLQJ FDVH VWXGLHV RI LQGLYLGXDOV NLQJRQUHILQLQJWKHQHZVNLOOZLWKWKHDLPRIHYHQWXDOO\
ZKRKDYHUHFHLYHG27VHUYLFHVRYHUWKH\HDUV)RUHDFK WUDLQLQJ WKH FDUHUVDVVLVWDQWV LQ KRZ WR HQFRXUDJH
FDVH VWXG\ DQ HYDOXDWLRQ SURFHVV DLPHG DW GHWHUPLQLQJ LQGHSHQGHQW XVH RI WKH VRFN DVVLVW GXULQJ PRUQLQJ DQG
VWUHQJWKV DQG ZHDNQHVVHV DQG OHYHO RI DZDUHQHVV DQG HYHQLQJVHOIFDUH
PRWLYDWLRQ ZDV HVVHQWLDO GHVSLWH WKH VSHFLILF GLDJ 
QRVLVDQGPRWRUFRJQLWLYHVHQVRU\DQGEHKDYLRUDOOLPL
&DVHVWXG\
WDWLRQV LQYROYHG ,Q HDFK FDVH WKH RFFXSDWLRQDO WKHUDS\
DSSURDFKOHGWRWDQJLEOHLPSURYHPHQWVLQDFWLYHSDUWLFL &DVHVWXG\LQYROYHVD\HDUROGPDOHZKRUHFHL
SDWLRQLQWKRVHDFWLYLWLHVZKLFKZHUHPHDQLQJIXOLQHDFK YHG27RXWSDWLHQWVHUYLFHVIURPWRIURPWKH
LQGLYLGXDO¶VOLIH DJHV RI  WR  7KH LQLWLDO GLDJQRVLV ZDV FHUHEHOODU

 6
Sandra Cicuttin: OCCUPATIONAL THERAPY AT ISTITUTO SERAFICO: THERAPY BY “DOING”
Psychiatria Danubina, 2023; Vol. 35, Suppl. 3, pp 102-106


K\SRSODVLD ZLWK DVVRFLDWHG DWD[LD DQG DOWHUQDWLQJ HVR 7KLVUHVLGHQWKDVDOZD\VVKRZQJUHDWLQWHUHVWLQWKH
WURSLD SV\FKRPRWRU GHOD\ DQG LPSDLUHG IHHGLQJ DQG YDULRXV FUHDWLYH DUW DFWLYLWLHV RIIHUHG E\ WKH LQVWLWXWH
VZDOORZLQJ VNLOOV DV ZHOO DV GHOD\ LQ H[SUHVVLYH ODQ SULPDULO\ WKRVH LQ WKH FHUDPLF ODERUDWRU\ :KDW 27
JXDJH DFTXLVLWLRQ QRQYHUEDO  6XEVHTXHQW JHQHWLF LQWHUYHQWLRQ ZRXOG DOORZ JUHDWHU DFWLYH SDUWLFLSDWLRQ LQ
DQDO\VLVOHGWRWKHLGHQWLILFDWLRQRIDGHQRYRSDWKRJHQLF WKH IDFH RI VXFK VLJQLILFDQW QHXURPRWRU GLVDELOLW\"7KH
PXWDWLRQRIWKH6371%JHQHQRWSUHVHQWLQWKHSDUHQWV GHJUHH RI G\VWRQLF PRYHPHQWV DQG WKH UHVXOWLQJ GLIIL
LQGLFDWLYHRIDQDIIHFWHGKHWHUR]\JRXVPDOHFRQGLWLRQ FXOW\LQUHDFKLQJDQGJUDVSLQJREMHFWVGLGQRWDOORZIRU
2Q D IXQFWLRQDO OHYHO WKH FKLOG GHPRQVWUDWHG YD WKH DSSURSULDWH PRWRU FRQWURO RI WKH XSSHU H[WUHPLWLHV
ULRXV OHYHOV RI GLIILFXOW\ LQ PDQ\ $'/ WDVNV GXH WR UHTXLUHG LQ RUGHU WR SDUWLFLSDWH LQ WKH DUWLVWLFFUHDWLYH
GHFUHDVHG WUXQN FRQWURO ZKLFK GLG QRW DOORZ IRU WKH DFWLYLWLHVWKDWWKH\RXQJPDQZDQWHGWRSDUWLFLSDWHLQ
