#OTalk 21st February – Stress and burnout.

This weeks chat is on the topic of stress and burnout and is hosted by Samantha Tavender (@SamOTantha).

Burnout is a stress-related syndrome that often affects professionals working in emotionally loaded and highly interpersonal environments (Volpe et al, 2014).

The term ‘Burnout’ is a multidimensional concept which was originally introduced by Freudenberger (1974), which consists of emotional/ physical exhaustion, depersonalization and a lack of feelings of personal accomplishment following a prolonged exposure to stress in the workplace.

Burnout is associated with low job satisfaction, higher staff turnover rates, sickness absence and poorer consumer outcomes (Scanlan and Still 2013). It is therefore in everyone’s vested interest for occupational therapists to make themselves aware of stress and burnout and how to reduce stress and what factors in the work environment may induce stress or burnout.

“One of the main coping strategies for managing stress and burnout is recognizing stress – to develop coping strategies we must first understand stress and burnout” (Scanlan & Still 2013).

Stress inducing factors:

Seeing little positive change or no change in service users over time:

Caseload Size:

Organizational Procedures:

Team Climate:

Stress reducing:

Strong Professional Identity and Professional Resilience:

Supervision:

Reflection and Recognizing signs of stress:

The first aim of the chat will be to address this issue and allow participants a chance to reflect on there own stress levels/ early warning signs.

 What is does stress and burnout mean to you?

what are the signs of stress and how can you tell that you are stressed?

 The second aim of the chat will be to focus on ways in which occupational therapists can reduce stress, and prevent burnout.

How do you manage stress inducing factors such as large caseloads and organizational procedures?

How do you maintain your professional identity within the MDT?

How do you look after emotions after a difficult day?

How do you make the most out of supervision?

What are your self care top tips

 

References and relevant articles:

Ashby, S.E., Ryan, S., Gray, M. and James, C., 2013. Factors that influence the professional resilience of occupational therapists in mental health practice. Australian Occupational Therapy Journal60(2), pp.110-119.

Brice, H.E., 2001. Working with adults with enduring mental illness: Emotional demands experienced by occupational therapists and the coping strategies they employ. The British Journal of Occupational Therapy64(4), pp.175-183.

Brown, G.T. and Pranger, T., 1992. Predictors of burnout for psychiatric occupational therapy personnel. Canadian Journal of Occupational Therapy59(5), pp.258-267.

Edwards, D. and Burnard, P., 2003. A systematic review of the effects of stress and coping strategies used by occupational therapists working in mental health settings. The British Journal of Occupational Therapy66(8), pp.345-355.

Freudenberger, H.J., 1974. Staff burn‐out. Journal of social issues30(1), pp.159-165.

Scanlan, J.N. and Still, M., 2013. Job satisfaction, burnout and turnover intention in occupational therapists working in mental health. Australian occupational therapy journal60(5), pp.310-318.

Volpe, U., Luciano, M., Palumbo, C., Sampogna, G., Del Vecchio, V. and Fiorillo, A., 2014. Risk of burnout among early career mental health professionals. Journal of psychiatric and mental health nursing21(9), pp.774-781.

 

#OTalk 14th February – Media Club “Beyond Winning”

This week #OTalk is a media club and is being hosted by Bill Wong (@BillwongOT).

 The subject is “Beyond Winning By Janet O’Shea at TEDxUCLA” and the video can be accessed below

https://youtu.be/MWrRkzluCPo

 Here is what Bill had to say about his topic;

For you #otalk regulars, some of you might have read that I will be doing a TEDx Talk for a second time in March 2017. In preparation for the vibe of this historic moment in OT, I have decided to go on a listening binge on non-OT TED Talks. By doing so, I thought it will be awesome to do a change of pace of my typical media club content, as I will use a TED Talk by a non-OT and use our OT lens to discuss the topic shared by these speakers.

For those of you who know me, I am a highly competitive person, especially in things I believe I am either at least decent at or I want to be good at. In my early OT career, I dreaded losing, as I only had winning in mind. Losing gracefully was very hard for me. (Some of you might have noticed my bitter Facebook statuses I made when I lost out on a meaningful opportunities in OT at that point of time.) The fact that I lose or got rejected more often than not in such situations made things worse. At that time, I remembered I wished, “If someone can just give me an opportunity, it will erase all the disappointments I accumulated over the years.” Not surprisingly, because of how I handled losing relatively poorly (since I vented on social media a lot back then), I got a fair share of constructive criticism from my peers.

Fast forward to now, I still am a competitive person. However, I have learned to handle losing more gracefully when I miss out on meaningful opportunities in OT. Instead of lamenting and expressing my disappointments on social media, I have learned to put things in perspective. Sure, having some awesome accomplishments since then has helped. But, I began to accept sometimes that moral victories are just as good, if not better than physical victories. I also have learned that great champions not only know how to win, but also how to lose.

