#OTalk 27th February – Trans, non-binary and gender identities in occupational engagement.

This weeks #Otalk is on the topic of “gender identities in occupational engagement.” and will be hosted by Rebecca Swanson (@75Rebecca) and supported by Eden Dowers.


Eden Dowers: Eden is a non-binary occupational therapy (masters) student living and studying in Melbourne, Australia. Their interest is in developing transgender-positive practice, highlighting the need to create more complex concepts of identity and multiple ways of becoming.

Rebecca Swenson: Rebecca is a lecturer in occupational therapy at London South Bank University. She is currently undertaking UKOTRF funded research into the lived experience of those who define as trans, non-binary or genderqueer, exploring the relationship between occupational engagement and identity expression.

Here’s what they had to say…

There has been a recent and profound shift in the understanding, and recognition, of transgender and non-binary identities. This is reflected in potential changes to legislation, namely the Gender Recognition Act which would make it easier for those who define as trans or non-binary to self-declare their gender rather than undergo the arduous legal and medical processes currently in place.

Whilst attitudes and legislation may be changing, those who are trans and non-binary can face hostility and discrimination and there remains misinformation about these communities particularly with regards to health needs. In 2016, the parliamentary Women and Equalities Committee published the results of their Transgender Equality Inquiry which examined the ways in which transgender people have yet to achieve full equality and involved the scrutiny of practice across health and social care professions. The report states that the NHS is failing to protect the rights of trans people, due in part to lack of knowledge and understanding from clinicians of the health needs of these communities.

With these proposed changes to legislation and an increasing number of people defining as trans and non-binary, as reflected in the significant increase of referrals to Gender Identity Clinics, it is timely to discuss gender identities in relation to practice. This will be an opportunity for the OTtalk community to discuss best practice and the positive role that occupational therapy can play in enabling those who are trans or non-binary express their gender and live a life authentic to them.






#OTalk 20th February 2018 – Employing OTs with seen and unseen impairments.

This weeks #Otalk is on the topic of “Benefits & myths of employing OTs with seen & unseen impairments” and will be hosted by Lynsey McClean (@LynseyMcc_OT).

The views and perspectives of colleagues have a significant impact on occupational therapists with impairments and disabilities, particularly in relation to job satisfaction and success. As occupational therapists work with clients with impairments and disabilities it would be presumed that they would have positive attitudes towards fellow employees with impairments and disabilities. However, previous research has highlighted that this is not always the case, with reports of bullying, discrimination and negative or unsupportive attitudes, which can negatively impact upon occupational therapists, and other health care professionals (HCPs) with disabilities’ self-esteem, self-confidence and self-worth (Velde, 2000; Bevan, 2014; Chacala et al., 2014).

Other studies have explored what staff perceive to be as issues with employing a person with an impairment or disability an as an occupational therapist or other HCP (Grainger, 2008; Aaberg, 2010; Wood and Marshall, 2010; Hibberd, 2011; Hargreaves et al., 2014).

Nonetheless, studies on managers of HCPs and qualitative studies which explored the experiences of occupational therapists and HCPs with impairments and disabilities have all challenged these assumptions and highlighted numerous unique benefits they offer (llingworth, 2005; Hernandez et al., 2008; Wood and Marshall, 2010; Neal-Boylan, 2012).

Some questions to consider…

  1. What do you think the potential benefits are of employing someone with an impairment or disability as an occupational therapist?
  2. Do you think there are potential issues of employing someone with an impairment or disability as an occupational therapist? If so what are they?
  3. Why do you think someone might not disclose their impairment or disability at work?
  4. How can you (or we) positively challenge and change colleagues’ negative attitudes towards fellow employees with an impairment or disability?

Post Chat

online transcript

#OTalk Healthcare Social Media Transcript February 20th 2018

The Numbers

1.621M Impressions
471 Tweets
45 Participants
377 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants



#OTalk 13th February – When we’re busy helping others how can we make time to look after ourselves?

This weeks #Otalk is on the topic of “occupational balance” and will be hosted byAmie Mowlam-Tett (@Amie_OT).

Here is what Amy had to say…

Personally, this topic is one close to my heart; during the second year of my MSc I experienced a number of personal setbacks, including the death of a close relative. At one time I couldn’t imagine myself qualifying, it took peer support and time to balance my occupations, remembering time for myself and I did it. I qualified. More importantly, I learnt a lot about balance and need for ‘me’ time. I want to share my experiences and get talking about the importance of our own health and wellbeing when so much of our times is focused on the health and wellbeing of others.

Wilson & Wilcock (2005) addressed the topic of occupational balance in student populations, finding time, money and stress to occupational imbalance and negatively affect wellbeing. Similarly, Clouston (2014) found Occupational Therapists often prioritised their workload and studying over leisure occupations negatively impacting on occupational balance and overall wellbeing.

With months to go before the end of the course for students, it’s easy to become focused on work and neglect time for yourself. I am asking you to take a break, breathe and think about your own wellbeing. Let’s talk about balance, what it means to us and come up with strategies to help keep that work-life balance healthy. This isn’t just for students, for clinicians, it’s a perfect opportunity to share your experiences, hints or advice and maybe pick up a few tips too.