VWDELOLW\ QHFHVVDU\ IRU HIILFLHQW XSSHU H[WUHPLW\ XVH $QLQGHSWKDQDO\VLVRIWKHDFWLYLW\LQTXHVWLRQZDV
HVGLIILFXOW\ZLWKSUHZULWLQJDFWLYLWLHVDQGUHIXVDOWR PDGH SRVVLEOH WKURXJK WKH YDOXDEOH DQG SURGXFWLYH
XVH D VSRRQ DQGRU IRUN IRU VHOIIHHGLQJ  6SKLQFWHU FROODERUDWLRQ ZLWK WKH GLUHFWRU RI WKH FHUDPLF ODE 7KH
FRQWURO KDG QRW \HW EHHQ DFKLHYHG 7KH HYDOXDWLRQ DQDO\VLV VKHG OLJKW RQ WKH QHHG IRU SURYLGLQJ WKH
SURFHVV LQ 72 UHYHDOHG YDULRXV VHQVRU\ LVVXHV ZKLFK UHVLGHQWZLWKSURSHUVXSSRUWIRUWKHXSSHUH[WUHPLWLHVLQ
UHTXLUHG D PRUH VSHFLDOL]HG DSSURDFK WR VXSSRUW WKH RUGHUWRHOLPLQDWHRUPLQLPL]HWKHHIIHFWVRIJUDYLW\RQ
FKLOG DQG PLWLJDWH SDWWHUQV RI K\SHUVHQVLWLYLW\ REVHU KLV G\VWRQLF PRYHPHQWV DV PXFK DV SRVVLEOH DOORZLQJ
YHG LQ ERWK DXGLWRU\ DQG WDFWLOH VSKHUHV DFFRPSDQLHG IRU JUHDWHU DQG PRUH HIILFLHQW DFWLYDWLRQ RI SDWWHUQV RI
E\ D UDWKHU ULJLG GHJUHH RI IRRG VHOHFWLYLW\ 7ZR YROXQWDU\PRYHPHQW
DVSHFWV ZHUH IXQGDPHQWDO LQ FRQWULEXWLQJ WR HIIHFWLYH $VDUHVXOWRIWKHDQDO\VLVLWZDVGHFLGHGWRKDYHWKH
WUHDWPHQWSODQQLQJDQGLQWHUYHQWLRQ UHVLGHQWWU\DQHOHFWURQLFVXVSHQVLRQDVVLVWZLWKYDULDEOH
ƒ WKH VROLG WKHUDSHXWLF DOOLDQFH FUHDWHG ZLWK WKH ER\¶V KHLJKW ZKLOH DWWHPSWLQJ WR FDUU\ RXW WKH DFWLYLW\ LQ WKH
SDUHQWVZKLFKIDFLOLWDWHGWKHLUDFWLYHUROHLQWKHWUHDW FHUDPLFVODE)ROORZLQJDQLQLWLDOSHULRGRILQWURGXFWLRQ
PHQW SURFHVV DQG OHG WR H[FHOOHQW IROORZWKURXJK RI WRWKHDVVLVWLYHGHYLFH DQGJLYLQJWKHUHVLGHQWDGHTXDWH
VXJJHVWLRQV WR DSSO\ LQ ERWK KRPH DQG VFKRRO VHW WLPHWRIDPLOLDUL]HKLPVHOIZLWKLWDWUDLQLQJSHULRGZDV
WLQJVLQFOXGLQJHQYLURQPHQWDODGDSWDWLRQV FDUULHGRXWLQRUGHUIRUWKHUHVLGHQWWRJUDGXDOO\DFFHSW
ƒ WKH LQYDOXDEOH FROODERUDWLRQ ZLWK WKH VSHHFK WKHUD KDYLQJ KLV ULJKW DUP SRVLWLRQHG LQVLGH WKH VXVSHQVLRQ
SLVWZRUNLQJZLWKWKHFKLOGDQGKLVIDPLO\IDFLOLWDWHG DVVLVWZKLOHDWWHPSWLQJWRSHUIRUPVRPHRIWKHDFWLYLWLHV
HIIHFWLYH LPSOHPHQWDWLRQ RI WKH SULQFLSOHV RI DXJ WKDWZHUHVHWXSIRUKLPVXFKDVPROGLQJFOD\SRVLWLRQHG
PHQWDWLYHDOWHUQDWLYHFRPPXQLFDWLRQZKLFKVKHZDV WKHSRWWHU\ZKHHO)XUWKHUDGDSWDWLRQV ZHUHQHFHVVDU\WR