An example of which was a difference in how I viewed opportunities from AOTA to further my CPD and CV. As recently as 2 years ago, I heard quite a bit of peers saying that I deserved to make the Emerging Leaders Development Programs because they believed I was a strong candidate for it. In addition, some of my friends who made that program wondered why I got snubbed by the process 3 times. As I am a competitive person, my mindset was “Emerging Leaders or bust”. Each time I received a rejection letter, I would almost cry in disappointment and wondered I wasn’t good enough. Although I would get over such disappointments in a day, I would make posts on Facebook about how disappointed I was.

Looking back, I realized I focused too much on the near-sighted results. Because of that, I completely overlooked the process I went through to put myself in position to compete for such things. I also overlooked that I was very resilient in trying to come back for more, in terms of going for opportunities in OT that don’t always have 100% success rate. Finally, I realized that the actual outcomes have little or no bearing on whether my peers view I am successful. Simply put, I was like a beauty conscious peacock.

Now, although I still feel some disappointment whenever my peers have opportunities to do things I wanted to do in OT, I have learned to move on without letting my disappointments dwell in my mind instead. I also constantly reminded myself that my attempts were already moral victories. One example of which was that I had none of my conference abstracts accepted for the 2017 AOTA conference, which is probably the AOTA conference with the most historical significance in this generation for OT students and practitioners. The old me would have been throwing tantrums on Facebook. The new me simply just told myself, “All I can do is try. There is always next year. Besides, since I go to so many conferences nowadays, you have more chances to succeed.” I was really proud of myself on handling such disappointments with grace in this instance, and my peers have noted my improvements in handling such situations now than a few years ago.

Bottom line, winning is not everything! Enjoying the process and experience is far more important. So, here are some discussion questions.

  1. On a scale of 1-10 (with 1 = not important at all; and 10 = it means the world), how much do you value winning as a kid? Why?
  1. Using the same scale, has anything changed now? If so, why so? If not, why not?
  1. What do you think of play’s significance across our lifespans?
  1. As OT students and practitioners, what can we do to help our clients to not get too caught up with winning across the lifespan?

 Post Chat

online transcript

The Numbers

1,222,059 Impressions
428 Tweets
57 Participants
342 Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

 

 

#OTalk Research – 7th February 2017 – Complex Interventions

February’s #OTalk Research is being hosted by Niina Kolehmainen and supported by Lynne Goodacre 

Complex Interventions

As a therapist, do you know what your interventions are? What they consist of? What the different components are (who does what to whom to what end)? What their benefits are, as well as the harms?

Or do you doubt your interventions, question yourself, feel unclear about what it is you are actually providing? Do you wonder what your interventions are really made of, even question whether they are doing much good at all? Quite a while ago I found myself in this second group. Feeling like a non-believer, a doubter (dare I say, a fraud?).

If you too find yourself in this second group, take solace: “The problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.” (Bertrand Russell).

Today, over a decade after my doubting started, I find myself in a world where the most credible thinking around non-drug interventions starts with a strong appreciation that we need to question our interventions. As a field, we have increasingly come to realise that we have tended to gloss over some key questions about our interventions, and just jump in to using them. We use them before we even really knew what they are. We don’t pay enough attention to questions like “what is this intervention actually made of?” and “how do I believe this intervention will lead to the outcomes I am trying to achieve?”.

In 2000, the UK Medical Research Council published its first guidance on how the international multidisciplinary research community should approach non-drug interventions [1]. This guidance recognises that non-drug interventions are complex: they have many moving parts that can be difficult to pin down and define, the relationships between the parts can be messy, and the pathways from the parts to the outcomes can be difficult to specify. The MRC guidance is also very clear that despite these challenges we must try to be clearer about our interventions.

Since its publication, the MRC guidance has been elaborated [2], and additional parts have been added (e.g. the process evaluation guidance [3] ). From when I first read the guidance in 2005 to today, I consider it and its added parts as the most fundamental and important methodology document for anyone doing any research into therapy interventions. I also think that if we as a clinical community took on board some of its basic tenets the quality of our thinking around our interventions would hugely improve – and would put us in a genuine position to lead health interventions across research and practice.

One key element of the guidance is the development of cumulative theory. In the simplest way this means we need to be very clear about our ideas before we start applying them. This may be ideas about the problem, e.g. being specific and having evidence about who exactly is affected, in what way, and the factors playing a role). This may be ideas about the solution, e.g. specific solutions that might make things better, the use of these solutions in different situations, and barriers to implementing the solutions. So all quite practical questions.