Some questions to consider:

  1. What does occupational balance mean to you?
  2. How important is occupational balance in your daily life?
  3. How well balanced do you feel your occupations are? (eg work/studying and home-life)
  4. What most affect your occupational balance?
  5. How do you create occupational balance, what strategies do you use?
  6. What tips do you have for students about to qualify?
  7. If you could change one thing about your occupational balance what would it be?


Clouston TJ (2014) Whose occupational balance is it anyway? The challenge of neoliberal capitalism and work–life imbalance. British Journal of Occupational Therapy. 77 (10) 507–515.

Wilson L & Wilcock A (2005) Occupational Balance: What Tips the Scales for New Students? British Journal of Occupational Therapy. 68 (7) 319–323.


Online Transcript

#OTalk Healthcare Social Media Transcript February 13th 2018

The Numbers

2.031M Impressions
612 Tweets
110 Participants
16 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants


#OTalk Research: Tuesday 6th February ‘The road less travelled? Supporting occupational therapists to conduct RCTs’

‘The road less travelled? Supporting occupational therapists to conduct RCTs’

This week’s OTalk Research is on the topic of conducting RCTs in occupational therapy and will be hosted by Avril Drummond (@AvrilDrummond1). Avril is Professor of Healthcare Research and Director of Research at the University of Nottingham, with a specialist interest in conducting randomised controlled trials (RCTs).

Here’s what Avril has to say ….

The term Evidence Based Practice (EBP) is used widely in both education and clinical practice. However, the reality is that evidence can mean slightly different things to specific groups who recognise different levels of quality; some advocate the traditional RCT evidence as the gold standard whereas others feel qualitative research is richer and more informative. However, although bodies who produce national clinical recommendations (such as NICE), are appreciating qualitative research much more than before, ultimately RCT evidence is the basis for many of their recommendations.

There are clear merits for using qualitative and quantitative methodologies and, increasingly, mixed methods. The bottom line is always what question is being answered. However, nonetheless, my impression is that OTs are more inclined to be involved in qualitative research (although I admit to having no hard evidence to back this up!). This might be for many reasons; a belief that the profession aligns itself more naturally with qualitative methodologies, more perceived difficulties in conducting RCTs and perhaps more bias in OT training towards ‘softer’ research. Yet generating RCT evidence is vital given that so many regard this as the gold standard – and fundamental to funding an intervention. Even results from small, underpowered RCTs can be used in meta-analysis to produce clear recommendations.

So the topic of this OTalk Research is RCTs. Here are some questions to consider:

  • Do you think OTs are more likely to do qualitative research? Why is this?
  • What is challenging for OTs about conducting RCTs?
  • What would make OTs more confident in conducting RCTs?
  • Has anyone been involved in an RCT? How did you get involved?
  • What would help more OTs to get involved in conducting RCTs?
  • What are the benefits of being involved – individually and for the profession?

Note that the topic title is the road less travelled (from the Robert Frost poem). The actual full line reads ‘Two roads diverged in a wood, and I- I took the one less travelled by, And that has made all the difference.


Online transcript

#OTalk Healthcare Social Media Transcript February 6th 2018

The Numbers
3.518M Impressions
423 Tweets
54 Participants
338 Avg Tweets/Hour
8 Avg Tweets/Participant

#OTalk Participants


#OTalk 30th January – Professional Boundaries- Where do we draw the line?

This weeks #Otalk is on the topic of “professional boundaries” and will be hosted by Bob Collins and Jo Southall (@BobCollinsOT and @JBOccyTherapy).

 With a bit of help (as we couldn’t resist it!) from:

Anne Keen: Professional Advisor – Professional Practice Enquiries Service, Royal College of Occupational Therapists: @annekeen55 @EnquiriesRCOT

Dr Stephanie Tempest: Professional Development Manager, Education and Research Team, Royal College of Occupational Therapists: @setG75

Heres what they had to say…​

“How much should I disclose about my own life to service users? What constitutes ‘therapeutic use of self’ and what is telling people too much?

How do I balance my existing friendships with line management responsibilities now I’ve been promoted to lead the team (who by definition have become my service users)?

Is it ok to give informal advice to my best friend to help him look after his mum?

Can I be friends, in the real or virtual world with my service users?

What do I do if I feel an attraction to someone who I met through professional channels?”

The idea for this #OTalk grew from discussions during an #OTalk last year (we’ll blame Bob!) and from reflections on previous ones, so we thought we’d host an event to talk about professional boundaries in occupational therapy. But we won’t be giving concrete advice or indeed directly answer the questions above. Rather, we aim to:

  • Encourage debate on the meaning of what professional boundaries means to you;
  • Create some space to share some reflective questions and ideas that may help us to think about where we, as individuals, draw the line;
  • Discuss the options on what to do if we have concerns.