GHYHORSLQJWKXVOHDGLQJWR DPRUHHIILFLHQWSDWLHQW DOORZ IRU DGGLWLRQDO VWDELOL]DWLRQ RI WKH ZULVW DQG DWWD
WKHUDSLVWLQWHUDFWLRQGXULQJ27WUHDWPHQW FKLQJ YDULRXV SRWWHU\ WRROV GLVWDOO\ LQ WKH KDQG PDNLQJ
7KHWUHDWPHQWSURFHVVLQ27OHGWRWKHSDWLHQWPHH RWKHU DFWLYLWLHV VXFK DV SDLQWLQJ RQ FHUDPLF LWHPV SRV
WLQJ D QXPEHU RI LPSRUWDQW GHYHORSPHQWDO PLOHVWRQHV VLEOH&XUUHQWO\WKH \RXQJ PDQLVDEOHWRSDUWLFLSDWH LQ
ZKLFK KDV FRQWLQXHG HYHQ EH\RQG WKH SHULRG RI GLUHFW WKH DFWLYLWLHV WKDW KH FKRRVHV LQ D PRUH DFWLYH PDQQHU
VHUYLFHSURYLVLRQ0RWKHUFXUUHQWO\UHSRUWVWKHIROORZLQJ ZLWK OHVV LQWHUIHUHQFH RI KLV G\VWRQLD UHVXOWLQJ LQ D
FRPSOHWH EODGGHU DQG ERZHO FRQWURO IXOO DFWLYH SDUWL VHQVHRIGHHSVDWLVIDFWLRQDQGSHUVRQDOIXOILOOPHQW
FLSDWLRQGXULQJK\JLHQHDQGGUHVVLQJWDVNVIRRGVHOHFWL 
YLW\UHGXFHGVLJQLILFDQWO\WRLQFOXGHDPXFKZLGHUUDQJH &DVHVWXG\
RISUHIHUHQFHVDVZHOODVDZLOOLQJQHVVWRWU\QHZIRRGV
7KLV ILQDO FDVH VWXG\ UHJDUGV D \RXQJ IHPDOH DGXOW
DWPHDOWLPHVDFWLYHDWWHPSWVDWXVLQJDVSRRQDQGIRUN
ZLWK VSDVWLFG\VWRQLF TXDGULSDUHVLV DQG G\VDUWKULD VH
IRU VHOIIHHGLQJ DQG D VLJQLILFDQW GHFUHDVH LQ DXGLWRU\
FRQGDU\WRSHULQDWDOHQFHSKDORSDWK\ZLWKLQWDFWLQWHOOHF
DQG WDFWLOH K\SHUVHQVLWLYLW\ DOORZLQJ IRU PRUH SRVLWLYH
WXDOFRJQLWLYHDELOLWLHVZKRUHFHLYHG27RXWSDWLHQWVHUYL
LQWHUDFWLRQVLQWKHKRPHDQGVFKRROVHWWLQJ
FHV GXULQJ KHU XQLYHUVLW\ VWXGLHV   8SRQ

LQLWLDOHYDOXDWLRQLWZDVQRWHGWKDW$'/VZHUHPDQDJHG
&DVHVWXG\ HQWLUHO\ E\ WKH SDUHQWV LQ WKH KRPH HQYLURQPHQW ZLWK
&DVHVWXG\GHVFULEHVD\HDUROGPDQZLWKVHYHUH YDULRXVDVVLVWLYHGHYLFHVDOUHDG\LQSODFH/LPLWDWLRQVLQ
VSDVWLF G\VWRQLFG\VNLQHWLF TXDGULSOHJLD VHFRQGDU\ WR DFWLYH SDUWLFLSDWLRQ ZHUH GXH WR WKH SUHVHQFH RI VHYHUH
SHULQDWDOGLVWUHVVDGPLWWHGLQRXUUHVLGHQWLDOVHWWLQJDQG G\VWRQLD ZKLFK DIIHFWHG YHUEDO ODQJXDJH SURGXFWLRQ DV
GHSHQGHQW LQ DOO DVSHFWV RI VHOIFDUH +H SUHVHQWV ZLWK ZHOO DV FRPSXWHU DQG FHOO SKRQH XVH FRQGLWLRQV UHVXO
RYHUDOOVHYHUHPRWRUGLVDELOLW\DQGPRGHUDWHLQWHOOHFWXDO WLQJ LQ OLPLWHG RSSRUWXQLWLHV IRU VRFLDOL]DWLRQ $GDSWD
GLVDELOLW\+HLVQRQYHUEDODQGFRPPXQLFDWHVYLDYLVXDO WLRQV IDFLOLWDWLQJ FRPSXWHU XVH ZHUH SURYLGHG E\ D
UHFRJQLWLRQ RI SKRWRJUDSKV DQG V\PEROV VLJQLILFDQW WR IDPLO\ IULHQG SRVVHVVLQJ HQJLQHHULQJ VNLOOV DQG DUPHG
WKH LQGLYLGXDO¶V OLIH FRQWH[WV ZKLFK ZHUH GHYHORSHG E\ ZLWKDQLQYHQWLYHVSLULWDQGFUHDWLYLW\SURYLGLQJDGRLW
WKH VSHHFK WKHUDSLVW DSSO\LQJ SULQFLSOHV RI DOWHUQDWLYH \RXUVHOI VROXWLRQ ZKLFK SHUPLWWHG WKH \RXQJ ZRPDQ¶V
DXJPHQWDWLYHFRPPXQLFDWLRQ ULJKW ZULVW WR EH VWDELOL]HG RQ D KDQGOH VHUYLQJ DV D

6

Sandra Cicuttin: OCCUPATIONAL THERAPY AT ISTITUTO SERAFICO: THERAPY BY “DOING”
Psychiatria Danubina, 2023; Vol. 35, Suppl. 3, pp 102-106


PRXVHZKLFKZDVFRQWUROOHGYLDIOH[LRQH[WHQVLRQPRYH DW 6HUDILFR LV D RQHSHUVRQ GHSDUWPHQW VHUYLQJ D
PHQWV :ULWWHQ WH[W ZDV SRVVLEOH XVLQJ DQ RQVFUHHQ UHVLGHQW SRSXODWLRQ RI PRUH WKDQ  LQGLYLGXDOV
YLUWXDO NH\ERDUG DQG VFDQQLQJ PHWKRGRORJ\ ZKHUH DGPLWWHG LQ UHVLGHQWLDO FDUH DQG DSSUR[LPDWHO\  LQ
VHOHFWLRQV ZHUH PDGH YLD IOH[LRQH[WHQVLRQ PRYHPHQWV WKH GD\KRVSLWDO VHUYLFH ,W¶V QR VXUSULVH WKDW XQGHU
DFWLYDWLQJWKHKDQGOH7KHPHWKRGGHVFULEHGDOORZHGIRU WKHVH FRQGLWLRQV LW LV QRW IHDVLEO\ SRVVLEOH WR PHHW DOO
D FHUWDLQ OHYHO RI DXWRQRP\ EXW SURYHG WLULQJ DQG SRVVLEOHQHHGVLQDWLPHO\DQGDSSURSULDWHPDQQHUZLWK
LPSUDFWLFDOIURPDQHUJRQRPLFVWDQGSRLQW$PRQJWKH WKH VDPH OHYHO RI FRPPLWPHQW DQG HQWKXVLDVP WKDW
\RXQJ ZRPHQ¶V VWUHQJWKV ZHUH KHU LQWDFW FRJQLWLYH HDFK LQGLYLGXDO GHVHUYHV 7KH UROH RI 27 LV SRRUO\
LQWHOOHFWXDO OHYHO DQG H[FHOOHQW RFXODU FRQWURO ZKLFK XQGHUVWRRGDVLWLVRIWHQQRWRUGHUHGLQFDVHVGHVHUYLQJ
SURYHGSLYRWDOWRWKHVXFFHVVRI27LQWHUYHQWLRQ2QFH RIDSRVVLEOHFRXUVHRILQWHUYHQWLRQ
RFXODU FRQWURO ZDV DGHTXDWHO\ DVVHVVHG DQ LQGHSWK ([WHUQDO IDFWRUV DOVR FRPH LQWR SOD\ UHJDUGLQJ WKH
DQDO\VLV ZDV XQGHUWDNHQ RI KLJKWHFK DVVLVWLYH WHFK XQGHUXWLOL]DWLRQ RI 27 VHUYLFHV LQ WKH LQVWLWXWH UHJDU
QRORJ\ VROXWLRQV DYDLODEOH XWLOL]LQJ YLUWXDO NH\ERDUGV GLQJ IXQGLQJ DYDLODEOH IRU RXWSDWLHQW VHUYLFHV WKDW DUH