The MRC guidance argues we need to take these questions as seriously as the question of “does this intervention work?”. This is so that we have clarity (a good theory!) about the problem and possible solutions, and a good foundation for thinking about out intervention. So for those who think theory has little benefit for practice, keep in mind that “There is nothing more practical than a good theory.” (Kurt Lewin).

So, here is the stall set up. Below is a running order for the haggling – but feel free to bring your own goods along and offer them up too so we’ll get a lively discussion =).

Running order for questions:

1) How clear do you feel on your interventions: what they are made of, and what ideas and evidence there is about the problems and solutions?

2) Have you come across the MRC guidance? Have you used it? What do you make of it?

3) How much, and in what ways, do you currently think about and seek evidence about the problems you are trying to address (as opposed to evidence about the interventions)?

4) How much do you consider each component within your intervention (how specific are you?), and form hypotheses about how each component targets the outcome?

5) What one thing can you do to become clearer about the interventions you use? How will this help you and the patients?

References:

[1] Medical Research Council. A framework for development and evaluation of RCTs for complex interventions to improve health. London: Medical Research Council; 2000.

[2] Craig P, Dieppe P, Macinture S, Michie S, Nazareth I, Petticrew M, et al. Developing and evaluating complex interventions: new guidance. London: Medical Research Council; 2008.

[3] Moore G, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. London: MRC Population Health Science Research Network; 2014.

 

POST CHAT

See Chat Transcript Here

The Numbers

1,038,026 Impressions
397 Tweets
44 Participants
318 Avg Tweets/Hour
9Avg Tweets/Participant

#OTalk Participants

#OTalk 31st January – The Therapeutic use of humour

This weeks #Otalk is on the topic of “The therapeutic use of humour” and will be hosted by Alice Hortop (@LaughingOT).

My name is Alice Hortop and I am a Senior Occupational Therapy Lecture at The University of the West of England. I’ve been studying humour, laughter and smiling with their therapeutic applications for nearly two decades both in theory and practice. I won an award for the 6 week laughter workshop I developed for initially use in adult mental health services, however since then it has been widely adapted. I am a proud laughter anorak and addict! Further I do occasional stand up, publish/present a fair bit and initiated the ‘Humour4OT’ group within the OT4OT face book suite of specialist sub groups. In the session I will be happy to go in the direction of the people engaging in the tweets as I am happy to talk about the evidence base, my experience, potential applications, cautions and the use of theory to generate great occupational therapy interventions e.g. occupational therapy models.

People often quote Mary Poppins when they begin to talk about the therapeutic use of humour, “just a spoon full of sugar makes the medicine go down”. For me though I prefer Willy Wonker and the Chocolate Factory, (careful googling this), the Gene Wilder version, obviously! It goes:

“Hold your breath, make a wish, count to three…

Come with me and you’ll be in a world of pure imagination,

Take a look and you’ll see into your imagination…

We’ll begin with a spin, travelling in the world of my creation,

what we’ll see will defy explanation…

If you want to view paradise, simply look around and view it, anything you want to, do it.

Wanta change the world? There’s nothing to it!

There is no life I know to compare with pure imagination,

living there you’ll be free if you truly wish to be…”

Humour therapy isn’t as simple as covering something unpleasant in glucose and hoping it’ll stick and that everyone has the same sweet tooth. It requires deep thought on the complexities of the use of humour, careful consideration of its application using creativity and imagination with a fair amount of courage in your conviction.

I really look forward to meeting you in the twittersphere, I am a tweeting novice so please go easy on me!

Keep smiling, Alice.

Post Chat

Online Transcript

The Numbers

1,630,952 Impressions
608 Tweets
62 Participants
486 Avg Tweets/Hour
10 Avg Tweets/Participant

#OTalk Participants

 

 

#OTalk 24th January – Attitudes towards people with intellectual disabilities

This weeks #OTalk is on the topic of “attitudes towards people with intellectual disabilities” and is being hosted by Allison Sullivan (@allisulliOTprof)

Here are some questions to consider:

1: Do you feel that your education prepared you adequately for treating medically complex patients, particularly when those clients have significant cognitive deficits?

2: Have you ever been frightened when initially encountering a patient w behavioral health issues such as intermittent explosive disorder, sexually aggressive behavior, and/or psychosis? Do you feel you are adequately prepared to address these issues in rehab & other non-psychiatric settings?

3: Do you believe your university or employer has an obligation to train/educate you regarding addressing these issue in non-psychiatric settings?

4: Have you ever assessed your own attitudes toward people with intellectual disability using a standardized assessment tool?

POST CHAT

online transcript

The Numbers

5,099,004 Impressions
2,064 Tweets
322 Participants
Avg Tweets/Hour
Avg Tweets/Participant

#OTalk Participants

#OTalk 17th January – Groups at the forefront of occupational therapy practice; myth or reality?

