#OTalk 17th Sep 2019 – Stigma – Intervention into toxic environments

This weeks #OTalk will be hosted by Keir Harding – @Keirwales
stigma
noun
noun: stigma; plural noun: stigmas; plural noun: stigmata
“a mark of disgrace associated with a particular circumstance, quality, or person”
On October 3rd the study day “Occupational Therapy and the Diagnosis of Personality Disorder” takes place in London.Personality Disorder is an interesting diagnosis in many ways, not least because of the amount of stigma associated with it.This #OTalk is based on one of the sessions taking place that day.
As occupational therapists, we are encouraged to look at the things people want to do, need to do and are capable of doing (Volition, Habituation and Skills).We also consider how the environment either supports or inhibits a persons ability to function.While it’s easy to pay attention to the physical environment and consider how it can be adapted, this is less obvious in the social environment.
In this #Otalk I’m going to suggest that stigma, prejudice and discrimination is a toxic part of the social environment that severely inhibits functioning.It has the potential to attach to a variety of people (normally disempowered minorities) with the effect of shaping staff attitudes and thus their ability to support those in their care.Equally the way that the environment responds to us will shape how we think about ourselves, others and the world with a profound effect on the occupations we are able to engage in.While my interest is predominately in mental health I’m very interested in this concept within the whole of healthcare.
On the night we will consider:
1 What do we think of the idea that Stigma is part of the social environment?
2 How do we see Stigma played out in our work environment? What is done? What isn’t done? What gets said?
3 What is the impact of stigma on those we are supposed to care for?
4 What is the impact on us and the staff we work with?
5 How do we adapt the social environment to facilitate optimal functioning? How do we challenge stigma?Is this a core part of our role?
If my dastardly plans come to fruition, we will all leave this talk convinced that an awareness of stigma and a determination to challenge it is a vital role for OTs.  We should also have picked up a few tools to ensure that we have the best chance of success.
You can book onto the study day here:
There’s discounted places for service users.  Let @Keirwales know you booked because you saw it on #otalk and he will give you a gift card for a coffee shop.
 
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Have you got 3 minutes to help us improve the #OTalk website?

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On 25th October, OTalk will be turning 8!

What started out as small weekly chats (made up mainly of the seven founding members of OTalk) has grown so much over the past 8 years. We had almost 1,000 chat participants in the first half of this year and we now have monthly chats dedicated to research.

However, our website hasn’t aged well. We last updated our design in 2014, and a lot has changed since then. We now have far better tools at our disposal to improve the responsivity of our website and to make the content more accessible for everyone.

Clarissa (@geekyOT) is revamping the OTalk website and would love to hear from you about what you would like to see in the new version.

Please take 3 minutes to complete the survey and share it with your friends and colleagues.

#OTalk 10th Sep 2019 – Supervision – what’s the point?

My name is Margaret Spencer @margaretOT360 I have been qualified for almost 35 years, and I am as passionate, motivated and enthusiastic about the profession as I was when I started my training in 1982.

I work a couple of days a week as a Senior Lecturer at Sheffield Hallam University, and the rest of the time I provide occupational therapy professional supervision. I also run relationships and sexuality workshops for Love2meetu a dating agency for people with learning disabilities. It’s safe to say occupational therapy is the lens through which I view life.

In the early years of my career, I spent a whole year without seeing or talking to another occupational therapist(it was before technology arrived). I delivered occupational therapy in a day centre in Peterborough. After a year as a band 5, all the other qualified Occupational Therapy staff (3) moved on and I was left to manage 15 occupational therapy support staff, delivering a service to 50 people with a learning disability. I was 22 and it was a baptism of fire that I survived.

When I finally had professional supervision I had been qualified for over five years, had moved jobs and locations 3 times.These days thankfully we should all be having regular supervision, I now pay for my own invaluable supervision.

I deliver professional supervision to over 60 occupational therapists, from every different clinical background you can think of, right across the country from Aberdeen to Guernsey. They include newly qualified band 5’s to Directors of Services. Each supervision session is unique, in frequency, duration and content. At the heart of every session is the high standard delivery of occupational therapy.

I use the Proctor model of supervision which covers the normative, formative and restorative aspects of professional life. So supervision for my occupational therapists is a safe space to reflect, off load, regroup, explore problems, identify solutions, explore work life balance, review current standards of practice and guidelines and have their clinical work linked to HCPC standards.

Working with Occupational Therapists, undertaking on the University of Derby and Sheffield Hallam University APPLE placement educator training course, as part of the workshop activity we looked at the use of supervision within placements, the educators were asked to identify, from their personal experiences, what they saw as positive supervision experiences and best practice and then to identify poor experiences and things to be avoided. This information was gathered from educators over three courses and was reviewed to identify themes.

The themes relating to best practice identified were the need for it to be positive

and motivating, organised, to be developmental, for there to be good communication, for it to be given dedicated time and take place in an appropriate environment.

The themes relating to poor supervision, with themes identified around supervision being negative and critical, unstructured, not being prioritised and given time or being cancelled, there being poor communication and taking place in inappropriate environments. Further issues included breaches of confidentiality and an imbalance of power.

Questions

  1. How often do you have professional supervision, and how long does your session last?
  1. What is the most important thing to you about having professional supervision?
  1. What do you see as the difference between mentoring and supervision?
  1. Do you use a model to underpin your supervision?

 

  1. How does having regular supervision make a difference to your practice?
  1. Does it make an difference having supervision from another person who is not an occupational therapist?
  1. How do you link the outcomes of supervision to your HCPC requirements?

Post chat updates

Online transcript here

PDF of transcript:

#OTalk Healthcare Social Media Transcript September 10th 2019

The Numbers

1.457MImpressions
432Tweets
63Participants

#OTalk Participants

References

Davys A and Beddoe L (2010) Best Practice in Professional Supervision A Guide for the Helping Professions Jessica Kingsley Publishers London

Hawkins P and Shohert (2012) Supervision in the Helping Professions fourth edition Open University Press Maidenhead

Health and Care Professions Council (HCPC) (2017) Continuing Professional Development and Your Registration. London: Health and Care Professions Council

Healey J and Spencer M (2008) Surviving your placement in Health and Social Care

A Student Handbook Open University Press Maidenhead

Thomas N T (2013) Solution-Focused Supervision A Resource-Orientated Approach to Developing Clinical Expertise Springer New York

#OTalk Research 3th Sep 2019 A Contemporary Assessment of Occupational Therapy Research 2019

This weeks OTalk Research will be hosted by @CAOT2019

Research has to start somewhere.

Occupational Therapy like many AHP professions is a challenging area to start a research journey within. This talk aims to look at where people get their ideas for research from, as well as the overall process of making their research a reality.

Do you have experience of conducting Occupational Therapy research? Or is it something you would like to do in the future? If this is you, join Diane and Annie from Sheffield Hallam University (@CAOT2019) in next week’s #OTalkResearch! This is a chance for you to share your views on the practicalities of conducting Occupational Therapy research. So, with that in mind, here’s what we’ll be discussing:

1.       Research has to start somewhere.  A lot of OT knowledge is in people’s heads.  What kind of things are you investigating?

2.       How do you pursue this activity/knowledge and make it into research?

3.       Do you do this in your own time or do you get work time?

4.       Have you thought about how you could translate this work into something badged as research?

5.       What areas of OT practice don’t fit into conventional research practice?

This #OTalk Research chat forms part of a larger project conducted by Sheffield Hallam University on behalf of RCOT entitled A Contemporary Assessment of Occupational Therapy Research. The project will map the current position of contemporary occupational therapy research across the UK.

In addition to the OTalk If you have completed OT research since 2014 or are currently working on an on-going OT research we would like to hear from you via this survey link:

https://shusls.eu.qualtrics.com/jfe/form/SV_72kGJMjTFmBdXZX?Q_CHL=social&Q_SocialSource=twitter

Please note this is a separate project to the one undertaken by RCOT and the James Lind Association.

Post Chat Updates:

Online transcript from Healthcare Hashtags

PDF of transcript: #OTalk Healthcare Social Media Transcript September 3rd 2019

The Numbers

1.099M Impressions
262 Tweets
60 Participants

#OTalk Participants

#OTalk 27th Aug 2019 – Evidence based practice and approaches to intervention.

This week  Jamie Cardell @OTJme, Becca Shelton @BeccasheltonOT, and Lyndsay Court @LyndsaycourtOT, will be hosting the chat is what they had to say:

The three of us are excited to be hosting our first OTalk on Tuesday 27th Aug. We have recently attended a CO-OP training course and this has sparked a lot of debate within our Paediatric Occupational Therapy team about evidenced based practice and top down Vs bottom up approaches.

Collectively we are trained in Sensory Integration and Bobath (NDT). These approaches have informed a lot of our practice, however with our recent CO-OP training and evidence in the Novak (2019) systematic review we have begun to question the use of these approaches in practice and wonder whether we are truly providing evidence based interventions to our clients. The Novak (2019) paper highlighted that NDT and SI were in the red/do not do interventions, whereas task/goal focused interventions I.E. CO-OP are green and definitely do. There is a suggestion that Occupational Therapy practice can lag 20 years behind the research; we are therefore keen to gain further insight into how other Occupational Therapists are using these approaches and what implications the Novak (2019) research paper has for future practice.

Questions that will be asked during the chat include:

  1. What top down and bottom up approaches are you currently using within your settings?
  2. What are your thoughts on top down versus bottom up approaches in Occupational Therapy and how effective do you find these?
  3. Has the Novak (2019) systematic review changed your practice or thoughts about using approaches such as Ayres Sensory Integration and Bobath for certain client groups?
  4. How do you stay up to date with the latest evidence and how do you apply this evidence to practice?

@OTJme,  @BeccasheltonOT, @LyndsaycourtOT

POST CHAT

Online Transcript

#OTalk Healthcare Social Media Transcript August 27th 2019

The Numbers

906.018K Impressions
173 Tweets
22 Participants
138 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

 

 

 

#OTalk Tuesday 20th August 2019. Do Occupational Therapist routinely assess clients menstrual cycle, it’s affect on functioning and ability to engagement in occupations?

This weeks Rachel @OT_rach from OTalk is hosting the chat this is what she has to say,

I have recently listened to an audiobook call ‘Period Power’ by Melissa Hill.

The introduction starts with the following.
In my profession as a woman’s health specialist I get asked a lot of questions, questions that my clients have had since they were 13 that they still don’t have an answer for in their 30s. Questions that usually begin with why, such as

Why is my period so painful/short/light/long/heavy?
Why are they so frequent/irregular/rare?
Why have they stopped altogether?
Why do I feel so great one week and so bloody awful the next?
Why is my vagina sore dry/wet/sensitive?
Why does sex hurt sometimes/all the time?
Why don’t I want to have sex?
Why am I so horny?
Why am I so goddamn tired all the time?
Why do I get so bloated that my dress size jumps up two sizes?
Why do I feel anxious/stressed/depressed?
Why am I so full of rage.
The answer to all of these questions is it’s your hormones. ‘

In another chapter she goes on to describe.

Follicular Phase: Menstruation to Ovulation.
Your period and your cycle are a reflection of your overall health and can be affected by little and large life events. Those gallons of wine and platefuls of delicious stinky cheesy cheese you devoured over Christmas, the crazy work project that nearly broke you, the relationship issues that keep you up all night, the death of a loved one, weight gain or loss, travelling, finally quitting smoking, the supplements you been taking, the Yoga class you’ve been going to, the new job that you love, the great sex you’ve been having, – they all have an impact on whether your period is early or late, light or heavy, short or long and painful or pleasurable.

Period Power – Maisie Gill Greentree 2019

What struck me as I listen to this book was how a lot of what she described were occupations that we engage in, and it got me thinking, Do Occupational Therapists routinely assess clients menstrual cycle, it’s affect on functioning and ability to engage in occupations they need to or want to do?

As I listened I tweeted out some of my thinking, got some great responses and had some interesting discussions from the OT community. Including Katie Major @KatieCMajor, who kindly agree to co host this chat.

Below are some questions that I plan to ask during the chat on Tuesday to generate discussion.

Question 1) Do you routinely ask about, assess for or provide interventions relating to your clients menstrual cycle? If so please give examples.

Question 2) From your own experiences of having a menstrual cycle or from knowing someone that does, what impact does it have on engagement in occupations that you need to or want to do?

Question 3) What assessment tools could we use as occupational therapist to understand the impact a clients menstrual cycles may be having on their functioning?

Question 4) What are the possible interventions we could engage our clients in to enable them to manage the occupation of their dealing with their period?

Question 5) What are the possible interventions we could work on with clients to enable them to manage and understand the impact of the menstrual cycle on their ability to engage in occupations?

Loving forward to the chat, Rachel

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`POST CHAT

Host Rachel Booth @OT_rach

Support on OTalk about @helenotuk

Online transcript

#OTalk Healthcare Social Media Transcript August 20th 2019

The Numbers

1.310M Impressions
523 Tweets
54 Participants
21 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

#OTalk 13th August 2019 – Breaking the silence: involuntary childlessness in the occupational dark shadows

Alice Hortop @LaughingOT Senior Occupational Therapy Lecturer The University of the West of England (UWE Bristol) is hosting the weeks OTalk, here’s what she had to say.

According to the NHS (2017), 1 in 7 UK couples have trouble in conceiving a child. The charity Fertility Network UK (2019) disputes the NHS figure as an underestimation and proposes a more realistic figure is 1 in 6, equating to infertility affecting 3.5 million people in the UK. The World Health Organisation (WHO, 2019) state that female infertility is graded the 5th greatest, serious global disability in populations under 60. They describe infertility as a disease, a medical condition and disability, which means access to healthcare in relation to infertility, sits under the ‘Convention of the Rights of Persons with Disability’. In addition, Schmidt (2010) refers to infertility as a ‘social situation’; moving beyond the WHO medicalised definition. Childlessness is a major life theme deemed as a chronic stressor associated with low control and long lasting negative social and psychological consequences (Schmidt, 2010). Zandi et al (2017) support the need for health care to treat infertility broadly beyond the ‘mere’ individual and biological dysfunction.