RSHUDWHGYLDYLVXDOWUDFNLQJ(\HJD]HWUDFNLQJGHYLFHV RIIHUHG6HUYLFHIXQGLQJPHFKDQLVPVDUHRIWHQXQDZDUH
ZRXOG DOORZ IRU HIIRUWOHVV VHOHFWLRQ XWLOL]LQJ YLVXDO RI WKH UROH DQG SRWHQWLDO RI 27 LQ YDULRXV SHGLDWULF
VFDQQLQJ RI D YLUWXDO NH\ERDUG )ROORZLQJ D VHULHV RI GLVDELOLW\ DUHDV 7KLV FRXSOHG ZLWK WKH UHDOLW\ RI
LQLWLDO FRQWDFWV DQG GHPRQVWUDWLRQV ZLWK YDULRXV VXS VKULQNLQJ HFRQRPLF UHVRXUFHV JUHDWO\ OLPLWV DXWKRUL
SOLHUV D V\VWHP ZDV FKRVHQ WR EH WKH PRVW IXQFWLRQDO ]DWLRQRI27WUHDWPHQWIRUFKLOGUHQDOUHDG\XQGHUJRLQJ
DQG D SURJUDP SURSRVDO ZDV SUHVHQWHG WR WKHUHJLRQDO SK\VLRWKHUDS\ DQG VSHHFK WKHUDS\ WUHDWPHQW LQ WKH
KHDOWK DXWKRULW\ ZKLFK DXWKRUL]HG IXQGLQJ IRU WKH LQVWLWXWH7KHHQGUHVXOWLVWKDWPDQ\RIWKHRXWSDWLHQWV
V\VWHP6XEVHTXHQWWRGHOLYHU\RIWKHDVVLVWLYHWHFKQR VHUYHG DW WKH ,VWLWXWR 6HUDILFR WKDW FRXOG DOVR EHQHILW
ORJ\ D SHUVRQDOL]HG WUDLQLQJ SURMHFW ZDV LQLWLDWHG LQ IURP 27 LQWHUYHQWLRQ VLPSO\ GR QRW UHFHLYH WKHP
WKH KRPH HQYLURQPHQW ZLWK WKH JRDO RI ZRUNLQJ WR OLPLWLQJ ZKDW WKH ,QVWLWXWH FDQ RIIHU UHJDUGLQJ D WUXO\
ZDUGVPD[LPL]LQJDFFHSWDQFHDQGHQVXULQJWKHKLJKHVW PXOWLGLVFLSOLQDU\DSSURDFKWRSHGLDWULFGLVDELOLW\
OHYHO RI LQGHSHQGHQW FRPSXWHU XVH 7KH WUDLQLQJ SUR 'HVSLWHWKHVHGLIILFXOWLHV27VHUYLFHVDWWKH,VWLWXWR
MHFWZDVYHU\VXFFHVVIXODQGOHGWRDFWLYHSDUWLFLSDWLRQ 6HUDILFR FRQWLQXH 7KH YDULRXV FDVH VWXGLHV GHVFULEHG
WKDW H[FHHGHG WKH IDPLO\¶V H[SHFWDWLRQV 7KH \RXQJ GHPRQVWUDWH KRZ FRPSOH[ WKH WKHUDSHXWLF SURFHVV LV
ZRPDQ ZDV DEOH WR FRQWLQXH ZLWK KHU XQLYHUVLW\ 27 UHOLHV KHDYLO\ RQ D ³SUREOHP VROYLQJ DSSURDFK´
VWXGLHVXWLOL]LQJDVVLVWLYHWHFKQRORJ\DSSURSULDWHWRKHU ZLWKLQ D FROODERUDWLYH LQWHUDFWLRQ EHWZHHQ WKHUDSLVW ±
QHHGV DQG WKLV IDFLOLWDWHG LQGHSHQGHQW ZULWLQJ RI KHU LQGLYLGXDODQGIDPLO\FDUHJLYHUVDOOZLWKLQWKHFRQWH[W
WKHVLV2QWKHGD\RIKHUJUDGXDWLRQWKH\RXQJZRPDQ RIKLVKHUHQYLURQPHQW$WWKHFRUHRIVXFFHVVIXORFFX
ZDV DEOH WR SUHVHQW KHU WKHVLV LQGHSHQGHQWO\ XWLOL]LQJ SDWLRQDO WKHUDS\ WUHDWPHQW DUH IXQGDPHQWDO FRQFHSWV
WKH WHFKQRORJ\ UHSUHVHQWLQJ WKH FXOPLQDWLRQ RI \HDUV IURP ZKLFK RQH FDQQRW WUDQVFHQG ,Q 27 WKH WKHUD
RI KDUG ZRUN DQG VKHHU GHWHUPLQDWLRQ 7KH PRPHQW SHXWLFUHODWLRQVKLSLVFRQVLGHUHGRQHRIWKHPRVWVLJQL
ZDV H[SHULHQFHG ZLWK JUHDW SULGH DQG HPRWLRQ E\ ILFDQWGLPHQVLRQVRIWUHDWPHQWLQWHUDFWLRQVZKLFKRSWL
HYHU\RQH SUHVHQW LQFOXGLQJ P\VHOI  $OWKRXJK GLV PL]HWUHDWPHQWRXWFRPHV )LQGOD\ $QRWKHUFRUH
FKDUJHG IURP RXWSDWLHQW 27 VHUYLFHV IRU PDQ\ \HDUV FRQFHSWLVWKHFRPPLWPHQWDQGDFWLYHFROODERUDWLRQRI
LPSURYHPHQW FRQWLQXHV DQG VHUYHV DV SURRI WKDW WKH IDPLO\ PHPEHUVFDUHJLYHUV FRQGLWLRQV ZKLFK OHDG WR
GHFLVLRQV PDGH \HDUV DJR ZHUH DSSURSULDWH WKH WKHIRUPDWLRQRIDWKHUDSHXWLFDOOLDQFHDOORZLQJIRU
DVVLVWLYH WHFKQRORJ\ FKRVHQ KDV SHUPLWWHG WKH \RXQJ DFFHSWDQFH DQG LPSOHPHQWDWLRQ RI DGYLFH DQG UHFRP
ZRPDQ WR EH IXOO\ FRQQHFWHG DQG GLJLWDOO\ LQGHSHQ PHQGDWLRQV IRUPXODWHG DQG EDVHG RQ VFLHQWLILF HYL
GHQW DFURVV WKH ERDUG IURP DFFHVVLQJ VLPSOH desktop GHQFH %OHVHGHOO&UHSHDXHWDO 7KHUHVHDUFKLQ
applications and QDYLJDWLQJVHDUFKHQJLQHVDOOWKHZD\ QHXUDOSODVWLFLW\FRQILUPVWKDWXVLQJUHDOOLIHDFWLYLWLHV
WR XWLOL]LQJ VRFLDO QHWZRUNV DQG VRFLDO PHGLD SODW DQG VLWXDWLRQV KDV WKH SRWHQWLDO WR FUHDWH FKDQJH RQ D
IRUPV 7KH \RXQJ ZRPDQ LV WKHUHIRUH QR ORQJHU QHXURORJLFDO OHYHO 'DYLV  7KH PRUH RFFXSDWLRQV
LVRODWHGEXW SDUWLFLSDWHV DFWLYHO\ DQG LQGHSHQGHQWO\ LQ DUHXWLOL]HGDVDYDOLGWUHDWPHQWPRGDOLW\WKHJUHDWHUWKH
YDULRXVDFWLYLWLHVDQGQHWZRUNVRQOLQH SRWHQWLDOIRULPSURYHPHQWLQWKHLQGLYLGXDOVVHUYHG
 ,WLVKRSHGWKDWLQWKHFRPLQJ\HDUVWKHRFFXSDWLRQDO
),1$/&216,'(5$7,216 WKHUDS\VHUYLFHZLOOFRQWLQXHWRJURZDQGJDLQYLVLELOLW\
DQG UHVSHFW DQG ILQDOO\ FRQVLGHU LWVHOI DQ LQWHJUDO FRP
7KH SRVLWLYH RXWFRPHV GHVFULEHG DUH D VRXUFH RI SRQHQW LQ WKH SURYLVLRQ RI UHKDELOLWDWLRQ VHUYLFHV DW
JUHDW VDWLVIDFWLRQ EXW LQ UHDOLW\ PXFK PRUH FRXOG EH ,VWLWXWR6HUDILFR
GRQH LQ RFFXSDWLRQDO WKHUDS\ DW WKH ,VWLWXWR 6HUDILFR 
$IWHUDOPRVW\HDUVRIVHUYLFHSURYLVLRQLQWKHLQVWL
WXWH 27 UHPDLQV D OLWWOHNQRZQ DQG DV D UHVXOW DQ Acknowledgements: None.