This weeks #Otalk is on the topic of group work within occupational therapy and will be hosted by Elinor Jordan (@Elinor_OT).

Groups at the forefront of occupational therapy practice; myth or reality?

Literature suggests working within groups can provide emotional support, social skills, motivation, self-confidence and a sense of camaraderie (Yeates et al., 2015; Moyer, 2014).

Experience shows that providing an array of groups tailored around leisure based activities but with a focus upon physical, cognitive and psychosocial domains some barriers to engagement can be overcome alongside providing optimal opportunities for practice of newly learned skills. Experience has shown that a strong individual therapy programme must be complimented with an enriching group programme to promote and facilitate our rehabilitative ethos with the neuro rehabilitation setting that I work within, however does this also transpire into other occupational therapy settings?

Within the slow stream neuro rehabilitation setting that I work within since re visiting and developing the service we offer, our input now involves a strong group programme across the whole Unit providing clear and enhanced opportunities for achievement of personal therapeutic goals alongside social interaction and emotional wellbeing through a range of transdisciplinary groups.

This chat aims to explore varying viewpoints and experiences on integrating groups into a range of settings. Questions and discussion points include:

  1. Are there specific “traditional” groups that people focused upon or do individuals break down “traditional”?
  2. What have been the barriers to developing groups into practice?
  3. How beneficial have collaborative groups been and can we tap further into this avenue?
  4. Can groups provide opportunities to enhance patient contact time?
  5. How can groups be evaluated to demonstrate positive impact upon interventions?

References

Moyer, E. A., O’Brien, J. C., & Solomon, J. W. (2014). O ccupational therapy (OT) practitioners often work with adults in groups for a wide variety of purposes. Occupational Analysis and Group Process, 106.

Tomchek, S., Koenig, K. P., Arbesman, M., & Lieberman, D. (2017). Occupational Therapy Interventions for Adolescents With Autism Spectrum Disorder. American Journal of Occupational Therapy71(1), 7101395010p1-7101395010p3.

Whisner, S. M., Stelter, L. D., & Schultz, S. (2014). Influence of Three Interventions on Group Participation in an Acute Psychiatric Facility. Occupational Therapy in Mental Health30(1), 26-42.

Yeates, G., Murphy, M., Baldwin, J., Wilkes, J., & Mahadevan, M. (2015). A pilot study of a yoga group for survivors of acquired brain injury in a community setting. Clinical Psychology267, 46.

Post chat

Online transcript

The Numbers

1,293,806 Impressions
542 Tweets
47 Participants
434 Avg Tweets/Hour
12 Avg Tweets/Participant

#OTalk Participants

#OTalk Research – 10th January 2017

The first #OTalk of 2017 is an #OTalk Research Chat.  We hope you can join us on Tuesday 10th January between 8pm-9pm.


Hosted by: Dr. Mary Birken, Post-doctoral Research Fellow in Occupational Therapy, Plymouth University

Supported by:  Jenny Preston

“Occupational therapy practitioners enter the profession to help improve people’s lives, but how do we know that our treatments work?” – Lin, 2013.

To test if occupational therapy works we need to do research, ultimately randomised controlled trials to evaluate the effectiveness of occupational therapy.

The need to demonstrate robust evidence of clinical and cost effectiveness of occupational therapy in mental health has been identified by commissioners of services, occupational therapists and managers as highlighted by the review of the Recovering Ordinary Lives Strategy (Smyth, 2014).

Other areas of occupational therapy practice have carried out successful randomised controlled trials and as a result feature in NICE guidance in that practice area. As an OT researcher in mental health I would like to discuss with OTs how we -occupational therapists in mental health- can pool resources, knowledge and skills to carry out research and feature in NICE guidance in mental health?

Questions to be discussed during this OTalk Research session are:

 

  1. OTs, commissioners & managers identified the need to demonstrate cost & clinical effectiveness of OT in mental health- what next steps do we need to take to do this?

 

  1. Are there existing forums/networks that can help us to do this research?

 

  1. Is the concept of community of practice a useful one that could support this?

 

  1. Who else do we need to collaborate with to make this happen?

 

  1. Following on from the previous qs, what is the next step for us?

 

References:

Lin, S.H. (2013) Special Issue on the Accelerating Clinical Trials and Outcomes Research (ACTOR) Conference. American journal of Occupational Therapy. 67 (3) 135-137.

Smyth G (2014) Recovering ordinary lives: the successes, challenges and future. OTNews 22(9) 22-23.

Post Chat

Online Transcript

The Numbers

2,181,238 Impressions
593 Tweets
45 Participants
474 Avg Tweets/Hour
13 Avg Tweets/Participant

#OTalk Participants