Child bearing is an expected transition into adulthood both socially and politically, imperative to humankind survival. For many the failed aspiration to establish a family is an intense, recurring, chronic sorrow for an intangible loss (Tufford, 2009). Involuntary childlessness associates with emotional problems with higher depression scores over a 2-year period with a greater tendency towards catastrophizing. Both men and women reveal higher levels of depressive symptoms, women report highest levels (Kraaij, Garnefski and Vlietstra, 2008). 42% of people experiencing infertility describe feeling suicidal with 90% sharing feeling of depression and describing their experiences as traumatic (Fertility Network UK, 2019). People try to access parenthood through alternative means such as adoption reported higher depressive symptoms than those who chose not to.

In order to understand the lived experience of people who are involuntarily childless it is useful to identify if there is a shared understanding of their needs by health professionals. If their needs are understood and further addressed appropriately. Half of 129 gynaecologists interviewed recommended offering psychological counselling to clients following unsuccessful fertility treatment (Wischmann, 2007). The majority (90%) of women in a post fertility treatment follow up survey felt psychological counselling ought to be offered, particularly at the point of stopping treatment (Hammarberg et al, 2001). Health professionals demonstrate a significant underestimation of psychological need and the timing of its delivery. Psychological counselling and infertility treatments dominate literature for the intervention options in health and social care. The author’s experience of failing to access IVF, fostering and adoption did not include any signposting or offers of talking therapies, even when actively sought. If the lived experience of childless people was more fully understood would signposting to charities such as Fertility Network UK be more prevalent. Fertility Network UK offer a support line, support groups and a downloadable ‘More to life’ self-help guide.

This section examines if the research is relevant to occupational therapists and if so how. Occupational therapists are concerned with the occupations that people engage with, the influence of occupations on their identity and their roles in their lives. Being unable to experience being a mother or father may influence the variety of occupations engaged with, the roles played in the individual’s life and occupational identity. Twinley (2013) discusses the dark side of occupation, advocating occupational therapists need to understand occupations in the shadows. Twinley (2013) suggests historically occupational therapists focussed on the positive influences of occupations on health and wellbeing. The background literature indicates involuntary childlessness strongly associates with grief, alienation and loss. She argues a need for exploration into occupations not considered beneficial for health and wellbeing, that if understood would enable working effectively with diverse populations. Or in this case occupations associated with parenthood that are missing that need to be understood to realise their effect on health and wellbeing. This begins with understanding the lived experience of people who are involuntarily childless.

The host hopes to share insights into the lived experience of involuntary childlessness on people’s roles, occupational identity and occupational engagement. The profession needs to consider their role in addressing childlessness in their interactions, therapeutically and practically.

Post chat updates:

Online transcript Healthcare Hashtags Transcript

PDF Transcript #OTalk Healthcare Social Media Transcript August 13th 2019

The Numbers

928.418KImpressions
171Tweets
17Participants

#OTalk Participants

References:

Davidson, S. (2016) Factsheet: Employment Issues [online] available at: http://fertilitynetworkuk.org/wp-content/uploads/2019/02/Employment-Issues.pdf (accessed on 02/03/2019)

Hammarberg, K., Astbury, J. and Baker, H. (2001) Women’s experience of IVF: a follow-up study. Human Reproduction, 16, pp 374-383

Kraaij, V. Garnefski, N. and Vlietstra, A. (2008) Cognitive coping and depressive symptoms in definitive infertility: A prospective study. Journal of Psychosomatic Obstetrics and Gynecology, 29 (1) pp 9 -16

NHS (2017) Overview infertility. [online] available at: https://www.nhs.uk/conditions/Infertility/ (accessed 6/10/2018)

Schmidt, L. (2010) Psychological consequences of infertility and treatment. In: Carrell, D. and Peterson, M. (eds) Reproductive Endocrinology and Infertility. Switzerland: SpringerLink pp 93-100.

Tufford, L. (2009) Healing the pain of infertility through poetry, Journal of Poetry Therapy, 22 (1), pp 1-9

Twinley, R. (2013) The dark side of occupation: A concept for consideration. Australian Occupational Therapy Journal, 60, pp 301-303

Wischmann, T., (2009) Implications of psychosocial support in infertility-a critical appraisal. Journal of Psychosomatic Obstetrics and Gynecology, 29 (2), pp 83-90

Zandi, M., Mohammadi, E., Vanaki, Z., Shiva, M., Lankarani, N. and Zarei, F. (2017) Confronting infertility in Iranina clients: a grounded theory. Human Fertility, 20 (4), pp 236-247