XQGHUXWLOL]HG LQWHUYHQWLRQ ERWK LQWHUQDOO\ DV ZHOO DV
LQ WKH FRPPXQLW\ )LUVW DQG IRUHPRVW WKH 27 VHUYLFH Conflict of interest:None to declare.

 6
Sandra Cicuttin: OCCUPATIONAL THERAPY AT ISTITUTO SERAFICO: THERAPY BY “DOING”
Psychiatria Danubina, 2023; Vol. 35, Suppl. 3, pp 102-106


5HIHUHQFHV 6. Decreto ministeriale 2 aprile 2001: Gazzetta Ufficiale 5
Giugo 2001, n. 128 (testo aggiornato 26 Aprile 2006). Deter-
1. Associazione Italiana terapia Occupazionale: La terapia minazione delle classi delle lauree specialistiche univer-
occupazionale ti aiuta. 2023. https://www.aito.it/aito/la- sitarie delle professioni sanitarie. https://www.fnopi.it/
terapia-occupazionale-ti-aiuta archivio_news/leggi/172/DM020401classi.pdf
2. Blesedell Crepeau E & Boyt Schell B: Teoria e pratica 7. Eliasson AC & Gordon AM: Constraint-Induced Move-
nella terapia occupazionale. In Blesedell Crepeau, E., ment Therapy for Children and Youth with Hemiplegic/
Cohn, E. S., Boyt Schell, B.A. (Eds.). In Willard & Unilateral Cerebral Palsy. In: Miller F, Bachrach S, Len-
Spackman Terapia Occupazionale (10° edizione) (pp. 159- non N, O'Neil M. (eds): Cerebral Palsy. Springer, Cham,
162). Edizione italiana a cura di Angela Puglisi, 2008 2019. https://doi.org/10.1007/978-3-319-50592-3_175-1
3. Blesedell Crepeau E, Cohn ES & Boyt Schell B: Pratica 8. Finlay L: The practice of psychosocial occupational the-
della terapia occupazionale. L’attuale pratica terapeutica rapy. 3rd ed. Cheltenham: Stanley Thornes, 2004. [Google
occupazionale. In Blesedell Crepeau, E., Cohn, E. S., Boyt Scholar]
Schell, B.A. (Eds.). In Willard & Spackman Terapia 9. Proia L: Viaggio nelle professioni sanitarie. I Terapisti
Occupazionale (10° edizione) (pp. 22-24). Edizione occupazionali, intervista al presidente Francesco Della
italiana a cura di Angela Puglisi, 2008 Gatta. 2021. https://www.quotidianosanita.it/lavoro-
4. Davis J: What can Occupational Therapy do for you? The professioni/articolo.php?articolo_id=94785
American Occupational Therapy Association, 2017. 10. The American Occupational Terapy Association: Domain
https://www.youtube.com/watch?v=jwwOXlLYQ4Q&t=796s and process: Occupations & everyday activities. 2023.
5. Decreto 17 gennaio 1997, n. 136: Regolamento concernente https://www.aota.org/practice/domain-and-
la individuazione della figura e relativo profilo pro- process/occupations-everyday-activities
fessionale del terapista occupazionale. note: Entrata in 11. World Federation of Occupational Therapy: About Occu-
vigore del decreto: 8-6-1997. pational Therapy. 2023.
https://www.gazzettaufficiale.it/eli/id/1997/05/24/097G0168/sg https://wfot.org/about/about-occupational-therapy

Correspondence:
Sandra Cicuttin, MS/TO, TdR, Occupational therapist
Istituto Serafico di Assisi
Viale Guglielmo Marconi, 6, 06081 Assisi, Perugia, Italy
E-mail: sandracicuttin@serafico.it

6


You might also like