But first of all, let’s define what we mean by ‘service user’. The Health and Care Professions Council (HCPC 2016) use a broad definition:

Service user: Anyone who uses oris affected by the services of registrants… (HCPC pg. 31 2016)

So, service users could be those we traditionally think of in the clinical settings or equivalent. But they can also be our staff, students, research participants, professional body members and so the list goes on.

When we provide services to anyone, we hold responsibility and power through therapeutic or professional relationships. As we know, with this privilege comes a duty of care in order to keep people safe from harm. We must not abuse the power we hold; we need to remain aware of the nature of the relationships and know how to interact in a way which maintains integrity.

To support us, we are bound by a number of standards and principles including:

  • HCPC (2016) Standards of conduct, ethics and performance
  • RCOT (2015) Code of Ethics and Professional Conduct

So, we’re looking forward to thinking about what these standards and principles look like in practice; to sharing reflective questions with each other to support our professional judgements; and discussing what to do if we have any concerns.

Best wishes,
Bob, Jo, Stephanie and Anne

Further resources:

HCPC (2016) Standards of conduct, ethics and performance: http://www.hcpc-uk.org/assets/documents/10004EDFStandardsofconduct,performanceandethics.pdf Accessed 9th January 2018

HCPC (2016) Guidance on conduct and ethics for students: http://www.hpc-uk.org/registrants/standards/students/ Accessed 9th January 2018

Nolan (1995): https://www.gov.uk/government/publications/the-7-principles-of-public-life (accessed 17th January 2018)

RCOT (2015) Code of Ethics and Professional Conduct https://www.rcot.co.uk/sites/default/files/CODE-OF-ETHICS-2015_0.pdf (accessed 17th January 2018)

HCPC (2017) Guidance on social media http://www.hpc-uk.org/assets/documents/1000553EGuidanceonsocialmedia.pdf accessed 17th January 2018)

RCOT Professional Practice Enquiries Service https://www.rcot.co.uk/practice-resources/professional-practice-enquiries-service/about-professional-practice-enquiries-service

Post Chat

online Transcript

PDF #OTalk Healthcare Social Media Transcript January 30th 2018

The Numbers

2.330M Impressions
753 Tweets
82 Participants
602 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

Data for #OTalk can be up to 15 minutes delayed










#OTalk 23rd January – Apraxia after Stroke.

This weeks #OTalk is on the topic of “Apraxia” and will be hosted by Terese Lebedis of the Stroke Forum of the RCOT Neurological specialist section (@OTStrokeSSNP).

This is the third #OTalk chat to be hosted by the Stroke Forum of the Specialist Section Neurological Practice. This weeks chat will be supported by consultant occupational therapist, Therese Lebedis.

Apraxia is a cognitive motor planning disorder.  It is a disorder of skilled voluntary movement which is not primarily due to a motor, sensory or comprehension impairment.  Apraxia is commonly seen in people with left hemisphere stroke and other neurological disorders. ​It has a significant impact on recovery from stroke and on the potential for people to achieve independent living. Occupational therapists have a key role to play in the identification, treatment and support of people with apraxia.
Some questions to consider…

1) How would you identify if a person with stroke has apraxia?

2) What types of apraxia would you generally see in a person with stroke?

3) In what ways can apraxia affect people’s occupational performance?

4) What interventions do you know of that are most helpful?

Post Chat

online transcript

PDF of #OTalk Healthcare Social Media Transcript January 23rd 2018

The Numbers

1.582M Impressions
522 Tweets
69 Participants
418 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants



#OTalk 16th January – The use of technology to enable engagement in occupation in adults with disabilities.

This weeks #Otalk is on the topic of “technology and occupational engagement” and will be hosted by Carrie Sant (@Carrie_Sant).

 Here’s what Carrie has to say…

As part of a newly created role within a charity supporting people with visual impairments, Henshaws Society for the Blind, I develop and deliver technology based assessment and training to enable older people with sight loss and other long term conditions to live more independently and engage in their valued occupations. This can include the use of specialist technology such as electronic magnifiers and text-to-speech equipment for reading, or mainstream devices such as smartphones and tablets for communication and socialisation.

I would like to know more about how other occupational therapists use assistive technology to enable the independence of their clients and service users, considering mainstream devices such as smartphones as much as our ‘traditional’ aids and equipment we would normally prescribe.

I intend to try and explore in what services assistive technology is used, who it is used by and what support and training exists in using the technology, both for the occupational therapist and the client. I would also like to identify what we consider the barriers to be to introducing assistive technology into our practice e.g. training, awareness, cost.

Q1 – What do you consider to be included in the term ‘assistive technology’?

Q2 – In what ways do you use assistive technology within your role to enable the independence or occupational engagement of your clients?

Q3 – Do you think there are any ways that assistive technology could be further incorporated into your practice to improve outcomes for clients?

Q3 – Are there clients for whom assistive technology is more or less appropriate or beneficial? How do we assess this?

Q4 – What do you consider to be the barriers to the use of assistive technology as part of your practice?


Online Transcript

PDF Transcript January 16th 2018

The Numbers

1.530M Impressions
469 Tweets
49 Participants
375 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants